226 Vanzant RdDAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT
Io., of Bedrooms _ 3 Date-
9nis permit is granted to v, ' for the installation of a septic
,, tank--
at; tJALL 1, he residence of Address /, �,�•. L"�C
Building Contractor y �� L Address
Septic Tank Specifications: Length Width Depth Capacity _Gal.
Manufacturer's Name Address _
C
Iv'o. of lines�widthin. Total Length o�c�) ft. No. of Sq. Ft. jr/D
Type of filter material .,C "�^rc /e�, Total tons used 30
Minimum Requirements: House ailer 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 //I— / - Signed: -
Sanitarian
hereby certify that the above septic tank has been installed according to specifications.
Signed:
Septic—Tank Con ractor
Note: Make sketb'-- of disposal system on back of sheet and mail to Health Center, Mocksville.