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Home My WebLink AboutWELL-09-2016-076679.TIF• 0,-cl, CATAWBA COUNTY Case# .¢ iiiG Public Health Department Subdivision 2 < Environmental Health Division PIN); 362706302357 Z PO Bos 389, 100-A Southwest Blvd,Newton, NC 28658 LOTH A NAME ON PERMIT: ZANE MICHAELS, PO BOX 993, DALLAS NC 28034 Site Address: 2783 ELBOW RD, NEWTON NC 28658 Property Size: Square Feet:435,600.00 Aeres:10 Directions: 321 TO STARTOWN RD RIGHT ON ELBOW RD, LAND ON RIGHT PAST FARM & LAKE Owner/Authorized Representative Acknowledgement of Permit Receipt • 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 the application for service RBPR-08-2016-24408 the following method(s): Received in Person Facsimile Transmittal (Return form with signature required) Electronic Image Transmittal/E-mail (Return receipt required) i of the the property owner or authorized representative I have reviewed and understand the specific conditions e 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: 09/12/2016 Owner/Authorized Representative Signatur /7-��G� Date 9—/Y-7( 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 elipenuit 09/12/2016 09:09 , ,A CATAWBA COUNTY ❑� r 0' h f❑s Case# WELL-09-2016-076679 • :Q421111 Public Health Department Subdivision ‘c. Environmental Health Division • _ r PIN# 362706302357 �� .. PO Box 389, 100-A Southwest Blvd,Nelaton.NC 28658 4° .i° t LOT# A H4 � •: � r ❑' rr . NAME ON PERMIT: ZANE MICHAELS, PO BOX 993, DALLAS NC 28034 Site Address: 2783 ELBOW RD, NEWTON NC 28658 Property Size: Square Feet:435,600.00 Acres:10 Directions: 321 TO STARTOWN RD RIGHT ON ELBOW RD, LAND ON RIGHT PAST FARM & LAKE 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 NATER 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 welt 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 (I5A 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 othenvise 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 09/12/2016 AUTHORIZED 5DCFE AGENT APPROVAL DATE ehpermit 09/12/2016 09:10 Catawba County Environmental Health AVS- 9- z0/ 6 - 076680 v't// -61. 2016 - 0766 79 I \ \•. \ t\-, ',,_ v. • N L w N ,Ar act b� _d 'CS -.. tkd‘f1W T 1 1 1 \CII' ( l30i3 1�.-.-._ EL801/4RD Parcel: 362706302357, 2783 ELBOW RD tin=80ft NEWTON, 28658 i This map/report product was prepared from the Catawba County,NC Geuspaaal Infomiaticn Services. Catawba County has made substantial eflons to ensure the accuracy of!oration and labeling information contained on this nwp or data on this report.Catawba County promotes and recommends the Independent verification of any data contained on this maphepur.product by tie user. the County of Catawba.hs employees,agents,and personnel.disclaim,and shall not be held liable for any and all damages.loss ur liability,whether direct,indirect ur oansequential which arses or may arise from this maprreport product or the use thereof by any person or entity. Copyright 2014 Catawba County NC 09111/2015 Ai /.:Still-C ' a'. _:. • . .. 1 t-'r. r ' - ..__:14••......1, _:, —.., .. ..., c... _ .......:14i4....71. ... . -r fJ1 .. .