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Parcel: 371120925180, 1921 DAVENPORT ST 1in=40ft
NEWTON, 28658
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Copyright 2014 Catawba County NC
04/07/2016
s4A • CATAWBA COUNTY 0 0,. f 0 Case# OP-04-2016-070993
Public Health Department - • .* Subdivision SANDY FORD DEVELOPM
® ^ Environmental Health Division • + 'r • PINit 371120925180
� PO Box 389, 100-A Southwest Blvd.Newton.NC 28658 — a •• _ 13-4. r CI e. LOT# 1-5
42 :u _
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NAME ON PERMIT: DONALD & EUNICE COPLEY, 1921 DAVENPORT ST, NEWTON NC 28658-8340
Site Address: 1921 DAVENPORT ST, NEWTON NC 28658
Property Size: Square Feet: 18,295.20 Aeres:0.42
Directions: From North side of Startown Rd, Right onto Robinwood Rd, 4th St on Right-Hileman at bottom of St, Right
onto Davenport (dirt road) 2nd house on left.
Catawba County Health Department Operation Permit
System Type: **** no system class assigned **** ()
(In accordance with Table Va)
Description:
System Code: System Code Description:
Types V and VI systems expire in 5 years.
Owner must contact health department 6 months prior to expiration for permit renewal.
System Installation Comments:
PERMIT CONDITIONS:
1. All maintenance, monitoring, and performance requirements shall be in accordance with
15A NCAC 18.1900, Rule .1961
2. Operation & Maintenance Specifics: NEW SEPTIC TANK ONLY
Subsurface system operator required? Yes No_X_
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
This system has been installed in compliance with applicable North Carolina General Statutes, Rules for Sewage
Treatment and Disposal, and All conditions of the Improvement Permit and Construction Authorization.
Brandon Martin #4716 04/06/2016
SYSTEM INSTALLER INSTALLATION DATE
Steven Price 04/08/2016
AUTHORIZED STATE AGENT DATE OF OPERATION PERMIT Form F
ISSUANCE
ehpennit 04/08/2016 16:21 Page 1 of 3