HomeMy WebLinkAboutWELL-05-2023-194873.TIF �1N (• ('A7A%VBA('OI\I V l
/ 'r * Puhhc health Department Subdivision
kr,�.� ,' I:muonmcntul Ilcnithl)ivisionPIN# 460701150086
tS4 PO Box 389.25 Government I/rive.Newton,N(' 2865K L(1't71 1
Site Address: 3720 LANDMARK DR, SHERRILLS FORD NC 28673
Name on Permit: HELMSMAN HOMES LLC
Property Size: Acres 0.57
Directions: Hwy 150 to Little Mt Rd to Landmark Dr on left
� Owner/Authorized Representative Acknowledgement of Permit Receipt
X/6 certily that I am the owner or authorized agent(owner's authorization required)representing the owner of
the property described ahem.
z CFCs the property owner or authorized representative, I have received the above referenced
pertnit(s)as requested in the application for service R131'R-02-2023-43415, by the Iollowing method(s):
Received in Person
Facsimile Transmittal (Return limn with signature required)
f Electronic Image Transmittal/E-mail (Return receipt required)
'3As 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(1SA 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: 05/03/2023
Owner/Authorized Representative Signature /z.MIL
Date 6-2-23
Documentation of Permit(s)Transmittal
(permit transmitted by electronic or other means)
Permit transmitted by. (name c1I person sending permit)
Signature Date/Time U ,'.3
Method: Fax 1 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 yoiPlease ttake a few momentts tto complette our custtomer service survey att
http://www.surveymonkey.com/s/EHCusttomerService
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! • CATAWBACOUNTY . Case# WELL-05-2023-194873
t-� f.1111Public Health Department Subdivision
Q Environmental Health Division PINS 460701150086
PO Box 389,25 Government Drive,Newton,NC 28658 LOTS 1
4 sw
Site Address: 3720 LANDMARK DR, SHERRILLS FORD NC 28673
Name on Permit: HELMSMAN HOMES LLC
Property Size: Acres 0.57
Directions: I iwy 150 to Little Mt Rd to Landmark Dr on left
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 15A North Carolina Administrative Code Subchapter 2C
The well driller must verify all setbacks before drilling the well.If the well driller is unable to maintain any of
the above setbacks,contact Catawba County Environmental I lealth at 828-465-8270,before drilling the well.
Grouting Depth:20 feet minimum
Casing Height: 12 inches minimum above finished grade
All newly constructed private drinking water wells are required to be sampled in accordance with the North Carolina Rules Regarding Private
Drinking Water Well Testing(I SA 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 I lealth when the well is ready for sampling.Water samples will be drawn from an
outside faucet unless otherwise specified.For questions or for more information,please contact Environmental I lealth.
05/03/2023
Authorized State Agent Pennit Issuance Date
5/3/2028
Permit Expiration Date
c6jr:nn! 05/03/2023 12:48
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VICINITY MAPNC SCALE welt OS.- 2023- in (.73
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LINE TABLE in -.P. JAMES H. &
LINE BEA THRING LENG
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L3 N 16'40'20 E 22.82'
L4 S 05'49'20" E 15.00'
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NOTES
1) THIS PROPERTY MAY BE SUBJECT
TO ANY EASEmENTS AND/OR
..
3)
ir a- RIGHTS OF WAY OF RECORD.
./
2) ACREAGE COMPUTER BY THE
./." wl.
././ COORDINATE METHOD.
UNDERGROUND POwER
0' 25' ,lte ,e 40- ,
- .- 4) NO GRID MONUMENT FOUND VA THIN,
2000 FEET.
111•111.11111111111111111 Cf:, r 5) SETBACKS SHOWN PER R-30 ZCNIN
SCALE IN FEET ....
372c, Lc..sd'Av./1 0.--
Site.e:iii 6,0
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gi WPDT Report
Area of Interest (AOI) Information
Area : 3,134,508.72 ft2
May 3 2023 9:33:55 Eastern Daylight Time
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