781 Redland RdDAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT
�o of Bedrooms L Date
rnis permit is granted to �v - for the install,n'on of a septic tank
at the residence of �� Address
Building Contractor 61 Address �J
Septic Tank Specifications: Length Width Depth Capacity Gal. qOD
Manufacturer's Name Address
Io., of lines C width_3L(, in. Total Length ft. No. of Sq. Ft.
Type of filter material Total tons used
Minimum Requirements: House Trai er[---- Tank Cap. 800 Sq. ft. line ?00
Two-bedroom house 800
Three-bedroom house lam'" 500
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: c
-� Sanitaria
hereby certify that the above septic tank has been installed according to spec'fications.
Signed::_
Septic Tank Contractor
Note: Make sketbh of disposal system on back of sheet and mail to Health Center, Mocksville,