P102268 Hwy 601SDAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT
Uo, of Bedrooms Date / D --.---) —
`_Eqis permit is granted to 2.a.,,Lp 1' , % �C�,, for the installation of a septic tank.
at the residence of Address
Building Contractor _ 1�� C� .�� (ice Address 4�?if�6:4z(,t�Y,16e(S>
Septic Tank Specifications: Length Width Depth T, Capacity Gal. a
Manufacturer's Name <..0 P %,
No. of lines _width Z -/(/-in. Total Length I<IaC ft. Uo. of Sq. Ft. yc1�
Type of filter materialTotal tons used?
Minimum Requirements: House Trailer Tank Cap. 800 Sq. ft. line I+00
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 been installed according to specifications.
Signed:,��
'Septic Tank Contractor
Rote: Make sketch of disposal system on back of sheet and mail to Health Center, Mocksville,
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