346 Hwy 801NDAVIE COUNTY HEALTH DEPARTIENT SEPTIC TANK PERMIT
No of Bedrooms i� Date 102-% %" 6
This permit is grant d for the installation of a septic tank
at the residence of - Address Sal �y0
Building Contracto � ���- Address,
Septic Tank Specification: Length Width Depth Capacity Gal.
Manufacturer's Name ji i/ , ` Address'`
No of lines I width yin. Total Length, ;9,3 ft. No. of Sq. Ft. ==
Type of filter material I' z LiLy,3� Total tons used -70
Minimum Requirements: House Trailer . % Tank Cap. 800 Sq. ft. line 1+00
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.
Signed:
r Septic"Tank Contractor
Note: Make sketch of disposal system on back of sheet and mail to Health Center,
Mocksville.