HomeMy WebLinkAboutEXSY-2-11-15228.TIF $, txsy- a - (I- is t5
N- CATAWBA COUNTY Case # !Wk. -a "II 9336
c Subdivision i n bow 14; l (5
H . . s ''.1 Public Health Department Subdiv Subdivision
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.. c Environmental Health Division T]00 a� a ti iµ3
PO Box 389, 100A Southwest Blvd, Newton NC 28658 PIN#
%lily (828) 465 -8270 Fax (828) 465 -8276 TDD (828) 465 -8200
Applicant/Owner fd hrowel !' ro Ps 4—
Site Address: 1134- Sa.rnes Parr, Rd itic., koy
Property Size: p, 9 t
Directions: _
EXISTING SYSTEM INSPECTION REPORT
Site /System 1)isurnm
See or 1 i r k puiv-1 -1;- (f54y'
i Ssue d-G-cm
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.0 n �� rc pay
ype of Facility : House Ed Mobile Home ❑ #Bedrooms 2
Business f Specify
Other n Specify
roposed Additions/Accessory Structure: I LP 1 Lo S Oralt )(M Ia ItAs
.pproved M Not Approved ❑ Reason 1
vidence of System Malfunction : YES ❑ NO Q Sysem Type/Description Cd,Veh <fra
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AUTHORIZED STATE AGE APPROVAL DATE
NOT FOR LOAN APPROVAL
,Document, and s«e„aekunii+ y Doo„oeds■EXISTING TANK CHECK.docx