447 Greenhill Rd (2)DAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT
�9jF r4; /er/I�o wJ Date
No of Bedrooms_ _
This permit is granted to ,G mo K for the installation of a septic tank
at the residence of �,ctr� l rP — Address green /1o,FsJI-Ile
Building Contractor Address
Septic Tank Specification/s: Length Width Depth Capacity Gal. 90
0
Manufacturer's Name Ch mq_Address43K, 3,'"(?Xan
No of lines_ width loin. Total Length oo ft. No. of Sq. Ft. 6.00
Type of filter material 622— Total tons used
Minimum Requirements: House Trailer Tan_'; 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:
Septic Tank Contractor
Note: Make sketch of disposal system on back of sheet and mail to Health Center,
Mocksville.