P42469 Wandering Ln t ,
DAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT
No. of Bedrooms Date
"'his permit-is granted to �L�` �, _ 4z2..�_/ for the installation of a septic tank..
at the ,residence, of Address
Building Contractor Address. ��G�
Septic Tank Specifications: Length Width Depth . Capacity____Pal. ._
Manufacturer's Name Address
Pio. of lines width in. Total Length 0 Sft. No. of Sq. Ft.
Type of filter material D Total tons used
Minimum Requirements: House Traile Tank.Cap. 800 Sq. ft. line 400
Two-bedroom house 1800 60o
Three-bedroom house goo 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
T hereby. certify that the above septic tank has been installed according to specifications.
Signed: =�✓�� y.
Septic Tank Contractor
Note: Make sketBh of disposal system on back of sheet and mail to Health Center, Mocksville,
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