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P111767 Hwy 601NDAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT 1o, of Bedrooms Date -his permit is granted to �.,cs r_ ��-zLt for the installation of a septic tank at the residence of� c� .'� .A �',c.+�� Address AY, 'R Building Contractor Address Septic Tank Specifications: Length Width Depth Capacity Gal. Manufacturer's Namee--� Address No. of lines S width e?© Total Length 5ft. No. of Sq. Ft. la o Tempe of filter material Total tons used -30 _ �✓lniinum Requirements: House Tr filer Tank Cap. 800 Sq. ft. line 400 Two-bedroom hese 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 hereby certify that the above septic tank has been installed according to specificatio S. Signed: Sep is ank Contractor Note: Make sketbh of disposal system on back of sheet and mail to Health Center, Mocksville, 1