P41367 Wandering Ln DAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT
:Ion of Bedrooms — Date s/3 — J _
This permit is granted to S for the installation of a septic tank-
at the residence of lIJ,P W. Ile Address
Building Contractor Address
Septic Tank Specifications: Length Width Depth Capacity Gal.
Manufacturer's Name Address
Tdo,, of lines width in. Total Length _ ft. No. of Sq. Ft. s �!
Type of filter material Total tons used
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
I hereby certify that the above septic tank has been installed according to specifications.
Signed:
Septic Tank Contractor
Note: Make sketch of disposal system on back of sheet and mail to Health Center, Mocksville.
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