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.
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