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Orange County Health Department 65 <br /> Environmental Health Division <br /> 131 West Margaret Lane <br /> (919) 245-2360 11 ,` Unit 100 <br /> ORANGE COUNTY P.O. Box 8181 <br /> NORTH CAROLINA Hillsborough, NC 27278 <br /> WELL PERMIT <br /> Parcel Number: 9865878090 Property Description : E/S HWY 86 NORTH <br /> Application Date : 07/09/2024 Property Address : 1033-UT NC 86 N <br /> Permit Number: W24-0165 HILLSBOROUGH, NC 27278 <br /> Applicant: Laura Haywood Owner: Wayne Honeycutt <br /> Address : 8041 Arco Coroporate Drive Suite 110 Address: <br /> Unit Suite 110 <br /> Raleigh, NC 27617 <br /> Phone : (919)804-7220 Phone: (704)576-2476 <br /> Email : laurahaywood@forestar.com Email: whoneycutt@dickensmithener.com <br /> Well Type : Community Well Lot Size : 78.30 <br /> Well Class : New Sewage Disposal : On-site System <br /> PERMIT CONDITIONS <br /> Comments/Conditions : <br /> Condition Description Comment <br /> 8001 Wellhead Wellhead must meet current NC&OCHD <br /> specifications before COC may be issued. <br /> General EH General Condition A preliminary well site approval letter <br /> is required from NC DEQ prior to <br /> drilling. <br /> General Preliminary Well Site Approval for NC DEQ Well must be drilled in accordance <br /> Division on Water Resources with 15A NCAC 18C .0203 regulations <br /> regarding Public Well Water Supplies. <br /> Once completed the well will be <br /> subject to regulations outlined in 15A <br /> NCAC 18C .0300&.0400. <br /> This Permit serves as the plan required for constructing, or repairing a water well for drinking, irrigation, or geothermal <br /> installations.The Building Inspection and Planning agencies in your jurisdiction may require this Permit for your project. <br /> Wells must be constructed, repaired, and abandoned by a person who holds a valid certification from the State and in accordance <br /> with the Groundwater Protection Rules as adopted by the Orange County Board of Health.The certified contractor must have a <br /> physical copy of this Permit during the time of installation. <br /> Refer to the attached site plan showing the system and the proposed structures and other site conditions.The well siting is <br /> based on setback distances from known or planned features and does not indicate nor guarantee that the quantity or quality of <br /> water will be provided by a well constructed in that area. <br /> Any changes to the site that affects setbacks shall result in the revocation or revision of the Permit. Construction of the well <br /> outside of the permitted area may result in Denial of the Certificate of Completion. Mark property lines. <br /> ISSUED : 10/01/2024 `' ---- -- EXPIRES : 10/01/2029 <br /> Ian Olson <br /> ENVIRONMENTAL HEALTH SPECIALIST <br /> rpt_PM_0C_EH_We11Permit 2024.10 <br /> Report created:10/14/2024 12:33:20PM <br />