P10868 Williams RdDAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT
L'o, of Bedrooms Date
This permit is granted to ,,.��, for the installation of a septic tanl ..
at the residence of ��„ F{> Address
Building Contractor Address
Septic Tank Specifications: Length/]Width Depth Capacity d( Gal.
Manufacturer's Name:19) a/� Address
No.. of lines__2- width Z 6 in. Total Length �2 o ft. No. of Sq. Ft. 00
Type of filter material Total tons usedU,1 0
Minimum Requirements: House Trailer Tank Cap. 800 Sq. ft. line 400
Two-bedroom house 800
Three-bedroom house 900
No one shall install a septic tank in Davie
or his agent.
Date of final approval
County without a permit from the Health Officer
Signed:
Sanitarian
I hereby certify that the above septic tank has been installed according to specifications.
_�¢
Signed: _,,G_
e -'Ke -
Septic Tank Contractor
Note: Make sket h of disposal system on back of sheet and mail to Health Center, Mocksville,
m