HomeMy WebLinkAboutWELL-09-2022-181325.TIF �` ie. CATAWBA COUNTY
41416,
y i tAi Public Health Department Subdivision
'i Environmental Health Division
'i.� PINS 367804628295
/ Government Box 389,25 Drive,Newton,NC 28658 LOTS 68
E:Lie a
Site Address: 3186 TIMBER RUN LN,MAIDEN NC 28650
Name on Permit: NEST HOMES LLC
Property Size: Acres 0.75
Directions: S Hwy 16 Left Cayton Dr Left N Wynswept Dr Right Timber Run LN
Owner/Authorized Representative Acknowledgement of Permit Receipt
1
h,1 I certify that I am the owner or authorized agent(owner's authorization required)representing the owner of
the property described above.
I
1t,i As the property owner or authorized representative,I have received the above referenced
permit(s)as requested in the application for service RBPR-03-2022-40480,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
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 consttuction of the wastewater system and/or water supply well permitted.
Permit Issue Date:09/28/2022
Owner/Authorized Representative Signature `s
Date R i22.._ . ._
l
Documentation of Permit(s)Transmittal
(permit transmitted by electronic or other means)
Permit transmitted by , (name of person snding permit)
Signature (..iE Date/Time ?Io,1))
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 yoaillease ttake a few momentts tto complette our custtomer service survey ett
http://mvw.surveymonkey.com/s/EHCusttomerService
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Blip n"I' 09/29/2022 08:50 TV\\IV\
CATAWBA COUNTY Case it WELL-09-2022-181325
Public Health Department Subdivision Wynswept
< „ 11-i � Environmental Health Division PIN# 367804628295
PO Box 389,25 Government Drive,Newton,NC 28658 LOT# 68
•
Site Address: 3186 TIMBER RUN LN, MAIDEN NC 28650
Name on Permit: *NEST HOMES LLC
Property Size: Acres 0.75
Directions: S Hwy 16 Left Cayton Dr Left N Wynswept Dr Right Timber Run LN
NEW WELL PERMIT
REQUIRED WELL SETBACKS:
Septic Systems and Repair Areas for Single Family Dwellings 50 ft.
Septic Systems and Repair Areas for Businesses and Multi-Family Residences 100 ft.
Underground Storage Tanks 100 ft.
Animal Barns 100 ft.
Lakes/Ponds 50 ft.
Streams/Brooks/Creeks/Rivers 25 ft.
Building Foundations 25 ft.
All Other Sources of Groundwater Contamination 100 ft.
Saprolite Septic Systems and Repair Areas 100 ft.
Septic Systems and Repair Areas to Wells with 2 or more connections 100 ft.
Wells shall be constructed in accordance with state regulations:
Article 15A North Carolina Administrative Code Subchapter 2C
The well driller must verify all setbacks before drilling the well.If the well driller is unable to maintain any of
the above setbacks,contact Catawba County Environmental Health at 828-465-8270,before drilling the well.
Grouting Depth:20 feet minimum
Casing Height: 12 inches minimum above finished grade
All newly constructed private drinking water wells arc required to be sampled in accordance with the North Carolina Rules Regarding Private
Drinking Water Well Testing(I5A NCAC I8A.3800).The fee for this sampling is included in the cost of the well permit.It is the applicant or
property owner's responsibility to notify Environmental Health when the well is ready for sampling.Water samples will be drawn from an
outside faucet unless otherwise specified.For questions or for more information,please contact Environmental Health.
09/28/2022
Authorized State Agent Permit Issuance Date
9/28/2027
Permit Expiration Date
chpermit 09/29/2022 16:13
WELL CONSTRUCTION RECORD 0174.1 Forina:m it Use Only
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max mar IN=verba¢as craw tie&cleffrstirrm 23.Sted-ugr mordalwelldeems:
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ouIy 1 GW-1 is maid.l:�cTOTA7:HII)+�1$of was
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9.Total well dei h below land aura= l Q 1O (Et) Submit this GW I within 30 days of well eampletiaa per the following:
For m,icmar6uaIIlexhrfrgrerrit t{�r,�le-3QIDJ'aa3Zedal)
242.For An Wens Orip al farmto Divisi n of Water Resources (DF1R),
20. fir levelbelowtapafcast SO .(R) Informal=Processing Unit,1617 MSC,1.14e,,IiC27 9-1617
Ifsatula,dtrebove paws,sae-+-
24b.For Tnieetion We I=Copy to DWR,Thtdage®ad Injection Control(IOC)
iL Borehole damGer 6 (�) Pmsczm,1636 MSC,Raleigh,NC27699-1636
12.Well earianletfts mddhtsch rotary 1 ere.For WaterSapply and Open-Loop Geothe mzl Rehm Wens Copy to the
Cr.ems totem sable, p eel easyenv:muu at-lberlthdepartmmtof the calmly where in:rolled
FOR WATER Sttij'f.Y WELTS ONT.Y 24d.Far Wnler Wells grooming over 100,000 G Ts:(ropy to DWR,CCPCiJA
13a.Yield(gpm)
14 Method of test:air pressure Permit Program,1611 MSC,Raleigh,NC27699-1611
graviated
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