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915 Greenhill RdDAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT of Bedrooms Date `� _ /,3 "hi" permit is granted to for the installation of a septic tank-_ at the residence of 6_�P'91'7 Address Building Contractor Address _ Septic Tank Specifications: Length Width Depth Capacity Gal. :2 -17.n ,Manufacturer's Name .�cz��v ,% .�,, r Address No. of lines___Lwidth_Yf in. Total Length fs'D ft. No. of Sq. Ft. Type of filter material/© p�1u,t_ Total tons used M- nimum Requirements: House Trailer Tank Cap. 800 Sq. ft. line 1+00 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 inst led according o specifications. Signed:�-- Septic Tank Contractor Note: Make sketaa of disposal system on back of sheet and mail to Health Center, Mocksville. i XOP �S • � OS o I F _,-- Pio uaai