HomeMy WebLinkAboutIMPV-03-2016-069836.TIF 7-4,3, CATAWBA COUNTY, Case# __ ___.._
/FTf .z. Public Health Department Subdivision
;4�
Q Environmental Health Division PIN# 366601260271
®' Y PO Box 389, 100-A Southwest Blvd,Newton,NC 28658 LOT#
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NAME ON PERMIT: MICHAEL GABRIEL, 3182 E MAIDEN, MAIDEN NC 28650
Site Address: 3182 E MAIDEN RD, MAIDEN NC 28650
Property Size: Square Feet: 700,880.40 Acres:16.09
Directions: Coming from town of Maiden - its 1/2 mile past Buiffalo Shoals Rd on the Left- Brick house with green roon on
left of driveway and white house on right at driveway
Owner/Authorized Representative Acknowledgement of Permit Receipt
Oki certify that I am the owner or authorized agent(owner's authorization required) representing the owner of the
property described above.
CVMthe property owner or authorized representative, I have received the above referenced permit(s) as
requested in the application for service RBPR-10-2015-22628 by the following method(s):
in
// Received in Person
Facsimile Transmittal (Return form with signature required)
Electronic Image Transmittal/ E-mail (Return receipt required)
...5g50 As the property owner or authorized representative I have reviewed and understand the specific conditions
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: 03/08/2016
Owner/Authorized Representative Signature C t '
Date ELFph&
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
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ehpermit 03/08/2016 09:04 Page 3 of 3
g a CATAWBA COUNTY 0 11 o 0 Case# IMPV-03-2016-069836
,�GL Public Health Department Subdivision
v Environmental Health Division
f o PIN# 366601260271•
PO Box 389, 100-A Southwest Blvd,Newton,NC 28658 , LOT#
/8.'2. su
NAME ON PERMIT: MICHAEL GABRIEL, 3182 E MAIDEN, MAIDEN NC 28650
Site Address: 3182 E MAIDEN RD, MAIDEN NC 28650
Property Size: Square Feet:700,880.40 Acres:16.09
Directions: Coming from town of Maiden - its 1/2 mile past Buiffalo Shoals Rd on the Left- Brick house with green roon on
left of driveway and white house on right at driveway
Improvement Permit
Facility: Primary Residence
Permit Category: New Septic Bedrooms 4
WATER SUPPLY: Private Well
Basement? Yes Basement Plumbing? No
INITIAL SYSTEM SPECIFICATIONS
Permit Valid: Expires In Five Years: _X_ No Expiration:
Projected Daily Flow 480 g.p.d
Proposed Wastewater System: 25% REDUCTION
Type: IIIG-OTHER NON-CONY TRENCH SYSTEMS
Permit Conditions: See AC for permit conditions
REPAIR SYSTEM SPECIFICATIONS
Repair System Required? Required
Proposed Wastewater System: 25% REDUCTION
Type: IIIB-SYSTEM W/SINGLE EFFLUENT PUMP
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 Sewa2e 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.
Jason Boyd 03/08/2016
AUTHORIZED STATE AGENT APPROVAL DATE
Permit Expiration Date:
03/08/2021
No grading or construction activity is allowed in areas designated for system and repair without approval of the Health Department.
ehpermit 08/25/2016 10:54
(3-A • CATAWBA COUNTY Permit# RBPR-10-15-22628
G Name Michael Gabriel
2 Public Health Department
q, 3 Address 3182 E Maiden Rd Maiden NC
�7
4. Environmental Health Division
\\ ' '/ xC PO Box 389, 100A Southwest Blvd, Newton NC 28658 PIN# 366601280271
/842 sw (828)465-8270 Fax (828)465-8276 TDD(828)465-8200 ,
Site Plan Authorization to Construct
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Department of Environment,Health,and Natural Resources Sheet:
Division of Environmental Health Property ID:
On-site Wastewater Section Lot#:
SOIUSITE EVALUATION File#:
for ON-SITE WASTEWATER SYSTEM AppID: RBPR-10-15-22628
Owner: Michael Gabriel Applicant:
Address: 3182 E Maiden Rd Maiden NC Date Evaluated: 3/1/2016
Proposed Facility: 4 BR home Design Flow(.1949) 480 Property Size:
Location of Site: Property Recorded:
Water Supply: Private well [ ]Spring [ ]Other
Evaluation Method: pits by owner [ ]Cut
Type of Wastewater: X Sewage [ ] Industrial Process 1 1 Mixed
P '.s i' +L a .. +�'{•+#k` y 4 `vtopop' yr ,die ,, a°" p a t z. k x x.r az #t ,f`i'+` r. o u :.
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01 r k `a I 1 „i'i'c SOIL�:MORPHOLOGY : g1 tt y 3-c.. s vim* 1b 117.1 T�� 4 n 2401D3-#1t
13` n a. 4 r a x a if ,tP vs 'f e t c� , �
gF �, ��,�',� �� t :��� � t �� `"` :., , ��1941¢ #t �'m ;°��: ,yaw L�l?ROFILE FACTORS -�M`� �1.Li""r`�n L. '���" �. ;.
IL .1,1-'4 r d Landscape IHo ii on9'1:414:141;*94 +icg rfia'=u�1941 qs id= pia 'P$fi?gg• 'if+..A..ct 8 .943 1,1956' gg h x t9' I l"h~.,4F,wi':
pp ' , 944 Profile c,
�E ,fir 1 f Po oh£ Dept y ,Structure/fig a iti;Aonsistencea ' 174I° W.600e0�4;, > r :ili ,IT.1S pro 1S �I e tr4 t °r Class„ gin'
4.. . =F i Slope%> __,,(IN)0 I: ,„1 Textureta,,y P x.,y Mineralogy a=„,f,., e --, Color :,rc,. . 1,Depth(IN.) ,.,tClaass,) .",�.=Hoiiz ._. 4&=LTAFk1 VA:
1 LL 6-8% 0-6" topsoil .3 PS
6-36" SCw/sap SS,SP,SEXP,FR 48"
36-48" SCw/sap some small rock
2 same as 1 48" .3 PS
3 LV 3-5% 0-6"
6-18" SC SS SEXP SP FR
4 184- chroma 2 or less throughout US
Description Initial System Repair System Other Factors(.1946):
Available Space(.1945) ps ps Soil Evaluation By: Jason Boyd
System Type(s) IIIG IIIBG Others Present:
Site LTAR .3 .3 Site Classification(.1948): PS
Site Evaluation By:
Others Present:
Sheet:
COMMENTS: FILE#:
Landscape Position Group Texture .1955 LTAR Structure
R-Ridge I S-Sand 1.2-0.8 SG-Single Grain
SS-Shoulder Slope LS-Loamy Sand M-Massive
LS-Linear Slope CR-Crumb
FS-Foot Slope II SL-Sandy Loam 0.8-0.6 GR-Granular
NS-Nose Slope L-Loam SBK-Subangular Blocky
HS-Head Slope ABK-Angular Blocky
CC-Concave Slope III SI-Silt 0.6-0.3 PL-Platy
CV-Convex Slope SICL-Silty Clay PR-Prismatic
T-Terrace Loam
FP-Flood Plain CL-Clay Loam
SCL-Sandy Clay
Loam
IV SC-Sandy Clay 0.4-0.1
SIC-Silty Clay
C-Clay
Consistence Consistence Min eralociv
Moist Wet SEXP-Slightly Expansive
VFR-Very Friable NS-Non-Sticky EXP-Expansive
FR-Friable SS-Slightly Sticky
FI-Firm S-Sticky
VFI-Very Firm VS-Very Sticky
EFI-Extremely Firm NP-Non-Plastic
SP-Slightly Plastic
P-Plastic
VP-Very Plastic
Sk h of Soil Evaluation Locations
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