167 Center Circle Lot 18No of Bedrooms _
This permit °is g
'at the residence
DAVIE COUNTY HEALTH DEPART11ENT !;J. SEPTIC TANK PERMIT
at
anted to (i�asfnfor, the instal�Gu1 ap„�seiltic tank
Building Contractor JOMeA' °' (Address,'
Septic Tank Specifications: fen66_ Width :_'_-Depth_ a acity Gal.2
01
Manufacturers Name Address`
No of linea_ width in. otal Length eft. No'. of
Type of filter material %a [al!ltufJL e � co . Total `tons used
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 Davi6e County without a permit from the Health
Officer or his agent.
Date of final approval Signed: 4 Al(�
ani an
I hereby certify that the above ,a tic tank has been ins led a rdin
specifications. //(Jp/�
Signed:
Note: Make sketch of disposal.eystem_on.back,of__sheet,,and
pt% Taxld Contractor
to_Healtlh Center,
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