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HomeMy WebLinkAboutEHPR-11-2023-45993--los ENVIRONMENTAL HEALTH G) Catawba County Government Center 25 Government Drive I P.O.Box 389 I Newton,NC 28658 Catawba county Phone:(828)465-8270 I Fax:(828)465-8276 public health Email: EHAdmin@CatawbaCountyNC,gov RAMC 111111. Environmental Health General Application QQ Case# 1f1PR W)03 S y13 Property Location: City of Newton Street Address: 2709 N Main Ave City: Newton 28658 State: NC Zip: Mikaela Virts Contact Person: Contact Phone Number: (828) 729-6056 mikaelavirts@gmail.com Contact Email Address: Establishment Name: licensed alternative family living home (2 clients) Architect Name(if applicable): Email Address: Architect Address: City: State: Zip: Phone: Please Note: Plans drawn to scale and specifications shall be submitted to the local health department for review and approval prior to initiating construction.Plans drawn to scale and specifications for changes to building dimensions, kitchen specifications,or other modifications to existing establishments shall also be submitted to the local health department for review and approval prior to construction.The local health department shall visit or inspect an existing or proposed center,within 30 days of the request,to determine compliance. Establishment Type _ Child Day Care n _Lodging Bed and Breakfast Home —— Bed and Breakfast Inn Residential Care Rest/Nursing Swimming&Wading Pools, Spas, School Building Splash Pads Water Supply Type Individual Well n Community Well n Public Water Ne Unknown n Sewer Supply Type Individual Septic n Public Sewer NeUnknown 0 All applicable information must be provided prior to submission. Contact Environmental Health for applicable fees. Applicant Signature Date