HomeMy WebLinkAboutEXSY-05-2023-195278.TIF CATAWBA COUNTY
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411%.i� Case a GXSY-OS-2023-195278
t II"A Public Health Department
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.zv ■. i Environmental Ilealth Division PINd 368615733527
.>/ Po Box 389,25 Government Drive,Newton,NC 28658 LonLon1 A
Site Address: 5716 HICKS DR, DENVER NC 28037
Name on Permit: TIMOTHY BEAL
Property Size:: Acres 3.17
Directions: Right on Radiostation Rd,0.1 mi Right SW Blvd,0 4 mi Left West C ST,8.6 mi Left Hwy 16 BusS, Left Hicks
Dr in 2 miles
Owner/Authorized Representative Acknowledgement of Permit Receipt
X
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 RRPR-02-2023-43474,by the following method(s):
Received in Person
_ Facsimile Transmittal (Return form with signature required)
I'. Electronic Image Transmittal/E-mail (Return receipt required)
;;•', As the property owner or authorized representative 1 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:05/09/2023
Owner/Authorized Representative Signature �`,-_ i ' ,� .: '" !;.-.__
Documentation of Permit(s)Transmittal
(permit transmitted by electronic or other means)
Permit transmitted by — (name of person sending permit)
Signature Lti'(i Date/Time 51i 5 I)3
Method: Fax J 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-02-2023-43474 ® Reconnection to Existing System
Property Owner/Applicant:TIMOTHY BEAL 0 Mobile Home Park Reconnection
Site Address: 5716 HICKS DR,DENVER NC 28037
❑Applicant Request
Type of Facility: 0 House ® Mobile Home Number of Bedrooms 3
0 Business
0 Other
Proposed Addition/Accessory Structure:
®Approved 0 Not Approved Reason
❑Approval Not Required/System Location Only
Evidence of System Malfunction ❑YES ®NO System Type/Description GRAVEL TRENCHES
Noncompliance Items and Notes
• Maintain 5 feet min.from any part of septic system with additions.
• No guarantee to the longevity of the existing system.
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5/9/2023
Authorized State Agent Date
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.
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Catawba County Environmental Health
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15.82 HOCK °R
Parcel: 368615733527, 6716 HICKS DR 1in=60ft
DENVER, 28037
This map/report product was prepared from the Catawba County.NC Geospatial Information Services. Catawba County has made substantial efforts
to ensure the accuracy of location and labeling Information contained on File map or data on this report.Catawba County promotes and recommends
the independent verification of any data contained on this map/report product by the user.The County of Catawba,its employees,agents.and
personnel.disclaim.and 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 any person or entity.
Copyright 2023 Catawba County NC
05/09/2023
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Plat Book/Pope.40/108
Survey PM/w
TIMOTHY EUGENE BEAL An existing iron
5716 HACKS DP DENVER. NC 78037
Mt Creek TownsMID. Cotowbo County, North Corokno rod in the
L 1..M 1 a.•...n1 on-wr o. .•V V.. PIN 368615733527 Drown By LKB
......,.a..,.....M...r.,.„....,..,.., Deed Book/Pope:3754/1346 FB 168 35
1*nice Date March 141h. 2073 Scant I-50' northern margin :
o...IE'1G..,Um Yap*not r•.-rr•••.••o..nr..er•'. Crystal Hicks Brown Plot Book/Page. 84/105
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