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HomeMy WebLinkAboutArgyle Place App 500058 03 11 10.TIF I'IHK-VJd-t=VJ1VJ ✓Jd: Jd r r om; 1 0 : f VJ4d f tic=I f Y'. It K RQ 0 U Da ls"),_ N.C. Department of Environment and Natural Resources Division of Environmental Health b-' e6 K4,n APPLICATION FOR PUBLIC SWIMMING POOL OPERATION PERMIT POOL INFORMATION: Name of public swimming pool: Street address of pool location: LtL Sj )L City: County: ~aia uka Type of public swimming pool: (check one) 01-swimming pool ❑ Wading pool © Spa ❑ Other (describe) Date constructed or remodeled: (check one) before May 1, 1993 ❑ May 1, 1993 or later Dates of operation: opening date closing date D~Oe Hours of operation: opening time dj Ayn closing time OWNER INFORMATION: Name of owner: fn Mailing address: I Y) e_ Contact person: ~)(),yl(~(~~ ~~4 Telephone: OPERATOR (On-Site Manager) INFORMATION: Name of pool operator: -n Address: aLm- 1 n LLD Q Telephone number: a) ~ U - T?j-] Pool operator trained by: (check one) 6/National Swimming Pool Foundation (Certificate Number: _ q5- !!"2•DD:) ) ❑ Other (please specify) APPLICATION SUBMITTED BY: Owner or operator: Signature Typed orprinted name Date: DENR 3961 (Revised 10197) Environmental Health Services section (Review 4/99) ~~A Cp CATAWBA COUNTY, NC 100-A South West Blvd Newton, NC 28658- PERMIT RECEIPT d+ Phone: (828)465-8399 V Thursday, March 11, 2010 84 2 sM www.catawbacountync.gov Permit Number: FLI-0000152 Invoice Number: FLI-3-10-260384 Permit Type: Food & Lodging Institutions Work Class: 50 - Seasonal Swimming Pool Receipt Number: RCPT-800380 Site Address: 2830 16TH ST NE, HICKORY, NC APPLICANT OWNER IMPORT-APP-PERMIT DEFAULT APPLICANT ARGYLE PLACE ASSOCIATES 1 180 FREE NANCY DR STATESVILLE NC 28677-3485 Payer: LIMITED PARTNERSHIP ARGYLE PLACE ARGYLE PLACE LIMITED PARTNERSHIP Contractor: Fees: FEE DESCRIPTION DATE FEE AMOUNT Pool Inspection Fee 04/11/2008 $150.00 Pool Inspection Fee 05/01/2007 $150.00 Pool Inspection Fee 03/11/2010 $150.00 PoolInSDection Fee 03/11/2009 $150.00 TOTAL FEES $600.00 Payments: Date Payment Type Check Number Amount Change 03/11/2010 Check 16024 $150.00 $0.00 Memo: Total Payment: $150.00 perm itreccipt; 190dabbb-c6(1,1- sc5-81ba-7333c')t~t1593;.rpt 03/11/2010 16:33 Page 1 of t