P41773 Milling RdFla
DAVIE COUNTY HEALTH DEPARTMENT SF,PT,I� �T'ANK4 PERMITZ
No of Bedrooms %7�orri Date
This per4t is granted—to for the installation of a septic tank
at the residence of I F6?rY ,' ,'aas Address
Building Contractor Address
Septic Tank Specifications: Length WidthL Depth Capacity Gal. g o
Manufacturer's Name r. _ . Address
No of lines width '�{j_ in. To `1' Length /-J—y ft. No. of Sq. Ft( �S`0
Type of filter material Total tons used
Minimum Requirements: House Trailer Tank Cap. 800 Sq. ft. line 1+00
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
specifications.
Note: Make sketch of disposal
Mocksville.
septic tank has been i talled ccor g to
Signed:
Septic ank Contractor
system on back of sheet and mail to Health Center,
.� _ _ _ ._ �Q. /. � .��
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