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P21971 CarterlY �DDAAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT No of Bedrooms Date This permit is granted to ^usDDs+ Ell:-, for the installation of a septic tank at the residence of Gf.7t�r, Address Building Contractor Address T' Septic Tank Specifications: Length Width Depth Capacity Gal. ©© Manufacturer's Name Address T No of lines_ width�n. Total Length 30c ft. No. of Sq. F . ,'9,0 o Type of filter material Total tons used 3 o. 6'r Minimum Requirements: House Trailer Tank Cap. 800 Sq. ft. line 400 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 approval 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 Health Center, Mocksville.