P82372 Davie Academy RdI
DA`IIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT
No of Bedrooms - (/6 t- Date ax,s? li i J
This permit is grant6d to ;x for the installatioi of a septic tank
at the residence of Address
12/ Building Contractor %9Ozo. ,amgn Address I /Cs ��/ P,/Yr
Septic Tank Specifications: Length Width Depth,.. Capaacity Gal.
Manufacturer's Name_ Address JTZ,•
No of lines p widths`* lin. Total Lengthft. No. of Sq. Ft. / `?�
Type of filter material Total tons used
Minimum Requirements: House Tr le Tank Cap. 800„ Sq. ft. line 1+00
Two --bedroom house 800 600
Three-bedroom house 900 900
No one shall install a-'deptic 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. /) / - 9 ��d
Signed:
Septic Tank Contractor
Note: Make sketch of disposal system on back of sheet and mail to Health Center,
Mocksville.