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Site Address: 8207 LONG ISLAND RD.CATAWBA NC 28609
Name on Permit BULLER RIVER DEVELOPMENT PARTNERS LP
Property Size: Acres 0 94
Directions: South on Brown Chappel Rd.Left on Long Island
Owner/Authorized Representative Acknowledgement of Permit Receipt
gtNt I certt that I urn the o sncr or authnriicd went teem ncr's uuthori,uliiin required)representing the saner eel
the propcm dc.crihcd ahmc•
4,5'{�,�As the property owner or authorised rcpre•entati%e, I hme receised the abo%c referenced
permit(s)as requested in the application for serf ice RIWR-08-2U21-38572,by the following method(s):
Received in Person
Facsimile Transmittal(Return loon with signature required)
I F.lectronic Image Transmittal I•-mail (Return receipt required)
As the property owner or authorized rcpresentati'c I hme reviewed and understand the specific conditions
4
of the permit issued, and further understand that all applicable regulatory requirements specified under the
it
North Carolina Laws and Rules for Sewage Treatment and Disposal Systems(15A NCAC I8A.1900).
and/or Well Construction Standards(I5A NCAC 2C•.0100). shall apply to the issuance of this permit a:'d
the construction of the wastewater system and or water supply well permitted.
Permit Issue Date:02/25/2022
Owner Authorized Representative Signature < (i(/' "
Date / - 2'7—
Documentation of Permits)'Transmittal
(permit transmitted by electronic or other means)
Permit transmitted by (name tfperson sett ling permit)
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'I t y/ ))ate Time fig,
Signature
Method: Fax i Email US Mad Other
Owner's request to send by the above indicated method of transmittal in lieu of signature
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