118 Parks Ln (2)DAVIE COUNTY HEALTH DEPARTIMENT SEPTI6 TANK PERMIT
t
No of Bedrooms .3 Date - - 20
This permit is granted toCJE�u .%:'�'_or the installation of a septic tank
at the residence of Addresses ; S
Building Contractor Address
Septic Tank Specifications: Length Width Depth Capacity Gal.
Manufacturer's Name [. )Qt,:,�v ,�1. Z, •_o Address—/,A
No of lines width in. Total Length a-2 ft. No. of Sq. Ft. a v
Type of filter material-=='i0vL� Total tons used X07
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, / e
Septic nk contractor
Note: Make sketch of disposal system on back of sheet a�m�il to Healt Center,
Mocksville .