P5768Ito. of Bedrooms
^his permit is
DAVIE COUNTY HEALTH DEPARTMENT
-3
granted to
SEPTIC TANK PEIMIT
Date
for the irstallat' n of a septic ta-1..
at the residence of Address
Building Contractor Address ZZ),-
Septic Tank Specifications: Length Width Depth Capacity Gal. -� bo
.=ianufacturer's Name `<Lt� �r� C�� Address
No; of lines J width �� in. Total Length ft. yo. of Sq. Ft. �a
1`;rpe of filterr material ��/D Total tons used L
Minimum Requirements: House Trailer Tank Cap. 800
Two-bedroom house 800
Three-bedroom house 900
No one shall install a septic tank in Davie
04 his agent.
Date of final approval
Sq. ft. line 400
600
900
County vithout a permit from the Health Officer
Signed:
Sanitarian.
I hereby certify that the above septic tank has been installed according to specifications.
Signed:
is Tank Contractor
Note: Make sketbh of disposal system on back of sheet and mail to Health Center, Mocksvill.eo
r
V y'
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