HomeMy WebLinkAboutWELL-04-2016-071719.TIF ;
CATAR'BA COUNTY � ;� 6�r o: i Q Case# WELL-04-2016-071719
,Q r� G Public Health Department �� ,.F Subdivision
d 1,1040 l i Environmental Health Division A y PIN# 365604738470
° PO Box 389, 100-A Southwest Blvd, Newton.NC 28658 0 a_ a '' LOT#
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NAME ON PERMIT: KEVIN COX, 2107 OKLAHOMA CT, LINCOLNTON NC 28092
Site Address: 2737 DAVID COX RD, MAIDEN NC 28650
Property Size: Square Feet: 1,278,921.60 Acres:29.36
Directions: From Buffalo Shoals Rd, Left onto David Cox Rd. Property is 500 feet on the Right.
WELL PERMIT
WATER SUPPLY: Individual Well
SETBACKS:
1 . BUILDNG FOUNDATIONS 25 FT.
2 . EXISTING & PROPOSED SEPTIC SYSTEMS MIN. 50 FT.
3. EXISTING & PROPOSED SEPTIC REPAIR AREA MIN. 50 FT.
4 . SEWAGE PUMP SUPPLY LINE 50 FT.
5. UNDERGROUND STORAGE TANKS 100 FT.
6. STREAMS/BROOKS/CREEKS 50 FT.
7 . LAKES/PONDS RESERVOIRS 50 FT.
ALL OTHER POSSIBLE SOURCES OF GROUND WATER CONTAMINATION 100 FT.
The well driller must verify all setbacks before drilling the well.
If the well driller is unable to maintain any of the above setbacks,
contact Catawba County Environmental Health at (828) 465-8270
before drilling the well.
Grouting Depth: Minimum 20 Feet
Casing Height: 12" Above Land Surface
All newly constructed private drinking water wells are required to be sampled in accordance with the North
Carolina Rules Regarding Private drinking Water Well Testing (15A NCAC 18A .3800). The fee for this
sampling is included in the cost of the well permit. It is the applicant or property owner's responsibility to
notify Environmental Health when the well is ready for sampling.
Water samples will be drawn from an outside faucet unless otherwise specified. Please note that all water samples are
taken during one visit. The processing laboratories have different protocols and timeframes for reporting results;
therefore, you may receive several different reports concerning your water sample. For questions or more information,
please contact Catawba County Environmental Health at(828)465-8270.
Jason Boyd 04/28/2016
AUTHORIZED STATE AGENT APPROVAL DATE
ehperml 04/28/2016 09.24 Page I of 3
U'A Permit i; 1 RBPR 4-16-23652
�''`�+�,�9 t CATA\4BA COUNTY Name Kevin Cox
1; Public Health Department
4 �p°q ' ,� Environmental Health Division j Address 2737 David Cos Rd Maiden NC
;.d�i„► PO Box 389, 100A Southwest Blvd, Newton NC 28658 PIN 365604738470
/842 „, (828)465-g270 Fax (823)465-5276 TDD(S2S)165-5200
Site Plan Authorization to Constru v1
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