HomeMy WebLinkAboutIMPV-11-2023-208366.TIF -
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=4, CATAWBA COUNTY
.t. Public Health Department Subdivision FAIRWAY ACRES
�. � Environmental Health Division PIN# 372018302541
oi w PO Box 389,25 Government Drive,Newton,NC 28658 LOT# 8&9
Site Address: 1299 FAIRWAY DR, NEWTON NC 28658
Name on Permit: TAYLOR HUFF
Property Size: Acres 2.19
Directions: Startown Rd to Sandy Ford Rd, Left on Fairway Dr, Lot is on the Right
Owner/Authorized Representative Acknowledgement of Permit Receipt
i s/7l certify that I am the owner or authorized agent(owner's authorization required)rcprcscnting the owner of
the property described above.
VSPi/As the property owner or authorized representative, I have received the above referenced
permit(s)as requested in the application for service RBPR-09-2023-45478,by the following method(s):
Received in Person
Facsimile Transmittal(Return form with signature required)
IElectronic Image Transmittal/E-mail (Return receipt required)
S'"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: 11/13/2023
Owner/Authorized Representative Signature - 1, S. 94
Date 11/27/2023
Documentation of Permit(s)Transmittal
(permit transmitted by electronic or other means)
Permit transmitted by (name of person sending permit)
Signature t Date/Time 11_1 r»I'3
Method: Fax J Email US Mail Other
Owner's request to send by the above indicated method of transmittal in lieu of signature
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chpenna I1/17/2023 06:55