P32172 Bermuda RunDAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT
No of Bedrooms 6 _
This permit is granted to
at the residence of IA/,,/t,-
Date c3 ^ a /— 90?
for the installation of a septic tank
Address
Building Contractor 1 ` Address 4.�� is
Septic Tank Specifications: Lqngth Width Depth Capacity Gal. -UJ -0
Manufacturer's Name 6!9.� Address t jC- 11
No of lines_ cZ_ width 4 in. Total Length a6' ft . No. of Sq. Ft. 6 6 o — t3 .xO A.4, Z71
Type of filter material -17;`/D aLva L`C&_ Total tons used 6r-9
Minimum Requirements: House Trailer Tank Cap. 800 Sq. ft. line 400
Two-bedroom house 800 600
Three-bedroom house , 900 900
Fe"t- ' • % z 5 c0 /}z®
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
I hereby certify that the above septic tank has been installed according
specifications.
Signed:
Septic Tank Contractor
Note: Make sketch of disposal system on back of sheet and mail to Health Center,
Mocksville.
7
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