HomeMy WebLinkAboutEXSY-07-2022-174940.TIF A ,. itio CATO%DACOtNrr Caren LXSY-07.1021-174140
%IR
it
`tIir 11rb1K.Italih tkirutmmr Suht,.'vbn BAKERSVIEW MEAD° 9lei fnvuorove+ut 1kivI h th.uKm PI`# 27900 7002
`, PO Dot 149, o.mmrnr 23 G Dv of,ti vt m,NC 2V S$
SO Address: 5903 GREENFIELD CT.HICKORY NC 28002
Nam*on►orn* CARLOS SOTO-TENORIO
Properly St:e: Acres 0 47
Otrections: Hwy 321 Take Ext 42 to 127 S,then Ron Pinew+nds Dr.Le at Stop on Sweetbrier LN.and Loft on Greenfield
Cl
Owner/Authorized Representative Acknowledgement of Permit Receipt
T I certify that I am the owner or authorized agent(owner's authorization required)representing the owner of
the property desaibed above.
ycsr As the property owner or authorized representative,I have received the above referenced
permit(s)as requested in the application for service RDPR-03-2022.40341,by the following method(s):
_ Received in Person
___ Facsimile Transmittal(Return form with signature required)
.4_ Electronic Image Trarumittal/E-mail (Return receipt required)
/4CS/ 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(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:07/01/2022
Owner/Authorized Representative Signature taLJO_5_ 9((7 ' /---
Date q-7 - zz,
Documentation of Permit(s)Transmittal
(permit transmitted by electroak or other means)
Permit transmitted by (name of person sending permit)
Signature (If Date/Time hi)1))
Method: Fax jEmall US Mail Other
Owner's request to send by the above indkated method of transmittal In lieu of signature
We wantt tto hear from yoaPlease hake a few moments tto complette our wsttomer senAce survey att
http://www.sunarymonkey.corn/s/DICusttornerServIca
ji,& saô Itmo4
dq.nad 01AI/1011 10111
(."31
catawba county
public health
EXISTING SEPTIC SYSTEM INSPECTION
NOT FOR LOAN APPROVAL
Case Number:RBPR-03-2022-40341 ❑ Reconnection to Existing System
Property Owner/Applicant:CARLOS SOTO-TENORIO ❑ Mobile Home Park Reconnection
Site Address: 5903 GREENFIELD CT,HICKORY ® Applicant Request
Type of Facility: ® House El Mobile Home Number of Bedrooms 3
❑Business
❑ Other
Proposed Addition/Accessory Structure: NFW Pont.
® Approved ❑Not Approved Reason
El Approval Not Required/System Location Only
Evidence of System Malfunction ❑ YES ®NO System Type/Description PPBPS
Noncompliance Items and Notes
*Septic Tank was located and was not failing at time of site visit
*New POOL waters edge must be 15'from any part of the septic system. Decks and porches must be at least 5' from
any part of septic system
* No guarantee given to the septic systems longevity
*Do Not cut, drive or Fill over septic system area
Authorized State Agent Date 7/1/2022
catawbacountync.gov
Environmental Health
Catawba County Government Center
25 Government Drive I PO Box 389 I Newton NC 28658 1828.465.8270
MAKING. LIVING. BETTER.