The URL can be used to link to this page

Home My WebLink AboutWELL-09-2023-205578.TIF r + , _• CATAWBA COUNTY Case# WELL-09-2023-205578 • -i. Public Health Department Subdivision Environmental Health Division PIN# 371411650976 PO Box 389,25 Government Drive,Newton,NC 28658 I.OT# 2 Site Address: 3519 9TH ST DR NE, HICKORY NC 28601 Name on Permit: *MARTHA NIQUEN Property Size: Acres 0.7 Directions: 16TH St NE, left 9th St Dr NE property on left before 35th Av LN NE Owner/Authorized Representative Acknowledgement of Permit Receipt j I certify that I am the owner or authorized agent(owner's authorization required)representing the owner of (� the property described above. KAs the property owner or authorized representative,I have received the above referenced permit(s) as requested in the application for service EHPR-09-2023-45575, by the following method(s): Received in Person _ Facsimile Transmittal(Return form with signature required) JElectronic 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: 09/28/2023 Owner/Authorized Representative Signature f Date Documentation of Permit(s)Transmittal (permit transmitted by electronic or other means) Permit transmitted by _ (name ofperson sending permit) Signature °1 Date/Time /0 f,3I�3 Method: Fax I 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 youPlease ttake a few momentts tto complette our custtomer service survey aft http://www.surveymonkey.com/s/EHCusttomerService Mir Ya8ga ADD,411A 6 9 /2_5, i 2-3 J ch emit W p 09/28/2023 10:20 S r- (I 1" Crc- '•-c_., ) Q Ike CATAWBACOUNTY Case# WELL-09-2023-205578 • tit Public Health Department Subdivision .,� Environmental Health Division PIN# 371411650976 • PO Box 389,25 Government Drive,Newton,NC 28658 LOT# 2 Site Address: 3519 9TH ST DR NE, HICKORY NC 28601 Name on Permit: *MARTHA NIQUEN Property Size: Acres 0.7 Directions: 16TH St NE, left 9th St Dr NE property on left before 35th Av LN NE WELL ABANDONMENT PERMIT Well Type: Dug Wells shall be abandoned in accordance with state regulations: Article 15A North Carolina Administrative Code Subchapter 2C The Well Abandonment Report must be submitted to the Catawba County Environmental Health within 30 days upon completion of a well abandonment. Well contractor must schedule well abandonment inspection with Catawba County Environmental Health. PERMIT CONDITIONS *WELL MOSTLY FILLED *TO ENSURE NO UNAPPROVED MATERIAL WAS USED TO FILL WELL,A CERTIFIED WELL CONTRACTOR WITH A BORING RIG MUST SET UP OVER WELLAND DIG TO A DEPTH OF 50FT *INSPECTOR WILL BE NOTIFIED WHEN HOLE IS FINISHED TO ENSURE ITS CONTENTS *ONCE APPROVED FILL WELL WITH CLEAN CLAY COMPACTING IN 5FT LIFTS. *REMOVE UPPER 3FT OF ROCK WELL CASING *A 5FT BY 5FT SQUARE CONCRETE PLUG SHALL BE POURED 6 INCHES THICK OVER WELL *LET CONCRETE CURE 24HRS THEN FILL THE REST WITH DIRT TO LAND SURFACE / '.C4,, Gu4NS !! 09/28/2023 Authorized State Agent Permit Issuance Date 9/28/2028 Permit Expiration Date chpe nut 09/28/2023 10:28 Catawba County Environmental Health Eg-oq Rivt yss� 0 -01- a ..WY •a - 2055. 7 lift CD 331.,s •3525 341.56 12.00 old f To 0 e3519 136 A d04 i 0 336.60 T. e355 l . 33111 • .65 Parcel:371411650976,3519 9TH ST DR NE 1 in=50ft HICKORY,28601 This maphaporl pied tar plowed glom . Wormation Services. Catawba County has made substantial efforts b ensure rho aoangdb�//an and rtlerrrllon an rtelp or data on this report.Catawba County promotes and recommends 1M indapendord tlefgodlorr d dr6r on/1fa product by Ms Loan.The County of Catawba,as employees.agents,and � and did as held lab for any and dbr�w,loss or Iabr/fy,whether dined kid a s oonaegoorttial wtkh t arises ofmay arloa torn/n rr�trtlpwr conductor Its um bored by arry pavan ar Copyright 023wiry.Cacsorte County NC 09/2B12023