P9866 Milling RdDAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT'/
,io, of Bedrooms Date 9 x
'":pis permit is granted to�[ for the installation of a septic tank...
at the residence of Address J T
Building Contractor Address _
Septic Tank Specifics ions • Length Width �W Depth CapacityGal <, _ � > �
Manufacturer's Name _Address_
tic, of Line &_Yidth_JL ,' Total Length _le ft. Slo. of Sq. Ft.
'y N(: of fi l I.er material _Total tuns used
141.nimuun Requirements: House Trailer Tank Cap. 800 Sq. ft. line 400
T 9 -bedroom house 800 600
Three-bedroom�house 900 900
Ida one shall. install a septic ie County without a permit froth the Health Officer
or his agent.
Date of fina-, approval 57/ (� ( _ _ Signed: ( -
Sanitarian
1.1-creby certi yr that the above septic tank has been installed according to specifications.
Signed:
Septic Tank Contractor
Note- Make sketG:" of disposal system on back of sheet and mail to Health Center, M
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