P63066 Hwy 64WNo. of Bedrooms 1)
DAVIE COUNTY HEALTIi DEPAR714ENT
SEPTIC TANK PMj IT
Date Co - 3 0 d (o
This permit is granted to Lee? u.S for the installation
of a Septic Tank at the residence of Address
Building Contractor . E • C9eAddress
Septic Tank Specifications: Length Width Depth Cap/a-city
Manuf acturer I s Name P L l Address
No. of lines 1,adth in. Total length ft. No. of Sq.Ft.___
Type of filter material T4 Total tons used /d /V
Minimum Requirements:
House Trailer
Two -Bedroom House
Three -Bedroom House
Tank Capacity
800
£300
900
Square Ft. of Line
100
600
goo
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 Z 3 0 6 Signed:
Sanitarian
I hereby certify that the above septic tank has been installed according to
specifications.
Signed
Septic Tank Contractor
Note: Make sketch of disposal system on back of sheet and mail to the Health
Center in 11ocksville.
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