227 Barney Rd (2)DAVIE COUNTY HEALTH DEPIaTIHENT
SEPTIC TANK PEM-aT
No. of Bedrooms Date a /�, tel✓ 3
This permit is granted to`ba,,; ST®�c� f�.9„�� Co, for the installation of
a Septic Tank at the residence of,) -06U4; eC, e�e,?j�,�,I�Address
Building Contractor 00JSvi//P /Qu /ciP/�S SpA/� Address 1"oe/(S�/,/%p
Septic Tank Specifications: Length %_�TidthT�-,_DepthCapacity oo Gal.
Manufacturer t s Name `lAu :C'SPpI . �' / � �� Address—J No e i t u, 'Ile
No. of lines a Width �l �in. Total length Ft. rdo. of Sq. Ft. goo
Tyke of filter material -I-u F- 1 -,'Te Total tons used 12- - / 3
%iinimua Requirements: Tank Capacity Square Ft. of Line
House Trailer 800 400
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 Signed:
Sanitarian
I hereby certify that the above septic tank has been installed according
to specifications.
Signed
ptic Tank Contractor
Note: Make sketch of disposal system on back of sheet and mail to the
Health Center in Mocksville.