HomeMy WebLinkAboutAUTH-07-2022-175276.TIF ��Al�r, CATAWBA COUNTY
t• .1E6 Public Health Department Subdivision WILDERNESS TRACE PH 5
t Environmental Health Division
~ y - PiNA 375504848528
'��LISP Po Box 389,25 Government Drive,Newton,NC 28658 LOIN 159
Stop Address: 3158 MEDICINE 80W,CLAREMONT NC 28810
Name on Permit LANDVESTCO HOLDING COMPANY LP
Property Size: Acres 0.48
Directions: Hwy 18 N,R 1st eve N,R Oxford Sch Rd, Lon Rest Home,R Wldemess trac, L Great Divide,R Medicine
Bow
Owner/Authorized Representative Acknowledgement of Permit Receipt
r,.)
1 certify that I am the owner or authorized agent(owner's authorization required)representing the owner of
the property described above.
1
As the property owner or authorized representative,I have received the above referenced
permit(s)as requested in the application for service RBPR-05-2022-41030,by the following method(s):
Received in Person
Facsimile Transmittal (Return form with signature required)
Electronic Image Transmittal/E-mail (Return receipt required)
p0 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:07/08/2022 a
Owner/Authorized Representative Signatur -`7.1 Q'i
"Date 7- ?C' 2 7_
Documentation of Permits)Transmittal
(permit transmitted by electronic or other means)
Permit transmitted by (name ofperson sending permit)
______CyfSignature_ Date/Time 7/ J 2
Method: Fax i 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 yooPlease ttake a few momentts tto complette our custtomer service survey att
http://www.surveymonkey.com/s/EHCusttomerServIce
Cra, it ocid+eL obtain:0hiscs.((hi
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dipema 07/05/2022 15:20