HomeMy WebLinkAboutWCOC-03-2016-070191.TIF �yy CATAWBA COUNTY Case# WCOC-03-2016-070191
T y Public Health Department Subdivision LUTHER COWANS SHERRI]
Q morel Environmental Health Division PIN# 462802563168
PO Box 389, 100-A Southwest Blvd,Newton,NC 28658 LOT# 63
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Name on Permit STEPHEN & JENNIFER FORD, 7914 SKYE LOCHS DR, WAXHAW NC 28173
Site Address: 2690 SOUTHERN BREEZE, SHERRILLS FORD NC 28673 0 : P1 j.' 9
19,166.40 0.44 ' F ,{yf Pro a rt y Size: Square Feet Acres
1,;•Directions: Hwy North to 150 exit, R onto 150, L onto Sherrills Ford Rd,R onto Island Point Rd,L onto 1' r •
Riviera Dr, R onto Southern Breeze, lot is on left G �-
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WELL CERTIFICATE OF COMPLETION
WATER SUPPLY: Well Type:
WELL-06-2015-061672 INSPECTIONS
INSPECTION# COMP DATE INSPECTION TYPE STATUS INSPECTOR
EHINSP-319128 03/04/2016 EH Well Head Approved Robbie Phelps
EHINSP-319129 03/04/2016 EH GPS Data Collection Approved Robbie Phelps
EHINSP-304815 08/31/2015 EH Well Record Received Approved EHAdmin
EHINSP-303145 08/11/2015 EH Well Grouting Approved Robbie Phelps
McCall Bros 08/11/2015
WELL DRILLER DATE DRILLED
Well permits are valid for 5 years from the date of issuance and are subject to suspension and/or revocation from
non-compliance with appropriate state and local rules and regulations, or if false information was given in order to obtain a
permit. Wells shall be constructed in accordance with all state and local regulations and rules.
The Well Completion Report must be submitted to the Health Department within 30 days upon completion of a well.
Robbie Phelps 03/04/2016
AUTHORIZED STATE AGENT APPROVAL DATE
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