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Home My WebLink AboutIMPV-03-2016-069670.TIF fig' • CATAWBA COUNTY Case# es Public Health Department Subdivision SNOW CREEK COVE d 0, Y Environmental Health Division PIN# 372515524531 �"�"- PO Box 389, 100-A Southwest Blvd,Newton,NC 28658 LOT# 6 1; su NAME ON PERMIT: TERESA BOGGS, 2178 ST JOHNS CHURCH RD NE, CONOVER NC 28613 Site Address: 4681 27TH ST LN NE, HICKORY NC 28601 Property Size: Square Feet:27,007.20 Acres:0.62 Directions: Sulpher Springs RDd, turn left onto 43rd AVE NE, go to end Sharp curve onto 29th ST DR NE, then left onto 28th ST Circle NE, Follow until road forks. I will meet at the fork in road and will lead to property. Owner/Authorized Representative Acknowledgement of Permit Receipt I certify that I am the owner or authorized agent(owner's authorization required) representing the owner of the i operty described above. el As the property owner or authorized representative, I have received the above referenced permit(s) as quested in the application for service RBPR-02-2016-23228 /' by the following method(s): y/Received in Person Facsimile Transmittal (Return form with signature required) Electronic Image Transmittal/ E-mail (Return receipt required) /; As the property owner or authorized representative I have reviewed and understand the specific conditions fif 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. )Owner!Authorized Permit Issue Date: 03/02/2016 Representative Signatu - /� mot/ Date 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 1 ehpermit 03/02/2016 08:03 Page3of3 tg CATAWBA COUNTY o ' '1te•- 0 Case# IMPV-03-2016-069670 Public Health Department �•.. JY' Subdivision SNOW CREEK COVE f� Environmental Health Division r PINK 372515524531 PO Box 389, 100-A Southwest Blvd,Newton,NC 28658 : .� �, LOT I 6 Ig.2 Ski Y C • yB GO NAME oN PERMIT: TERESA BOGGS, 2178 ST JOHNS CHURCH RD NE, CONOVER NC 28613 Site Address: 4681 27TH ST LN NE, HICKORY NC 28601 Property Size: Square Feet:27,007.20 Acres:0.62 Directions: Sulpher Springs RDd, turn left onto 43rd AVE NE, go to end Sharp curve onto 29th ST DR NE, then left onto 28th ST Circle NE, Follow until road forks. I will meet at the fork in road and will lead to property. Improvement Permit -**:r ii -- `-�-v , . J re g 33i add ' z' , i c' @ e u i wsi{-.i a ,-, ro.al G .._, . ITiITIAL,Sl S„TEIVIEXISTING � ,_.. . « Facility: Primary Residence - mobile home Permit Category: Other l3edrooms 2 WATER SUPPLY: Private Well Basement? No Basement Plumbing? No INITIAL SYSTEM SPECIFICATIONS Permit Valid: Expires In Five Years: _X_ No Expiration: Projected Daily Flow 240 g.p.d Proposed Wastewater System: CONVENTIONAL Type: IIA-CONY SYSTEM (SINGLE-FAMILY OR 480 GPD OR LESS) Permit Conditions: Existing 2 bedroom mobile home to be removed and replaced with new 2 bedroom mobile home. New home will connect to existing septic system. See attached original septic permit from 6/14/1990 for system specifications REPAIR SYSTEM SPECIFICATIONS Repair System Required? Required Proposed Wastewater System: 50% REDUCTION Type: IVA-ANY SYSTEM WITH LPP DISTRIBUTION PUMP REQUIRED ***** OPERATOR 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. Megen McBride 03/02/2016 AUTHORIZED STATE AGENT APPROVAL DATE Permit Expiration Date: 03/02/2021 No grading or construction activity is allowed in areas designated for system and repair without approval of the Health Department. ehpennit 03/02/2016 08:03 Page I of 3 I.P, NEW WE► Regik 0-20110-137)1 t{bSI 11-‘42 9-. Ln NE., \-14ocy le IA was ?reviouslr connected -lb a vJell Iocr.c a oh ana{her froper n4 cc4iquoos —Ii�iS�is 1�4 / J New Well -}-o be, drilled ob.4tiis Proper{y - w ll serve, onl7 lke ekeP•/ rvoLlt lie. Weil M4 be: 504 sefht. systems • s-tic repair Armes, 25-FI. fmrn Anic}'Xe5,inCl'diIA decl!5 a�& eordke5 , anal 5-P, -From e eri7 IUAeS. Keel yid (V} f on Fiji- -of- war and eaSer't'1s. * Area -From -le pruccrrid nevi PAN 4o —the read i5 Very Steel. Gradi n + -rec, rer oQa l u`i 11 Lake- be needed i r ordev -f o dell Well and set u? new MobiIt bow,. 0-1- grade 0( -611 11 . to ea e. ode{ SeA-Cc 6.15ken1 or senhc rein'? area. 1"r he IS, S — I ex. 01d IexKfinq M� is 57k R r,, ( local-ea i" desigSK}ed so7. gerrAr $pp}IC,repc�ir areg 7px30�1on W 46' 1 11 S, -Cron bark °4 new r'1}I dcbdeck 1° eXIS+in) $Qjnicignic pttyed MM 3•— ' YY i u i5 ri • . min flu k•lo S So sed 6pAt ° din Wel� e` well Area 50' rtinipuM from-1ha S .,n WTI{ to {hI brtk o4 ri ono' t- Mcile' koi e' "; 50' 1TthSt Lin NE DEPARTMENT 4T OPENVIRONMENT AND NATURAL RESOURCES Sheel_of_ DIVISION OF ENVIRONMENTAL HEALTH PROPERTY ID X: COUNTY: ON-SITE WASIEWATERSEC ION SOIIJSTfE EVALUATION Q for ON-SITE WASTEWATER SY$ EA4 OW1JEt1�,(tS0. Oo APP ELicAWONDATE 111ff16 R nsD -2016-23 5 ADDRESS: SIT DATE EVALUATED: D�;6,16 PROPOSIDFACQTfY: a V� PR�OQPOSED DESIGN FLOW 0 PROPERTY Sig: D.1,3-acco IOCATTONOFSTIE 681 01_ S I_rt NE, tlitra PROPERTY RECORDED WATER SUPPLY: /Private 0 Public N Well U Speing 0 Other EVALUATION METHOD: ® Auger Boring 0 Pa 0 Cut TYPE OF WASTEWATER ® Sewage IndtatnalPmcess U Mucd • 15=_ ..._.._.. _.._.........._........_......._._._...._.._____ R:vv.::::=:.Y =T.^A:::::::::::::vtL._._.,::C -:.�1-.....25,t :f: .^ .. ... :: _e_�tss=_�ste_:-aea�:: e�=� :144I :::-a:.=.:=<_:::=='=€i=_:€__ �:=i [ YRCIPIL'FF��COEtSL_..._..._......_........_.......__.._._......... .::- .. _.... `'.:._.._.._5 .�=`_ � ��_� i �H,S„1�'#3:Cr�t-_:`%9F TtaF __-�OJk;'s:::art[ SIAF6_ _ )`;�.'.:'.:`.....1''tC' ' ..._. . .._ Idl[I {A2GY' _ C4>+YI �Rt3Yft __ SI{tRi SI.Y'AR.: 04 Wsjk !- -fr.SC yip _ 4-Lig SbKL >fr 55: Seri P 1. I5.7 D•3 • 2 • 3 • 4 axis-hny DPscsuPnOY ATnAL sYSra t REPAIR SYSTEM OTHER FACTORS(.1946): Q� SITE CLASSIFICAITON(.1948):(�ar,� p Atsn,ble cr(1945) "' Rut— I- `4'/1 1 Gl C. i s -�T EVALUATED BY: J' A 1� Q OTAEE(S)PRESENT: • . Site LIAR 013 COMMENTS: LA kt i _____ _ . _ ex, 1 ra n its j etc.ST I /eXis{in rH p 50' ro .n—eu TtllS adj11acen l 14 I mg / N4; loco{4 I rMi{{ep OK—{►?S acyCfrri i WLSa009-b0636 14. Mo rvkliS 'IJhcl, ' 11-0 i I nit' SF Lh NE