HomeMy WebLinkAboutAUTH-07-2023-200377.TIF 40.111riv. CATAWBA COUNTY
qIv Public Health pepertrnenl Subdivision DOUGLAS CORNERS
Y; , 1s Environmental Health Division PINN 268701251295
+\4 PO Box 389,25 Government Drive,Newton,NC 28658 LOTt 19
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Site Address: 37B9 AMBER DR,VALE NC 28168
Name on Permit 'CMH HOMES,INC./DBA OAKWOOD HOMES#712(NEWTON)
Property Size: Acres 0.6
Directions: Right SW blvd, Right NC 10,Left Banoak RD,Left West Lee Dr,Right Amber DR
Owner/Authorized Representative Acknowledgement of Permit Receipt
_I certify that 1 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
III permit(s)as requested in the application for service RBPR-03-2023-43759,by the following method(s):
Received in Person
Facsimile Transmittal (Return form with signature required)
7 Electronic Image Transmittal/E-mail (Return receipt required)
NIAs 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 I8A.1900),
aod/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:07/17/2023 1),
/Owner/Authorized Representative Signature /`j' C/oL 2-e---'
.--- /Date ---
Documentation of Permit(s)Transmittal
(permit transmitted by electronic or other means)
Permit transmitted by __ _ (name of person sending permit)
Signature Date/Time .51j)3
/ I
Method: Fax Y Email US Mail Other
Owner's request to send by the above indicated method of transmittal in lieu of signature
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http://www.surveymonkey.com/s/EFICusttomerService
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rhprn■i 07/16/2023 13:44