P112268 SalmonsDAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT
`co, of Bedrooms Date -2- -
c
'':his permit is granted to for the installation of a septic tank..
at the residence ofEuuL Address
Building Contractor =L27' 11z Address Aj '
Septic Tank Specification.: Length Width Depth Capacity _� 9o -n
Manufacturer Is Name Address'����.�a�
No. of lines o2 widthin. Total Length ft. Uo. of Sq. Ft. _
Type of filter material�Total
Minimum Requirements: House Trailer Tank Cap.
Two-bedroom house
Three-bedroom house
No one shall install a septic
or his agent.
Date of final approval
tons used
800 Sq. ft. line 1:00
800 600
900 goo
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 specifications.
Signed:
Septic Tank Contractor
Note: Make sketbh of disposal system on back of sheet and mail to Health Center, Mocksville,.