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P62971 Jolley RdDAVIE COUNTY HEALTH DEPART11ENT SEPTIC TANK PERMIT No of Bedrooms Date o-Z�&)L� �_ This permit is granted to < for the installatio of a septic tank atthe residence of Address /3 Building Contractor Address Septic Tank Specifications: Length Width Depth Capacity Gal. Manufacturer's Name Address No of lines width in. Total Length ft. No. of Sq. Ft. Type of filter material Total tons used Minimum Requirements: House TrailerTank Cap. 800 Sq. ft. line 1+00 Two-bedroom house 800 600 Three-bedroom house 900 900 J 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 installed according to specifications. Signed: Septic Tank Contractor Note: Make sketch of disposal system on back of sheet and mail to Health Center, Mocksville.