2372 US Hwy 64 W Lot 3DAVIE COUNTY HEALTH DEPARTMENT
No of Bedrooms
This permit is granted to SW%C 4r for the
at the residence of Address
Building Contracto a_- Address d'
Septic Tank Specifications: Len" h Width Dep
SEPTIC TANK PERMIT
1 f'
Date
AA4, �w
;Capacity Gal.'
Manufacturer's Name 4! Address'/
No of linea width-Un.—Total-Lentgth �ft.!,No. of�Sq. `Ft. ,�O t .3Z�lCs�
Type of filter material 1 1 Total Eons used 35 �'•
Minimum Requirements: House Trailer Tank Cap. 8001. Sq. ft. line 400\
Two-bedroom house J8001 - 600
Three-bedroom` house,-. 1.900 goo
1.._5�_._.__ t�
No one shall install a septic tank in Davie Co ty vithout a permit from the Health
Officer or his agent. _- 1 :i
Date of final approval Signed:
,I y- C Sanitarian s
I hereby certify that the aboveiseptic tank has been installed according
specifications. n
Signed:-Y-e1V15�
eptic Tank Contractor
Note: Make sketch of disposal system on back of sheet and-mail--to-Health Center,
Mocksville. i
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