179 Tatum Rd (2) DAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT
Tio, of Bedrooms 3 Date
':his permit is granted to 'P o.for the installation of a septic tank
at the residence of )_C:�, C. T u Address C. /y
Building Contractor Address %% - ' Tt
Septic Tank Specifications: Length Width/ /� Depth Capacity Gal. 6 o _
Manufacturer's Name V; �p f �Z -7—P fi c..e� _ Address T !i. T
No. of lines 1 width 1f.3? in. Total Length A A 5' ft. Uo. of Sq. Ft,
Type of filter material / Dy L' Total tons used
Minimum Requirements: House Trailer Tank Cap. 800 Sq. ft. line 40o
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, i
Dame of final approval Signed: r
Sani�_..
I hereby certify that the above septic tank has been installed according to spe 'fications.
Signed:
Septic Tank Contractor
Note: Make sketbh of disposal system on back of sheet and mail to Health Center, Mocksville.
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