HomeMy WebLinkAboutAUTH-3-11-15882 CATAWBA CUUNTY Case# AtJTH-3-S 1-15882
', Public Health Depertmeat Subdivision 3VORTtiViEW HARBOUR
� Environmental Health Division
'. PO Box 389, 100 Southwest Blvd, Newton, NC 28658 LOt # � 3
_ .
PIN# 462903004192
AppltcanslOwner TOM PALMER HOMES TNC
Site Address: 2281 NORTHV[EW HAR64UR DR, Sherrills Ford, i�EC
Property Size: SF 0.589 ACRES
Directfons: HIGHWAY 16 S- TUIt?J LEF'I' OI�TO HIGHWAY t 50 - TURN LEFT ONTO SHERRILLS FORD RQ - TURN RIGRT
ONTO ISLAND POTNT Rll -'fURN LEFT ONTO NORTHVIEW HARSOUIt DR - LOT ON LEFT
OwaerlAuthorized Representative Acknowledgement of Permit Receipt
1 certify that I am the owner or authorized agent (owner's authorization required) representing the owner of the
property described above. �
As the properiy owner ox authorized representat�ve, I have received the above referenced permit(s) as
requested in the application for service EHPR-3�-11-9655 , by the following method(s):
Received in Persan
Facsimile Transmittal (Return form with signature required)
r Electronic Image Transmittall E-mail (F:eturn receipt required)
As the progerty owner or authorized eepresentative I have reviewed and understand the specific
conditions of the permit issued, and further understand that all applicable regulatory requirements
speci�ed under the North Carolina Laws and Rules for Seva�age Trextment and Disposat Systems (15A
NCAC 18A .1900), and/or V4'eEl Construction Stan�dards {15A NCAC 2C .OI00), shall apply to the
issuance of this permit and the canstruction of the wastewater system and/or water supply well permitted.
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Permit Issue Date: 03/08/2011 �'� ,/, :,,
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Owner/Authorized Representative Signatnre �� `°'��,����_�'� `r`
Date � � �� ��
Documentation of 1Perrr�it{s) Transmittal
(permit transmitted by electronic or other means)
Permit transmitted by �!�, (name ofperson sending permit)
Signature _ Date/Time �/711 I �'S �
Method: Fax �Email US Mail C3ther
Owner's request to send by the above 'rndicated method of transmittal in lieu of signature
acknowledges the condit:ions and stateme�nts above.
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