221 Howell RdDAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT
No of Bedrooms �z w i Date 7,7-9t)
This permit is grante to for the installationof septic tank
�Q.,
at the residence of ddress
Building Contractor Address
Septic Tank Specifications: Length Widtht4 Depth_ %-Capacity Gal. d C�
Manufacturer's Name aebd L4 �c Address
No of lines_ width in. Total Length LV ft. No. of Sq. Ft. la V
Type of filter material J 7To l\l ,-- _ Total tons used
Minimum Requirements: Ouse Trailer Tank Cap. 800 Sq. ft. line 4o0 .
Two-bedroom house 800 600
Three-bedroom house 900 900
No one shall install a septic tank in Davie
Officer or his agent.
Date of final approval
County without a permit from the Health
Signed:
Sanitarian
I hereby certify that the above septic tank has been installed according to
specifications.
Signed: �� E
Septic Tank Con actor
Note: Make sketch of disposal system on back of sheet and mail to Health Center,
Mocksville.
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