HomeMy WebLinkAboutRock Barn Spa Indoor Spa 550017 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: pa L- LGC-
Street address of pool location: X779 6;'p AC 0/4- A,
City: Gp~/ov~it- A,,~ 44-1.Y County:
Type of public swimming pool: (check one) ❑ Swimming pool
❑ Wading p of
Sd Spa / hooti Nom 7'.i
❑ Other (describe)
Date constructed or remodeled: (check one) ❑ Before May 1, 1993
R May.1, 1993 or later
Dates of operation: opening date yA ,epyjtX closing date
& 101,
Hours of operation: opening time 9z?w closing time
OWNER INFORMATION:
Name of owner: AgAot- V 451-111O/14 4`9,010- G G
Mailing address: 379/
Contact person: 3-"* Telephone: ~d~9-36 0
OPERATOR (On-Site Manager) INFORMATION:
Name of pool operator: !]Ed ,S1iursv jo~
Address: ,T791 G~~c~JlzouSC_.t~i2 G°ertoye~ ve-
Telephone number: 9z-f-- ~,$~-3L09
Pool operator trained by: (check one) ❑ National Swimming Pool Foundation
(Certificate Number: )
a Other (please specify) Q 7,vCAtf zo,3 .4 vvy~
APPLICATION SUBMITTED BY:
Owner or operator: D-Al S5,huw ,►,ol-e_-
gnature Typed or printed name
Date:
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 04, 2009
3 CLUBHOUSE DR
CONOVER, NC 28613
Year Round Swimming Pool/Spa Permit Renewal
ROCK BARN SPA - INDOOR SPA Case#: FLI-0000236
3791 CLUBHOUSE DR NE Facility ID#: 02018550017
CONOVER, NC 28613
YEAR ROUND SWIMMING POOL/SPA PERMIT RENEWAL
This is to inform you that your Year-Round Spas 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 Spas
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.
Si rely,
Paige Yngoyen, RS
Environmental Health Specialist
0,111 CARO(,,Y
q
Accredited '
Health E '
i Dep'arimen m GREATER
,ZO,~ "Keeping the Spirit Alive Since 1842! M TRO Recycled paper
~O`tRment P~~~
b
c~ ro
0 0 0 L, 0 rri
0 0 0 0 0 o Y
0 0 0 0 0
O o 0 0 0 cn
~p w ~o w
Uh rn rn 00
r ro
0
W y
^ O
O n
b
Y 0 0 0 0 0 d
O o 0 0 o N
C C C C C =i
w w w w m
0
td 'O `O b 'r1
0
coo coo * Irl
~ pry
7 V V V V V
° 00 00 00 00 w n n
O O O O O
0 = = = p7
::T :7
00
o ~ O p
N p
O b
n N o =°s
0
c O CD
p ~
O ~
0 0 0 0 0
v, v, v, v, v, o
0 0 0 0 0
N N N N N a
O O O O O ~
ro ~ x O O O O O C
C7\ a,
W W UJ W
CD r W W W W W M
t
cD O O O O O c
p ~ ~ ~ O O O O O
O d ~ f
~ y
0
a
0 0 GO) o
0 00 °o 0 0 0 0 0 c
3
O O y p O O O
O
O O
C d. O O O O O O
c o
w ~
N N
A
W N
a d