P6271 Hwy 158DAVIE COUNTY HEALTH DEPARTi`4ENT SEPTIC TANK PERMIT
No of Bedrooms Date �' a H 2 0� 1 i�
This permit is granted to r for the installation of aseptic tank
at the residence of rns Address
Building Contractors ,nom Address
Septic Tank Specifications: Length Width Depth Ca`p�acity Gal. 9 e 0
Manufacturer's Name Address /r .?�
No of lines_ width J( i Total Length 20 ft. No'. of Sq. Ft�
Type of filter material Total tons used 33
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 installed accor ing to
specifications.
Signed: /
Septic Tank C tractor
Note: Make sketch of disposal system on back of sheet and mail to Health Center,
Mocksville.
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