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ENVIRONMENTAL HEALTH
Catawba County Government Center
catawba county 25 Government Drive I P.O.Box 389 I Newton,NC 28658
public health Phone:(828)465.8270 I Fax: (828)465.8276
.arum.flail..Citron.
Email: EHAdmin@CatawbaCountyNC.gev
Application for Public Swimming Pool Permit
Pool Information `� �(
Name ofpebOcswimmiegpool: �� S �'�� ',) )D 66&) Y
Street address: t \o rn-1 1`Yriov( C 1 A Sf
City: CO'Yl 6A/1.1C State: — ZIP: 2.O 13
Type of poblk swimming pool E)wotip pool f Wad"mg pool ❑Spa QOthe►(desmbe)
Dort cottoned or remodaled:Ohfor.May I, 1993 ter May I, 1993
Dates of operetiac Opel*duce:duce: t rM�11 d /C�osing date:v( V 0t " Opottiig
Hors of operotioet toe: 1 : A Closing tone: 1) y�1 I ' I
Owner Information I ;Q
Name of owner.c3 �TGt`C.Yct'»o �Ckv L1C Owner email: Rick rate) " VQh09.. ;
Mailing address: I7 ) D FCi^\75Ivy? c s e ,,/
City: Co'YIOVf-r State:NC ZIP: (V C 2 G \3
Coned Person: (R)Cf" f)t4 1 Phone#: (02—g ' t 6$ 1 2.3-7 2(
Operator(On-Site Manager Information
Pool operator: CR i C.k Phone#: 2g-- (t 6� - 23��
Street address: `T I b _�"c 'Y�' 'O V eY C)1 g' se
p/+1
City: .ve b/ State:NC ZIP: iv C " 2d b 3
en kit( (atl)'s III 1t
Pool operator Mined by: ED<rtional Swimming Pool Foundation(Certificate#: 0 24-44 2 o /'
❑other(please specify)
rarfion Submitted by: Ck- Cc/4 ❑Owes ®OpMar
Appl' �'" 1
Signalers of Applicant r— Date:
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Dpenneaa.lEsrkamnt.JN.oesi hewn 1630MeiSvc.Caw,Rulelpb,NC27611.1632,(Geir32.01.00)
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