HomeMy WebLinkAboutWELL-11-2023-208240.TIF 4,i% e CATAWBACOUNTY
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//.tII, Public Health Department Subdivision DEERFIELD SUED
Environmental Health Division PINK 269905089900
411 PO Box 389,25 Government Drive,Newton,NC 28658 I O'I'# 80
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Site Address: 5950 WOODHALL, HICKORY NC 28602
Name on Permit: GARY BLAIR
Property Size: Acres 1.04
Directions: NC 127, left onto Deerfield Ln, road name changes to Fawn Trail, left onto Shierbourn, right onto Brandywine,
left onto Woodhall,property ont he left
Owner/Authorized Representative Acknowledgement of Permit Receipt
)( g certify that I am the owner or authorized agent(owner's authorization required)representing the owner of
the property described above.
4 gAs the property owner or authorized representative, I have received the above referenced
if
permit(s)as requested in the application for service EHPR-11-2023-45978,by the following method(s):
Received in Person
I Facsimile Transmittal (Return form with signature required)
11 Electronic Image Transmittal/E-mail (Return receipt required)
Stl5As 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: 11/10/2023
Owner/Authorized Representative Signature y 7_ g
ia,:,
Date 11/26/23
Documentation of Permit(s)Transmittal
(permit transmitted by electronic or other means)
Permit transmitted by (name of person sending permit)
Signature Date/Time_ NM )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 yoePlease ttake a few momentts tto complette our custtomer service survey aft
http://www.surveymonkey.com/s/EHCusttomerService
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\ CATAWBA COUNTY Case# WELL-11-2023-208240
•
�Q .f. y Public Health Department Subdivision DEERFIELD SUBD
Environmental Health Division PIN# 269905089900
/ PO Box 389,25 Government Drive,Newton,NC 28658 LOT# 80
1 ,}2/�,
Site Address: 5950 WOODHALL, HICKORY NC 28602
Name on Permit: GARY BLAIR
Property Size: Acres 1.04
Directions: NC 127, left onto Deerfield Ln, road name changes to Fawn Trail, left onto Shierbourn, right onto Brandywine,
left onto Woodhall, property ont he left
REPLACEMENT 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.
Wells shall be constructed in accordance with state regulations:
Article 15A 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 Private
Drinking Water Well Testing(15A NCAC I 8A.3800).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 be drawn from an
outside faucet unless otherwise specified.For questions or for more information,please contact Environmental Health.
a142-401il) pe;kl,4.s 11/10/2023
Authorized State Agent Permit Issuance Date
11/10/2028
Permit Expiration Date
ehpennit 11/10/2023 15:07
Catawba County Environmental Health
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Parcel: 269905089900, 5950 WOODHALL 1 in=60ft
HICKORY, 28602
This map%report-product was prepared.from the Catawba County,NC Geospatial Information Services. Catawba County has made substantial efforts
to ensure the accuracy.of location and labeling information contained on this map or data on this report.Catawba County promotes and recommends
the independent verification of any:.data contained on this map/report product by the user.The County of Catawba,its employees,agents,and
personnel,disclaim,:and shall not be:held liable for any and all damages,loss or liability,whether direct,indirect or consequential which arises or may
arise from this map/report product or the use thereof by any person or entity.
Copyright 2023 Catawba County NC
. 11/09/2023
WPDT Screening Report
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Area of Interest (AOI) Information
Area : 3,134,508.59 ft2
Nov 10 2023 15:36:01 Eastern Standard Time
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