P102266 SnowDAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT
rio, of Bedrooms Date
.his permit is granted to
,cy, - ep y_t for the installation of a septic tank_.
at the residence of Address
Building Contractor Address
Septic Tank Specifications: //L��ength Width Depth Capacity Gal. �_.._�
'Manufacturer's Name .141 �=�,� Address
61 '
I1o,, of lines—J—Width�in. Total Lengthft. No. of q. Ft.
Z,fpe of filter material
Minimum Requirements:
Total tons used
House Trailer Tank Cap. 800
Two-bedroom house 800
Three-bedroom house 900
Sq. ft. line100
00----
�0
No one shall install a septic tank in Davie County without a permit from the Health Officer
or his agent.
c
Date of final approval Signed:
'.1 Sanitarian
1 hereby certify that the above septic tank has been installed according to specifications.
Signed:
Septic Tank Contractor
Note: Make sketb of disposal system on back of sheet and mail to Health Center, Mocksville.