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P72265 Hwy 64E
DAVIE COUNTY HEALTH DEPARTi,IENT SEPTIC TANK PEFJiIT Noy of Bedrooms 3no-c S A Date 12 TiLis permit is granted to �_ for the installation of a Septic Tank at the residence of Building Contractor Address 11 Septic Tank Specifications: Length tiJidth Depth 6 Capacity Mo C--,,1,, '-IanufacturerI s Name0/Ye- COZY Ci-e7fe Address No., of lines Width 6 © in. Total length ft. No. of Sq. Ft . 6 E� Type of filter material t�-jPp,C i �� C i leWP- p Total tons used 1� _ Minim= Requirements: Tank Capacity Square Ft. of Line House Trailer 800 100 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 approbal Signed: Sanitarian I hereby certify that the above septic tank has been installed according to specifications. E PvkSigned ,%' �i Septic Tank Contractor Note: Hake sketch of disposal system on back of sheet and mail to the Healtz Center in I,Iocksvil1 e.