295 Cherry Hill Rd (3)DAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK RMIT
No. of Bedrooms 2� "�
Date
This permit is granted to. iia
v i
for the irst dation of a septic tau;
at the residence of �� , � ,
%���� t�
Address .1 �[� �.
//
Building Contractor
Address
Septic Tank Specifications:
Length Width
Depth Capacity Galt
Manufacturer's Name ) `
a-
1 v
S J ,:
Address t��
No: of lines / width -�(?
in. Total Length
loo ft. ro. of Sq. Ft.
T�Tpe of filter material
o
Total tons used 14
Minimum Requirements: House
Trailer Tank
Cap. 800 Sq. ft. line
400
Two-bedroom house
800
600
Three-bedroom house
900
900
:o 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 instal ed according to specifications.
Signed:
Septic Tank Contractor
:dote: Make sketbh of disposal system on back of sheet and mail to Health Center, Mocksviile..
,;? / c.rez in L o7 - Next to 2ree h