P92970 Salmons Rd (2)DAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT
No of Bedroomsrcr ` 4r- Date g ^ — 9
This permit is granted to .7,IA)e 5 for the installation of septic tank
at the residence of 16 Va An n vc,s Address ,T�-f-�-_ /3IV
Building Contractor Address
Septic Tank Specifications: Length Width Depth Capacity Gala
Manufacturer's Name Address
No of lines_I width_ff in Total Length ! o oft. No . of S Ft.( o
Type of filter material4— Total tons used /,J—
Minimum
�
Minimum Requirements: House Trailer Tank Cap. 800 Sq. ft. line 400
Two-bedroom house_ 800 600
Three-bedroom house 900 900
No one shall install aseptic 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:
Sep ff Tank Co actor
Note: Make sketch of disposal system on back of sheet and mail to Health Center,
Mocksville.