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Home My WebLink AboutWELL-06-2016-073107.TIF �B' CATAWBA COUNTY Case# _ __ tis .�L Public Health Department Subdivision FLYING V ACRES G ; ��.� „ys, Environmental Health Division PIN# 362703336437 Igg2 „ PO Box 389, 100-A Southwest Blvd,Newton.NC 28658 LOT# 2 NAME ON PERMIT: CHARLES GANTT, 3342 STONESTHROW DR, NEWTON NC 28658-8883 Site Address: 3981 NORTHERNMISTIC DR, MAIDEN NC 28650 Property Size: Square Feet:20,037.60 Acres:0.46 Directions: Startown Rd, right Blackburn Bridge Rd, left on Herter Rd, left on Northernmistic, on left Owner/Authorized Representative Acknowledgement of Permit Receipt P^"-` I certify that I am the owner or authorized agent(owner's authorization required) representing the owner of the property described above. />`'—.As the property owner or authorized representative. I have received the above referenced permit(s) as requested in he application for service RBPR-05-2016-23912 by the following method(s): Received in Person Facsimile Transmittal (Return form with signature required) Electronic Image Transmittal/ E-mail (Return receipt required) 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 construction of the wastewater system and/or water supply well permitted. Permit Issue Date: 06/06/2016 3Owner/Authorized Representative Signature / `^ Date L((' ( 1° 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 ape'to 06106/2016 09:53 Page 3 of 3 -f t o CATAWBA COUNTY 0 '--7 -�a 0 0 Case# WELL-06-2016-073107 Public Health Department s' r Subdivision FLYING NACRES < Environmental Health Division PIN# 362703336437 PO Box 389, 100-A Southwest Blvd,Newton.NC 28658 r r-a k OT L / 2 s, s. 1i '• ',5 . NAME ON PERMIT: CHARLES GANTT, 3342 STONESTHROW DR, NEWTON NC 28658-8883 Site Address: 3981 NORTHERNMISTIC DR, MAIDEN NC 28650 Property Size: Square Feet:20,037.60 Acres:0.46 Directions: Startown Rd, right Blackburn Bridge Rd, left on Herter Rd, left on Northernmistic, on left 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 concerting your water sample. For questions or more information,please contact Catawba County Environmental Health at(828)465-8270. 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