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P72369 Edgewood Cir (2) DAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT No of Bedr6or s 67 Date 7 —20 m��/f 'rhiis permit is granted tp eo , for the installation of a s ptic tank; . at the. rE s idel ce of eza&-Z_ SL4�_ _ Address .� Building Conti actor 1� � :-r- Address ,1 I Lel Seg+tic Tack Specifications: Length SdidtYi Depth Capacity__ Gal . M4 Manutact-arer's Name Address--- 11o. of lines width �rj'in. Total Length /,S o ft. . No. of Sq. Ft. 6 o 0 ly;e of falter materialLp Notal tons used 1,Hni; ixi Revirements: 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: ' - y optic Tank Contractor Note., Make sketl.- of disposal system on back of sheet and mail to Health Center, Mocksville. `� � a �. a _ �, � �� © < o � �,' ��