P82665 HendrixDAVIE COUNTY HEALTH DEPAR71,,ENT
SEPTIC TANK PIT11IT
No. of Bedrooms Date
This permit is granted to �-Z "r4 for the installation
of a Septic Tank at the residence of Address
Building Contractor Address
rr
Septic Tank Specifications: Length Width 5- � Capacity �f � 41 Gal.
Manufacturer's Name ��,,,�,� t, (vim, AddressNo. of lines / Width� in. Total length -ft. No. of Sq. Ft ._'V � Q
Type of filter material 9=iTotal tons used / V
iiinimum Requirements: Tante Capacity Square Ft. of Line
House Trailer 800 100
Two -Bedroom House £300 600
Three -Bedroom House 900 900
No one shall install a septic tank in Davie County without a perriut 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.
1
Signed r
Septic Tani: Contractor
Note: I•Zake sketch of disposal system on back of sheet and mail to the Health
Center in Hocksville.