P32867 BarnhardtDAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMI`.T
':o, of Bedrooms 3 Date
"his peZ i.t is granted to % for the installation of a septic tack_-.
at the residence of ZAddress,
Building Contractor Address
Septi: Tank Specifications: Length Width Depth Capacity Gal. o fl
Manufacturer's Name Address 64 ` Z �
No:. of lines 02 width ,-_�_ in. Total Length 3oa ft. Zo. of q. Ft.
T _)e of 'il_ter material `j ,uc Total tons used 3 0
Mi n-im:ur. Requirements: House Tr iler Tank Cap. 800 Sq. ft. line 400
Two-bedroom house 800
Three-bedroom house 00 90
No ane shall_ install a septic tank in Davie County without a permit from the Health Officer
or t --.s agent.
Date of f= ral approval �� _ Signed:
Sanitarian
I t'-er^by certify that the above septic tank has been installed according to specifications.
Signed: ��tz
Septic Tank Contractor
PTo{.e: Make sket h of disposal system on back of sheet and mail to Health Center, Mocksville,
Ir F'7 t'�