HomeMy WebLinkAboutIMPV-06-2022-173226.TIF f I '
• CATAWBA COUNTY Case# IMPV-06-2022-173226
Public Health Department Subdivision LONG BAY
Environmental Health Division PIN# 470002898853
PO Box 389,25 Government Drive,Newton,NC 28658
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CLOT# 21
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Site Address: 7862 LONG BAY PKWY, CATAWBA NC 28609
Name on Permit: DAVID ASHE
Property Size: Acres 0.81
Directions: Hwy 10 E, right Hudson Chapel Rd, right Kale Rd, right Long Bay Pkwy, on right
Owner/Authorized Representative Acknowledgement of Permit Receipt
1, _I certify that I am the owner or authorized agent(owner's authorization required)representing the owner of
the property described above.
xAs the property owner or authorized representative, I have received the above referenced
permit(s)as requested in the application for service EHPR-03-2022-40464, by the following method(s):
Received in Person
Facsimile Transmittal (Return form with signature required)
• 7 Electronic Image Transmittal/E-mail (Return receipt required)
,_ 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:06/09/2022
Owner/Authorized Representative Signature
Date
Documentation of Permit(s)Transmittal
(permit transmitted by electronic or other means)
Permit transmitted by (name of personsendingg permit)
Signature c' f/
//
Date/Time (i)/D f ).)
Method: Fax Ni/ 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 yosPlease ttake a few momentts tto complette our custtomer service survey att
http://www.surveymonkey.com/s/EHCusttomerService
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„ LOCATION MAP
\O.nennp Certificate Its Cvem l�liom SuWnis{on land Division Plot
I hereby certify thot Bedgewoler Compony V.LLC isthe owner of the ♦'
e property described hereon,which properly is located within the subdivision �q
nregulation jurisdiction of Cott..County. 4.0'' ITE
a
d Bridgewater/M. ...LC C 'ppQ
,Tail,-�:Nanaglr N01 TO SCALE
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a North ca.aina,uenienw�q wanly +”
n 1-Shirley P Montgomery,a Solnry Public for said County and Xj
Stole do codify that Jellrey Cernulo.manager of Bridgewater V, 02 +b
illf'
LLC..a bonded f bAly canrymy,personally oppaated before me this
0 day ono kno..edged In,email...n1 the foregoing instrument ern
beheld I the corneal,
sOtnes9 me nit and II¢id I the 2.1n I June 21J02
own ery ore a- - / \ I
lay •piss•Aug. 2,200 / \ 1
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I / / • \ .�. v.•sePllc Cawmml
t / C_ e3 @•for lot 23
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LONG BAY I / �+-r/- ('! C05-2 s
Moo I of 5 / / Septic Easm.enl
cos-It l / / to Lot 26 ; 4.7
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\ / EndTTenor ',' „
,' C82
a1 / g: .€° I. 25.30
Illiiii Plat Showing Location of Septic Linea /y1y,} 4._L- 54 a $
0► LONG BAY p �r �� 'so .g,
on Lake Norman p A-_�_,I �� `S ll'
r Map 3 of 5 "..w^•+.`^r ` (1..w:',e,v.
Recorded al Plat Boole 54 Page 57 7� Af
for
J
C114Bridgewater V.LLC
P.O. Bo.3608
Moores 11e.NC 28117 ex n IM survey Is another category,such as the recontinghpn a
OPilb 704 799-9770 stet°paces,o coat order survey.a others ea diner to die
April 27, 2002 Scale I' w 100• i o rhry tho1 the pot.s erupt it m Colowba Coanly rap .a swdmhoit.(As win locetans of septic`�s and
Catawba Township,Catawba COVoty, NC Subdi son Reg bons. septc a easements)
ry,�/
0 -100 200 300 0I(qt/Y 1^r�tlY
--- anon 1.Montgomery N 597
!__` • proctor of I ning orDesignee Dole „H'"C4R'O,
I.Thomas E.Montgomery certify that this map was drown •'•
�m ��..1s� U L/' under my supervision from on•dual survey made baler my /09- eCSSie /I i.
9... _J unyly 111rppY I]SURVEYING I, 3tte- 4,014 _.Review Officer of Cato*. Supervision(hot the do f precision as Calculated by latitudes -2 go d' 9\
��3 NIIIo rnos uR nIN co ty seRley that the map o plot to which this certification and departures is I:I15,000. that the boundaries not wrwsed i . SEAL r
\kik...ft(
,!i %most Ibnlgomery is (fixed Teel•all slot tory r meats far recording. ore shown as broken line plotted from plats and deeds o L_2J83 )
o a
`l NC era
Land;m a 1 2593 p �/I 47-30Mot
°Mended is p witness wog my ed m orl nolccordancetVe witnesoilon 5 Z 'sp g fa
\''_— 3000 Grey Rood -$.l�y.��1i -.._ .._—__._...._.._ 17- my 9 eigno cg s o; SUR`/' J,
Davidson,NC 2&156 Dole Rwie Doer number and lea the 27th day of April 2002. ;,,9y. (y�{
�..� E MONS
2593
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