1938 Hwy 64E (2) DAVTE COUNTY HEALTH DFPAR7.1E17T SEPTIC TANK PINIIT
No of' Be(L-ooms 3 c Date � — � �9 �
This permit is granted to for the installation of a septic tank
at the residence of =P -: „o ',�'� -z; :��3lress 1��. =
Building Contractor /_cam. ':uf,c � Address
Septic Tank Specifications: LengtV Width. Depth Capacity'
Manufacturer's Ncme �.r. Address ` _�____
No of lines�_ vridth cam,in. Total Length. ft. No.. of q. F
9 DO
Type of filter material. ,� Totaltons used
Minimum Requirements: House Trailer Tank Cap. 800 Sq. ft. line 400
Two-bedroom house 800 600
Three--bcdroom hot'.see 900 900
No one shall install a septic tank in, Pavie County without a permit from the - lth
Officer or his agent. d
Date of final approval Signed:
unitarian
I hereby certify that the above septtic tank has been installed according to
specifications.
Signed:'
epti feank Contras —
Note: Maka sketch of disposal system on back of sheet and mail to Health Center,
Mocksville. 41
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