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Home My WebLink AboutIMPV-03-2016-069897.TIF 405• CATAWBA COUNTY Case# IMPV-03-2016-069897 h;AU Public Health Department Subdivision 2 tifot,� Environmental Health Division PIN# 378003310543 "4-,, � PO Box 389, 100-A Southwest Blvd,Newton,NC 28658 LOT# 1 v842 s. NAME ON PERMIT: DAVID & EMILY NOBLE, 3132 SW MILFORD CHASE, MARIETTA GA 30008 Site Address: 5095 SHERRILLS FORD RD, CATAWBA NC 28609 Property Size: Square Feet:219,542.40 Acres:5.04 Directions: Hwy 150 E, Left on Sherrills Ford Rd, 9.4 miles on Left Owner/Authorized Representative Acknowledgement of Permit Receipt c. ,, old I certify that I am the owner or authorized agent(owner's authorization required) representing the owner of the property described above. av As the property owner or authorized representative, I have received the above referenced permit(s) as requested in the application for service EHPR-02-2016-23134 by the following method(s): IReceived 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 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: 03/09/2016 (117/ Owner/Authorized Representative Signature / Date 3 110 I l(.0 Documentation of Permit(s) Transmittal (permit transmitted by electronic or other means) Permit transmitted by (name ofperson 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/ENCustomerService ehpennit 03/09/2016 12:54 Page 3 of 3 ,P, CATAWBA COUNTY CI ' I": f 0 Case# IMPV-03-2016-069897 T Public Health Department } '" .1 Subdivision i~ �� 1 r r PIN# 378003310543 a --T �, Environmental licalth Division r PO Box 389, 100-A Southwest Blvd,Newton.NC 28658 LOT# 1 i; .2 :. ri. 0 • O O NAME ON PERMIT: DAVID & EMILY NOBLE, 3132 SW MILFORD CHASE, MARIETTA GA 30008 Site Address: 5095 SHERRILLS FORD RD, CATAWBA NC 28609 Property Size: Square Feet:219,542.40 Acres:5.04 Directions: Hwy 150 E, Left on Sherrills Ford Rd, 9.4 miles on Left Improvement Permit Facility: Primary Residence - House Permit Category: New Septic Bedrooms 4 WATER SUPPLY: Public Water Basement? No Basement Plumbing? 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: II1G - OTHER NON-CONY TRENCH SYSTEMS Permit Conditions: *Do not grade, fill, or drive over any designated septic area. REPAIR SYSTEM SPECIFICATIONS Repair System Required? Required Proposed Wastewater System: 25% REDUCTION Type: IIIG -OTHER NON-CONY TRENCH SYSTEMS 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. , Robbie Phelps 03/09/2016 AUTHORIZED STATE AGENT APPROVAL DATE Permit Expiration Date: 03/09/2021 No grading or construction activity is allowed in areas designated for system and repair without approval of the Health Department. • ehpennit 03/09/2016 12:54 Page I of 3 Catawba County Environmental Health TM el- 3 -20(6- Obtggi R��t5f0 RD (296) (Bo) i 1 • ao 6" . X15 tit gig C T.\ Q k s • $ M 4� • • I Parcel: 378003310543, 5095 SHERRILLS FORD 1in=60ft RD CATAWBA, 28609 This map/report product was prepared from the Catawba County,NC Geospalial Information Services. Catawba County has made substantial efforts to ensure the accuracy of location and labeling information contained on this map or data on this report Catawba County promotes and recommends the Independent verification of any data contained on this madreport product by the user.The County of Catawba,its employees,agents,and personnel,disclaim,and shall not be held liable for any and all damages,loss or liability,whether direct,indirect or consequential which arises or may arise from this map/report product or the use thereof by any person or entity. Copyright 2014 Catawba County NC 03/09/2016 DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES Sheet_of DIVISION OF ENVIRONMENTAL HEALTH PROPERTY ID It: ON-SITE WASTEWATER SECTION COUNTY: SOIL!S1'1'E EVALUATION yy�� iL, for ON-SITE WASTEWATER SYSTEMS OWNER: //'I"I"I a- �nl'y' A'°dlc APPLICATION DATE 1��4Q--2313 { ADDRESS~ 701 rU4.rr; F.r/ � DATE EVALUATED: 2&9-16 PROPOSED FACILITY: if AA- PROPOSED DESIGN FLOW(.1949): led 0 . PROPERTY SIZE: LOCATION OF SITE PROPERTY RECORDED: WATER SUPPLY: 0 Private BPublie 0 Well 0 spring 0 Other EVALUATION METHOD: 0 Anger Baring Et Pit 0 Cut TYPE OF WASTEWATER: Er Sewage 0 Industrial Puns 0 Mixed ....::::::...::: .... :....__...- ....................::_ :' ii[_`' ::: g _ ?as;::::a;_ -:: .:r....... i5t3Ti Mnk180Y:OG1-;f(= ::: :::::::::: :: TSER' ::::.=;.e:; -=r:::::::: c :(iT84Ij__`iii':=[[f !l=_::::..._........_...._.. 94p....._ ....._.:..::.....= : :::::: _:-::: ::-:: :::::_:::::_:_:::::::::-::_=::s::::::::::,;::::::.=.:ra=i €iii_[iii-_€. €;::: :;:::_:: __ .. ... .=_ �!1;/rtb:::[a ::HDRr:: ...........................__::':::::: :: ,...:-::::_ . r•VSC V::;;i• :::ii°:: ;:: ......:-__-_:::. : "it,";;;; ORAL= 3 4 - ` emu, x • t 444 ? _pO iONt t1EPPti UCF Ct CbNSi$'{'LNty w' ''+ $'� SOIL: 5.4gItQ .B Std[ S .. sy OP G :_ .... . ... ....hW Cf<A�OLY:. Su3K DEer� cI;AC$ .. ...; . g TAR€ 9 —tit (,L wak F- y4k ��_-S7 C s 5 h - F� ,r b N 1 )��° S.) , 3 ! is j3 61- =/r 4 ....,. 1 ?r lJ ✓Ch C '51-.S$' ary0h . Fr JJ 1t 2 Sly _1 T.- , 5 V-21 6,L,/ L..1(h N rr r1H III 7-5-S1 C Ak Fr _ r Ail 3 / 0-2i CL 4-c11 Fr r✓ rlh 5 '6 Z1-41 C ss h C.- If rlh 3 4 it DESCRIPTION ATSiAL SYSTEM REPAIR SYSTEM OTHER FAC,1 ORS(.1946): r Ar+atn a srSpace C-lsas) 2 J s SITE CLASSIFICA ION(.194S): P / SycTYpr(s) 2 St; 2Y 11 EVALUATED BY: RyLtiL filer - O1HLR(S)PRESENT: _ - Sire LIAR ' 3 t 3 COMMEMS: S) 0 — f 0 C L riA Frmre I 30 —111 [t-tap 64.1k Fr;Pr, .--'-------- 45 . f �. ,r ly yf 3 t.C:fl� t �` tkEa " • . f 961 1� . , i ' J 8Gi _ D 'gyp • '\hJl 't ,4ti 17- II . \d I I i \\\\I \ . y 9 . r • 0 a . Parcel: 378003310543, 5095 SHERRILLS FORD 1in=60ft RD CATAWBA, 28609 This map/report product was prepared from the Catawba County.NC Geospatial Information Services. Catawba County has made substantial efforts to ensure the accuracy of location and labeling information contained on this map or data on this report.Catawba County promotes and recommends the Independent verification of any data contained on this map/report product by the user.The County of Catawba,its employees,agents,and personnel,disclaim,and shall not be held liable for any and all damages,loss or liability,whether direct,indirect or consequential which arises or may arise from this map/report product or the use thereof by any person or entity. Copyright 2014 Catawba County NC 03109/2016