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1 t Public II ,i .Is,,,nknl Subdivision 1NYNSWEPT PH 5.2
r r s Envimnnlental I kuhh Division
'i 'ot IINM 367804618180
\/ PO)[lax 389,25 Government Di ivc.Newton.N(' 28658 1.0Tir 84
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Site Address: 4653 CAYTON DR,MAIDEN NC 28650
Name on Permit: 'NEST HOMES LIC
Property Size: Acres 0,76
Directions: Intersection of Buffalo Shoals Rd&NC 16 S; NC 16S to left on Cayton Dr
Owner/Authorized Representative Acknowledgement of Permit Receipt
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1 certify that I am the owner or authorized agent(owner's authorization required)representing the owner of
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the property described above.
As the property owner or authorized representative. I have received the above referenced
pennit(s)as requested in the application for service R13PR-08-2022-41950,by the following method(s):
Received in Person
Facsimile Transmittal (Return form with signature required)
_
._J Electronic Image Transmittal/E-mail (Return receipt required)
As the property owner or authorized representative I have reviewed and understand the specific conditions
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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(ISA 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: 11/30/2022
Owner/Authorized Representative Signature p
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Date I d.•tp- 2c22.-2—
Documentation of Permit(s)Transmittal
(permit transmitted by electronic or other means)
Permit transmitted by (name 0/person sending permit)
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Signature _ t Datc/•Time f? ?Z —
Method: Fax i/ Email US Mail Niher.
Owner's request to send by the above indicated method of transmittal in lieu of signature
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8%fie CATAWBA COUNTY Case# AUTH-11-2022-185306
H -t.a Public Health Department Subdivision WYNSWEPT PH 5.2
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'"1 Environmental Health Division PIN# 367804618180
PO Box 389,25 Government Drive,Newton,NC 28658 um 84
Site Address: 4653 CAYTON DR, MAIDEN NC 28650
Name on Permit: *NEST HOMES LLC
Property Size: Acres 0.76
Directions: Intersection of Buffalo Shoals Rd&NC 16 S; NC 16S to left on Cayton Dr
Proposed System: DRIP IRRIGATION
System Classification: VA-SAND FILTER PRETREATMENT
Pump Required ***** Operator Required
The issuance of this permit by the Health Department does not guarantee the issuance of other permits. It is the responsibility of the applicant
/property owner to insure that all Catawba County Planning/Zoning and Building Inspections requirements are met. This Authorization to
Construct Permit is subject to revocation if the site plan,plat or the intended use changes,or if site conditions are altered. The Authorization to
Construct Permit is not affected by a change in ownership of the property. This permit was issued in compliance with the provisions of the
North Carolina'Laws and Rules for Sewage Treatment and Disposal Systems' (I5A NCAC I8A.1900). Neither Catawba County nor the
Environmental Health Specialist warrants that the septic tank system will continue to function satisfactorily for any given period of time.
Any permit issued for a conventional system may be used for an accepted system without Environmental Health authorization or permit
modification.Please notify Environmental Health of this change prior to system installation.
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11/30/2022
Authorized State Agent Permit Issuance Date
11/17/2025
Permit Expiration Date
No grading or construction activity is allowed in areas designated for system and repair without approval of the Health Department.
12/07/2022 09:54