P32069 DullDAVIE COUNTY HEALTH DEPARTMEINT SEPTIC TANK PERMIT
T'o . of Bedrooms �i Date 3^ R o —6 9
":h.is permit is granted to for the installation of a septic tank_
at, the residence of � e,ti�� _ Address
Building Contractor �— Address
Se-ptic Tank Specifications: Length Width Depth Capacity Gal. '114-0
Manufacturer's Name ,� Address
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No. of lines ---/—Width in. TotallLength _ft. No. of Sq. t.
Ty e of filter material �Lz , ��`�_P Total tons used �3
i nimuue. Re uirements .
q e Trai er Tank Cap. 800 Sq. ft. line 1"o -
Two house 800
Three-bedroom house 900 900
No one shall install a septic tank in Davie County without a permit from the Health•Officer
or his went
Date of final approval
Signed: _
Sanitarian
I Hereby certify that the above septic tank has been ins ailed accord* to specifications.
Signed:
S tic Tank Contractor
Note- Make sketh':. of disposal system on back of sheet and mail to Health Center, Mocksville.
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