161 Harmony Ln (2)/ -§-0 -, ZIW
DAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT
No. of Bedrooms Date ']`— �/—b
''.:his permit is granted to rc-c iil2 0 '�for yythe installation of �Aa septic tank..
at the residence of Addrei�t, f2- 8by 9 � .�+ /G'�8�Z-rL,__�
Building Contractor Address T�
Septic Tank Specificatio s: Length Width Depth Capacity Gal. Oa
Manufacturer's Name Address 41��k
No. of line s_Lwidth__ZLin. Total Length ad -S ft. No. of Sq. Ft. D o
Type of filter material z4aCL�t,(�^ Total tons used Jct _
Minimum Requirements: House Trailer Tank Cap. 800 Sq. ft. line �t00
• Two-bedroom house 800 600
Three-bedroom house 900) 960
No one shall install a septic tank in Davie County with ut 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:
Septic Tank Contractor
Note: Make sketbh of disposal system on back of sheet and mail to Health Center, Mocksville.
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