609 Boxwood Church RdI hereby certify that the above septic tank has been i;7ul4q
d according to specifications.
Signed:oleazzf' "
Septic Tank Contractor
Notes Make sketbl! of disposal system on back of sheet and mail to Health Center, Mocksville.
DAVIE COUNTY HEALTH
DEPARTMENT SEPTIC TANK PERMIT
o, of Bedrooms (� (AC—CA—a-
Date
"_'his permit is granted to _
/ , for the installation of a septic tank..
at the residence of
Addressi',T/�.�i
Building Contractor
Address
Septic Tank Specifications: Length
Width Depth Capacity Gal,(z)- f _
��
Manufacturer's Name 1� �T, % fir,
Address
11o, of lines___width�in. Total
Length 7-6-Dft. lo. of Sq. Ft. Dr)
Type of filter material
Total tons used '30
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
o: his agent.
Date of final approval
Signed: Y
Sanitarian
I hereby certify that the above septic tank has been i;7ul4q
d according to specifications.
Signed:oleazzf' "
Septic Tank Contractor
Notes Make sketbl! of disposal system on back of sheet and mail to Health Center, Mocksville.
I