P102271 Danner RdDAVIE COUNTY HEALTH DEPARTMENT
No of Bedrooms c `
This permit is granted to for the
at the residence of Eg J,,e c^�,2 ,S Address
SEPTIC TANK PERMIT
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Date L�L,�, /,J
installation of a se tic tank
Building Contractor Address
Septic Tank Specifications: Length Width Depth Capacity Gal.
Manufacturer's Name Address
No of lines_/ width in. Total Length ft. No. of Sq. Ft.
Type of filter material Total tons used
Minimum Requirements: House Trailer - Tan_': Cap. 800 Sq. ft. linefm
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.
N -I
/Ij