P41568 Davie Academy RdDAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT
:Qo, of Bedrooms 3 Date
`.Uhis permit is granted to 412e for the installation of sentiV tank
ac the residence of Address_
Building Contractor Address
Septic:. Tank Specifications: Length Width Depth Capa ty__- Gal. � you
,:4a ufacturer's Name T4""5 Address (4vez_-, i
I?o, of lines c!2—width /,�Vin. Total Length oda) ft. No. of Sq. Ft. _202�
°Type of filter material Total tons used is
i�Jnimum Requirements: House Trailer Tank Cap. 800 Sq. ft. line 400
Two-bedroom house 800 �\
Three-bedroom house 00 9GG
No one shall install a septic tank in Davie County without a permit from the Health Officer
o,: his agent.
Bate of final approval Signed:
Sanitarian
I hereby certify that the above septic tank has been installed according to specifications.
Signed: __..
SepTic Tank Contractor
'aV4e: Make sketbr of disposal system on back of sheet and mail to Health Center, Mocksville,
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