214 Vineyard Ln (7)DAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PEliMIT ;
',tr.. of Bedrooms .3 Date 7----
:,: prz:rit is granted to _ L�-�-.z for the installation of a `se>p�t�ic
-the residence of %����Lcr v� � � Adaress
Building Contractor Address
Scptic. Tank. Specifications: Length Width Depth Capacity Gal.
'Manufa. turer's Name Address. j(`
Sq.
too. o" lines p�width (rs/Jaqin. Total Length 3 az. ft. �'�o. of
l �]
T;rpe of filter materiav Total tons used
:%i.n-l.r=n Requirements: House Trailer Tank Cap. 800 Sq. ft. line k+00
Two-bedroom Ouse 800 600
Three-bedroom house 900 900
No one shall install a septic tank in Davie County irithout a permit from the Health Officer
or his agent.
Dote of final approval T Signed:
Sanitarian
1 here -try certif)r that the above septic tank has been installed according toospecificaticns.
Signed:
Septic Tank. Contractor
?3ote, Make sketR, of disposal system on back: of sheet and mail to Health Center, Mocksville
r
��D