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P91070 Beck,. DAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT No of Bedrooms 3Date © 9 i This permit is granted to for the installat n of a septic tank at the residence of A4LT e c Ste. zrl Address , Building Contractor Address , Septic Tank Specificati ns: Length Width Depth Capacity ��Gal..4 0x30 Manufacturer's Name C t Address ��- . i No of lines_ _/ width in. Total Length .03 S ft. No. of Sq. Ft. } a° Type of filter material �— ` Total tons used Minimum Requirements: House railer Tank Cap. 800 Sq. ft. line 400 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 approval Signed: Sanitarian I hereby certify that the above septic tank has been installed according to specifications. Signed: t`�5'Iceptic Tank Contractor 7,1111ote: Make sketch of disposal system on back of sheet and mail to Health Center, Mocksville.