1903 Angell Rd (4)DAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT
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No of Bedrooms Date
This permit is granted to for the installation of a septic tank
at the residence of 10 Address yL(c���
Building Contractor Address
Septic Tank Specifications: Length Width Depth Capacity Gal.
Manufacturer's Name /! Address ,,41-t-1
No of lines_ widths in. Total Length,2 U ft. No. of Sq. Ft.
Type of filter material Total tons used Z
Minimum Requirements: House Trailer Tank Cap. 800 Sq. ft. line 400
Two --bedroom house (99) 00
Three-bedroom house 900 900
No one shall install a septic tank
Officer or his agent.
Date of final approval
in Davie County without a permit from the Health
Signed:
Sanitarian
I hereby certify that the above septic tank has been installed according to
specifications.
Signed:��-
Septic Ta Contractor
Note: Make sketch of disposal system on back of sheet and mail to Health Center,
Mocksville.