459 Pleasant Acre Dr (2) _DAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT
No, of Bedrooms �} Date 13 o
'17his permit is granted to �i %r for the installation of a septic tank'..
at the residence of �,'a,19e v S 7-;-Ie Address
Building Contractor -S?q M z+ Address S Ain
Septic Tank Specifications: Length Width Depth Capacity Gal. o a
Manufacturer's Name 2a Li �. /, g.✓l� Address Q
No. of lines�_width�in. Total Length ga- .fft. No. of Sq. Ft. /?,o -o
Type of filter material owe Total tons used 3 0
Minimum Requirements: House Trailer Tank Cap. 800 Sq. ft. line 400-
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 Signed:
Sanitarian
hereby certify that the above septic tank has been installed according to spe ifications.
Signed: 0-
Septic
� _�
6
Tank Contractor
Note: Make sketbh of dis-osal system on back of sheet and mail to Health Center, Mocksville.
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