HomeMy WebLinkAboutOP-03-2016-069932.TIF ,g CATAWBA COUNTY 0 . L 0 Case# OP-03-2016-069932
tt i L Public Health Department T r Subdivision RUSSELL RIDGE PH 2
< $3Y En vironmental Health Division , r i't. '. : PIN# 378004520887
"'s PO Box 389, 100-A Southwest Blvd,Newton,NC 28658 _ G _ LOT# 25
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NAME ON PERMIT: *LAKE VISION DEVELOPMENT INC, 2242 LONGCOVE CT, SHERRILLS FORD
NC 28673
Site Address: 5527 LIGHTNING LN, CATAWBA NC 28609
Property Size: Square Feet: 34,848.00 Acres:0.8
Directions: Hwy 10 E to Murrays Mill/ RT go to end left on Sherrills Ford RD, 1/2 mile on left.
Catawba County Health Department Operation Permit
System Type: IIIG - OTHER NON-CONV TRENCH SYSTEMS
(In accordance with Table Va)
Description: 25% REDUCTION
System Code: IQ4W System Code Description: Infiltrator Quick 4 Standard W
Types V and VI systems expire in 5 years.
Owner must contact health department 6 months prior to expiration for permit renewal.
System Installation Comments:
PERMIT CONDITIONS:
1. All maintenance, monitoring, and performance requirements shall be in accordance with
15A NCAC 18.1900, Rule .1961
2. Operation & Maintenance Specifics:
Subsurface system operator required? Yes No_X_
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
This system has been installed in compliance with applicable North Carolina General Statutes, Rules for Sewage
Treatment and Disposal, and All conditions of the Improvement Permit and Construction Authorization.
Shannon Henderson#1091 03/09/2016
SYSTEM INSTALLER INSTALLATION DATE
Jason Boyd 03/10/2016
AUTHORIZED STATE AGENT DATE OF OPERATION PERMIT
ISSUANCE Form F
ehpennit 03/10/2016 09:14 Page 1 of3
�1S''A Permit# RBPR-II-15-22793
7, ral be CATAWBA COUNTY
G'2 Public Health Department
Name Lake Vision Development
H Address 5527 Lightning Lane Catawba
< - ,� „`, Environmental Health Division
., PO Box 389, 100A Southwest Blvd,Newton NC 28658 NC
�8�42 (828)465-8270 Fax (828)465-8276 TDD(828)465-8200 PIN# 378004520887
Lot 25
Site Plan Operation Permit
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Scale
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