P111767 Fleming - CooleemeeDAVIE COUNTY HEALTH DEPARTD,MNT SEPTIC TANK PERMIT
;:o, of Bedrooms Date //— / > —
-'his permit is granted to ��Lt4 6 `-rte for the installation of a septic tank
+, the residence of '1,ykF-, � �zr.��u-�-- _ Address /V
Building Contractor �� Address
Septic Tann Specifications: Length Width— Depth Capacity Gal.
Maizufacturer'sName s L�1 t ��c-czQ c�� C�-�, Address d, -c-
Iro.• of lines � width_%"7����^f. Total Length sift. Uo. of Sq. F4�
of filter material Total tons used /9
Minimum Requirements: House Trailer Tank Cap. 800 Sq, ft. line 1+00
Two-bedroom house 800 600
Three-bedroom house 900 900
No one shall install a
or his agent.
Pate of final approval
septic tank in Davie County without a permit from the Health Officer
Signed:
Sanitarian
I hereby certify that the above septic tank has been installed according to s ecifications.
Signed:
Septic Tank Contra'' -tor
Note: Make sketb`a of disposal system on back of sheet and mail to Health Center, Mocksville.
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