HomeMy WebLinkAboutRBPR-09-2013-17993.TIF
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'CATAWBA COUNTY HEALTH DEPARTMENT 'Xl
(704) 465~70 TDD: (704) 465-8200 N~ - 696 2 ~
Construct Repair Permit___Oper, Permit 'System TYP~(
Phone Lt~ - 227'- '\
Subdivision u.Jk-y J~ lL..r
Section/Block/~ ~ Lo # ~
L. L ;sJ., 4d Un-II (JU
t+r ~ A
1/ ftJ '7 5hA-tl. _~
Other: Tax Map Q"Y- _~ - 2;-f(~ "Z.. Ulr Z()
Zoning Approval # M{o()SLf
Application Rate . ~/ GPD Flow \~C)
100% Repair Area yes/no
Facility: House_____ Mobile Home
Multi-family Other
# Bedrooms ~# Seats # Employees
Hot Tub or Spa yes/(!9 Special Fixtures
Basement yes/~ Basement Plumbing yes/no
Water Supply: Private Well_____ Public~
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Type of System: Trench~Bed_____pump_____pump/panel_____panel LPP_____Other
Tank Size: Septic Tank Size /000 Pump Tank Size
Depth of Stone IJ /4.
Business
Nitrification Field: Total Square Feet ~5r)
Trench Width ~U T,1ft:~ngt-'h ,...,-F Z.l 1 'T'rpnr<hes 16 ()
Indi vidual Trench Length:Sf) / ~I ~/_/_ Feet on Center
1110
Bed Size
Number of Trenches
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Maximum Trench DepthS~
Distance of Nearest Well
*DO NOT INSTALL WHEN WET*
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Tapa ~-IO % Slope
Texture (' I ~-I'y
!''Z. ~
Clay Min. /;, /
Soil Wetness ;'5
Soil Depth ~ Y II
Restric. Hoz. at -II
Available space~/no
Overall Class S~ U
Comments:
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**NO GUARANTEE OR WARRANTY
SYSTEM WILL FUNCTION**
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IS IMPLIED OR GIVEN AS TO THE PERFORMANCE OR LENGTH OF TIME THIS
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*Improvement Pe~it 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 years from date issued and is not transferable.
Permit Date ~. _ ,-I -'7 t.//'L2
~:~:i~;:n~y -------------'- Dat" 5"-);-57~~~~~~':
. ,
White - Office Blue - Building Inspection Operation Permit Yellow - Owner/Agent Green - Building Inspection Authorization to Construct