247 Howardtown RdDAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT
':o, of Bedrooms Date
"his permit is granted to for the installation of a septic tank -
at the residence of C t Address ?/t:24.,.c.L�{
Building Contractor ' Address , (ic. 1,
Septic Tank Specifications: Length Width Depth Capacity Gal 20o
Manufacturer's Name s ! - Address !T_y , ;�C���i—�-, 'C'Ll�
No. of line: 3 width 3 4• in. Total Length .3 X14) ft. No. of Sq. Ft. el o
Type of filter material Total tons used 3 !_>
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
hereby certify that the above septic tank has been installed according to /specifications.
Signed:
a
Septic Tank Contractor
0
Note: Make sket".'sof disposal system on back of sheet and mail to Health Center, Mocks-ville,
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