356 Davie Academy Rd (2)DAVIE COUNTY HEALTH DEPARTi,1ENT
SEPTIC TANK PERTiIT
No. of Bedrooms .. Date o
This permit is granted to �Au�or the installation
of a Septic Tank at the residence of �' ��,,� Address
Building Contractor
Address
Septic Tank Specifications: Length 1,iidth Depth
Manufacturer's Name Address
Capacity Gal,
No. of lines Z Iddth 36 in. Total length / D d ft. No. of Sq.Ft.3O0
Type of filter material Total tons used /p
Minimum Requirements:
House Trailer
Two -Bedroom House
Three -Bedroom House
Tank Capacity
800
£300
900
Square Ft. of Line
100
600
900
No one shall install a septic tank in Davie County without a permit 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 __ acc�
Septic Tank Contractor
Note: bake sketch of disposal system on back of sheet and mail to the Health
Center in Hocksville.