P101471 Center St3'v
/ 5 -� /�
DAVIE COUNTY HEALTH DEPARTtIENT SEPTIC TANK PERMIT v��,
No of Bedrooms � Date 4�vY
This permit is granted to ` for the installation of a se tic tank
at the residence of Address
Building ContractorAddress
Septic Tank Specificat' ns: Length Width Depth Capacity
Manufacturer's Name � liC c, Address
No of lines, width__-?�6 in. Total Length �ft. No. of
Type of filter material �� Total tons
Minimum Requirements: House Trailer Tank Cap. 800
Two-bedroom house 800
Three-bedroom house 900
Gal. ,,/,o
Sq. Ft.
usedler-
Sq. ft. ine 1+00
600
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
Q
specifications.
Signed:
Septic Tank Contractor
Note: Make sketch of disposal system on back of sheet and mail to Health Center,
Mocksville.
NONE