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HomeMy WebLinkAboutWELL-11-2022-185180.TIF • J CAIAWBA COUNT'. ►' wuh,iwtsion J C HOWAR0 PROP 111 .�.. ruhlic Health Dcpartmcat Ili Not ,Ili i l:nieirtnntcntat Bath pcvmm l'INo 461602590311 \ P0liu%3X .25(imminent bow.Newton.NU2RMMX 1 t.+rq 15 :L1► a, Site Address: 4361 BEECHWOOD TR,TERRELL NC 28682 Name on Permit PATSY TALBOTT Property Size: Acres 0 69 Directions: 150 W to Kiser Island Rd(L)Fieldstone Dr(R)8eechwood Tri(L) Owner/Authorized Representative Acknowledgement of Permit Receipt 0 I certilj that I am the owner or authorized agent(owner\authorisation required)representing the owner of )( the pmpert) de>eribed abt' e. As the properly owner or authorized representative. I have received the above referenced K permit(s)us requested in the application for service RBPR-1)9-2022-42367,by the following tncthod(s): Received in Person Facsimile Transmittal(Return form with signature required) iii Electronic Image 1 ransmittal:E-mail (Return receipt required) As the property owner or authorized representative I have reviewed and understand the specific conditions ► ' e 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 NC'A(' 1NA.1900), and/or Well Construction Standards(15A NCAC 2('.0100). shall apply to the issuance of this permit and EEi1Ei : nstruction Si natu ' Date..12411.12.2, Documentation of Permits)Transmittal (permit transmitted by electronic or other means) Permit transmitted by rn,nne r,1'pcv:tirm sending permit) Signature Date,'l'ime I / /;) Method: Fux `j F.mail US Mail _ ________________ Other Owner's request to send by the above indicated method of transmittal in lieu of signature We wantt tto hear from yo►.tPiease ttake a few momentts tto complette our custtomer service survey att http://www.su rveymon key.com/s/E HCusttomerSe ry ice 1 n )- g LtO# d 5.b1 it)s , tix. A r It vi'U?' ti:r 12/2/22,9:34 AM about:blank WPDT Report Mad Area of Interest (AOI) Information Area : 3,134,508.74 ft' Dec 2 2022 9:29:24 Eastern Standard Time 820 .. —.. IIIIIrilp,N 0 ...---- '44„, ,. ...,,.. NN/ , r -` fi _ --- _L........,_, • N , -,.......) r--- �1tm' �rryC : • _ - 8ozR -------- , v __-- (/' ..... . \.._,____ . . - \_____ • L . .. ,. 1:4,514 Parcels(Polygons)-Parcels '" Prgected Rate 0 0 63 0.06 0.�2 mt I 1 1 1 % N N ti 4 Non-System Roads — °tiler State Agency Route 0 006 0.1 011011 — Fetters:Route — Secondary Route Non-System Primary Roads Other System Roads — Interstate E i a.c.,w.er U. C..mb h Veda Cava, Stan w*All cr,m. MY . OnmStsanim tarr-.va Evi MERE. Gam. SaNC/aah — Ramps.Rest Areas,Non Mamtme — US Route aeT.v,tiye.,s ertnNasA,usos,toy Ems US Corm...Duos USDA N:AOT G.5 u=.d See res Dv, Arun DS USGS NGA NASA - NC Ror.te about:blank 1/2 12/2/22,9:34 AM about:blank 4361 Beechwood Tr All North Carolina Department of Environmental Quality(NCDEQ)GIS data is expressly provided"AS IS"and"WITH ALL FAULTS".The NCDEQ makes no warranty of any kind,express or implied,concerning this information,including but not limited to any warranties of merchantability or witness for any particular purpose.The NCDEQ assumes no responsibility or legal liability concerning the Data's accuracy, reliability, completeness,timeliness,or usefulness.The data is not intended to constitute advice nor is it to be used as a substitute for specific advice from a professional.Users should not act(or refrain from acting)based upon information in the Data without independently verifying the information and obtaining any necessary professional advice. Users are solely responsible for ensuring the accuracy,currency and other qualities of any products derived from or in connection with the NCDEQ's Data.The Data is collected from various sources and may be modified over time without notice to improve spatial andattribute accuracy.The NCDEQ disclaims responsibility for the spatial accuracy and attribution of GIS features and makes no warranty concerning same. about:blank 2/2