HomeMy WebLinkAboutWELL-04-2018-098614.TIF ,1V}' , `CATAWBA COUNTY Case N
i.i' n.1 $ ., Public Health Department Subdivision
< S'ccy Y Environmental Health Division PM377202878671
\°'g� s.� PO Box 389, 100-A Southwest Blvd,Newton,NC 28658 LOIN 3
NAME ON PERMIT: *RMR CONSTRUCTION CO INC, 119 CONOVER BLVD E, CONOVER NC 28613-
Site Address: 3445 WIKE RD, CATAWBA NC 28609
Property Size: Square Feet:38,768.40 Aci es:0.89
Directions: 1-40 E/Oxford School Rd Exit/right Wke Rd/on right
Owner/Authorized Representative Acknowledgement of Permit Receipt
. '''hcertify that I am the owner or authorized agent(owner's authorization required)representing the owner of
//`` the property described above.
\il✓k"••As the property owner or authorized representative, I have received the above referenced
I ' permit(s)as requested in the application for service RBPR-04-2018-28844, by the following method(s):
Received in Person
Facsimile Transmittal (Return form with signature required)
Electronic Image Transmittal/ E-mail (Return receipt required)
y11w'zAs 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 (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: 04/23/2018 P AS Representative Signature 1 `^ ^�t)
Date t a Li l tY
Documentation of Permit(s)Transmittal
(permit transmitted by electronic or other means)
Permit transmitted by (Hume 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 wand tto hear from yoaPlease ttake a few momentts tto complette our custtomer service survey att
http://www.surveymonkey.com/s/EHCusttomerService
ehpennit 04/24/2018 09:45
a\3A C,\'IA\VRA COUNT/' ❑� j[]° Calc(; WELL-04-2018-098614
TAR Public Health Department -v � � r Subdivision
< "-"� Environmental Health Division rJ '-t e 3 • F PING 377202878671
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Y PO Box 389, 100-A Southwest Blvd,Newton,NC 28658 - + , r LOT?/ 3
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NAME ON PERMIT: *RMR CONSTRUCTION CO INC, 119 CONOVER BLVD E, CONOVER NC 28613-
Site Address: 3445 WIKE RD, CATAWBA NC 28609
Property Size: Square Feet:38,768.40 Acres:0.89
Directions: 1-40 E/Oxford School Rd Exit/right Wike Rd/on right
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 verily 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
heJhre 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(ISA NCAC I8A.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 alt 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.
04/23/2018
AUTHORIZED STAFF AGENT APPROVAL DATE
Permit Expiration Date: 02/26/2023
eapennit 04/24/2018 09:45
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Parcel: 377202878671, 3445 WOKE RD lin=40ft
CATAWBA, 28609
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Copyright 2014 Catawba County NC
04/23/2018