P82471 Sheffield ParkF
DAVIE COUNTY HEALTH DEPARTMENT
No of Bedrooms 3 V ly' r"
This permit is granted to -)!r
at the residence of,664'c—
i Car for the
Address
SEPTIC TANK PERMIT
Date
Building Contractor T*4414 ` Address° V
.Septic Tank Specifications' hength Width _Dep Capacity_ Gal. 00
< -Manufacturer's Name )Address
No of lines_/_ width— dn, Total -Length o? ft. No. of Sq. Ft. 9,010
Type of filter material , � i Total tons used �iC/
Minimum Requirements: House Trai er Tank Gap. 800 Sq. ft. line 400
Two -bedroom -house) �j! k 800 600
Three-bedrooa�,house' 1 BOO 900 f i
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: _
I Sanitarian
I hereby certify that the above septic tank has been in talled accordin to
41
specifications.
Signe W' -
j Septic Tank Contractor
Note: Make sketch of disposal syifeli,on back of sheet and mail to Health Center, -• _.
Mockaville.
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