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i <br /> i <br /> Jul 19 22 09:41 p Vernon Davis 919-869-7687 P.1 213 <br /> CAEOP22-0013 <br /> State of NC EOP LHO Reference: <br /> this section Is for Owner use to either designate PE as thePr legal representative or to self-submit the 11101. <br /> Designation of Registered Professional Engineer as legal representative of owner for this Notice of Intent. <br /> I, hereby designate ATHAN M PARKER PE <br /> Print Name of Owner Print Nome of Aeglstered Professional Engineer <br /> as I al representative for pur ose of this Notice of Intent pursuant to G.S. 130A-336.1. <br /> Signature of owner Date <br /> Owner self submittal of NOI., <br /> i, hereby submit this NOI prepared by <br /> Print Name of Owner Print Name of Licensed PE <br /> pursuant to G.S.13OA-335.1. <br /> Signature of Owner Date <br /> NOTES: <br /> LIABILITY; The Department,the Department's authorized agents or local health departments shall have no!lablirty <br /> for wastewater systems designed,constructed and installed pursuant to on Engineered option Permit.[(NC General <br /> Statute 13OA-336.1(f)] <br /> RIGHT OF ENTRY.• The submittal of this Notice of intent to Construct grants right of entry to the Local Health <br /> Department and the State to the referenced property. <br /> ISSUANCE OF BUILDING PERMIT: Once the LHD deems that the Notice of Intent to Construct is complete via <br /> signature in the section above,the owner may apply to the local permitting agency for a permit for electrical, <br /> plumbing,heating,air conditioning or other construction,location or relocation activity uhder any provision of <br /> general or special law pursuant to G.S.130A-338. <br /> Page 3 of 6 <br /> VftH5/EH5/05WP8-COMMON FORM Effectivelune 1,2018 <br />