HomeMy WebLinkAboutRBPR-12-2020-36385.TIFAcknowledgement of Optional Environmental Health Services
Catawba County Environmental Health
25 Mvernment Drive I P.O. Box 389 j Newton, NC 28658
Phone: 828 465,8270 I Fax: 828.465 8276 1
EHAdmin@CatawbaCountyNC.gov
Property Owner. T 1n`X j+ f tce lf
Phone Number 99 k ;�q 4 `( -7 2 57 Email
Project Address:
Project Description:
I ; • -:;':' RedulredSetbadisforWelfs � � I
geotdined SetiWi for`Sepik
Deck, Patio
5 feet
Swimming pool
15 feet
Building foundation on crawispace or slab
5 feet
Building foundation with basement located: uphill of septic/repair
10 feet
beside septic/repair
15 feet
downhill of septic/repair
25 feet
Retaining wall, foundation drain located: uphill of septic/repair
10 feet
beside septic/repair
15 feet
downhill of septic/repair
25 feet
• No grading, cutting, or filling is permitted within 15 feet of septic system or repair area
' No vehicular traffic, driveways, or sidewalks are permitted over septic system or repair area
` Do not divert surface water over septic system or repair area
I understand that Environmental Health can field review an existing well, septic system, and septic repair
area for required setbacks, and the County recommends this optional service. Structural additions,
swimming pools, decks, and other accessory structures constructed on septic systems or in septic repair
areas, can irreversibly destroy the area and may result in an inability to Install aseptic repair system. If
the undersigned is an agent for the property owner, the undersigned is responsible for informing the
property owner of this optional service. An Environmental Health inspection and permit are required if
building a new house or adding a bedroom to an existing house.
_ I want the well/ septic review and inspection
do NOT want the well septic review and inspection
0Owmer/Agent Signature Date
1 e Ile ISLue- s
Printed Name
OFFICE USE
A copy of the septic permit was provided to the owner/agent
i f4 / No septic permit was found on file