Carter, CraigNo. of bedrooms _ 9
This permit is granted to
DAVIE COUNTY HZALTH DEPAhTiMT
SEPTIC TANK P:r"l •TTT
Date` Gs
for the installation of
a Septic Tank at the residence of ep-ajg_ ��`1rr`0" Address A I va
Duilding Contractor mac. Address
Septic Tank Specifications: LengttkatEITidth Depth., ,CapacityGal.
Manufacturer's Name �j am. Address
No. of lines_ t.lidthin. Total lengthy Ft : PIo e of Sq. Ft
Type of filter material i,,Ef Total tons used -$ /s'�Q
%finirmiza he iuirernents: Tank Capacity Square Pt. of Line
House Trailer 800 100
Tic-Dedroom House 800 600
Three-bedroom House 900 900
No one shall install a septic tank in Davie County vrithout a permit from the
Health Officer or his agent.
Date of final Approval �- / y Signed:
Sanitarian
I hereby certify that the above septic tank has been installed according
to specifications.
Signed e J&; i?� Z—,
Septic Tank Contractor
Note: I -lake sketch of disposal system on back of sheet and mail to the
Health Center in 1Iocksvil7.e.