2248 Hwy 601SDAVIE COUNTY HEALTH DEPART111ENT SEPTIC TANK PERMIT
No of Bedrooms 9. Date :3i�9u �� 1?24
This permit is granted to1-3,75!r"0!3for the installation 6f a septic tank
at the residence of Mblrzo ,Ic"rli-torz Address &o c �s mil/P
Building Contractor Address
Septic Tank Specifications: Length Width Depth Capacity Gal. Oa
Manufacturer's Name Address C ,V,'h K
No of lines__ width in. Total Length eft . No . of Sq. Ft . s a �. l'f
Type of filter material Total tons used �vZ
Minimum Requirements: House Trailer Tank Cap. 800 Sq. ft. line 400
Two --bedroom house 800 600
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 Signed: _
Sanitarian
I hereby certify that the above septic tank has been ins t lled according to
specifications. .;
Signed:
ic
SeptTa Contractor
v3 �, Note: Make sketch of disposal system on back of sheet and mail to Health Center,
f' Mocksville .