P020174 Sheffield Park Lot 34/fo�3�
DAVIE'COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT
No of Bedrooms 3 Date
This permit is granted toZYla cP �.f i C�o� for the installation of a septic tank
at the residence of Address
Building Contractorngi Address �7i
Septic Tank Specificatiio�ns:� L th_,p&Width Deptk_Capaaci`t�y_ Gal. 6
Manufacturer's at
Name te?ag 9,71 a Address
No of,rli'nes width in. Total Length"aa.S'ft. No. of S6. Ft. a .2
Type of filter material 7 D 7,, v otal tons used ^:!5-0
Minimum Requirements: House Trailer Tank Cap. .800 Sq, ft. line 4001'
Two-bedroom houses -
"'1800" � 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 3 — / - 9 ;Z Signed: _
'Sqazitarian
I hereby certify that the above septic tank has been installed according to .
specifications.
Signed: Pxtp
Septic Tank Contractor
p Note: Make sketch of disposal system on back of sheet and mail to Health Center,
`.r Mocksville.
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