P62466 Edgewood Cir DAVIE COUNTY HEALTH DEPARTN1ENT
SEPTIC TANK P=IT
No. of Bedrooms 3 Date
This permit is granted to for the installation
` of a Septic Tank at the residence of Address
Building Contractor Address
Septic Tank Specifications: Length lydidth Depth Capacity___2Fo Gal..
Manuf acturer's Name T, Address ("S � -
No. of lines tiJidth in. Total length ft. No. of Sq.Ft.—.
Type of filter material (%w_ .�p Total tons used
Minimum Requirements: Tank Capacity Square Ft. of Line
House Trailer £300 100
Two-Bedroom House £300 600
Three-Bedroom House 900 900
No one shall install a septic tank in Davie County without a perrai.t 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.
Signed ` CmL 41L_
Seplc Tank Contractor
Note: Make sketch of disposal system on back of sheet and mail to the Health
Center in 11ocksvil3 e.
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