HomeMy WebLinkAboutWELL-11-2023-208208.TIF ��rZy- CATAWBA COUNTY • •
8•/-i- r Public Health Department Subdivision CRESCENT LAND AND TIMBE
31 ; �el Environmental Health Division PIN" 462701275134
Alp\...-0 PO Box 389,25 Government Drive,Newton,NC 28658 LOT# 97
Sits Address: 9252 LEGRAND DR,TERRELL NC 28682
Naar on Permit: 'HOWELL ENTERPRISES,INC;RICK
Property Slzs: Acres 1.63
Directions: Coming 150 towards Mooresville take a Right on Gordon St before the 150 bridge,then left on Legrand
Owner/Authorized Representative Acknowledgement of Permit Receipt
I certify that I am the owner or authorized agent(owner's authorization required)representing the owner of
the property described above.
'i, As the property owner or authorized representative,I have received the above referenced
permit(s)as requested in the application for service RBPR-09-2023-45602,by the following method(s):
Received in Person
f Facsimile Transmittal(Return form with signature required)
�! Electronic Image Transmittal/E-mail (Return receipt required)
1, fa 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:11/10/2023
Owner/Authorized Representative Signature 64. r),"- i
Date I I/e1 /c.3
Documentation of Permit(s)Transmittal
(permit transmitted by electronic or other means)
Permit transmitted by
(name of person sending permit)
q
Signature f Date/Time 1 /1 ))/)3
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 yoaplease ttake a few momentts tto complete our customer service survey att
http://www.surveymonkey.tom/s/EHCusttomerService
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e%r14 CATAWBA COUNTY Case# WELL-I1-2023-208208
t.l Public Health Department Subdivision CRESCENT LAND AND TIMBI
Environmental Health Division PIN# 462701275134
PO Box 389,25 Government Drive,Newton,NC 28658 LOT# 97
sw
Site Address: 9252 LEGRAND DR,TERRELL NC 28682
Name on Permit: *HOWELL ENTERPRISES, INC; RICK
Property Size: Acres 1.63
Directions: Coming 150 towards Mooresville take a Right on Gordon St before the 150 bridge, then left on Legrand
WELL ABANDONMENT PERMIT
Well Type: Drilled
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.
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11/10/2023
Authorized State Agent Permit Issuance Date
11/10/2028
Permit Expiration Date
elipeiinn 11/10/2023 16:23
Catawba County Environmental Health
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Parcel:462701275134, 9252 LEGRAND DR 1in=50ft
TERRELL,28682
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