1483 Yadkin Valley RdDAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT
No of Bedrooms 3 Date —� ,� — 9
This permit is granted to for the installation of a septic tank
at the residence of _ FS Address'A
Building Contractor Address
Septic Tank Specifications Length Width Depth Capacity Gal. 2 SD
Manufacturer's Name Address
No of lines` width_,3,4 i1f. Total Length ay ft. No. of Sq. Ft. y'dD
Type of filter material Total tons used
Minimum Requirements: House Trailer Tank Cap. 800 Sq. ft. line 400
Two-bedroom house. 800600
Three-bedroom house 900 M 900
No one shall install a septic tank in Davie County without
Officer or his agent.
Date of final approval
a permit from the Health
Signed:
Sanitarian
I hereby certify that the above septic tank has been installed according to
specifications.
Signed:
Septic Tank Contractor
Note: Make sketch of disposal system on back of sheet and mail to Health Center,
Mocksville.