P52567'i -a, of Bedrooms
This permit is
DAVIE COUNTY HEALTH DEPARTMENT
granted to
SEPTIC TANK PERMIT
Date s - Z; —( 7
for the installation of a septic tank -
at the residence of
Address
Building Contractor "LL -/d.--0
Address
Septic Tank Specifications:
Length Width.
Depth
Ca acity Gal.
ddress
Address-
Manufacturer's Name
No, of lineswidth
7
in. Total Length _L eft. iso.
of Sq. Ft.
Type of filter material
Total tons
used
Minimum Requirements:
e r ler Tank
Cap. 800
Sq, ft. line 1+00
Two -be room house
800
600
Three-bedroom
house
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: cd'z-=2- -
Septic Tank Contractor
Noise: Make sketb'a of disposal system on back of sheet and mail to Health Center, Mocksville,