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Home My WebLink AboutWELL-05-2016-072340.TIF �l,A\ CATAWBA COUNTY Case# (7"- G Public Health Department Subdivision _ ASTORIA G r,,,, ,'? Environmental Health Division PIN# 471001454271 �� PO Box 389, 100-A Southwest Blvd,Newton,NC 28658 LOT# 15 is 42.7sm NAME ON PERMIT: BRIAN & SHERRY NOE, 1327 MEADE DR, LINDENHURST IL 60046 Site Address: 1080 ASTORIA PKWY, CATAWBA NC 28609 Property Size: Square Feet:34,848.00 Acres:0.8 Directions: Sherrills Ford Rd/ left Hopewell Church Rd/cross Monbo/continue on Hopewell Church / right Regal Blvd/ right Astoria Pkwy / Gate Code#0015 Owner/Authorized Representative Acknowledgement of Permit Receipt �.1 certify that I am the owner or authorized agent(owner's authorization required) representing the owner of the Ild property described above. a As the property owner or authorized representative. I have received the above referenced permit(s) as ��quested in�t e application for service RBPR-03-2016-23418 by the following method(s): Received in Person Facsimile Transmittal (Return form with signature required) Electronic Image Transmittal/E-mail (Return receipt required) IS As the property owner or authorized representative I have reviewed and understand the specific conditions of the permit issued, and further understand that all applicable regulatory requirements specified under the North Carolina Laws and Rules for Sewage Treatment and Disposal Systems (15A NCAC 18A .1900), and/or Well Construction Standards (15A NCAC 2C .0100), shall apply to the issuance of this permit and the i construction of the wastewater system and/or water supply well permitted. Permit Issue Date: 05/12/2016 Owner/Authorized Representative Signature ti a, AY Date 5lb -/& Documentation of Permit(s) Transmittal (permit transmitted by electronic or other means) Permit transmitted by (name of person sending permit) Signature Date/Time Method: Fax Email US Mail Other Owner's request to send by the above indicated method of transmittal in lieu of signature We want to hear from you. Please take a few moments to complete our customer service survey at: http://www.surveymonkey.com/s/EHCustomerService ehpermit 05/13/2016 09:07 Page 4 of Tl � CATAWBA COUNTY Q '.'a G-r 0 Casc# WELL-05-2016-072340 ; :� Public Health Department 4,�64:. is 'irt1 Subdivision ASTORIA 4 �{ s Environmental Health Division PIN!! 471001454271 t-° PO Box 389, 100-A Southwest Blvd,Newton,NC 28658 � ' . P LOTO 15 CI NAME ON PERMIT: BRIAN & SHERRY NOE, 1327 MEADE DR, LINDENHURST IL 60046 Site Address: 1080 ASTORIA PKWY, CATAWBA NC 28609 Property Size: Square Feet: 34,848.00 Acres:0.8 Directions: Sherrills Ford Rd/ left Hopewell Church Rd/cross Monbo/continue on Hopewell Church / right Regal Blvd/ right Astoria Pkwy (Gate Code#0015 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. 9 . 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. Robbie Phelps 05/12/2016 AUTHORIZED STATE AGENT APPROVAL DATE ehpennit 05/13/2016 09:08 Page 1 of3 Catawba County Environmental Health _ 3o 11' 4 , K • • • 'r • 0 if- .. 'y/ k? 1 -----t..— p � r / /2 y o"/ t AT*4,00,- f $. '/� 1� .. . . r 40- her yo' 3f . a., y 40 gs _ o .r- i �� gSrOR14 e,/ i . Parcel: 471001454271, 1080 ASTORIA PKWY 1 in=50ft CATAWBA, 28609 This maplrepon product was prepared from the Catawba County,NC Goospadal Intrmatton Services. Catawba County has made sutetamial aftons to ensure Me accuracy of location and labeling information curtained on this map or data on this report.Catawba County promotes and recommends the independent verification of any data contained on this rnap/reporl product by the user.The County of Catawba,its employees,agents,and peiau,nal,disclaim,and shall not be held liable for any and all damages,loss or liability,whether direct,indirect or consequential which arises or may arise born this map/report product or the use thereof by any person or entry. I Copyright 2014 Catawba County NC 05/12/2016