134 Lakeside Drive Lot 2 (2)DAVIE COUNTY HEALTH DEPARV-1ENT SEPTIC TANK PERMIT
No of Bedrooms 3 Date
This permit is granted to 66At&ah for the installat'on of a septic tank
at the residence of F-r4K /c<1 Address Address . /VQ A
Building Contractor ,
J
0— Ft /fe vt Address
Septic Tank Specifications: Length Width Depth Capacity Gal. a D
Manufacturer's Name �h D Q Address 3 `
�a
No of lines_ width in. Total Length (/ooft. No. of Sq. Ft. D
Type of filter material Total tons used $ U
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. pp
Signed: l- --eZ::—J G -+,:! -
ySeptic Tank Contractor
Note: Make sketch of disposal system on back of sheet and mail to Health Center,
Mocksville. -
F&MIC