HomeMy WebLinkAboutWELL-07-2023-200732.TIF ,
I . „I v:IIIY CATAWBA COUNTY
` �i1� Public Health D` `t`neM Subdivision DOUGLAS CORNERS
16
f fs Environmental Health Division
PING 268703242977
'IL.,/ Goverment PO Box 389,25 Goverent Drive,Newton,NC 28658
t i t LOTN 17
Sao Address: 3817 AMBER DR,VALE NC 28168
?tampon P.rmit: •OAKWOOD HOMES
Pmporty Size: Acres 0.64
Directions: Left Radio station RD,:efet Long DR,Right Hay 10,Left Banoak, Left West Lee Dr,Right Amber Dr end 3817
Amber Dr
i
Owner/Authorized Representative Acknowledgement of Permit Receipt
xDo I certify that I am the owner or authorized agent(owner's authorization required)representing the owner of
the property described above.
XAs the property owner or authorized representative,I have received the above referenced
i permit(s)as requested in the application for service RBPR-03-2023-43882,by the following method(s):
Received in Person
_ Facsimile Transmittal(Return form with signature required)
✓Electronic Image Transmittal/E-mail (Return receipt required)
i
)D As the property owner or authorized representative I have reviewed and understand the specific conditions
X
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:07/21/2023
4 c&eOwner/Authorized Representative Signature
�j i
I Date a 7' Z 3 _ 1
.
f
Documentation of Permit(s)Transmittal
(permit transmitted by electronic or other means)
Permit transmitted by __ _ _ (name of person sending permit)
Signaturecie Ig1 )3 ! !
` Date/Time ! ! I
Method: Fax 'Y 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
yaPlease ttake a few momet>tis tto complette our custtomer service survey att
http://www.surveymonkey.com/s/EHCusttomerServIce
ekt Ayq. add ie-019Atea ezn,
i4-1
ehpermit 07/27/2023 D7:23
I.
41i�e CATAWBA COUNTY Case ti WELL-07-2023-200732
UiiE.,- Public Ilealth Department Subdivision DOUGLAS CORNERS
d '1 Environmental Health Division PINK 268703242977
Po Box 389.25 Government Drive.Newton.NC 28658 I OTN 17
/8. _ w
Site Address: 3817 AMBER DR, VALE NC 28168
Name on Permit: *OAKWOOD HOMES
Property Size: Acres 0.64
Directions: Left Radio station RD,:efet Long DR, Right Hay 10, Left Banoak, Left West Lee Dr,Right Amber Dr end 3817
Amber Dr
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.
PERMIT CONDITIONS
*Proposed well area is located between a drain field on a neighboring property and a dry drainage bed. Careful
measurements are highly recommended to ensure that all setbacks are met prior to drilling the well.
Wells shall be constructed in accordance with state regulations:
Article I 5A 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 Health 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 Pnvate
Drinking Water Well'resting(I5A NCAC I8A.381K)).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 Health when the well is ready for sampling.Water samples will he drawn from an
outside faucet unless otherwise specified.For questions or for more information,please contact Environmental Health.
D /AZIgkee Ply:t'Rs
�yv(/� 1 ) 07/24/2023
Authorized State Agent Permit Issuance Date
7/24/2028
Permit Expiration Date
08 04 2023 07.52