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1518 Hwy 64WDAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT No of Bedrooms0-.,7/,7 �'� �n�u9 Date This permit is gran'Led t for the ins allation of a septic tank at the residence of �© .met-,:�!Q�. Address Building Contractor Address Septic Tank Specifications: Length Width Depth Capacity Gal. ` 00 Manufacturer's NameAddress No of lines_ width d 9 in. Total Length 42 ft: No. of Sq. Ft. cs-D —f Type of filter material -77�- r0 .fr Total tons used coo Minimum Requirements: House Trailer Tank Cap. 800_ Sq. ft. line 400 Two --bedroom 4 use00 600 Three-bedroom house 90 900 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: G�7 �irf Septic Tank Contractor Note: Make sketch of disposal system on back of sheet and mail to Health Center, Mocksville.