HomeMy WebLinkAboutRBPR-09-2022-42367.TIF County: Catawba
This Section for Local Health Deportment Use Only
Initial submittal received:9/23/22 by RP
Dote Initials
Permit Number:
G.S.130A-335(a4)states the following: 'if a local health department falls to act on an application for an Improvement permit
submitted pursuant to subsection(o3)of the section within 10 business days of receipt of a complete application, the local health
department shall Issue the improvement permit.'
In accordance with G.S.130A-335(a3)the improvement permit application Is:
Ej Incomplete(If box is checked,information in this section Is required.)
The following items are missing:
A signed and dated statement from the applicant(owner or owner's legal representitive)that reads as follows:
-The LSS evaluation attached to this application is to be used to Issue an Improvement Permit in accordance with G,S.130A-335(a2)and(a3).
Copies of this were sent to the LSS and the Owner on 10/5/22
�R PLief Dote
State Authorized Agent: Date:
10/5/22
❑ Denied(See attached report.)
Copies of this were sent to the LSS and the Owner on
Dote
State Authorized Agent: Date:
❑ Complete
State Authorized Agent: Date of Issuance:
This Improvement Permit is issued pursuant to G.S.130A-335(a2),(a3),and(a4)using the signed and sealed LSS/LG evaluation(s)
attached here. The issuance of this permit by the Health Department in no way guarantees the issuance of other permits. The
permit holder is responsible for checking with appropriate governing bodies in meeting their requirements. This site is subject to
revocation if the site plan,plat,or the intended use changes,or if information submitted in the application was falsified,
inaccurate or misleading. The Improvement Permit shall not be affected by a change in ownership of the site. This permit is
subject to compliance with the provisions of the Laws and Rules for Sewage Treatment and Disposal and to conditions of this
permit. The location and identification of all property lines,easements,water lines,and other appropriate utilities shall be the
responsibility of the owner.
The Department,the Department's authorized agents,and the local health departments shall be discharged and released from
any liabilities,duties,and responsibilities Imposed by statute or In common law from any claim arising out of or attributed to
evaluations,submittals,or actions from a licensed soil scientist or licensed geologist pursuant to GS 130A-335(a2).
Improvement Permit Expiration Date:
•See attached site sketch*
CamScanner