1278 Calahaln RdDAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT
,c), of Bedrooms pp Date
_'*his permit is granted to S % for the installation of a septic tank_
at the residence ofAddress /, �/1l,4
Building Contractor 61 Address
Septic Tank Specifications: Length Width Depth Capacity Gal. O 0
Manufacturer's Name ,i&A LP Address '` ,5�, �1�����•Cl��cc ;E�i
No, of lines % width�0( in. Total LengthS B ft. No. of Sq. Ft. fo OP
11.rme of filter material_ Total tons used o2/ _
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 ins t lled according to "specifications.
/ 7
Signed: � /UL LZ �� —
Septic Tank Contractor
Note: Make sketch of disposal system on back of sheet and mail to Health Center, Mocksville