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gA CATAWBA COUNTY Case # EPHR-10-09-2416
Public Health Department Subdivision Crossing Creek
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Environmental Health Division SP~ n/Bl/Ph/Lot# 36
PO Box 389, 100A Southwest Blvd, Newton NC 28658
18 4~ SM (828) 465-8270 Fax (828) 465-8276 TDD (828) 465-8200 ~ A - I ! , 0 q
Applicant/Owner Jesse Hector
Site Address: 4214 Clear Spring Dr, Claremont
Property Size: 0.58 a
Directions:
EXISTING SYSTEM INSPECTION REPORT
Site/System Diagram
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Type of Facility : House Mobile Home #Bedrooms 3
Business 1-1 Specify
Other F-1- Specify
Proposed Additions/Accessory Structure: Mobile Home Change out
Approved N Not Approved ❑ Reason
Evidence of System Malfunction : YES ❑ NO ® System Type/Description 2a
_ A4V,4-'~4 11-6-09
AUTHORIZED STATE AGENT APPROVAL DATE
NOT FOR LOAN APPROVAL
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