340 Howardtown Rd (4)DAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT
i'^„ of Bedrooms /'C Date 9— 2 0 — 6,
`t'his permit is granted to for the installation of a septic tank
ir
at -the residence of _ F, I �/i/y�..GLf��.-�-� Address
Building Contractor Address
Set)tic Tank Specifications- Length Width Depth_ Capacity Gal. � e> D
Manufacturer's Name � Address
Ito; of lines o; width�in. Total Length ft. iio. of Sq. Ft.Do
T;T,e of filter material ';V1 , Total tons used O
i�t'i.n1L71li1 Requirements: House Trailer Tank Cap. 800 Sq. ft. line 400
Two-bedroom house 800 600
Three-bedroom house 900 900
o one shall install a septic tank in Davie County without a permit from the Health Officer
or his agent.
Daae of final aoproval Signed:
Sanitarian
I hereby certify that the above septic tank has been installed according to specifications.
Signed: r��--(� —
Septic Tank Contractor
I1ote- Make skete` of disposal system on back of sheet and mail to Health Center, Mocksville.
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