3355 Hwy 601SDAVIE COUNTY HEALTH DEPART11ENT SEPTIC TANK PERMIT
No of Bedrooms Date Uk? /3/�
This permit is granted to sQm 42� d;s for the installation of aseptic tank
at the residence of 7_a_�p Lq, 7V/e Address x LGo/s)
Building Contractor Ja�trzC_r uJo rdr Address IfZ, �� / c ,� �' d . C,
'
Septic Tank Specifications: Length Width Depth Capacity Gal. / dult,
Manufacturer's Name ( Address �� �ps v �`�/, i
No of lines_ width in . Total Length.za s ft . No. of ; Sq. Ft. 90,0
Type of filter material �/v/e 7-,STotal tons used�..�
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 installed according to
specifications.
`Signed:
Sept'c Tank Contractor
Note: Make sketch of disposal system on back of sheet and mail to Health Center,
Mocksville.
I