P12666 Cherry Hill RdDAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT
T',7, of Bedrooms Date —6
permit is granted to, ' ) ��/� , , %i �r for the installation of a septic tank'_"
at the residence of Address1�
Building Contractor Address
Address _
Septic Tank Specifications: Aength Lf.S'Width <// Depth Capacity Gal.
Manufacturer's Name Address t;'-�°�-:
No. of lines / width �/<,/in.' Total Length ft. Pio. of Sq. Ft.
Type of filter material
11
Total tons used 5
Minimum Requirements: House Trailer Tank Cap. 800 Sq. ft. line I+00
Two-bedroom house 800 600
Three-bedroom house CO C900
No one shall install a septic tank in Davie County without a permit from the Health Officer
or his agent. /n_
Datr "�!e of final approval /� /. — (� G Signed:
l' Sanitarian
T hereby certify that the above septic tank has been installed according to specifications.
Signed: '//J�'rjL c -
Septic Tank Contractor
Note: Make sketba of disposal system on back of sheet and mail to Health Center, Mocksville,