HomeMy WebLinkAboutEXSY-02-2023-188570.TIF dire CATAWBA COUNTY
;Q' .t.II -L Public Health Department Subdivision CROSSING CREEK
d „ . H Environmental Health Division PIN# 376304747611
PO Box 389,25 Government Drive,Newton,NC 28658 LOT# 4
84
Site Address: 4218 DEAL RD, CLAREMONT NC 28610
Name on Permit: CLAYTON HOMES#81 (UNLICENSED GC-BILLING ACCT)
Property Size: Acres 0.46
Directions: Left off of Bunker Hill School Rd onto Deal Rd.4th lot on right after passing Crossing Creek Dr.
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-01-2023-43163, 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: 02/03/2023
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
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catawba county
public health
EXISTING SEPTIC SYSTEM INSPECTION
NOT FOR LOAN APPROVAL
Case Number: RBPR-01-2023-43163 ® Reconnection to Existing System
Property Owner/Applicant:CLAYTON HOMES ❑ Mobile Home Park Reconnection
Site Address: 4218 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 02/07/2023
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: 376304747611, 4218 DEAL.RD lin=40ft
CLAREMONT, 28610
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personnel,disclaim,end shall not be held liable for any and all damages,loss or liability,whether direct,indirect or consequential which arises or may
arise from this map/report product or the use thereof by C pyright 2021 Cperson or atawba County NC
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