HomeMy WebLinkAboutRBPR-02-2020-33850.tifN~ 6442,x!
,~ ***Op. Permit and/or Cert. Op. Required (Mu'st be completed prior to final)
C A T A W B A C O iJ N T Y H E A L T H D E P A R T M E N T ~~
(704) 465-8270
Lot Eva1.~Improve. Permit~,Repair Permit Cert. of Comp. Permit Lr.=9~er. Permit
Facility: House Mobile Home ~ Business Other: Tax Map # ~ X ~" 3 -~f
Multi-family Other Zoning Approval # Z93C/Z.S~/
Bedrooms 3 Seats Employees Application Rate ~~ GPD Flow,
Hot Tub or Spa yes/moo Special Fixtures 100 Repair Area a /no REPAIR NOTICE:
Basement yes/~fS; Basement Plumbing yes REPAIRS MUST BE WITHIN 30 DAYS OR
Water Supply: Private, Public DAYS FROH DATE OF PERMIT.
tR f.Aar.4*Ar-,?it*ArY.'**~fi f~**sr ~t it ylrA ~t*R*71t R7R*tlt It***tR 7t***tk***7R*!7R*~***1ttR*******************************'~*
Type of System: Trench ~ Bed Pump Pump/Panel Panel LPP Other
Tank Size: Septic Tank 1~ ~~ Pump Tank
Nitrification Field: Total Square Feet epth of Stone z /!c'-~ Bed Size
Trench Width ~ ~`f~ Total Length of All Trenches ~'" Number of Trenches 3 ~
Individual Trench Lengthy/(~'T_/_ Feet on Center ~ ~ Maximum Trench Depth~,_
Distance of Nearest Well Lot Evaluation: Approved yes/no (Void After 24 months)
Topo~`~ Slope ~ Sketch of lot Evaluation Site - System Design - Final
Texture ~ , ^ -._ t_.,,,,_` ~`
Structure
Clay Min. ~
Soil Wetness ~' ~ ( ' ~ n
Soil Depth Ci~ k ( ~ t ~.t~c( ~- I
Restric. Hoz. at ~" ~ I =, ~" r.- - -~-~ 6~- '
Available space /no ~ ` -- /~.
Overall Class S~ ~ 1 O) ~. ~o ~ I
Comments: ~ O
! ~ ~) mob~(.~
~ °
~ ~ N
I
> ` ~~
I ~ ~~ ~ I
I I ~ 4
~ ~ ~ ~o~ I
Septic Tank Contractors ~ ,_..,. ~ .-- ___1 ~
t~JST contact the ~ m f P`~qs@_,~.~ ~ ~ ~ "~
Sanitarian BEFORE ~
changing permit. ~
**NO GUARANTEE OR WARRANTY IS Il~LIED OR GIVEN THROUGH THE ISSUANCE OF THIS PERMIT**
Permit Date ~ 2 " v ~ "~ ~~ ( Improvement P i oid a 60 months )
Owner/Agent Sanitari ^~
Installed By Dated ~7 ~' Sanitari - - -
-'~')~/t~w~t,It1~-O~.c.(,Note any changes/information in red or by sketch on back) ~•
*******IF A PERIrIIT HAS TO BE RIDESIGNED AND/OR REPRIPS MADE TO THE PROPERTY, THERE********
IS AN ADDITIONAL $25 CHARGE. _
White-Office Blue-Bldg. Insp. Comp. Yellow-Owner/Agent Green-Bldg. Insp. I.P.
Owner/Agent ~ Phone
Address Subdivision