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HomeMy WebLinkAboutRBPR-03-2014-18637.TIF- . ? ~ ~ ~ Uv ~ATAWBA COUNTY `HEALTH DEPARTMENT Telephone: (704) 465-8270 TDD: (704) 465-8200 u 1 `t Improve. Permit~horization to Construct~~Kepair Permit_Oper. Permit System Type \ Owner/Agent iFi~c'F~:Dr--2/GIG G ~ IJ~--.~b5 d2 Phone '3~~~' (~) ~~" Address ~~ ~ ~~~~-K;~-.~._~~~~ Subdivision~7~ /z~~ ~.,~ C'~~ct1d~~/~ ~'~ Section/Block/Phase Lot#~_ Lot Size ,~~~~~Directions: ~~~~ B~ir=~.~l-Lt7 $yyfn~s fin' p~S Facility: House_~G Mobile Home Business Other: Tax Map # c' - 3 $'~ Multi-family Other Zoning Approval # - # Bedrooms~_ # Seats # Employees Application Rate GPD Flow~~ Hot Tub or Spa yes/~pecial Fixtures 1000 Repair Are es no Basement es o Basement Plumbing ye /no Water Supp y: Private We11~PUblic *********************************************************************************************** Type of System: Trench t~Bed t Pump Pump/Panel Panel LPP Other Tank Size: Septic Tank Size / ~ ~-~ Pump Tank Size Nitrification Field: Total Square Feet Depth of Stone ~~ ~ Bed Size .rte Trench width ~ ~~ Total,-L~e~ngth of All Trenches ~®-®'~ Number of Trenches 7- l Individual Trench Length Js~j~ /~J 7~ Feet on Center~~ Maximum Trench Dept ~~ Distance of Nearest Well ~ ,l- *DO NOT *****,r****,r*********************,r****** Topo s - ope Texture C,~,g.U~7 I ~ ~`~` I Structure ~~_ Clay Min. / ~~ Soil wetness Soil Depth L/.~ " Restric. Hoz. at ~f " Available space yes no~ Overall Class I~ Comments : If .. ~I 1 ~ ~-F ~7 r~ / /~' -- ~ '~ ~ ~ .pR %~c ~~s~ eb ~D' _~r. ~ ~/ ~I l ®i _~~ ~ / ~~j / /f~/' ~--'' ~ ~ r*,t**,t*,r*,t,t*,t,r*,t*,r,t****,t***** ~~~c~ES '~~~ X 3 ~ 0 .` **NO GUARANTEE OR WAR Y IS IMPLIED OR GIVEN THE PERFO CE OR LENGTH OF TIME THIS SYSTEM WILL FUNCTION** ************************ ******************************tir\ ***,rw* ****************************** *Improvement Permit has no expiration date and is transfex'ab ut may be revoked if site plans or intended use changes for the proposed facility. An\°~uthorization to Construct is valid for (5) fiv y rs from date issued and is not transferabl'+e. Permit Date~~~ ~~, l~'g ~ /' Owner/Agent~';~c.~l.`.z~ ~.~ >Gi.~-~~~%~i Sanitarian !~'~ S~ Installed By t~t1e EGf=n-~ p,~C Dat~~~~jt -~ ~;~ Sanitarian White - Office Blue -Building Inspection Operation Permit Yellow -Owner/Agent Green -Building Inspection Authorization to Construct