1508 Yadkin Valley RdDAVIE COUNTY HEALTH DEPART11ENT SEPTIC TANK PERMIT
No of Bedrooms 62 Date lL — Z ? -- q /
This permit is granted to for the installation of a septic tank
at the residence of, -7)al� � Address
Building Contractor %a-ya . cis Address
Septic Tank Specifications: Length Width Depth Capacity Gal.fd-b
Manufacturer's Name Address
No of lines_ width_? ,L in. PTotal Length c9db ft. No. of Sq. Ft. zx�
Type of filter material P Total tons used 2 8,,1-o
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 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
Note: Make sketch of disposal system on back of sheet and mail to Health Center,
Mocksville.
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