P111865 Davie Acadamy RdNo. of Bedrooms -_3
DAVIE COUNTY HEALTIi DEPARTtMT
SEPTIC TANK PER,=
Date L- � S/ -- G )
This permit is granted to y. for the installation
of a Septic Tank at the residence of j hw , j�d$,�G; Address
Building Contractor Address
Septic Tank Specifications: Length Width Depth
Manufacturer's Name Address
No. of lines Ididth in. Total length
Type of filter material
Capacity Gal:
ft. No. of Sq.Ft.__w
Total tons used
Minimum Requirements: Tank Capacity Square Ft. of Line
House Trailer 800 100
Two -Bedroom House £300 600
Three -Bedroom House
(9,00
900
No one shall install a septic tank in Davie County w ithout a permit from the
Health Officer or his agent.
Date of final approbal Signed:
Sanitarian
I hereby certify that the above septic tank has been installed according to
specifications.
^„--
Septic Tank Contractor
Note: I -lake sketch of disposal system on back of sheet and mail to the Health
Center in Hocksville.
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