P12970 Howardtown RdDAVIE COUNTY HEALTH DEPAR —VENT SEPTIC TANK PERMIT
No of Bedrooms Date /"may / eq
This permit is granted to A bpi /l's for the installation of a septic tank
at the residence of mn Met,. Address "}Alco^
Building Contractor-
� Address - j 49 d LICD ,.�_�
Septic Tank S ecifications:Width De th Capacity Gal.
P Specifications,,: Length_P
Manufacturer's Name Address
No of lines width inV Total Length ft. No. of Sq. Ftr
Type of filter material a, Total tons used 130
Minimum Requirements: House Trair Tank Cap. 800 Sq. ft. line 1+00
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 installed according to
specifications.
Signed: ,r
Septic Tank ont for
Note: Make sketch of disposal system on back of sheet and mail to Health Center,
Mocksville.