P41866 Redland RdNo. of Bedrooms -�
DAVIE COUNTY HEALTH DEPAR71,1ENT
SEPTIC TANK PERMIT
Date y— /V - G
This permit is granted to for the installation
of a Septic Tank at the residence of ` � �Address
_ l
Building Contractor u Address
Septic Tank Specifications: Length Width Depth Capacity IaD Gal,
Manufacturer's Name �✓ Address
No. of lines Vadth in. Total length
ft. No. of
Type of filter material Total tons used
Minimum Requirements: Tank Capacity Square Ft. of Line
House Trailer 800 100
Two -Bedroom House / 800_- 600
Three -Bedroom House 900 900
No one shall install a septic tank in Davie County without 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: Make sketch of disposal system on back of sheet and mail to the Health
Center in I,iocksville.