2651 Hwy 601N (2)DAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT
I.o.s of Bedrooms �3 Date
'''his permit is granted to for the installation of a septic tank..
at the residence of �; YAddress
Building Contractor nyr�- c�-w� 2 Address
Septic Tank Specifications: Length Width Depth Ca�pacit��y,�� Gal. 7z� n
Manufacturer's Name1 Address
No. of lines _L Total Length -,2-0,0 ft. deo. of Sq. fit. � 00
Type of filter material a Total tons used a �! - / .�,.rC'►1J
Minimum Requirements: House Trailer Tank Cap. 800 Sq. ft. line 400
Two-bedroom house 800 600
Three-bedroom house 900 900
No one shall
or his agent.
Date of final
install a septic tank in Davie County without a permit from the Health Officer
approval
Signed: _
Sanitarian
1 hereby certify that the above septic tank has been inst'Alled`aco ing to specifications.
Signed: z�,--
Septic Tank Contractor
Note: Make sketbh of disposal system on back of sheet and mail to Health Center, Mocksville.