HomeMy WebLinkAboutEHPR-8-11-12019 (2).TIF
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C'ATAWBA C~OUNTY'IttALTH DEPART~ENT
Telephone: (704) 465-8270 TDD: (704) 465-8200 N~ . 1 066 .
Authorization to Construct___Repair Permit___Oper. Permit___System Type :3 f:j
A
Imprf4>ve. Permit
Owner/Agent
Address
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LO~ize
Other: Tax Map # -A~ "L)(/ , ',,' /t#~ J "'-/41-
Zoning Approval # 296lJ-S"3.S'tD oot--"
Applicati?n Rat~ GPD Flow ~()
100% Repalr Are e no
Facility: House~ Mobile Home~ Business_____
Multi-family_____ Other
# Bedrooms:; # Seats # Employees
Hot TUb or Spa yes~Special Fixtures
Basement yes~ Basement Plumbing yes~
Water Supply: Private Well~public_____
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Type of System: Trench~Bed_____pump~pump/panel_____panel_____LPp_____Other P~~~pFt.n~F~
Tank Size: Septic Tank Size / tJ ~. Pump Tank Size 100 () ,
------
Nitrification Field: Total Square Feet 90 tJ
Depth of Stone
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Bed Size
Number of Trenches
~
3" Total Length of All Trenches ~
../"~ J--- ._~ 0'
Individual Trench Length~/ ?~/~/~/____ Feet on Center /
Distance of Nearest Well ..s-t) I-+- *DO NOT INSTALL WHEN WET*
Trench Width
Maximum Trench Depth..2:y'+ .
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Topo r % Slope
Texture S"n.T'I CCAY
Structure ct$Lc')('.lK: Y
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Clay Min. I: I
Soil Wetness II
Soil Depth ~'2. II
Restric. Hoz. at V~I
Available space ~no.
Overall Class S~ .
Comments:
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**NO GUARANTEE OR W
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SYSTEM WILL FUNCTION*-
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IMPLIED OR GIVEN AS
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* '1)0(.,1.. TfJ 06' LI>(J~/cb
GO' ;::/U)H\. A-NL, .s{;~C T/MJI"- ..J5<5,(Ff7'.. '*-
TO THE PERFORMANCE OR LENGTH OF TIME THIS
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*Improvement Permit has no expiration date and is transferable, but may be revoked if site
plans or intended use changes for the proposed facility. An Authorization to Construct is
valid for (5) five ye s fro date issued and is not transferable.
Permit Date
Blue - Building Inspection Operation Permit
S=itarian C ~
Date )/ - )fF...9c Sanitarian - . -s
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Yellow - Ow~er/A~ent
"reen - Building Inspection Authorization to Construct