P52369 Cloer - SheffieldDAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT
'io, of Bedrooms 2 /, ,�,�-z Date 6 (,
"'his permit is grante eto for the i .stal ion o aseptic tank
at the residence of /�vZL' Address
Building Contractor Address
Septic Tank Specifications: Length Width Depth Capacity___.Pal.
Manufacturer's Name Address
No, of lines__j width'Nin. Total Length ft.
No. of Sq. Ft
Type of filter material �/D Total tons used
Minimum Requirements: House Trailer v 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 witnout a permit rrom the nealtn urricer
or his agent.
Da --e of final approval
Signed:
Sanitarian
T hereby certify that the above septic tank has been installed according to specifications.
Signed:��Zr�Z
Septic Tank Contractor
Note: Make sketb!-: of disposal system on back of sheet and mail to Health Center, Mocksville,