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HomeMy WebLinkAboutEXSY-10-2022-181590.TIF dotloop signature verification: , • r • • `r`a CATAWBA COUNTY Case# EXSY-10-2022-I 81590 11 Public Health Department Subdivision J W SHUFORD FARM ii(..... ;,3 .4 Environmental Health Division PIN# 278108992050 .zio. PO Box 389,25 Government Drive,Newton,NC 28658 LOT" 46 w Site Address: 6073 OGLESBY LN, HICKORY NC 28602 Name on Permit: RICHARD CRABTREE Property Size: Acres 4.07 Directions: 1-40 Ashville,continue to exit 43-B, then take exit 121 toward Long View,turn right onto 33rd ST SW/Old Shelby Rd, right on Oglesby Ln, property on the left Owner/Authorized Representative Acknowledgement of Permit Receipt 1 certify that I am the owner or authorized agent(owner's authorization required)representing the owner of gl .T •oiioiii tproperty described above. oT As the property owner or authorized representative, I have received the above referenced dotioopersit(s)as requested in the application for service EHPR-07-2022-41756,by the following method(s): Received in Person _ Facsimile Transmittal (Return form with signature required) ,/ Electronic Image Transmittal/E-mail (Return receipt required) 0/06/2, As the property owner or authorized representative 1 have reviewed and understand the specific conditions d°rIov',MTpermit issued, and further understand that all applicable regulatory requirements specified under the North Carolina Laws and Rules for Sewage Treatment and Disposal Systems(1 SA 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: 10/03/2022 dotloop von zed RtdgalgeiAinee 10/06/22 356 PM EDT Owner/Authorized Representative Signature Cl/t 9FLJ•00P6-TI%V-F3R/1 Date 10/6/22 Documentation of Permit(s)Transmittal (permit transmitted by electronic or other means) Permit transmitted by (name ofperson se ding permit) Signature Date/Time 10 !v/7) Method: Fax 1 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 yoiPlease ttake a few momentts tto complette our custtomer service survey att http://www.surveymonkey.com/s/EHCusttomerService daVi. ci g SID eeut,g,c ila l a6lxmut io/04/2022 09.15 catawba county public health EXISTING SEPTIC SYSTEM INSPECTION NOT FOR LOAN APPROVAL Case Number: EHPR-07-2022-41756 ® Reconnection to Existing System Property Owner/Applicant:RICHARD CRABTREE ❑ Mobile Home Park Reconnection Site Address: 6073 OGLESBY LN,HICKORY ❑Applicant Request Type of Facility: ® House ❑ Mobile I Tome 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 Gravel BED 15'X60' Noncompliance Items and Notes *Septic Tank was located and was not failing at time of site visit *New Home, including all decks and porches must be at least 5' from septic tank and drainfield *New Home will be 3 bedrooms; No guarantee given to the septic systems longevity *Do Not cut, drive or Fill over septic system area Authorized State Agent Date 10/03/2022 catawbacountync.gov Environmental Health Catawba County Government Center 25 Government Drive I PO Box 389 I Newton NC 28658 1828.465.8270 MAKING. LIVING. BETTER.