P112469 Barney RdDAVIE COUNTY HEALTH DEPART11ENT SEPTIC TANK PERMIT
No of Bedrooms c Date 1 —
This permit is granted to ma�Q ,T�N_, r for the installation� of a. se tic tank
at the residence of Address
Building Contractor & 19r441 Address A:f-e
Septic Tank Specifications:Length Width Depth C`a�pacity Gal. 96'b --
Manufacturer s
6'b--Manufacturer's Name �' ,% , C.�, Address
` No of lines _L, widthin. Total Length /S-Dft. No. of Sq. Ft. c�a
Type of filter material .f Total tons used-o70—z1
,Minimum Requirements: House Traile 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 Signed:
Sanitarian
I -hereby certify that the above septic tank has been installed according to
specifications.
Signed:
Septic Tank Contractor
Note: Make sketch of disposal system on back of sheet and mail to Health Center,
Mocksville.
DAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT
No of Bedrooms C Date /J
This permit is granted to'� ,',Tfc° for the installation of a.se tic tank
at the residence of J -%P Address ce. 416 19)
Building Contractors z Address E -
Septic Tank Specifications. Length WidthDepth Capacity Gal. 1 �"
Manufacturer's Name ) 9 f- 47,Address
No of lines_ width in. Total Length _✓S`10ft. No. of -Sq. Ft. Z> aZ,
Type of filter material0 Total tons used
Minimum Requirements: House Traile 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 Signed:
Sanitarian
I hereby certify that the above septic tank has been installed according to
specifications.
Signed:
Septic Tank Contractor
Note: Make sketch of disposal system on back of sheet and mail to Health Center,
Mocksville.