HomeMy WebLinkAboutEHPR-2-10-3849 (2).TIF
***O~. Permit and/or Cert. Op. Required_ - (Mttst be completed prior to finali
CATAWBA COUNTY #-iEALTH 13 EPARTMENT 9 ~ k
(704) 465-8270 J~
Lot Eval.4- ImpAve. PermitX _Repair Permit Cert. of Comp. Permity-Oper. Permit
Owner/Agent &V'(0 ~4-e- Phone
Address Subdivision SS i
S~eQtion/ k Phase ~'to
Lot Size Directions: `tom ~4
'7D c9z~
Facility: House Mobile Home Business Other: Tax, Map #
Multi-family- Other Zoning Approval # 0/
Bedrooms 25 Seats Employees Application RateCkl/ GPD Flow
Hot Tub or Spa yes/(Z)Special Fixtures 100% Repair Area~'Le3/no REPAIR NOTICE:
Basement yes/(D asement Plumbing yes/rQ. REPAIRS MUST BE WITHIN 30 DAYS OR
Water Supply: Private Public DAYS FROM DATE OF PERMIT.
Type of System: Trench )C Bed Pump Pump/Panel Panel LPP Other
Tank Size: Septic Tank f c)no //~~r~,, Pump Tank
Nitrification Fiel : Total Square Feet?00 Depth of Stone MY r Bed Size
Trench Width 3 XI Total Length of All Trenches 300 Number of Trenches -73
Individual Trench Lengthy//tV/1W/Feet on center Maximum Trench Depth
Distance of Nearest Well Lot Evaluation: Approved(a/no (Void After 24 months)
Topo % Slope ( Sketch of lot Evaluation Site - System Design - Final
Texture CY~7 I DO NOT
I INSTALL
Structure I WHEN WET
I ~v Z
Clay Min. - l
Soil Wetness l - 1
Soil Depth 4F9 I I ~in
Restric. Hoz. at ~ 12
Available space ~nol I
Overall Class S 0 U
Comments:
wam
I
I
I
I I r
I ~
Septic Tank Contractors 7~ Z
MUST contact the l
Sanitarian BEFORE
changing permit.
**NO GUARANTEE OR WARRAN S IMPLIED OR GIVEN THROUGH THE ISSUANCE OF THIS PERMIT**
Permit Dat 1- r~7 (Improveme P i oid ter 60 months)
Owner/Agent Sanitaria
Installed By Date - - 9 Sanitarian LIZ,
(Note any changes/information in red or by sketch on b4ky
*******IF A PERMIT HAS TO BE REDESIGNED AND/OR RETRIPS MADE TO THE PROPERTY, RE********
IS AN ADDITIONAL $25 CHARGE.
White - Office Blue - Bldg Insp. Comp Yellow - Owner/Agent Green - Bldg. Insp. I.P.
CATAWBA COUNTY
/Ti : Public Health Department Case # WLS2008-00556
Environmental Health Division Subdivision
: PO 13o.e 389. 100-A Southwest Blvd. Newton. NC 28658 SecdBL/Ph/Lot # 4
(828) 465-8270 FAX (828) 465-8276 TDD (828) 465-8200 PIN# 376115740015
Applicant/Owner: ROBERT THOMPSON
Site Address: 3762 CINDERELLA ST CLAREMONT NC
Property size: SF .93 ACRES
Directions: HWY 10/ LT ON BETHANY CH RD/ RT ON BOGGS/ LT ON CINDERELLA ST / FOLLOW DIRT ROAD
TO THE "Y" / GO TO LT/ 4TH LOT ON LT "SW MOH change-out"
EXISTING SEPTIC SYSTEM INSPECTION REPORT
o-
ite stem -Diagram
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Y /
6 V
61
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Type of Facility: House Mobile Home X # Bedrooms _3
Business Specify
Other Specify II
Proposed Additions / Accessory Structures:
Approved ✓ Not Approved Reason
Evidence of system malfunction: YES NO ✓ System Type/Description J-4 /T-
Authorized State Agent: DATE:
NOT FOR LOAN APPROVAL Form E
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