HomeMy WebLinkAboutAUTH-04-2018-098323.TIF /a4 \ CATAWBA COUNTY Case#
/riat ,: Public Health Department Subdivision
< ll0:,. Y Environmental Health Division PIN# 373506372815
fit' PO Bos 389, 100-r1 Southwest Blvd,Newton,NC 25658 LOT#
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NAME ON PERMIT: JONATHAN SPATZ, 4068 PINECREST DR, HICKORY NC 28601-8750
Site Address: 5593 37TH ST NE, HICKORY NC 28601
Property Size: Square Feet:51,400.80 Acres:1.18
Directions: Left off of Sulphur Springs Rd onto 37th St Dr NE,turn left on 37th St NE, property at end
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 pfoperty described above.
V13 As the property owner or authorized representative, I have received the above referenced
permit(s) as requested in the application for service 1413PR-01-2018-28135, by the following method(s):
/Received in Person
Facsimile Transmittal (Return form with signature required)
Electronic Image Transmittal/ E-mail (Return receipt required)
1 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 (ISA NCAC 18A.1900),
and/or Well Construction Standards(ISA 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: 04/17/2018
Owner/Authorized Representative Signature .'% .--
Date yl30//p 7/
Documentation of Permit(s) 'Fransmittal
(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 wantt tto hear from yo.Please Rake a few momentts tto complette our custtomer service survey att
http://www.surveymonkey.com/s/EHCusttomerService
chpeunit 04/19/2018 14:18
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Parcel: 373506372815, 5593 37TH ST NE �, ,lin=60ft
HICKORY, 28601 CSO 6,4'
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Services. Catawba County has made substantial�/ 135' 1.25 ,.
toThisenure/the product rwas cpronand hem theCatawban n NC Goospatial Information Sesvl ecom effortsn
Id ensure the accuracy of location and labeling Information contained on this map or data on report.Catawba County promotes and recommends
the Independent verification of any data contained on this map/repon product by the user.The County of Catawba.Its employees,agents,and
personnel,disclaim,and shall not be held liable for any and all damages,loss or liability,whether direct,leaked or consequential which arises or may
arise from this map/report product or the use thereof by any person or entity.
. - ', Copyrighl 2014 Catawba County NC i; .
41/172018