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HomeMy WebLinkAboutEXSY-4-11-17283.TIF ��.s�-�-�i i�a�3 �$ CATAWBA COUNTY Subdiv�'sion � � o �, - Public Health Department � Q ,,��, Environmental Health Division PIN# O PO Box 389, 100A Southwest Blvd, Newton NC 28658 I8 w (828) 465-8270 Fax (828) 465-8276 TDD (828) 465-8200 A licanUOwner r Site Address: r Dn Pr Size: Directions: EXISTING SYSTEM INSPECTION REPORT �� lr. — �no.1 �' ' �GSe � c�ric�iv��.P �o p�,rM,,-� is5ucd �,s�, �-3-q�i -�- t �''� � � _ , � � � � � , ►� �� �- �. 5 �s'� � cr — — � 1..,�ie. C�" 13' � . d,,ra,,;�h Q�c� O �P�m,�.� p r ype of Facility : House . Mobile Home �� #B�O°� —�—�— Busin$ss �_ Sl��' Other �, SP��fY i � raposed Additions/Accessory Structure: «� �l �'1 e�N 5'1'r'lq � 5�� d� �� � G�d IVL�I � d � k �/ a(J�n �K .pproved � Not Approved ❑ Reason vidence af System Malfunction : YES ❑ NO (� Sysem Type/Description ('�3Y�UQII ��`'�! �-4�' �o — I I AUTHORIZED STA AGENT APPROVAL DATE NOT FOR LOt�N APPROVAL � „ �,�,� �,�.�xis,� T,� CHECK.docx