1880 Hwy 601SO
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DA,IIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT
0
91
No of Bedrooms Date,�P�%L acz, / � 0
This permit is granted t use C96 for the installs o of a septic tank
at the residence of Mri Moo A 1014, Address
i
Building Contractor � Address
Septic Tank Specifications: L ngth Width .Depth Capacity Gal. 20,0
Manufacturer's Name v ` je
g1j 2,. k, Addres s ��a s/irn
No of lines th in. Total Length "2 ft.. No. o Sq. Ft. 1,a C
Type of filter material ane Total tons used &9.-f-
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 acco .ng
specifications. �� /) 17
I �*
;a
Note: Make sketch of disposal system on back of sheet and mail to Health Center,
Mocksville.