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Home My WebLink AboutIMPV-03-2016-070048.TIF �gA CATAWBA COUNTY Case# IMPV-03-2016-070048 `r �' Subdivision ¢' tin.%l, Public Health Department ® ,� Environmental Health Division PIN/t 374120904085 PO Box 389, 100-A Southwest Blvd,Newton.NC 28658 LOT# 2 1:4 NAME ON PERMIT: HALDAN & KRISTIN JOHNSON, 2474 KEISLER DAIRY RD, CONOVER NC 28613 Site Address: 1978 BURRIS RD, CONOVER NC 28613 Property Size: Square Feet: 179,467.20 Acres:4.12 Directions: Hwy 16 S from Conover, LEft onto Burris Rd & lot will be 1/2 mile on Left Owner/Authorized Representative Acknowledgement of Permit Receipt - IA) 1 certify that I am the owner or authorized agent (owner's authorization required) representing the owner of the property described above. • HI1 As the property owner or authorized representative, I have received the above referenced permit(s) as x, requested in e application for service EHPR-02-2016-23224 by the following method(s): _ Received in Person Facsimile Transmittal (Return form with signature required) Electronic Image Transmittal/ E-mail (Return receipt required) /stn) 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: 03/14)2016 a i� wner/Authorized Representative Signaturrce . 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 ehpermit 03/14/2016 11:49 Page 3 of 3 Irani• CATAWBA COUNTY U 02 f o Case# IMPV-03-2016-070048 �' L Public Health Department `5 :1 Subdivision S r Q � Environmental Health Division r - • PIN# 374120904085 ` *- PO Box 389, 100-A Southwest Blvd, Newton,NC 28658 ' ' ie LOT# 2• 0 r. 8 "e0 NAME ON PERMIT: HALDAN & KRISTIN JOHNSON, 2474 KEISLER DAIRY RD, CONOVER NC 28613 Site Address: 1978 BURRIS RD, CONOVER NC 28613 Property Size: Square Feet: 179,467.20 Acres:4.12 Directions: Hwy 16 S from Conover, LEft onto Burris Rd & lot will be 1/2 mile on Left Improvement Permit Facility: Primary Residence Permit Category: New Septic Bedrooms 4 WATER SUPPLY: Public Water Basement? No 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: 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 ISA.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 03/14/2016 AUTHORIZED STATE AGENT APPROVAL DAVE Permit Expiration Date: 03/12/2021 No grading or construction activity is allowed in areas designated for system and repair without approval of the Health Department. ehpermit 03/14/2016 11:49 Page 1 of 3 Catawba County Environmental Health ceg oz-zx� z�z2�( 1118 $c&rr:5 .J Croft / >72 / / / 8 / / / / (4g) 1 / / / a '65.32 / I / / , (�0;3� fo 4 rap hor- Cr.,.k, C1 r:Je7 -ill/ ar Srcdt o"K' / % / / .SeQ4.t cv`cc, / & �/ / / / / • / / / • / / / / / 20 .59 (8B / / / % )11 i / (2a/ � IM1 ns a y kt I i / r "ri PU -1.q:r (1 i \ G P3 s` \ J•i/ --- - Fh°c< `flan sen.s° ;(' 6 eV�J�Q\5Q� (698) To IraN; PI 200'44 s t°o• E Pz ViSs@ SSi° E Parcel: 374120904085, 1978 BURRIS RD Q3 z45,� 50( tin=80ft CONOVER, 28613 P tc 305'Co 5 '19° C tit/ 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 03/11/2016 EW o2- 2J/6- 23aay DEPARTMENT OF HEALTH AND HUMAN SERVICES Sheet 1 of DIVISION OF PUBLIC HEALTH,ENVIRONMENTAL HEALTH SECTION PROPERTY ID#: ON-SITE WATER PROTECTION BRANCH COUNTY:Z'cr—ler_ SOIL/SITE EVALUATION for ON-SITE WASTEWATER SYSTEM (Complete all fields in full) OWNER: _ APPLICATION DATE ADDRESS: DATE EVALUATED: 1/7�6 PROPOSED FACILITY: Q4 11.E PROPOSED DESIGN FLOW(.1949): YkV PROPERTY SIZE: • LOCATION OF SITE: PROPERTY RECORDED: WATER SUPPLY: U Private 1 Public U Well U Spring U Other EVALUATION METHOD: U Auger Boring X.Pit U Cut TYPE OF WASTEWATER: Sewage U Industrial Process U Mixed . . - r h R SOIL MORPHOLOGY OTHER E- (1941) - PROFILE FACTORS .1940 E LANDSCAPE IIORIZON POSITION/ DEPTH .1942 PROFILE #-_ . ..SLOPED/ (IN.) .1941 .1941 SOIL .1943 .1956 .1944 CLASS STRUCTURE/ CONSISTENCE/ WETNESS/ SOIL SAPRO • RESTR & LTAR • TEXTURE MINERALOGY COLOR DEPTII CLASS HORIZ p_3 k Sc% Fie st rvA /5 G5 3-7H c -4,2, Fe sr NA- IN 414- 013 1 _CZ 2`{- `Iy vs6t cc ri SE- o--2t 5Lk C _ m Sec N� 6 - NR cjr AiA z2- Lis- Lis:sIC a rit se- 2 LS /n.;cuL 3 '7,0 b-21 _S 6L G le Se L5 Zl-tiy uSeL cc 1--'7 Jc v 4- cry ,v A- A/A 6 3 sz /n'. _ a 3 b-,7 fat c lit. r---)f s L5 riA I o WA A- 4 /7- /fo '"S6L cc 1- / S� '4 ,o°t u�.:c.:,*P 0.3 6 ,-1 t DESCRIPTION INIFAL SYSTEM REPAIR SYSTEM OTHER FACTORS(.1946): Available Space("1945) SITE CLASSIFICATION (.1948): 6 EVALUATED BY: Sk-ne(5 /if SystemType(s) 155 fe-ct 25 Oct OTHER(S)PRE ENT: 9-0,- Site LTAR 0. 3 a 3 COMMENTS: