HomeMy WebLinkAboutRBPR-03-2015-20976.TIFs ~roo N_ ? .1807
CATAWBA COUNTY HEALTH DEPARTMENT o<<
Telephone: (704) 465-,8220 TDD: (704) 465-8200
Improve. Permit Authorization to Construct_Repair PermitOper. PermitSystem Type~%~~~~~~~
Owner/
Addres
Lot Size LrU~I Directions:
>hone , 3oc11 ~- O ~Q~
division
~ection~dlock/Phase Lot#
Fa'~ility: House /~ Mobile~Home Business Other: Tax Map # ~~ ^ ~f-~ ~~
Multi-family Other Zoning Approval # O
# Bedrooms~_ # Seats # Employees Application Rate GPD Flow
Hot Tub or S a yes/no Special Fixtures 1000 Repair Area es no
Basement ~no Basement Plumbing ~1e /no
Water Supply: Private Well Public
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Type of System: Trench~Bed Pump Pump/Panel Panel LPP Other
s
Tank Size: Septic Tank Size ~ Pump Tank Size
Nitrification Field: Tjotal Square eet d ~ Depth of Shone ~ Bed Size
Trench Width / Total Length of All Trenches d Number of Trenches
Individual Trench Length/~/Z/~/ Feet on Center Maximum Trench Depth/'/~
Distance of Nearest Well ~Q ~'l~ *DO NOT INSTALL WHEN WET* '
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Topo ~ ~ ~ Slope
Texture
Structure
_ _ _
Clay Min.
Soil Wetness ~ ~
Soil Depth ~ ~ `J~1-
Restric . Hoz . at I ~ ~~~1.-~
Available space e /no~ ~
Overall Class S U ~ , < ~
Comments : i~ /~ .' Q ~~ ` IO
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**NO GUARANTEE OR WARRANTY IS IMPLIED OR GIVEN AS TO THE PERFORMANCE OR LENGTH OF TIME THIS
SYSTEM WILL FUNCTION**
*****************************.r***.,**.*****w******************************w*********************
*Improvement Permit has no expiration date and is transferable, but may be revoked if site
plans or intended use changes for the proposed facility. An Authorization to Construct is
valid for (5) 've ears f om date issued and is not transferable.
Permit Date " ~ ,./J ~~77~
Owner/Agent Sanitarian ~,~
Installed By ~ Date ~ ^~ ~ Sanitaria ,_~
White - Office Blue -Building Inspection Operation Permit Yellow -Owner/Agent Green -Building Inspection Authorization to Construct