808 Milling RdDAVIE COUNTY HEALTH DEPARTIMT SEPTIC TANK PERMIT
,. o;, of Bedrooms L�rx� �=-� pp Date
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This permit is granted to ���j for the installation of a septic tank _.
at the residence of -Address 1/7
Building ContractorAddress _
Septic Tank Specifications: Length Width.___._ Depth--.__ Capacity Gal.
,Manufac-zurer l s Name Address
Ido.. of lines- width in.
T je of filter material
Total Leng-uh
No. of Sq. Ft. _-------- -----
Total tons used
ML-Inimu.a Eeq:aireirents:House Trailer Tank Cap. 800 Sq. ft. line _FrOC
Two-bedroom house 800 -_--- - — 6c0
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.
Dia,t�:: of final approval T Signed:
Sanitarian
I hereby. certify that the above septic tank has been installed according to specifications
Signed: _
Septic Tank Contractor
?'dote: Make sketc'.'. of disposal system on back of sheet and mail to Health Center, Mocksville,
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