1889 Milling Rd (2)DAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT
No of Bedrooms r- v Date 12. 'l
This permit is granted to for the installation of a septic tank
at the residence of -t�-� J ` ,&,�g Address
Building Contractor;�j ��' f-%�k,� z_ v Address
Septic Tank Specifications: Length Width Deptli Capacity Gal.
Manufacturer's Name - _ --, , /7.. --%J Address
No of lines! width Total Length ft . No. of Sq': Ft. 4�
Type of filter material= rL�
�,� u2Z✓ Total tone used -?67
Minimum''' Requirements: House Trailer Tank Cap. 800 Sq. ft. line 400
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:
c Tank Contractor
Note: Make sketch of disposal system on back of sheet and mail to Kealth Center,
Mocksville.