HomeMy WebLinkAboutAUTH-06-2023-197430.TIF toCATAWBA COUNTYCase# AUTH 06 2023 197430
. t NI) Public Health DepartmentSubdivision CLEARVIEW ACRES PL 9-50
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Environmental Health DivisionPIN# 372306493288PO Box 389,25 Government Drive,Newton,NC 28658 LOT# 1 2
Site Address: 2408 28TH ST NE, HICKORY NC 28601
Name on Permit: BILLY BAKER
Property Size: Acres 0.36
Directions: Springs Rd NE, left onto 28th St NE, right to stay on 28th St NE, right onto 24th Ave NE. property on the left
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
perinit(s)as requested in the application for service EHPR-05-2023-44452,by the following method(s):
Received in Person
Facsimile Transmittal(Return form with signature required)
—7 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:06/06/2023
.�j Owner/Authorized Representative Signature
r Date
Documentation of Permit(s)Transmittal
(permit transmitted by electronic or other means)
Permit transmitted b(y�, (name of person sending permit)
`�I
Signature £ Date/Time &At/)3
Method: Fax '!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 yotPlease ttake a few momentts tto complette our custtomer service survey att
http://www.surveymonkey.com/s/EHCusttomerService
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Parcel: 372306493288, 2408 28TH ST NE 1 in=40ft
HICKORY, 28601
Thts map/report product was prepared from the Catawba County,r NC Goosned on patlal Information Services. Catawba County has made substantial efforts
tto ensure he Independentt verificatio of n of anydata cond tained on thismepfrelport product by the user.The or data on ls Cou report.
of Catawba.Its employees,oyees,agents,
romotes doamdmends
personnel,disclaim,and shall not bo held liable far any and ell damages,loss or liability,whether direct,Ind:rod or consequential which arises or may
arise from this map/report product or the use thereof by anCopyright or t t Cwba County NC
06/06/2023