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Home My WebLink AboutIMPV-07-2023-199574.TIF +. . a \ 41-11r.,0; 'CiTAWBA COUNTY . Case 1/ „1,99,574 tits Pubiliffealtkt Dqmrtrnent Subdivision , -OtA E . '' '---'-41.':.,, 4 fit:'• . 1; tavitorinental Health Division PINT :, )157420 1110,N.......400111 PO Btu 389,25 Government Drive,NCV/t0f1 NC 28658 LCY171 taw . •L, _,,,, ..,;.,'...to' 'et;.- ',',..1 ...7„. ',.'...,/-4•,;,,`,""f - Site Address: 1293 MISTY LN, HICKORY NC 28601 Nan*on Minnie JESS&DENISE EVERETT Property Size: Acres 9.61 ' 1 ,14:, ';„ity.lf,t, •. • Directions: Sulphur Springs Rd, left on Lynchburg Rd,left Reitz&Dr left Misty Ln,left on ROW 260 to Private . I roughly cut in Owner/Authorized Representative Acknowledgement of Permit Receipt 1,•t: :. ,,, .,..c: .., . ... I certify that I am the owner or authorized agent(owner's authorization required)representing the owner of . . ,, the property described above, ". ,. •'.--*- .71;'..•';':',.. ,,, , ,1",;As the property owner or authorized representative,I have received the above referenced '.v,...,t,',',;.1.."„.",==:- ,.?-,-•: permit(s)as requested in the application for service EHPR-06-2023-44546,by the following method(s): Received in Person Facsimile Transmittal(Return form with signature required)7 Electronic Image Transmittal/E-mail (Return receipt required) 4- J) 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 ws and Rules for Sewage Trentment and Disposal Systemlit(i$ANeAc 18A.1908k .-,1!;.i,;.. (tit and/or Well C true,tion Standards(15A SICAC 2C:.0100); shrill applyto the issuance of this permit and. the construction of theiwastewater system and/or water supply well permitted. Permit Issue Date:07/06/2023 . _ VJ ,.• Owner/Authorized Representative Signature '''' e°44-‘4C. ,"---- Date 9‘ ) 191 '1' . ' ,, „,, 4..f ,.,-- Documentation Of Permit(s)'Fransinittal. •.i., ,,,'4°It''' ''ci ', 1 , , (permit transmitted by electronic or other means) ,;iiii,100-,1•„, IT- , , ••.,- , ,.•,-,-.,. ,, ''...14.;N:rf;444;1.- lli;d:'•'?:,.. .;•'li." t .2`,..';‘,4-1, • 'r••,:',:;i'":,,j.4;141.r.,,:‘ ,1::;5'..,''' ''',.;",2,1f , • , . Permit transi#itted•by i,'' '-/':', • (name 0/person;ending per It .,..'.Alt,,,-!•:.:41' z,'''''' . .. - ' 7 i)1,,.1 41.47-„v1. k Stgnatur),:•:':' - ,. . —- . Date/Time //I.? 4) e..:k r.vet,-,./10'. --' hr...--) k.' .. '• . ,..,,,,,,kiii„4,,, ; .,,I,i''7.,,,- ".07,;„ -,;":"4...• --ttrge.--e* : , meth - Fax 4 all US Mail • ' •__________ Other '•,..etitit,4:*#' .4 c-'4-'',7:: ;-.',`ii ),i' 77 ,----------7---- y ;.- ;,',', ' • ' 4e, . , , ‘tr;,!' • '' ' ' , .).--° F1, ,, ,,' ,.',0 " .'''4'.4,,, 1 Owner's re est to send by the above Indicated method of transmittal In lieu ottslit4A".0.4.;A,•4. . : 1.,1„'''.4'5i,.•;,.1'•' t„, .. n• ..t` 1- la 4`.1/:;.'ILA ,`,:•L';•,.,',4,:),,,1?":„ ),',,,,.%, .-...,-----. -.....—-,....— , We wantt tto hear from yoiPlease twice a few moment ts tto cornpletbs our custtomer serve- ett',"+'W"14'-at'••-ti.'''''... ' ''+'i4,',eymo _ •• .. %...t,+- ,*"•'•re'4,• •-.r••,.. - ...,1,+*3,,• '- .•,... , http://wunsr.survrikey.com/s/EHOusttornerService ,;,.t..1.,.?«,,,1,,,-;,'41,;;!,fii:-,„.1.',*,'''. , l' ::A.:,t,!!7,-•45u @Lim) 1 i T •' , 1,,... .=I ' ,- ',-'..i*::',,i,;-.;i'',kk " • -.,41,4,:if -;,--ii '1.1- - ' --' ' '?-'-.I';:41 34;14-:,.. l.rikilViA,-1.,.•-4., _;"; •', •. •• . ', ••:..;-,,,;.,', ----.J.•1-.•,-,7,.-4 ,.,.,,•••:,f,,,,t V.I., '...,". z:1-.,',- Cl/ 2Q2 1 .6'1 6 '...".'''''..1.;,-:::fl.'??1',':3 . ,..•-; ... ' • W3 ' ,",t''' ,••• '-.A,,,AQ, . '.',i--k;'1,terf7:4'i,is,.' ,''' ‘-------* --1-3'--,,,,I:Ire '''','-• '''l'-'-i..144iiiiiiiiigr.t5;P,A9:- * ,-.. ,i-..,,,t!,-..., ,-11,-;;II--...