HomeMy WebLinkAboutIMPV-07-2022-176234.TIF CATAWBACOUNTY Casetr IMPV-07.2022-176234
6r7IIt Public Health Department Subdivision
k `-ij Environmental Health Division PINK 376009169901
Y\ PO Box 389,25 Government Drive,Newton,NC 28658 LOTH
9.
Skit Address: 3207 E NC 10 HWY, CLAREMONT NC 28610
Name on Permit: TERAMORE CONSTRUCTION
Property Size: Acres 2.29
Directions: Hwy 10 E,at corner of East End Court
Owner/Authorized Representative Acknowledgement of Permit Receipt
I certify that I am the owner or authorized agent(owner's authorization required)representing the owner of
the property described above.
10 } As the property owner or authorized representative, 1 have received the above referenced
permit(s)as requested in the application for service EHPR-05-2022-40920,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
1/1
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(1SA 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:07/22/2022
Owner/Authorized Representative Sibauai
Date 77_.2X'.J-1 j/
i'
Documentation of Permit(s)Transmittal
(permit transmitted by electronic or other means)
Permit transmitted by (name of person sending permit)
Signature qf...._
Date/Time -17 f i11))
Method: Fax 'Email US Mail Other
Owner's request to send by the above indicated method of transmittal in lieu of signature
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,hr", ‘ 07.222022 to HI