P31767 Redland RdDAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT
o. of Bedrooms Date
per. -.nit is granted to (�� �`.�(�� for the installation of a septic tank._.
:.Yt the residence of AddressIfr_e� a... -L)
Building Contractor Address
Ser)tic Tank Specifications: Length Width -7 Depth Capacity Gal. w?_0 o
Manufacturer's Name r1=r G�" Address cis.-Z�_
No,. of lines_! o�? width J 6 in. Total Length ft, lio. of Sq. Ft.
Type of filter material Total tons used
Mini=nn Requirements: House Trailer Tank Cap. 800 Sq. ft. line h -4o
Two-bedroom house�8Q0� G
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 - / i - Signed:
Sanitarian
1 hereby certify that the above septic tank has been installed according to specifications.
Signed:
Septic Tank Contractor
?dote: Make sketch-, of disposal system on back of sheet and mail to Health Center, Mocksville,
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