P71769 Deadmon RdDAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT
?.> of Bedrooms Tzzl >! �1 /. , Date
..his permit is granted to ` lJ�" vorthe installation of a septic tank
at the residence of Address
Building Contractor �� Address
Septic Tank Specifications: Length Width Depth Capacity
A
Manufacturer's Name S 171e Address
i
No. of lines_width in. Total Length D�> ft. Uo. of Sq. Ft.
'Pjpe of filter material/,r-7 /� Total tons used
Minimum Requirements: House Trailer / Tank Cap.1-ii0o]
Sq. ft. liner -I 1+00
Two-bedroom house 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:
I hereby certify that the above septic tank has been i
Signed:
Note: Make sketch of disposal system on back of
Sanitarian
Vdccording speci cations.
eptic k Contractor
i'
and mail to Health Center, Mocksville. i
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