HomeMy WebLinkAboutEXSY-10-2022-182035.tif .S1Ie CATAWBA COUNTY Case EXSY-10-2022-182035
1' .t. 2 Public Health Department Subdivision CROSSING CREEK
d '3 Environmental Health Division PIN# 376304746891
PO Box 389,25 Government Drive,Newton,NC 28658 LoT# 6
8. - w
Site Address: 4240 DEAL RD, CLAREMONT NC 28610
Name on Permit: *CLAYTON HOMES#81 (BILLING ACCT)
Property Size: Acres 0.46
Directions: Take I-10E,Take Exit 135, Keep R at the fork,take left onto Centennial Blvd, Take left onto N Lookout St,
Take Left onto Deal Rd, 1.1 Mile
Owner/Authorized Representative Acknowledgement of Permit Receipt
I certify that I am the owner or authorized agent(owner's authorization required)representing the owner of
the property described above.
As the property owner or authorized representative, I have received the above referenced
permit(s)as requested in the application for service RBPR-09-2022-42183, by the following method(s):
Received in Person
Facsimile Transmittal (Return form with signature required)
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 construction of the wastewater system and/or water supply well permitted.
Permit Issue Date: 10/11/2022
Owner/Authorized Representative Signature
Date
Documentation of Permit(s)Transmittal
(permit transmitted by electronic or other means)
Permit transmitted by (name of person sending permit)
Signature Date/Time
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 yosflease ttake a few momentts tto complette our custtomer service survey aft
http://www.surveymonkey.com/s/EHCusttomerService
Iyninui 10/I1/2022 10:03
(L *11)
catawba county
public health
EXISTING SEPTIC SYSTEM INSPECTION
NOT FOR LOAN APPROVAL
Case Number: RBPR-09-2022-42183 ® Reconnection to Existing System
Property Owner/Applicant:CLAYTON HOMES ❑ Mobile Home Park Reconnection
Site Address: 4240 DEAL RD, CLAREMONT ❑ Applicant Request
Type of Facility: ❑ House ® Mobile Home 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 TRENCHES
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
*NEW HOME MUST BE 25FT MIN FROM ANY WELL
Authorized State Agent Date J O/1 1/2022
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.
Catawba County Environmental Health
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Parcel:376304746891,4240 DEAL RD 1in=40ft
CLAREMONT, 28610
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10/0412022