P7971 Williams RdDAVIE COUNTY HEALTH DEPARVIENT SEPTIC TANK PERMIT
No of Bedrooms Date " 9 1 1
This permit is grant d to C4 0,11 M for the installation of a septic tank
at the residence of Address P, -3
Building Contractor Address
Septic Tank Specifications: Length Width Depth Capacity Gal.
c
Manufacturer's Name CAddress ,-_ S d
No of lines_ width (c in. Total Length ghc, ft. No. of Sq. Ft. o n
Type of filter material ��� _ Total tons used 2 S -
Minimum Requirements: House Trailer Tank Cap. 800 Sq. ft. line 400
Toro -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 septic tank has been inst led according to
specifications.
Signed: � -
Septic Ta Contractor
Note: Make sketch of disposal system on back of sheet and mail to Health Center,
Mocksville.