153 Sheffield Rd Lot 11I -or H
DAVIE COUNTY HEALTH DEPART11ENT SEPTIC TANK PEST
No of Bedrooms n Date
This permit is granted to � rC,7 l6. - for the install atio of .a septic tank
at the residence of Address 4
Building Contractor ` ` Address
Septic Tank Specifications: Lengt _ Width Depth Capacity_ Gal."
Manufacturer's.Name 4<. f S:71 a Address ZL%, ec �
No -of lines_/ width,2ejin.
��Total L�eng�tth g aSft No. of 6q. Ft. g�
Type.of filter material ow� d -e- Total -tons used O
Minimum Requirements: House Trailw Tank Cap. 800 Sq. ft. line 400..
Two-bedroom house 800 600:
Three-bedroom house 900 900
No one shall installja 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 septid tank has been installed according to
specifications.
Signed: &4!9 42i 9
eptic Tank Contractor
Note: Make sketch of disposal system on back of sheet and mail to Health Center,
Mocksville.
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