HomeMy WebLinkAboutEHPR-5-11-10909 (2).TIF i
� � CATAWBA-LINCOLN-ALEXANDER DISTRICT HEALTH DEPARTMENT
� NICKOR7, N. Cr–NEWTON, N. C.—LINCOLNTON, N. C.—TAYLORSVILLE, N. C
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� Phones 345-3883 464-2011 735-5521 632.3101
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� PEitMIT TO INSTALL SEPTIC TANK /
i PERMIT NO .... .. ...... :. ......... .. ` PERMIT DATE..................�� � / 50
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i Owner.......... ' .............. Address.....................................
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� Tenant ........................ ..... - ...... Address....................... .........
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i lnstalled by ...... . . .:................ . .......................... dress............... ......................................... . .....
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� Locotion of P erty.......... . C� ��'`�
' .�.��G� � .�.c,�.. .�. .....�� ..�.Y.����:. ... . " �........
� ............. . . ....... ..,�.�'...... ..... ........... ...... . ...................
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i Kind of tank..........'� .:......................Size............ .. ......................Length of trench..... .....................�..................
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� NOTIFY HEALTH DEPART ENT AS LEA EIGHT HOURS BEFORE TANK IS TO BE INSPECTED
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i Final Inspection ................ ...�............ ................19....�j ..� Approved ( Discpproved ( )
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� Remarks:
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� First five ine froru outfet from house shou►d be of casi iron soil pipe.
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i � �J Sanitarian.
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i Sketch of tank and line showing distance
� � j�s-�� from dwelling and well on subject pruperty
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� ond on adjoining property.
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