HomeMy WebLinkAboutAUTH-10-2022-181748.TIF •
44 CATAWBA COUNTY Case N AUTH-l0-2022-181748
((LILPublic Health Department Subdivision Witherspoon Estate
O Environmental Health Division PIN# 378009051893 I
lbPO Box 389,25 Oovemment Drive,Newton,NC 28658
fittt LOTH 21-24
site Address: 1247 MCDOWELL CIR, CONOVER NC 28813
Name on Permit: JARRETT FRAZIER
Property Size: Acres.590
Directions: E NC 10 Hwy right McDowell Dlr •
Owner/Authorized Representative Acknowledgement of Permit Receipt
X. 1 certify that I am the owner or authorized agent(owner's authorization required)representing the owner of
the property described above.
XAs the property owner or authorized representative, I have received the above referenced
permit(s)as requested in the application for service EHPR-I0-2022-42418, by the following method(s):
•
Received in Person
/ Facsimile Transmittal (Return form with signature required)
Y Electronic Image Transmittal/E-mail (Return receipt required)
KAs 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(I5A 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: 10/05/2022
Owner/Authorized Representative Signature
Date /C)--IL'—a bc2 L
Documentation of Permit(s)Transmittal
(permit transmitted by electronic or other means)
Permit transmitted by -(name of personsending permit)
Signature ----CK/ Date/Time 10/,st
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 youPlease ttake a few momentts tto complette our custtomer service survey aft
http://www.surveymonkey.com/s/EHCusttomerservice
j4?se(EVO/iwetf.
een&
101 .
a pvimil 10t03I2022 I0.03