HomeMy WebLinkAboutRPBR-12-2017-28040.TIF ***Op. Permit and/or Cert. Op. Required (Must be completed prior to final)
' C A T A W B A C O U N T Y H E A L T H D E P A R T M E N'T O
6
~ (704) 465-8270
Lot Eval. Improve. Permit~Repair PermitT^Cert. of Comp. Permit~Oper. Pe it
r ~
Owner/Agent W ~ l~ ~~w'?~~ a Phone C/ / ~
Address a ~ Subdivision
Section/B o k/Phase Lot# / ~
Lot Size Directions: _ o'ri tJZ
~ u
Facility: House Mobile Home Business Other: Tax't~iap # - S i
P4u1ti-famil Other Zoning Approval # 2. c1' G'
Bedrooms_~ Seats Employees Application Rated GPD Flow -~5
Hot Tub or Spa es/no Special Fixtures 1000 Repair Area yes/no REPAIR NOTICE:
Basement yes ~ Basement Plumbing yes/no REPAIRS MUST BE WITHIN 30 DAYS OR
Water Supply: Private Public DAYS FROM DATE OF PERMIT.
**~**xx*******,~*x*~******,~***,~**********x**********~:*****x*****xxx****x«******«****~**~**
Type of System: Trench~Bed Pump Pump/Panel Panel LPP Other
Tank Size: Septic Tank ~~(~U ~~t~ Pump Tank
Nitrification Field: Total Square Feet ~o~~-' Depth of Stone Bed Size
i
Trench Width ~ Total Len ~h of All Trenches ~jU~1 Number of Trenches_~
_ s ~
Individual Trench Length Feet on Center Maximum Trench Depth y'~
Distance of Nearest Well Dc~~ Lot Evaluation: Approved e~/no (Void After 24 months)
***********~**********.***************,~****x****
Topo~o Slope ( ~ ('Ser`
Texture ~ ~crl DO NOT
~ s~ INSTALL
:f~ Structure ~ ~ WHEN WET
Clay Min. ~ 1r ~um n S6 ~ l1~QIf
• Soil Wetness '~`'!Y ~ ~ KC'I~C~I i^ ~
Soil Depth Tom" ~ ~ G ~ ~rQ~
Restric. Hoz. at 7`i Y" ~ ~~t~
Available space ~~no~
Overall Class S U ~ )!G
Comments: i ~ ']v~,r•2 ~~ow ~?~~de~-Ci<<)
f
C~.Qf~,d ~ ,~~,.~~A~ ~ tG,1 e.clc t~
!/i~Q~," s ~ ~ a ~ ~ ~ ~ ~l /I yam" `
Septic k Contractors f, -
MUST contact the ~ aka ~ ~ ~ o' ~
Sanitarian BEFORE ~ L S~ y y ~ ~
changing permit. ~ s5
**NO GUARANTEE OR WARRANTY IS IMPLIE ~ VEN 9UGH THE~ISSU E OF THIS PERP4IT"`*
Permit Date l7 ~ C1.~4 (Impro Permit void a ~ 0 months)
Owner/Agent //Sa itarian
Installed By_ ~ Date ~'tJl Sanitarian
(Note any changes/information in red or by sketch o back)
******~IF A PERMIT HAS TO BE REDESIGNID AND/dR RETRIPS MADE TO THE PROPERTY, THERE*******"
IS AN ADDITIONAL $25 CHARGE.
White -Office Blue -Bldg Insp. Comp. Yellow -Owner/Agent Green - Bldg. Insp. I.P.