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HomeMy WebLinkAboutWELL-05-2023-195316.TIF . k. 7,-"- f 1 1t.1w11.t(( i•\t1 .71•, • lli HER COWANS Sa+ERRi:I 111`41, 4616v26 tl h . . ... i. \ruL,. 'FI •\!! I t.i. a:1 ',qt.Aldrr..,i. 9G_45 R•VIERA DR SHFRft:l I S FORD NC 2°47 3 ,.dery on all,nt '©URT WARD'S HOME Of- DiSfINCTION INC: Proper'',Sae &l s 0 4S ::Ira•_t.orrs: Is:and Point DR to R11.era Or Ownar/Atttht)riir(I Ileprccrnt:,ir\( .fit I\ritlt,It dvytlrt'ilt 111 1'cnnit Ilrt't ipC /` I CLY,It'. Ill..;I Gill the c.Irncs .II .•.I Arcot I.o..1),t ,.! •,,..;t• ,i•ray.: I,, 'L't-IC ,'11 I F hi:,•N I•01!!I 1, 1..,,tv:n, J4141.4, ,131.io,c, !,l,.r,:..;,, •.,,•r..•rI• ;: uf!.1..'. :iptc•rn1a!t4C.S 11:1,,. •.1v.,.v.I Ilte:I iIt: r."lv.:nerd .-1.1111,t..• .,••.I.:..iC.1 :n the,,:5;. .1.1: 0:1 L.r ,er111 r KIllk-O5-21123-14230.tst Ow Ii11.n,inl! •th•t`I.%dI sr. Reco%od in I'cr.l+r. I JI:.i11It11:'I I1IrN.tiliittll e'icIl•I'i I•,I II ,5 I'I .I;In;Itinv IClgIII?c..I 1 I itt1101N, 11'r.;t.•: I I,u1,'n!;:..1 '. I 1,i:...: I :c'a;11 :,,I•, l'Ali f. 'S• . 1' •1 rr.!Kf Of.111t1FL'i iL.. 11.1',:, !:!..LI•,_ . ...1,- !,' ..! !;,1 '?i.li',I,tAY,I I'I.••I'i, I', ,111illitl(4t1 l''::,4,1-11,. ;,,L:,..:, .1'1•i ilt111)Cr tiiiik-r'.t.tti.l t11,11.. • .!--111.,5'1% ?.-:!:.::1.•1, I..: : Iciurt,'• f!d11'i•. .II .'it :nt \utlh I arutiaa Taws and Rules for Sett age'1rratm(ni and I)i.pncal S)\ttm I I$.\ \( 1( I 1 .1911111. undl,i-Veen Construction Standard*II'.A NUM' 21 .01utlf. ,hall a,rl :0c1: i•,,,,,: 1,.:.:I•: 1:>.i the t(in•cittictilst of Iitc,.u.lct,attr s:"%tein and or sv.t:er supply uel!portmiIIcJ I'.s'mn 1.•a. I)J:c L' .:ss2t1:3 i r\.i►cr'11.30144144M Itcpnr.tntal.,i• \11:ttattae \a -� I)Itt,• silo'r,3 �� �w��++ Documentation of 1'crrniti•) I ran%mitlul pt,1Mit Iratl.ntil1ed h► electronic or other mean.) I'ermit trltt'.l • . •,+,.% ..u' , i .r.tr. rr. yit;nulnt1• l't1>.lc I'n1r 5 116 j��1Lctim& Fut */ ['mail I \ !Hail Other t i.%ncr•. reque.t I.,'rnd b► the Anise Indicated method of trancmiltni in lieu ut.ignature We vearat tta h.ar from yo(Please rtatie a few momontts no compiette our customer service sarvey rtt http://www.survCymonki y.corn!i/EHCusnornerService 1- D 7)goe v .rt,,A . CA'LWi l3A COL'NTV Case# WELL-05-2023-195316 N y Public Health Department Subdivision LUTHER COWANS SHERRILL "1 Environmental Health Division PIN# 462802655812 PO Box 389.25 Government Drive.Newton,NC 28658 LOT# 33 /Hq2 •,.0 Site Address: 9696 RIVIERA DR, SHERRILLS FORD NC 28673 Name on Permit: *BURT WARD'S HOME OF DISTINCTION INC. Property Size: Acres 0.45 Directions: Island Point DR to Riviera Dr NEW WELL PERMIT REQUIRED WELL SETBACKS: Septic Systems and Repair Areas for Single Family Dwellings 50 ft. Septic Systems and Repair Areas for Businesses and Multi-Family Residences 100 ft. Underground Storage Tanks 100 ft. Animal Barns 100 ft. Lakes/Ponds 50 ft. Streams/Brooks/Creeks/Rivers 25 ft. Building Foundations 25 ft. All Other Sources of Groundwater Contamination 100 ft Saprolite Septic Systems and Repair Areas 100 ft. Septic Systems and Repair Areas to Wells with 2 or more connections 100 ft. Wells shall be constructed in accordance with state regulations: Article I 5A North Carolina Administrative Code Subchapter 2C The well driller must verity all setbacks hefoty drilling the well. If the well driller is unable to maintain any of the above setbacks.contact Catawba County Environmental I Icalth at 828-465-8270.before drilling the well. Grouting Depth:20 feet minimum Casing I leight: 12 inches minimum above finished grade All newly constructed private drinking tarter wells are required to be sampled in accordance with the North Carolina Rules Regarding Pm ate Drinking Water Well Testing 1 I5A NCAC I8A.3800) The fee for this sampling is included in the cost of the well permit It is the applicant or property owner's responsibility to notify Environmental Health when the well is ready for sampling.Water samples will be drawn from an outside faucet unless otherwise specified.For questions or for inure information,please contact Environmental Health. 05/09/2023 Authorized State Agent Permit Issuance Date 5/9/2028 Permit Expiration Date elireoi 05/10.2023 16:09 C> i i i 4 11 r'-'-' % J .?c le y,..,i jil i . i_ , ,.... aptivglkiim n n a .; nnsv . g 1 ......9 .z.-- lwailitifiplow li iv oo cr i / 4. .; ,k ,.. a, . ,-, 11 r. i ,,,g f.1.51,, 911 II§ 1 q 0 S'''g t 6 r / \ 1 ti id Ei r/ t t / / ;' 1` f L..0 di f/Cn / 7 s: ' / 'f $ ' <3 t./..,)/ •—• y f. k \1 , F., r I F a � C, s Ty. ,/,* cis ,c , , --- A . / v E0t1 ., i / flig4 !I ,,,,,. /„/ _ / opi ,.,,, .,,... t ( • x i gegl�`eer* 8� s r is .r to. t e ,� ; I/ "3 ' °; r '"4.'/ \': 4 / *''''i.7 i l • i s /� ` / rg '+t‘ i „ / $; I p It r 1 'ff ,2i'�. _k rgrr`c, c.-'sia� cotp+r 07,7 "'. - - --- l!'1a i'€Si: ,Far.internal Tim Daly: Brad il:list A-4579 w & g. F.CTfdicottret�e scniaytiotn , - s C Pump�Isr.i r"}ti,a Z; 7.5.0ma^�n 3G4Turmerlti-cstrttrgrislTIRi.3PL£treantUntla . _tt � Well:t= man: t so-... .. DIABIWZR. . i lisMai>:ss I.anon=IIAL _ Campanyk O FI 4!.i} e1/4 ►Q. IsD1 ? lPvc 3.6.i terwil 1'em.erl4a-ticathes=1chuc:I-dean) i i.W¢u eireSireN like :ter,.W.3- (9 S 3 I. 6 Mil 1 TO 1 DIAMETER 1'BERMS S la rear' .- letritrspyare l=ecitcanur aim'kertrnrirsitc.me Canng:Sram Fralarm,etc) I Ill I Fa. 2 imply : 3T SCftss lit 1 - - mom i i mina e. .r. sr'..rs= .lard IEiS 1 nL:aRIAL �� iiLTICioE>ffln11)'v . 1 fc I I _ 1_ aeotherurel{Bm-tht lCmrraza pply) t aResidentiai Ti nterzltppiy(.fo ie) .n, ( { xt,-. dt #tCott? aa7 LZ6id tialWaterSapP1y(e r al) 4��otr I 'legation FROM 1 III I.L X. •Ati_ACet'it>,v:ntero aa li{OtP.= 5:.ae-Van,.:ecTifis::�1: 0 fa I �o =_ I BTATEn BentorMe I P-ourrd ,rj$ :rotram-trTm. 1-7SESCOY017 Syr sa I sh DAgtriferRealim a nOnnmdwateri enediation t 1 20.Srs10rMZ4..V ZPACK(natmlimuT^) l-1.-A r*tSinmsentni ecaser9 _SermireSarizs i IZt K . _TO rbb iza1.95. i?letil.£DS 3fi511113D "Aquiver inst r`StOrMI00t°r�JrAmte ft :` #.. 1 . .s.-p.iimen2]Tccbnalo i 5tthsdenceCon�i xxLIC>~oihmaifCioIinop) rc=i 3o.�It?.Js�re LOG tct taCcrliaanistlt=tsitR�r:a��cl T'.0 d TO SFSCP.IP'i!t?iv eforlientes,mnlrael:tsrstrains.etel rCT^-aiixemsaIESE 3ia_1Coniirreite.�3 _iaBm'(=,iaianndtrgrtAcmaas) 1 6 C l ��/. K a' (sy;WVe.=c: 1 64— '3 Ici�T "SQ6 =,. 11T($4 �` r.L--eo�.k1..,a.c*1, i2 t _ _ w.rz_nr••r;: IA 1 '1 1 NOS it 1 g Cc v � . 1 s� I (line+�.sb 4}orf.e�} 0 i5•�;.,c�+on % nG,. ?, EL ; ltl INI-m= TtyMN(iicppf=li r) .. Physio.1Arldram aty,aadi ip • - t i r.A..wbCn. Li 6).4 oa.cess`d 1 a- 3,_ :zee.„ :r'-m r... :re-sflacrttscriae ro.{Pm .. - - -.. ._-'_ m t:neccaria30,-�,: c-e ang._JM, •_a=Js=osr's CI:e`•^� '-cegr.--••.^ - wC a _1 gun; .j✓c 1:1;vi �7 r_=-+ sigmuyeercerahedWell Contractor Date �.swstrig Arc:Prm..l harbp mrtj•Mat rho trar l Iran!Trak)cosine d in accordance `a_s:'+`.�sa=^ �-'=�"`� r�"�- of i`io Trztlrl3.4at7✓eai.0-MD nr ill 2151CMC.B2DilWEI'1i:onstr>ilanStmtdard end dmra freztLaresea+flan:r"-•t.T=z-J:e....zrauslrosrlrrnaerr=m•b=..+�'=1•6-•� svjshirr_coral=barn pvyidediilk!vagarraar. roalrrteTter 'i+.+uw`ssc=tmrm'oaakaszthaj8•L-nor_ AlEttiaEttg'1amor adfAdonalwondeinl:5: S.=erckoprob r6e- r in:rezuon> -nal` e is riingthesorae YouT,nuy nse the itacTt aegis pop to provide additional wail site tiptryls or iire)t twin leih.onlyY 3ism"+teA liortwaeiOiALNTI3tvE92t afi:elis enrrLTucfionaeiaiis Timmyelsoatlaett2ddltianaiab tfneess2�r driltec Su'et A 1-145 C'1e'3NS _opt Wiii i5Z3r2t A.adare -,let_; 05 t=�'l rya.For MI;dells: Snbmit lids faint within 3D days of completion of stall .Form ripte.ar/irraibi�kr tli •f=.__ole- c200-roM2exurs3 con56uctionio She m7toi'n3s: V.Smilt trrIzodtraar:Z0pw-:C=a: , J Q - - -- (-=) DizlSltl?ilf fsaM.r esoBices,brormato3i TFfi55nlgeln_4y iftexerlc:ils shoe dubs:: `-" z,z7rraT isir,,kt .'eoa.ZatPtgh,.NC2769 67.7 _, r s�,- = (:-? 2411. 6r Zuktion Weis: 3n addition to sending the foot the addles in 24a r ohm,also submit one copy of tills form-Within 30 nays of completion of ta11 ?.7 V x:c%q?z ar..tee a �iigi-2f4= caasi;ztetion Io4Ttrt io)latv)ng ,tct- ==5:e=3t=-di tpinitat) a cZo'e4L1`DEi'aea+'s38ir i j•=onorr•,rater Zsortras,Jnde,vnu bjea .?r elT� �+ pwoe as A'r _- Va.For Water Simla,a Intendant Wells: In addition to sending thedonna to {4Sr } the addra5lrn)ebove also rebuilt one Dopy or this Iona idtlrin 30 days of s� .cctiea+�-�_• Granular watt \`•"' Z completion construction to the county health depudinent of the county ._.rb�mn` .._ Moth �eliaa�r s" 'rttII urEtn rea=la1-iiteneflVcternecoeteee RRLi4ed2 22-2Ola ..