P62863 Hwy 601DAVIE COUNTY HZ,,ALTH DEPAR.LENT
SEPTIC TANK PM-1IT
No. of Dedrooms Z— Date _
This permit is g ranted to %�/%� for the installation of
a Septic Tank at the residence of Address
building Contractor ,�j �„ , . �� Address f-��¢:e2 /7llJ7 zu 4K
Septic Tank Specifications: 'Length 1idth Depth Capacity Gals
Manufacturer's Name e T� '�J�� � Address
No. of lines Width t!" in. Total length jj Ft. No. of Sq.Ft.&/ o' d
Type of filter material --Lt:i--f��� Y. Total tons used 0
Minimiu,m Requirements: Tank Capacity Square Ft. of Line
House Trailer 800 100
Two-Dedroom House 800 600
Three-Dedrocm 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 /0 —(1---6 `Signed:
Sanitarian
I hereby certify that the above septic tank has been installed according
to specifications.
Signedy •
Septic Tank Contractor
Note: Make sketch of disposal system on back of sheet and mail to the {'
Health Center in Mocksville.