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Home My WebLink AboutWELL-09-2016-076843.TIFr 4.A8A CATAWBA COUNTY Case#;fa nGL Public Health Department Subdivision PINE CREEK 6 ---roq H Environmental Health Division PIN# 268602989515 moo• 110 Box 389, 100-A Southwest Blvd,Newton.NC 28658 LOT# 16A Igg2 ,w NAME ON PERMIT: CRISTIAN MURA, 4833 FOREST RIDGE DR, Site Address: 3783 PLANTATION DR, VALE NC 28168 • Property Size: Square Feet:69,696.00 Acres:1.6 Directions: 127 south straight onto platau right onto burls left onto Gilbert saint road left onto plantation property on the left. 11 Owner/Authorized Representative Acknowledgement of Permit Receipt Dd I certify that I am the owner or authorized agent(owner's authorization required) representing the owner of the roperty described above. :x M As the property owner or authorized representative, I have received the above referenced permit(s) as requested in the application for service RBPR-08-2016-24461 by the following method(s): IReceived in Person Facsimile Transmittal (Return form with signature required) Electronic Image Transmittal/E-mail (Return receipt required) • '1bn) 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: 09/14/2016 Owner/Authorized Representative Signature L . 'lDate q//5--Ah . 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 ehpernat 09/15/2016 08:47 ACATAWBA COUNTY ❑■ a cr. ❑ Case# WELL-09-2016-076843 cep -1-;\G Public Health DepartmentSubdivision PINE CREEK iswe, 4 Environmental Health Division . r 'r PIN# 268602989515 n" Ire""ti� % PO Box 389, 100-A Southwest 61vd,Newton.NC 28658 act, LOT# 16A /8 2 sx ❑l . bO O NAME ON PERMIT: CRISTIAN MURA, 4833 FOREST RIDGE DR, Site Address: 3783 PLANTATION DR, VALE NC 28168 Property Size: Square Feet:69,696.00 Acres:1.6 Directions: 127 south straight onto platau right onto burts left onto Gilbert saint road left onto plantation property on the 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. 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. Steven Price 09/14/2016 AUTHORIZED S'rArE AGENT APPROVAL DAVE chpenuit 09/15/2016 08:51 IP, A/C, WELL RBPR08-2016-24461 3783 Plantation Dr, Vale A/C • Do not cut, drive,fill, or grade over septic or repair areas. • Septic system must be 10 ft from property lines; 50 ft from wells; 5 ft from building foundations and appurtenances; and out of right-of-ways and easements. • Install a new 1,000 gallon septic tank and 1,000 gallon pump tank that will pump to a pressure manifold with 3 sch 40 1/4 ' taps. • Install 330 linear feet of 25% reduction system with maximum trench depth of 30 inches; proposed (3) lines 110 ft each on contour. • Final grade of septic area must shed surface water off and away from system. WELL • Well should be 5 ft from property lines; 25 ft from structures; 50 ft from septic systems; and out of right-of-ways and easements. Scor 23� Z�l P �Y4( • • Srj fy : 'N n( tlwsz ,� k� G.71 x vy lr q, I O ' A D.;*_ Op' D.;*_ act `l3 ,l• y are , iP , 1= C,o