P111671 Junction RdDAVIE COUNTY HEALTH DEPART14ENT SEPTIC TANK PERMIT
No of Bedrooms 3 ^ Date 6/— /� — %/
This permit is granted to ` ( for the installation of a septic tank
at the residence of Address
Building Contractor 4ddress
Septic Tank Specif ations: Length Width Depth Capacity Gal. 49 e.0
Manufacturer's Name p '/% �j Address JP �{_ .
No of lines_/ width�e,. in. Total Length lift. No. o Sq. Ft. f'd D
Type of filter material � ,® a Total tons used 3 o
Minimum Requirements: House Trailer Tank Cap. 800 Sq. ft. line 400
Two --bedroom housa 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. W^
Signed. �?�'
Septic Tank Contractor
Note: Make sketch of disposal system on back of sheet and mail to Health Center,
Mocksville.