167 Quail Ridge Ln Lot 31DAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT
No of Bedrooms � _ Date //— / a — -) %
This permit is granted to (?a, for the installation of a s ptic tank
at the residence of Address , ? C
Building Contractor Address
Septic Tank Specifications: Length Width Depth CapacillAyyGal.
Manufacturer's Name'>Q,'M� g,1, Address
No of lines [ width -51 Total Length p2jgS ft. No. of Sq. Ft.
Type of filter material o Total tons used a A
Minimum Requirements: House Traile Tank Cap. 800 Sq. ft. line 1+00
Two-bedroom house- 800 600
Three-bedroom house 900 900
No one shall install a
Officer or his agent.
Date of final approval
septic tank in Davie County without a permit from the Health
Signed:
Sanitarian
I hereby certify that the above septic tank has been installed according to
specifications.
Signed: 6 V- �U2-e
Septic Tank Contractor
Note: Make sketch of disposal system on back of sheet and mail to Health Center,
Mocksville.