652 Greenhill RdPACGrnei, dij I Or
DAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT
fdo„ of Bedrooms r-- Date
`i'his permit is granted to „ for the installation of a septic tsLs;
at the residence of Address r`�i`� /a , s � 1) cL+-2M/1
y
Duiiding Contractor Address
Septic Tank Specifications: Length �) Width Depth Capacity Gal. g " 0
Manufacturer's Name �.t-�� �,�. % . C Address r
No. of lines I wiath_.�n. Total Length __tZn ft. No. of Sq. Ft.�Zr'y
Type of filter material o c!. Total tons used .o v
Minimum Requirements: House Traile Tank Cap. 800 Sq. ft. line 400
Two-bedroom house 800 600
Three-bedroom house goo 900
No one shall install a septic tank in Davie County without a permit from the Health Officer
or ;:.is anent.
Date of final approval
Signed:
Sanitarian
lzexcby certify that the above septic tank has been ins t _led according to s fcifications.
Signed:
Septic Tank Contractor
Note Make sketbh of disposal system on back of sheet and mail to Health Center, Mocksvillep
A
I
DAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT
No. of Bedrooms Date S� ^6
This permit is granted to for the installation ofa septic ta_:
at the residence of _ Address
Building Contractor Address
Septic Tank Specifications: Length Width Depth Capacity Gal. o
Manufacturer's Name ^� K�c�-�P �• l , (� Address c ra c
No, of lines__L_width�in. Total Length /OD ft. No. of Sq. Ft. :Zzsa
Type of filter material -�L� Total tons used j,3./�
Minimum Requirements: House Traile3V Tank Cap.800 Sq. ft. line 400
Two-bedroom house 800 600
Three-bedroom house 900 900
No one shall install a septic tank
or his agent.
Date of final approval
in Davie County without a permit from the Health Officer
Signed:
Sanitarian
I hereby certify that the above septic tank has beeninst .led accordin to s ecifications.
Signed:
Septic Tank Contractor
Note: Make sketbh of disposal system on back of sheet and mail to Health Center, Mocksvilleb
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