1938 Hwy 64E (3)DAVIE COUNTY HEALTH DEPAR'nIENT SEPTIC TANK PERMIT
No of Bedrooms Date — �O
This permit is granted 0-111 for the installation of a septic tank
at the residence of cam- Address
Building Contractor,, R '°`` Address
Septic Tank Specifications: Lengtii: Width Depth Capacity Gal.
Manufacturer's Name Address
No of lines Z width in. Total Length ft. No. of q. Ft/.
D 0
Type of filter material Total tons used
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 lth
Officer or his agent.
Date of final approval Ja Signed:
anitarian
I hereby certify that the above septic tank has been installed according to
specifications.
Signed:
tept'ia0fank Contractor
Note: Make sketch of disposal system on back of sheet and mail to Health Center,
Mocksville.