HomeMy WebLinkAboutEXSY-08-2022-178525.TIF ,1.10' • CATAWBA COUNTY Case# EXSY-08-2022-178525
.'. 2 Public Health Department Subdivision
.�n ' Environmental Health Division PIN# 365802589252
!g 2 �+ PO Box 389,25 Government Drive,Newton,NC 28658 LOT# 1
Site Address: 2622 HICKMAN RD, MAIDEN NC 28650
Name on Permit: WILLIAM EADES
Property Size: Acres 2.2
Directions: 2622 Hickman Rd, Maiden
Owner/Authorized Representative Acknowledgement of Permit Receipt
L,Ji-I certify that I am the owner or authorized agent(owner's authorization required)representing the owner of
the property described above.
)Y W/iAs the property owner or authorized representative, I have received the above referenced
` permit(s)as requested in the application for service RBPR-07-2022-41683,by the following method(s):
Received in Person
Facsimile Transmittal (Return form with signature required)
TElectronic Image Transmittal/E-mail (Return receipt required)
XAs 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: 08/24/2022
.
Owner/Authorized Representative Signature
Date
Documentation of Permit(s)Transmittal
(permit transmitted by electronic or other means)
Permit transmitted by (name of person sending permit)
Signature . Is
Date/Time
Method: Fax • 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 aft
http://www.surveymonkey.com/s/EHCusttomerService
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Catawba county
public health
EXISTING SEPTIC SYSTEM INSPECTION
NOT FOR LOAN APPROVAL
Case Number: RBPR-07-2022-41683 ® Reconnection to Existing System
Property Owner/Applicant:William Eades ❑ Mobile Home Park Reconnection
Site Address:2622 Hickman Rd,Maiden _ ❑ Applicant Request
Type of Facility: ® House ❑ Mobile I lome Number of Bedrooms 3
❑ Business
❑ Other
Proposed Addition/Accessory Structure:
® Approved ❑Not Approved Reason
❑ Approval Not Required/System Location Only
Evidence of System Malfunction ❑ YES ® NO System Type/Description HA-Gravel Trenches
Noncompliance Items and Notes
-Existing system inspection for proposed new 3 BR house to verify setbacks.
-Proposed structure must maintain 5 foot setback from any part of the septic system area.
*NOTE: this inspection does not reflect on the lifespan or efficiency of the drainfield.*
h, M
Authorized State Agent Cheyannc Morgan rfv,. c" 11` Date 8/24/2022
catawbacotync. v
Environmental Health
Catawha County Government Center
25 Government Drive I PO Box 389 I Newton NC 28658 1828.465.8270
MAKING. LIVING. BETTER.
Catawba County Environmental Health
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Parcel: 365802589252, 2622 HICKMAN RD 1 in=60ft
MAIDEN, 28650
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08/23/2022