P81468 HofferDAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT
No, of Bedrooms 3 Date
`Pais ,permit is granted to for the ir_stalla on of a e tic taL;!�,
at t:he residence of 1%,KF/�,�, /7� r✓ tC Address
Building
Building Contractor ` Address
Septic Tank Specifications: Length idth Depth_ Capacity Gal. 20
Manufacturer's Name 6J/r,�,�.� S,71 Address—
:i o, of lines__21 width in. Total Length ft, No. of Sq. Ft. � � � 00
T4j-.:e of filter material *,o -l� ,u� Total tons used 3.0
Minimum Requirements: House Trailer Tank Cap. 800 Sq. ft. line 400
Two-bedroom house 800 600
Three-bedroom 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 _ Signed:.
Sanitarian
i hereby certify that the above septic tank has been installed according to specifications.
Signed:
pTic Tank Contractor
dote: Make sketc'a of disposal system on back of sheet and mail to Health Center, Mocksville.l
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