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P1963 Hwy 801S - Sheets BBQDAVIE COUNTY HEALTH DEPARTt,IENT SEPTIC TANK P= -IT No. of Bedrooms Date This permit is granted to for the installation 4W i' of a Septic Tank at the residence of T.14 cce- ;._ Address �o/ Building Contractor Address Septic Tank Specifications: Length Width Depth Manufacturer's s Name Address Capacity No. of lines L,Jidth in. Total length ft. No. of Sq.Ft._u_. Type of filter material Total tons used 11inimum 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. d < Septic Tank Contractor Note: I•lake sketch of disposal system on back of sheet and mail to the Health Center in 1Iocksville. ::... f, ..� � .. .