HomeMy WebLinkAboutWELL-09-2016-076526.TIF CATAWBA COUNTY Case N
's Public HealthDepartmentSubdivision
CRESCENT LAND AND TIN
�yr Environmental Health Division
rPINK 460604545994
\16` PO Box 389, 100-A Southwest Blvd,Newton,NC 28658 LOT# 138
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NAME ON PERMIT: JAMES "MICHAEL" STRICKLAND, 1136 TORRENCE CIR, DAVIDSON NC 28036
Site Address: 4869 TRESTLE LN, DENVER NC 28037
Property Size: Square Feet:47,916.00 Acres:1.1
Directions: Campground Rd, left on Catawba Burris, Right on Bankhead, left on Trestle Ln, left on driveway
Owner/Authorized Representative Acknowledgement of Permit Receipt
1. I certify that I am the owner or authorized agent(owner's authorization required) representing the owner of the
rr property described above.
t 4. As the property owner or authorized representative, I have received the above referenced permit(s)as
requested in the application for service REP R-05-2016-23865 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 i
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: 09/06/2016
Owner/Authorized'Representative Signature ., � _ 1000,-//
n/ �.
Date `I '/ y
Documentation of Permit(s)Transmittal
(permit transmitted by electronic or other means)
Permit transmitte yk i (name ofperson sending permit)
Signature Date/Time i/
'1�J11'Q
Method: Fax Email US Mail Other •
Owner's request to send by the above indicated method of transmittal in lieu of signature
/
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e]permit 09/07/2016 10:00
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trITA CATAWBA COUNTY ❑e : jr";:f. ...iEl Case# WELL-09-2016-076526
Q• .,,y ' Public Health Departments
,+ Subdivision CRESCENT LAND AND TI1
< -ld� „—i Environmental Health Division • .;a r PIN# 460604545994
zs5 PO Box 389, 100-A Southwest Blvd,Nocton.NC 28658 110 --CSD D i_ 0 + LOT# 138
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NAME ON PERMIT: JAMES "MICHAEL" STRICKLAND, 1136 TORRENCE CIR, DAVIDSON NC 28036
Site Address: 4869 TRESTLE LN, DENVER NC 28037
Property Size: Square Feet:47,916.00 Acres:1.1
Directions: Campground Rd, left on Catawba Burris, Right on Bankhead, left on Trestle Ln, left on driveway
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 verity 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 ISA .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 09/06/2016
AUTHORIZED STATE AGENT APPROVAL DATE
ehpermit 09/07/2016 10.48
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