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Home My WebLink AboutEXSY-05-2023-195726.TIF dotloop signature verification: A t ,I.1" s CATAWBA Crt)UNT1' Case E LXSY-05-2023-195726 4 Public health Department Subdivision BARRINGER WOODS PH 1 4 "4 Environmental I Icalth Division PM 366801292953 PO Box 389,25 Clover:meat Drive.Newton.NC 28658 LOP/ 4 Site Address: 2328 CORDIA CIR, NEWTON NC 28658 Name on Permit: 'KEITH ESTES Property Size: Acres 1.45 Directions: 16s/left Balls Creek Rd/left Cordia Cir/1st house on right Owner/Authorized Representative Acknowledgement of Permit Receipt es/z ertify that I am the owner or authorized agent(owner's authorization required)representing the owner of °.•:4e i 'tiperty described above. As the property owner or authorized representative. I have received the above referenced 1:Io PM rmit(s)as requested in the application for service RBPR-05-2023-44239, by the following rnethod(s): dotloopveri zed Received in Person Facsimile Transmittal (Return form with signature required) I_ Electronic Image"Transmittal/E-mail (Return receipt required) /� s the property owner or authorized representative I have reviewed and understand the specific conditions osn 3 permit issued, and further understand that all applicable regulatory requirements specified under the dots WoEt4 Carolina Laws and Rules for Sewage Treatment and Disposal Systems (15A NCAC 18A.1900), and/or Well Construction Standards(I5A 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:05/15/2023 r dotloop verified /\e t 05/26/23 1:50 PM EDT 37FT-31VW-H8VA-PTVC Owner/Authorized Representative Signature - Date Documentation of Permit(s)Transmittal (permit transmitted by electronic or other means) Permit transmitted by (name o/person sending perrnil) Signature Dr Date/Time .1)11 Method: Fax s Email US Mail Other Owner's request to send by the above indicated method of transmittal in lieu of signature We wantt tto hear from yoLPlease ttake a few momentts tto complette our custtomer service survey att http://www.surveymonkey.com/s/EHCusttomerService Cr e bss 3 At 64. NI\fry,., �,n, t;zt, catawba county public health EXISTING SEPTIC SYSTEM INSPECTION NOT FOR LOAN APPROVAL Case Number: RBPR-5-2023-44239 ❑Reconnection to Existing System Property Owner/Applicant: Keith Estes ❑Mobile Home Park Reconnection Site Address: 2328 Cordia Circle Newton NC 28658 ® Applicant Request Type of Facility: ®House ❑ Mobile Home Number of Bedrooms 3 ❑ Business ❑Other Proposed Addition/Accessory Structure: 70'Y7d' dptnehedt garego ® Approved ❑Not Approved Reason ❑ Approval Not Required/System Location Only Evidence of System Malfunction ❑ YES ®NO System Type/Description 25%reduction See OP-8-2022-177701 Noncompliance items and Notes Inspection done to verify location and condition of existing well permitted under WELL-06-2021-152520. See attached variance approval for detached garage to be constructed 8' from well. There shall be NO termite treatment applied to the ground within 25 feet of the well. If termite treatment is necessary for this structure, applicant must work with building inspections to use alternative methods. No sign of septic system outbreak at this time.No guarantee or warranty is implied for system with this inspection. Authorized State Agent Date 5/15/2023 Existing System I pections expire 1 ye from approval date catawbacountync.gov Environmental Health Catawba County Government (enter 25 Government Drive I PO Box 389 I Newton NC 28658 1828.465.8270 MAKING. LIVING. BETTER. Catawba County Environmental Health r a -A- r 300.69 ■ r �` J)( rr\ 17� 0 tr 0 0 U N .2328 3�er (-c.i f� 30p, v + �1 r �c ) 71C Sr P1'+` IQuTN • c7C. -Z of I- ISLSZf (;„—tI ._rw ; �J u,"Jur I,,,W- - tab LeZf- (Sl5Za 4- a eav r tv`1 pr-,7polc i Parcel: 366801292953, 2328 CORDIA CIR 1in=50ft NEWTON, 28658 _ ( 5., _ 5-- 1-3 -r-Lb 26Prz - 5 - 23 - 39 This map/report product was Prepared from the Catawba County,NC Geospatiel Information Services. Catawba County has made substantial efforts to ensure the accuracy of location and labeling Informaton contained on this 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 05/15/2023 Scanned with CamScanner Nt5U7F0,4, ROY COOPER • Governor NC DEPARTMENT OF KODY H. KINSLEY • Secretary HEALTH AND �0 o 1,r HUMAN SERVICES HELEN WOLSTENHOLME • Interim Deputy Secretary for Health • • . MARK T. BENTON •Assistant Secretary for Public Health Division of Public Health Onsite Water Protection Branch May 25, 2023 Bradley Elmore 2328 Cordia Circle Newton, NC 28658 Re: Approval No. JMB3031 Private Well Located Less than 25' from Building Perimeter [Rule 15A NCAC 2C .0107(a)(2)(P)] Property location: 2328 Cordia Circle Newton,NC 28658 Dear Mr. Elmore On May 25, 2023, the On-site Water Protection Branch received your request for a variance from the Well Construction standards, Title 15A North Carolina Administrative Code Subchapter 2C .0100. The request for the variance concerns a water supply well on the referenced property. A structure is proposed to be within twenty-five feet of the well. Specifically, the variance request grants you permission to use a water supply well at a distance closer than the twenty-five-foot setback to a building perimeter. Achieving the twenty-five-foot setback would be difficult given the challenges of the property. Based upon information provided by you, and the Catawba County Health Department, it is my finding that based upon current conditions as the site exist today (as well as the current proposal for use of the structure) you meet the conditions necessary for approval of a variance as specified by 15A NCAC .0118 (a) (1) and (2). On that basis and if the following conditions are met,the requested variance is approved: NC DEPARTMENT OF HEALTH AND HUMAN SERVICES • DIVISION OF PUBLIC HEALTH LOCATION:5605 Six Forks Road, Raleigh, NC 27609 MAILING ADDRESS:1642 Mail Service Center, Raleigh, NC 27699-1642 www.ncdhhs.gov • TEL:919-707-5874 • FAX:919-845-3972 AN EQUAL OPPORTUNITY/AFFIRMATIVE ACTION EMPLOYER 1) The well/wellhead shall meet all current 2C. 0100 standards, including but not limited to being properly grouted,terminated at least 12" above land surface, properly sealed, and having a thread-less sample tap etc. 2) The well shall be sampled for the same parameters required of a newly constructed well. If samples indicate contamination, further repairs or treatment will be necessary. 3) No potential sources of groundwater contamination shall be stored near the wellhead. 4) No termite treatment shall be applied to the structure within twenty-five feet of the well unless alternative methods are approved by Catawba County Health Department. The granting of this variance is for the well location only. It in no way relieves the owner or agent from other requirements of the North Carolina Well Construction Standards including, but not limited to the requirements in 15A NCAC 2C .0113(b)to repair or to abandon any well which acts as a source or channel for the migration of contamination. This approval does not imply sufficient water quality. Further, the approval does not relieve your responsibility to comply with any other applicable Federal, State, or local laws or regulations. If you have any questions regarding this variance, please contact me at(828) 713-3335. Sincerely, John M. Brooks R.E.H.S, MS 2