P121071 Danner RdDAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT
No of Bedroomsr i �' Date
This permit is granted �o Dvr e S.Ttfor the Ainsllion o asepta ic tank
at the residence of Lr�,� —AddressS
Building Contractor Address
Septic Tank Specifications: Length Width Depth Capacity Gal.
Manufacturer's Name Address
3
No of lines_ width_ �`4 Total Length 16M ft. No. of Sq. Ft.
—t
Type of filter material _ Total tons used / S
Minimum Requirements: House'Tra4r. Tank Cap. 800 Sq. ft. line 1+00
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:
Sep(A Tank C tractor
Note: Make sketch of disposal system on back of sheet and mail to Health Center,
Mocksville.
177