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DAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT
<1,,
No of Bedrooms13 Date /�
J
r' �—
This permit is granted < :711 SS'V-141,;-01� the installation of a septic ank
at the residence of Address
i
Building Contractor Address
Septic Tank Specifications: Length Widths Depth Capacity Gal./6--la
Manufacturer's Name Address
No of lines_ Z width in. Total Length ft. No. of Sq. fit.
Type of filter material Total
Minimum Requirements: House Trailer Tan.'% Cap. 800
Two --bedroom house 800
Three-bedroom house 900
tons used
Sq. ft. line
No one shall install a septic tank in Davie County without a permit from the
Officer or his agent.
Date of final approval Signed: _
Sanitarian
600
9 001
Health
I hereby certify that the above
specifications.
Note: Make sketch of disposal
Mocksville.
septic tank has been jistalled according to
Signed:
Septic Tan Contractor
system on back of sheet and mail to Health Center,