545 Sandpit Rd (2)DAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT
;loo of Bedrooms
Date
":his permit is granted to
for the installation of a
septic tank..
at the residence of �~
Address`f
Gam`' -w, %/2
Building Contractor ` -�'
Address
/
Septic Tank Specificateions: Length Width
Depth
Capacity Gal.
Manufacturer's Name
Address
Fo. of lines width in: Total Length
ft. No.
, of Sq. Ft. 25
0
Type of filter aterial
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
or his agent.
Date of final approval Signed:
Sanitarian
I hereby certify that the above septic tank has been installed according to specifications.
Signed:
Septic Tank Contractor
Note: Make sketb'a of disposal system on back of sheet and mail to Health Center, Mocksville.