P102166 Jamestowne Dr DAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT
Ito. of Bedrooms ;3' _-_ Dete -2-
.his
/c 2"his permit is granted to r (for ,f6r the 'nstallation of a se tic tank.
at the residence ofjq
Bul. ding Contractor '• Addre - ' = --
Septic Tank Specifications: Length Width Depth Capacity_____.Pal.
Gal.
Mt nufacturer's Name s ` Address /.),
Tdo., of lines ,�_widthin. Total Length ac-j, ft. No. of Sq. Ft.
Type of filter materialTotal tons used 3o-'k, '
Minimum Requirements: House Trailer Tank Cap. 800 Sq. ft. line 400
Two-bedroom house 0 600
Three-bedroom house 90b 900
No one shall install aseptic tank in Davie County withou permit frothe Health Officer
or his agent. f
Date of final approval Signed:
Sanitaria:
1-
I hereby certify that the above septic tank has been installed according to specifications.
Signed: - 7L
Septi Tank Con ractor
Note: Make sketbh of disposal system on back of sheet and mail to Health Center, Mocksvil_le,
,3
E4r
x 3 /�.,