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Home My WebLink AboutIMPV-02-2016-069508.TIF „p . CATAWBA COUNTY Case# IMPV-02-2016-069508 r i.4.j t Public Health Department Subdivision Jimmy L Moore and wife Sh 4 U ,� Environmental Health Division PIN# 374309159477 -4, PO Box 389, 100-A Southwest Blvd,Newton. NC 28658 LOT# 2 I8c sv NAME ON PERMIT: JIMMY L. & SHIRLEY C. MOORE, 36 SULLIVAN POINT LN, TAYLORSVILLE NC 28681 Site Address: 4274 JAYOUNT FARM RD, CONOVER NC 28613 Property Size: Square Feel:43,908.48 Acres:1.008 Directions: County Home Rd, County Home Dairy Rd, right Spring Hill Dr, left JA Yount Farm Rd, property in curve on right Owner/Authorized Representative Acknowledgement of Permit Receipt / ed ify that I am the owner or authorized agent(owner's authorization required) representing the owner of the i property described above. (�/pjl s the property owner or authorized representative, I have received the above referenced permit(s) as requested in the application for service EHPR-02-2016-23138 by the following method(s): JReceived in Person Facsimile Transmittal (Return form with signature required) Electronic Image Transmittal/E-mail (Return receipt required) ,t/As the property owner or authorized representative I have reviewed and understand the specific conditions f of the permit issued, and further understand that all applicable regulatory requirements specified under the North Carolina Laws and Rules for Sewage Treatment and Disposal Systems (15A NCAC 18A .1900), and/or Well Construction Standards (15A NCAC 2C .0100), shall apply to the issuance of this permit and the construction of the wastewater system and/or water supply well permitted. Permit Issue Date: 02/24/2016 '—�Owner/Authorized Representative Signature L 72i7 ” " Date b2/)5 /6 Documentation of Permit(s) Transmittal (permit transmitted by electronic or other means) Permit transmitted by (name of person sending permit) Signature Date/Time Method: Fax Email US Mail Other Owner's request to send by the above indicated method of transmittal in lieu of signature We want to hear from you. Please take a few moments to complete our customer service survey at: http://www.surveymonkey.com/s/EHCustomerService ehpennit 02/24/2016 16:55 Page 3 of 3 t$A CATAWBA COUNTY 0 Case# IMPV-02-2016-069508 Public Health Department ' - -fr Subdivision Jimmy L Moore and wife Sh �� a 374309159477 Q p„�, Environmental Health Division -;,'L.° PIN# ® w PO Box 389, 100-A Southwest Blvd,Newton.NC 28658 -� � o f LOT# 2 ar{ CI NAME ON PERMIT: JIMMY L. & SHIRLEY C. MOORE, 36 SULLIVAN POINT LN, TAYLORSVILLE NC 28681 Site Address: 4274 JAYOUNT FARM RD, CONOVER NC 28613 Property Size: Square Feet:43,908.48 Acres:1.008 Directions: County Home Rd, County Home Dairy Rd, right Spring Hill Dr, left JA Yount Farm Rd, property in curve on right Improvement Permit Facility: Primary Residence - house Permit Category: New Septic Bedrooms 3 WATER SUPPLY: Private Well Basement? No Basement Plumbing? No INITIAL SYSTEM SPECIFICATIONS Permit Valid: Expires In Five Years: _X_ No Expiration: Projected Daily Flow 360 g.p.d Proposed Wastewater System: 25% REDUCTION Type: IIIG- OTHER NON-CONY TRENCH SYSTEMS Permit Conditions: House may need to shift upslope to allow for more area for gravity initial system REPAIR SYSTEM SPECIFICATIONS Repair System Required? Required Proposed Wastewater System: 25% REDUCTION Type: 111G -OTHER NON-CONY TRENCH SYSTEMS PUMP REQUIRED Landscaping or other site alterations that potentially divert groundwater or surface water toward the septic system, or prevent proper drainage away from the septic system, including the direction of gutter flows or foundation drains, is not approved,and may result in failure to approve the initial system installation, or the suspension/revocation of existing permits. The issuance of this permit by the Health Department does not guarantee the issuance of other permits. It is the responsibility of the applicant/property owner to insure that all Catawba County Planning/Zoning and Building Inspections requirements are met. This Improvement Permit is subject to revocation if the site plan,plat or the intended use changes,or if site conditions are altered. The Improvement Permit is not affected by a change in ownership of the property. This permit was issued in compliance with the provisions of the North Carolina 'Laws and Rules for Sewage Treatment and Disposal Systems' (15A NCAC 18A.1900). Neither Catawba County nor the Environmental Health Specialist warrants that the septic tank system will continue to function satisfactorily for any given period of time. Steven Price 02/24/2016 AUTHORIZED STATE AGENT APPROVAL DATE Permit Expiration Date: 02/23/2021 No grading or construction activity is allowed in areas designated for system and repair without approval of the Health Department. ehpermit 02/24/2016 16:55 Page I of3 IF /AIR- z313Q 14274 3 A k104+t F.r.. A Conwv q Do 4.4 st.dc. C.. 4.'(, o r al;it *Vote Scpi:c altos 1-Lutc MC•.l SLZC ttpsl.{c c.n(,k y� L7. i zA..1 p w4•. 11k is cop (ma Pr Iot1 0,-,&e�. 1 1 .{� 4 Qt'sentd SK0WvU L- 4 l:w ec $L.ea p .f a." 4et. ".4.•LI ;n tt i W. l.{ 04.4t4- be etc.rd.a prt.r {o inst.-Lc o€ AC. 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Cc' DEPARTMENT OF HEALTH AND HUMAN SERVICES h0 E R -02- toll, - 2-3(3 57 Sheet l of f DIVISION OF PUBLIC HEALTH,ENVIRONMENTAL HEALTH SECTION PROPERTY ID II: ON-SITE WATER PROTECTION BRANCH COUNTY:C44.4's SOIL/SITE EVALUATION for ON-SITE WASTEWATER SYSTEM (Complete all fields in full) J OWNER: ,.M.-Y ,o,-c _ APPLICATION DATE ADDRESS: DATE EVALUATED: 441.44 PROPOSED FACILITY: 36r- PROPOSED DESIGN FLOW(.1949): SGo PROPERTY SIZE: i cc LOCATION OF SITE: PROPERTY RECORDED: WATER SUPPLY: U Private U Public s-�/Well U Spring U Other EVALUATION METHOD: U Auger Boring £Pit U Cut TYPE OF WASTEWATER: gsewage U Industrial Process U Mixed P R SOIL MORPHOLOGY OTHER F (.1941) PROFILE FACTORS I .1940 E LANDSCAPE HORIZON POSITION/ DEPTH PROFILE q • SLOPE% UN .1942 .1941 .1941 SOIL .1943 .1956 .1944 CLASS STRUCTURE/ CONSISTENCE/ WETNESS/ SOIL SAPRO RESTR &LTAR TEXTURE MINERALOGY COLOR DEPTH CLASS HORIZ 0^L I'Shc" CL. (-e- SC (CS 4-5 6 - h uk-/ C Fr Sc N� 37 PS � � 1 o. 3 /s lD'6 f7-37 'Sal et . ft Se 37-49 Sts Shp L flit 1C • o-(o lisEfc c Fit SE Ps fS ID- 3t 56k c /st;c $ few N 4- (1Z- rich Al 4-- 2 ,6 32-- In- msdlc cc- ✓/-tca SSE 0,3 • 0-7 `Sac- / cc. Fie S8' _ 1-31 sal, / c n Se _ iii 4- ti ,ti,� Al+ QS 3 f'6 31-if 2_ 4rsaft-/ cc A ft— ti a-g Q..5ttAL rt. se P L5 Pp S61c 7 4. Fr SC , - yY ,vr rvif 4 f�•� 3(-4Y `'S`Ic/ ct. Fr sr _ ° Li DESCRIPTION INITIAL SYSTEM REPAIR SYSTEM OTHER FACTORS(.1946): Available Space(.1945) Pr PS SITE CLASSIFICATION(.1948): �/ Es Lj(� �5 EVALUATED BY: 51`. A-1. System Typc(s) OTHER(S)PRESENT: Site LIAR o.3 0,3 COMMENTS: