HomeMy WebLinkAboutRock Barn Spa Mineral Pool App 530070 09 29 09.tif
N.C. Department of Environment and Natural Resources
Division of Environmental Health
APPLICATION FOR PUBLIC SWIMMING POOL OPERATION PERMIT
POOL INFORMATION:
Name of public swimming pool: Jqask Street address of pool location: 37ept Gp174 D/L •f/~
City: .!/C- z8'6,13 County: ee oh4 -
Type of public swimming pool: (check one) ❑ Swimming pool
❑ Wading pool
X11 Spa oi4e.oo4l %op/
❑ Other (describe)
Date constructed or remodeled: (check one) ❑ Before May 1, 1993
a May.1, 1993 or later
Dates of operation: opening date At y"?,eP closing date
Hours of operation: opening time closing time X/u
OWNER INFORMATION:
Name of owner: gAeak
Mailing address: 37~/
Contact person: '7-f{ SIM PM0s-e_- Telephone: 94'~'-W9 3i/oD9
OPERATOR (On-Site Manager) INFORMATION:
Name of pool operator: s w w o, -e_
Address:
Telephone number:
Pool operator trained by: (check one) ❑ National Swimming Pool Foundation
(Certificate Number: )
Other (please specify) P7.,Ve-" zvMyo-Fv
APPLICATION SUBMITTED BY:
Owner or operator:
Si ature Typed or printed name
Date: 9--09 9'
DENR 3961 (Revised 10/97)
Environmental Health Services Section (Review 4/99)
9sm CATAWBA COUNTY
Public Health
Environmental Health Division
P .O. Box 389 • 100-A South West Boulevard • Newton, North Carolina 28658
(828) 465-8270 • FAX (828) 465-8276 • TDD (828) 465-8200
ROCK BARN PROPERTIES August 03, 2009
3791 CLUBHOUSE DR
CONOVER, NC 28613
Year Round Swimming Pool/Spa Permit Renewal
ROCK BARN SPA - MINERAL POOL Case#: FLI-0000196
3791 CLUBHOUSE DR Facility ID#: 02018530070
CONOVER, NC 28613
YEAR ROUND SWIMMING POOL/SPA PERMIT RENEWAL
This is to inform you that your Year-Round Swimming Pools permit will expire 09/18/2009.
Please come to the Permit Center either at the City of Hickory, 66 N Center Street, Hickory
or the Catawba County Government Center, 100-A South West Blvd., Newton, fill out an
'Application for Swimming Pool Operation Permit', and pay the $200.00 fee.
If we do not receive an application and payment by 09/18/2009, your Year-Round
Swimming Pools permit will expire, and the facility cannot continue to operate.
Also, you may go to the web address below and print the application at
www.catawbacountync.gov/phealth/swimappl.pdf
Complete the application and mail with your fee to:
Catawba County Environmental Health
PO Box 389
Newton, NC 28658
Or you may bring the completed application with your fee to the Permit Center.
Please call if you have any questions.
Sin ly,
Y~~--
Paige Yri o en, RS
Environmental Health Specialist
PSH CAROZ
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