HomeMy WebLinkAboutAUTH-07-2022-175996.TIF H- .. cVLovIIA COUNTY
Public Health Dc
'hi ( [ annent
I: Subdivision
< . Environmental I leahli Division PI NO 360903140283
1�
PO Box 769,25 Gnvcmnmm Drive,Ncmw.NC 28658 .
t.aru
Site Address: 1833 YODER FARM RD, HICKORY NC 28602
. Name on Permit: JONATHAN YOUNT
Property size: Apes 10.63
Directions: Right off Hwy 10 Towards Shell by right on Yoder Farm rd
Owner/Authorized Representative Acknowledgement of Permit Receipt
1.4 I certify That I am the owner or authorized agent(owner's authorization required)representing the owner of
I property escribed above. - .
. the property owner or authorized representative, I have received the above referenced
nnit(s)as requested in the application for service RIWR-U5-2022-4I037, by the following method(s):
_ Received in Person
IFacsimile Transniiu.d (Return form with signature required)
Electronic Image Transmittal/ E-mail (Return receipt required)
roperty owner or authorized representative I have reviewed and understand the specific conditions
issued, and further understand that all applicable regulatory requirements speci lied tinder the
North Carolina Laws and Rules for Sewage Treatment and Disposal Systems(I5A NCAC I8A.1908),
and/or Well Construction Standards(I5A NCAC 2C .III00), shall apply to the issuance of this permit and
the construction of the wastewater system and/or water supply well permitted.
/
Pennil Issue Date: 07/19/2022 /� -//�/jJ�—
Owner/Authorizedd Representative Signaun• :,G/ . (2. 01 r'
•
Date 7 (/iz0 L pr✓2.___.
Documentation of Permit(s)Transmittal
(permit transmitted by electronic or other means)
Permit I raps in ilted by (name oI Person sen rat;pernril)
Signature Gift Date/Time 7 iJi))
r
Method: __Fas Entail _IUS Mail Other
Owner's request to send by the above indicated method of transmittal in lieu of signature
We wantt tto hear from yotelease ttake a few momentts tto complette our custtomer service survey att
http://www.surveymonkey.com/s/EHCusttomerService
.Lw"'^ 01/20R022 10:15 p p
•
Catawba County Environmental Health
051
162.21
31.50
(524) 72y6/ . .
353.20
(16PQ-o5-7077 - wo37-
mpv-o7 - to1Z - q5995 707?- 175„,. 7/1
(198
.769•S
•
o
I t
40 50r lap
by (1St ?CO?
57 4ea t �9
t HaugSD N
at e; \e
uti
• \ 4 4 \
k .dscy\ 1 ao
•
• �aPt?' r rYr wv
N lee
frd+ CVO/ o
(718)
�ry
Parcel: 360903140283, 1833 YODER FARM RD 1in=10oft
HICKORY, 28602
Thin amp/report product wen prepared from the Catawba County,NC Ouoepallot Information Survicoe. Catawba County hen made substantial efforts
to ensure the nccurucy of location and labeling Information conlninod on this nlnp or data on thin report.Cntnwbn County promotes nod recommends
the Indopondont verification of any data contained on this map/report produul by Ihu flour.The County of Culnwbo,its employees,agents,and
personnel,dtsdelrn,and shall not bo hold liable for any and all dumps,loss or liability,whollwr direct.Indlruol or consogtwntlnl which arises or may
arise from this mop/report product or Ihn usnn thereof by tiny portion or rinitly.
Copyright 2021 Catawba County NC
07/19/2022