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281 Double A Trail (3)IV DAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK ERMIT No of Bedrooms -,,3 Date _ 2,2 %0 This permit is granted to or the irlpt.allation of a septic/tank at the residence of ` Address Building Contractor Address Septic Tank Specifications: Length Width Depth Capacity Gal. O� Manufacturer's Name Address No of lines �� width_,Jj�o in. Total Length _off ft. No. of Sq. Ft �o-D Type of filter material Total tons used 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:&��,��,l e&� Septic Tank Contractor Note: Make sketch of disposal system on back of sheet and mail to Health Center, Mocksville.