P8765 Cornatzer RdDAVIE COUNTY HEALTH DEPARYEENT
SEPTIC TANK PEMiiIT
No. of Bedrooms 3 Date 7 7- e 5
This permit is granted to P -2 / �y0�.�..�� for the installation
of a Septic Tank at the residence of ,�� Address
Building Contractor _ Address
Septic Tank Specifications: Length
LLII!idtl�_ Depth d9Capacity Ze6 Gal.
Manufacturer's Name Address
No. of lines_ Widthin. Total length 3 6,6 ft. No. of Sq.Ft.,?oe_
Type of filter material Ro-d" Total tons used 3 0
IYinimum Requirements: Tank Capacity Square Ft. of Line
House Trailer 800 100
Two -Bedroom House £300 600
Three -Bedroom House 900 900
No one shall install a septic tank in Davie County w ithout 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
Septic Tank Contractor
Note: Idake sketch of disposal system on back of sheet and mail to the Health
Center in Hocksville.
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