P91670 Hwy 601S - Spillman Trailer Park.,1
.,..
DAVIE COUNTY HEALTH DEPARTIMENT SEPTIC TANK PERMIT
a-,- ;/e, 5, �- 1, Date b/. //" . /i ),0
This permit is granted & for the in tallati of'a entic tank
at the residence of0F0;//r„.,is rM, er rk AddressDe-a7f'6o/,r
Building Contractor /i1E'cc� �,o���„on Address o�-4r»g
Septic Tank Specification Length Width Depth Capacity Gal. 90 o
Manufacturer's Name, ��� Addre s s-&& NX r'�r s To h
No of lines a vridth, in. Total Length . .'�ft . No . of Sq. Ft . yo�
Type of filter material Total tons used
Minimum Requirements: House ailer 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 according to
specifications. ,�
Signed: a�z�
Septic Tank Contractor
Note: Make sketch of disposal system on back of sheet and mail to Health Center,
Mocksville.