HomeMy WebLinkAboutAUTH-09-2022-180754.TIF (.1.01 (t)t NI
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PIt leas ill.2%(4„emn,(m I)rne.WNW/1.NC 210140- Hits u 9 18 2916
Site Address. 2489E NC 10 HWY,CONOVER NC 28013
Name on Permit 'YAMILES ALMONTE
Property Sets Acres 1 83
otr.cuon.: NC18,Left on MI Olive Church Rd.Left on NC 10.Property on right
Owner/Authorized Representative Acknowledgement of Permit Receipt
)(11)I ccrur' that I um the on.ncr or authorized agent tom.ner's authorization required)representing the uancr of
�t`he property described above.
�i As the property owner or authorized representative,I have received the above referenced
permit(s)as requested in the application for service RBPR-08-2022-41855,by the following method(s):
_ Received in Person
Facsimile Transmittal(Return form with signature required)
�{ Electronic Image Transmittal/F.-mail (Return receipt required)
1 As the property owner or authorized representative I have revicssed 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(1 SA 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:09121/2022
Owner/Authorised Representative Signature (,ff �'ti ✓`Z '
Date 1 t?` t (_?s-..-7 2
---------------------------------------- --4- ------- ___ -----------
Documentation of Permit(s)Transmittal
(permit transmitted by electronic or other means)
Permit transmitted by_ _ (ironic nl pm rson se dorm permit,
_—__-_ — -- __ Date,Time.�7/07')
)
Method: Fax sl Email _US Mail Other
Owner's request to send by the abuse indicated method of transmittal In lieu of signature
we wants tto hear from yotfkase stake a few momentts tto complette our custtomer service survey aft
http://www.surveymonkey.com/s/ENCusttomerService
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