HomeMy WebLinkAboutIMPV-10-2022-182740.TIF t 1I 111tts11,1 \I1 I i.:r•
ot t. I'ublrc I Icar11,I k1,„u �.',.I:. n CHERRY RIDGE
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• Pt)lb s icx :;rl,,ei n.ua I�;,. \r.•'r,,-. m. �R+ag I t li'r 3 REVISED
Site Address: 5905 SUNSET VIEW LN,CATAWBA NC 28609
Name on Permit: AMANDA STEVENS
Property Size: Acres 0 67
Directions Hwy 1010 Hwy 16 S.6 5 males turn Lett But'alo Shoals RD. t/2 mre Right Little Mtn RD 1 5 mI Left Joe
Johnson RD• t b mt Lett Mathis Church RD property 1 2 mt on Left(Corner of mathts charch 8 sunset stew)
(hsner/Authorvcd Representative.. ckno+%ledgement of Permit Receipt
#13 seN that I am ihr"ogee or auth++riied,tgent iowner's authirrii.uion required)representing the owric ni
ihe(+roperis descr ihcd ulst%e.
bib
As the property owner or authorised representative.I base received the atx,se referenced
permii,(s)as requested in the application for service RBPR-0S-2022-11005,by the Iisllowing method(s):
Recessed in Person
Facsimile Transmittal(Return h0rltl ssilh signature required)
JElectronic Image Transmittal' E-mail (Return receipt required)
As the property owner or authorized representative I have res iewed and understand the specific conditions
of the permit issued. and further understand that all applicable regulator} requirements speei lied under the
f'
North Carolina Laws and Rules for Senagc Treatment and Disposal Systems(I5A\( A(• ISA.1900).
and/or Well Construction Standards(I5A NSA('2C.II100). shall apply to the issuance of this permit and
the construction of the wastewater sy stein and or water supply well permitted.
Permit Issue Date: 10/21/2022
(honer/Aulhoriicd Represeotatise Si'nature r Yi(
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Date 1 0/camel/;&4c
Documentation of Permit(%) I•ransmittal
(permit transmitted by electronic or other means)
Permit transmitted hs warn('r//r;',\III/ ,,•+r,fiiic f',•r Imo
C)'
Signature `� I)ete Iimr IbI)y(��
Method: _I;as " F:mail US Mail Other
Ossner'c request to send by the:those indicated method of transmittal in lieu of signature
we w.intt no hear from yo&Please ttake a few momentts tto comptette our custtorner service survey att
http://www.survr'yyninnkey.rom/s/FHCusttomerScrvice
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► IAL Lk(' Ra ee OS- _2022- 9IooS
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Parcel: 368904839483, 5905 SUNSET VIEW LN 1 in=40tt
CATAWBA, 28609
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Copyright 2021 Catawba County NC
10/21 f2022