HomeMy WebLinkAboutEHPR-09-2012-16235.TIFCATAWBA CO~JNTY HEA~T~I DEPARTMENT
Telephone: (704) 465-8270 TDD: (704) 465-8200
Improve. PermitAuthori~zJa~t/ion to Construct_Repair Permit~Oper. Permit System Type
Owner/Agent ~~{'~ / ~ ~ ~l~fQ'n1s Phone
Address Subdivision
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Si e Directions: ~ (~
Facility: Housey~ Mobile Home Business Other: Tax Map #
Multi-family Other Zoning Approval #
# Bedrooms # Seats # Employees Application Rate GPD Flow
Hot Tub or Spa yes/no Special Fixtures 100% Repair Area yes/no
Basement yes/no Basement Plumbing yes/no
Water Supply: Private Well Public
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Type of System: Trench Bed ~ Pump Pump/Panel Panel LPP Other
Tank Size: Septic Tank Size ~~(/~~~L( Pump Tank Size
Nitrification Field: Total Square Feet Depth of Stone ~ 'l ~~ Bed Size X
Trench Width Total Length of All Trenches Number of Trenches
Individual Trench Length / / / / Feet on Center Maximum Trench Depth
Distance of Nearest Well *DO NOT INSTALL WREN WET*
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Topo % Slope
Texture
Structure ~ >,~J,
Clay Min. ~ ~
Soil Wetness "
Soil Depth
Restric. Hoz. at "
Available space yes/no~
Overall Class S PS U
Comments:
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**NO GUARANTEE OR WARRANTY IS IM~GIV~i TO~TH}'~' RFORMANCE OR LENGTH OF TIME THIS
SYSTEM WILL FUNCTION**
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*Improvement Permit has no expiration date and is transferable, but may be revoked if site
plane or intended use changes for the proposed facility. An Authorization to Construct is
valid for (5) five years rom date issued and is not transferable.
Permit Date ~ ` ~b ~ ~~
Owner/Agent Sanitar' ~v
Installed By ~ ~~,~,(,~,--- Date ZZ :. ~~ S~nitar' n ~
White - Office Blue -Building Inspection Operation Permit Yellow -Owner/Agent Green -Building Inspection Authorization to Construct