P92970 Salmons Rd r
- DAVIE COUNTY HEALTH, DEPARTP= SEPTIC TANK PERMIT
No of Bedrooms 'i^4 i/e Date F9-10,
This permit is granted,to r w r 01Kes for,the installation 'of a ,septic tank
at the residence of TosPT_ Address
Building Contractor Address
Septic Tank Specifications: Length Width Depth ''Capacity ` Gal.�[dZTtr�
Manufacturer's Name Address i
No of-'lines_ width n. Total length ,/DO ft.l No:i of Sq. Pt.""'Z!n
Type of filter material Total tons used -
Minimum Requirements: House Trailer Tank Cap. 800 Sq. ft. line 400
7D F 00 n7/0 AI-e(/Two--bedroom house 800 600
Three-bedroom house 900 900
y Ouj n e Y—. L i�,, c�
No a shall install a s pti tank in Davie County without a permit from the Health
Officer or his agent.
Date of final approval Signed:
Sanitarian -
I hereby certify that the above septic tank has been installed according to T t
specifications. ,
Signed:
Septic ank Contractor
Note: Make' 'sketch of disposal system-on back •of sheet and mail to Health Center,
Mocksville.,..
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