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P5668 McCallisterDAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT No. of Bedrooms Date— 'j''nis permit is granted to for the installation of aseptic t&__s:. s c the residence of , y,�a%%= CGGC�-QX�L_ Address /, ��� /✓� Duilding Contractor Address Septic Tank Specifications: Length Width Depth Capacity Gal. 0,0 Manufacturer's Name Address No, of lines width in. Total Length _ ft. No. of Sq. Ft. zo a q4 -pe of filter material Total tons used _ Min:ialm Requirements: House Trailer 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 _M Signed: Sanitarian hereby certify that the above septic tank has been installed according to specifications. Signed: Septic Tank Contractor Note: Make sketbr of disposal system on back of sheet and mail to Health Center, Mocksville. --y