P52567 Campbell RdDAVIE COUNT HEALTH DEPARTMENT SEPTIC TANK PERMIT
,:o, of Bedrooms f% Date -5-
'-his
his permit is granted to vu'c _ ,, for the installation of a septic tank'-.
wt the residence of ,( Address
Building Contractor �� - / Address
Septic Tank Specification : Length Width Depth Capacity Gal. l d
Manufacturer's Name y Address_ �
IIo. of lines—_Z width34,S" in. Total Length 1,510 ft. Ko. of Sq. Ft. 6 00 _
ly-
pe of filter material Total tons used
✓ini.mum Requirements: House Trai er Tank Cap. 800 Sq. ft. line 40O
Two-bedroom house 00 60
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 C-6 Signed:
Sanitarian
hereby certify that the above septic tank has been installed according to specifications.
Signed:d,, , ZL / L._2�G
v Sg]�tic Tank Contractor
?Dote: Make sket h of disposal system on back of sheet and mail to Health Center, Mocksville,