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A CATAWBA COUNTY Case # EHPR-2-10-3964
Subdivision
Public Health Department
Q Environmental Health Division Secdon/BUPlifLot#
PO Box 389, 100A Southwest Blvd, Newton NC 28658 P1N4 3743-11-56-6099 y~
1 42 s~ (828) 465-8270 Fax (828) 465-8276 TDD (828) 465-8200 'U-5 79
Applicant/Owner Guy Clifford Baker III
Site Address: 1387 Cessna Ln. Conover, NC
Property Size: 12.079 acres
Directions: Sk kin Mobile Home Park, Lot 21
EXISTING SYSTEM INSPECTION REPORT
Site/System Diagram
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G.at~{ - Condck{-ions'
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Type of Facility: House Mobile Home #Bedrooms 3
Business Specify
Other _ Specify
Proposed Additions/Accessory Structure: replace previously existing 3 bedroom mobile home with new 3 bedroom mobile home
Approved ® Not Approved ❑ Reason
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Evidence of System Malfunction: YES ❑ NO ® System Type/Description Ila PuMii # (Oszo
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7J1'~ APP OVA ,DATE
A*ZED TE AGENT ~n
NOT FOR LOAN APPROVAL