P022068 Juney Beauchamp Rd DAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT
No. Rf_tBe = Date -2-,? a E, _
This. permit: is granted to � � 4for the installation of a septic tank,.
at the-re F449adTce of Address
Building Contractor ,`� Address
Septic Tank Specifications:. Length Width Depth Capacity Gal. Lj
Manufacturer's Name �' Address
No. of lines�o width 3 ,in. Total Length 2,sb t. No. of Sq. Ft.
Type of filter material /a Total tons used
M�.nimiza Requirements: House Trailer Tank Cap. 800 Sq. ft. line I+00
Two-bedroom house 800 600
Three-bedroom'house 900 900
No one shall install a septic tank in,Davie County without a permit from the Health Officer
or his agent.
Date of final approval 2 _7_ / Signed:
L� Sanitarian
I hereby certify that the above septic tank has been installed according to specifications.
Signed: Al A
Septic Tan C ntractor
Note: Make sketbh of disposal system on back of sheet and mail to Health Center, Mocksville„
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