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P22867 Hwy 158
DAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT �7o. of Bedrooms _ Date This permit is granted to for the installation of a septic tail; at the residence of-,,� Address % �/s j ✓�� Building Contractor Address Septic Tank Specifications: Length Width Depth Capacity ___ Gal. �� L Manufacturer's Name Address No.. of lines width in. Total Length _ ft. Jo. of Sq. Ft. Trpe of filter material L Total tons used Z - Minimum Requirements: House Trailer Tank Cap. 800 Sq. ft. line 400 Two-bedroom house 00 MOM Three-bedroom house 900 900 No one shall install a septic or his agent. Date of final approval tank in Davie County without a permit from the Health Officer Signed: Sanitarian I hereby certify that the above septic tank has been installed according to specifications. Signed: - lontractor . �, ... .�_.. _.. S/ l� 1 �- .. , . - _ _. ., . , .____- �___.____._.._...._._._____._._.___..._._._.__.._.v___...__._�____.w__._.._. _ -_ �� ,, �_ - ... c :;.: ., �._.I _. ..._.-- ,'-: '... � ., i.: i ... .'.'. ..: ii _ .: i.i ..., _.. ..... Jam. .�.. ., �� ©?.,� - _ 1 �.._`f ...f JV.-. _�., �., _...� .... �.i: .. ._ .t.' i�fi .r 1: '?:^ :.�,� ,.. r—,+� f.. v� —.. .a^ .. .. * ..