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HomeMy WebLinkAboutIMPV-4-11-17372.TIF y1�' Permit # EHPR 3-1 ]-10170 CATAWBA COUN1'Y �" ''� � Name DV Wise Inc Tom Wise � � '2� Public Health Department � Address 2485 Penngate Dr Sherrill's Ford �',�,� ,,�, Environmental Health Division PIN# 462801381529 PO Box 389, 100A Southwest Blvd, Newton NC 28658 1� t�'L sM (828) 465-8270 Fax (828) 465-8276 TDD (828) 46�-8200 Site Plan Authorization to Construct � � ` , 5�,�.. � � ' p�..,., �� � � �JJ �' , � , �l.si � �c ��;�- � a� � 5 y sa-�,� � ��„ o rs � � � � ���t� . � , ` (.1 rr.-� y U�� ye�d ��-} ,,,� w����, �°, S°-Pk . n �,,, � L. �P � � , s � � ;1���- � � � s � � � ?V, .� , / (31 7l -� r�����5 � J �� 010 \ ��n ���,, a � l„� �� e -�- n� ,�c.�.�� f' ' 1 . � p�� � t . �Ig' � a � ��.,-��r' J 7?' , � � � � � � oo � � e � 1 � � ( I S �-E- �� � � Q..q "� , � �-�.� a�c� - o�N 3 �' � �'. 3� � �--^ � iv�-��� �o, � � � r � , � � � c�.............. � — _ , � �° o`f � � v„ �..�k � � , o � � L. � ►� � � , � o �-- � �., �-- � 1 � r�, �- o,� S+ � 1 I t--I- ��, �, � �. , . -{�o ���'c.r/��.n� _ �✓�_�i�� SYS{e.n� �'� . � T � �1 '��,-- �- � „ � �l 5 � �� (�vl'�y � 1 �`�� (�' . � 5 0 ' �� ,,�, g.� w� I I � l��� � � } //� �� ��� . � c� C c� ,j J S�. � ��� ���� ��.� P � r �-� � ����5 (S���o�. PJJ 7�f ra,•-� I I� a�,�. � L�� a.-s �- D�� ��� S �- � t I�.� o� c- � �-� � � � q �� � ; ^� o-� -��� Y � �� L.-� cl�� r ��� ; � r � ✓� ''� Y � . I � � 5 U � S,,,,� �( I -�- r��. J c•� � u n c� Q. (" Lj r� I� �'� S Y S 1' �. � Scale � � �� n� i � c, r�-� t,,, : l 1 t`�s � L� l� (�.� c� � c� ��^ o��� �.: Apr 27 11 02:23p DV Wise, Inc. 704 248-8299 p.1 CATA W BA COU NTY' Case �l Public liphh Dcpartmrnl Subdivision LAKEPOINTE NORTH � Grrvi�nmcntal Fleatth Division PO Box 3R9, 104-A Southwest Blyd, Newton, NC 28G58 Lat �i z � �' , P�n'� 462801381529 Applicanvowner DV WISE INC TOIvI V�ISE Site Address: 2485 PEt�'�VGATE DR, Shemlls Fo�d, NC PropertySize: SF 0.819 ACRES Direciions: 150 � LEI-I' ONTO SHERRI�L3 FOkD 1tll, ftlGHT ONTO tSLAND PQTV7' RD, L£FT ONTO PGNNGAT� DR, LOT 21 ON I,EFT ]US7� �EFORE CUL D£ SAC Owner/Authorized Representative Acknowledgement of Permit I��ce�pt _ 1 ceRify that 1 am the owner or authoriaed agent (owner's authorization required) representing the owner of the property described above. As the property owner or authorized representative, I have received the above referenced permit(s) as requested in the application for service EHPR-3-11-14170 , by the following method(s): Received in Person _ Facsimile Transmittal (Return form with signalure requ�red) ec onic Image Transmittal/ E-mail (Return receipt reqaired) As the propecty owner or auchocized representative I have reviewed and understand the specific conditions of the permit issued, and further understand tl�at a]( applicable regulatory requirements specified under the �1orth Carolina Laws and Rules for Sesvage Treatment and Disposal Systems (15A NC�iC 18A .1900), and/or Well Const�uction Standards (LSA NCAC 2C .0100), shall apply to the issuance of ihis pernli� and the consiruction of ttie waste�vater system and/or water supply well permitted. Pernut Tssue Date: 04/27l2011 Owner/Anthorized Repr�sentative Sigaature ` ��� � Date Documentation of'Permit{s)'I'ransmittal (perroit transmitted by electtonic or otber means) Pennit transmitted by l�ii- � L (name ofperson sending permit) Signature Date/Time :�? 1�,j � Method: Fax J Email US 1�Iai1 Oiher Owner request io send by the above iredicsted mcthod of trans;nittal in lieu of signature acknowledges the cvnclifions and statements above. � i n � � d �/w>:� . C��t oar_7r� i a9:3 � �?� �.�� � �'�