166 Center Circle Lot 25DAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT
No of Bedrooms DateZ—
This permit is granted to �'�l C°d i for the installa't on of a septic tank
at the residence of Address
Building Contractor�is�D�Address-gaf i
Septic Tank Specifications: Len th— Width DepCapacity_,Gal..-5? f,'nA
Manufacturer's Name -0 r /% / . Address n-coi2 XXv
f No of lines_ aridth�in. Total Length Za No. of Sq. Ft. —
Type of filter material 4:�-4o2cro-ru Total -'tone used
Minimum Requirements: House Trailer Tank Cap. 900 Sq. ft. line 400 ;
Two-bedroom house 800 600
Three-bedroom house 900 goo
No one shall install a septic tank in Davie County without a permit from the Health
Officer or his agent:
` Date of final approval ^.�J`�— I % Signed: r
anitarian.
I hereby certify that the,above septic tank has been installed according
specifications. I;�lp�//�/p
Signed:C)L
eptic Tank Contractor
Note: Make sketch of disposal system on back of sheet and mail to Health Center,
Mocksville.
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