131 Frank Short Rd (2)DAVIE COUNTY HEALTH DEPART11ENT SEPTIC TANK PERMIT
a
No of Bedrooms �,�A� •c— Date /-/--//. — �o
This permit is granted to orL for the installation Qf a Uptic tank
at the residence of ,-'ria wk?Z-ho r6L Address 4±.
Building Contractor �- Address
Septic Tank Specifications: Length Width Depth Capacity Gal._
Manufacturer's Name Addressa
No of linesrwidth 34 1(!'. Total Length ft., No. of Sq. t. 2
Type of filter material Total tons used
Minimum Requirements: House Trailer Tank Cap. 800 Sq. ft. line 400
Two --bedroom house 800 600
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: _
Sanitarian
I hereby certify that the above septic tank has been Inst led acc rdin to
specifications.
Signed: ,
Septic Ta Contractor
Note: Make sketch of disposal system on back of sheet and mail to Health Center,
Mocksville.
L
12f 2G,
DAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT
No of Bedrooms 3 Date
This permit is granted to Q C ,T, oZ for the insjtq•lation of a se is tank
at the residence of 9",ro,, ,r Address /F'', Z . ?,,Ifs -
Building Contractor Z�f k d r ikl— (91,r r t'� e r Address /1/sa�
Septic Tank Specifications: Length Width Depth: ..Capacity_.,.Gal.
�
Manufacturer's Name c��,�.+� , % Address 7,
No of linesiL width�in. Total Length JT- ft. No. of Sq. Ft. Z O O
Type of filter material ;4//m Total tons used J/
Minimum Requirements: House Trail r Tank Cap. 800 Sq. ft. line 400
Two-bedroom house 800 500
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: _
Sanitarian
I hereby certify that the above septic tank has been inst led accord ng to
specifications.
Signed: c.(�
rSl'o 3 f /Ya/
aQ eptic Tank Contractor
Note: Make sketch bf disposal system on back of sheet and mail to Health Center,
Mocksville.
7
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