P92068 Pleasant Acre Dr (2)j
D`AVIE CO Y HEALTH DEPARTMENT SEPTIC TANK PERMIT
oa of Bedrooms Date
"`his permit is granted to `So_wax for the installation of a septic tank
at the residence of To npeh_� Address
Building Contractorae�s L Address _
Septic Tank Specifications: Length Width Depth Capacity___ _Gal. a
Manufacturer's Name �_.� .�_i1t � , % � (vim ( Address /N t Yvi
No., of lineswj width___y in. Total Length /,0 z) t. No. of Sq. Ft. _0
Type of filter material WID � Total tons used /.Z
Alinimum Requirements: House Traile Tank Cap. 800 Sq. ft. line 400
Two-bedroom house 800 6o0
Three-bedroom house 900 goo
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:
--Septic Tank Contractor
:dote: Make sketbh" of disposal system on back of sheet and mail to Health Center, Mocksville,
r
r
ct