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CONSTRUCTION For Office Use Only
AUTHORIZATION *CDP File Number 3 5$ 4 3
Catawba County Public Health Department County ID Number: EHPR-10-09-2264
Environmental Health Division Evaluated For: NEW UTIt_)
t-'"~IQ M' P.O Box 389, 100-A Southwest Blvd
PERMIT VALID UNTIL:
,/,tom e Newton NC 28658 1 1/ 0 / D 0 1 4
Phone: (828)-465-8270 Fax: (828) 465-8276
Applicant: Donnie And Kathy Fulbright Property Owner: Donnie and Kathy Fulbright
Address: 2198 Willow Creek Dr Address: 2198 Willow Creek Dr
City: Newton City: Newton
State/Zip: NC 28658 State/Zip: INC 28658
Phone Phone# :
Property Location & Site Information
Address/Road Subdivision: Phase: Lot:
5927 Startown Rd
Maiden NC 28650 Directions
Structure: SINGLE FAMILY
# of Bedrooms: 3
# of People:
*Water Supply: NEW WELL
s em ecl Ica is
Minimum Trench Depth: 3 0
Inches
*Site Classification: PS Minimum Soil Cover:
Inches
Design Flow: 3 6 0 Maximum Trench Depth: 3 6
Inches
Soil Application Rate: 0 . 3 Maximum Soil Cover:
Inches
*System Classification/Description: *Distribution Type: GRAVITY - SERIAL
TYPE III G. OTHER NON-CONY. TRENCH SYSTEMS
Septic Tank: 1 0 0 0 Gallons
*Proposed System: 25% REDUCTION 1-Piece: QYes QNo
Nitrification Field Pump Required: QYes QNo Q May Be Required
9 0 0 Sq. ft.
Pump Tank: Gallons
No. Drain Lines 3
1-Piece: QYes QNo
Total Trench Length: 3 0 0
ft, GPM--vs-- ft. TDH
Trench Spacing: 9 ()Inches O.C.
*Feet O.C. Dosing Volume: _ Gallons
Trench Width: Qlnches
3 *Feet
Aggregate Depth: Grease Trap: Gallons
inches Pre-Treatment: O NSF OTS-1 OTS-11
Septic Tank Installer Grade Level Required: 01 011 0111 01V
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CDP File Number 35847 County ID Number: EHPR-10-09-2264
❑ Open Pump System Sheet
Repair System Required:OYes O No ONo, but has Available Space
Repair System
Trench Spacing: Qlnches O.C.
*SiteClassification: Ps - QFeetO.C.
Trench Width: Qlnches
Design Flow: 3 6 0 - Q Feet
Soil Application Rate: 0 3 Aggregate Depth: inches
u Minimum Trench Depth:
*System Classification/Description: Inches
TYPE III G. OTHER NON-CONY. TRENCH SYSTEMS Minimum Soil Cover:
Inches
Maximum Trench Depth: Inches
*Proposed System: 25°° % REDUCTION M
Maximum Soil Cover:
Nitrification Field Inches
9 0 0 Sq. ft.
No. Drain Lines 3 *Distribution Type:
1 Total Trench Length: 3 0 0 Pump Required: QYes QNo QMay Be Required
ft.
Pre-Treatment: O NSF OTS-1 OT,-11
"Site Modifications
No grading or construction activity is allowed in areas designated for system and repair without approval of Health Department.
'Permit Conditions
The issuance of this permit by the Health Department in no way guarantees the issuance of other permits. The permit holder
is responsible for checking with appropriate governing bodies in meeting their requirements.
This Authorization for Wastewater System Construction shall be valid fora person equal to the period of validityof the Improvement Permit, not
to exceed five years, and maybe Issued at the same time the Improvement Permit issued (NCGS 130A-336(b)). If the installation has not been
completed during the period of validity of the Construction Permit, the information submitted in the application for a permit or Construction
Authorization is found to have been incorrect, falsified or changed, orthe site is altered, the permit or Construction Authorization shall become
invalid, and may be suspended or revoked (.1937(8)). The person owning or controlling the system shall be responsible for assuring compliance
with the laws, rules, and permit conditions regarding system location, installation, operation, maintenance, monitoring, reporting and repair
(1938 (b)).
Applicant/Legal Reps. Signature Required? OYes ONO
/
Applicant/Legal Reps. Signature Date:
"Issued By: 1952 - Phelps, Robert Date of Issue: i 1 / 0 a a 0 0 9
Authorized State Agent: 4 Malfunction Log OYes
U Hand Drawing Olmport Drawing Total Time:(HH:MM)
**Site Plan/Drawing attached.**
Hours Minutes
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CDP File Number: 35847 County ID Number: E"PR-10-09-2264
Drawing Type: Construction Authorization Date- 1 1 0 a 0 0 9
0Inch
Scale: OBlock = ft.
Drawing ON/A
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