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Home My WebLink AboutIMPV-03-2016-070114.TIF v0A . CATAWBA COUNTY Case# IMPV-03-2016-070114 .T " Public Health Department Subdivision PALM TREE HEIGHTS PH n z e 4 "943 4' '"�, Environmental Health Division PIN# 268601096441 Pb Box 389, 100-A Southwest Blvd,Newton,NC 28658 LOT# 53 Igo w NAME ON PERMIT: BEAM & SAIN, INC, PO BOX 70, VALE NC 28168-0070 Site Address: 4829 KIWI LN, VALE NC 28168 Property Size: Square Feet:20,037.60 Acres:0.46 Directions: 10W/ LEFT CAT SQUARE RD /LEFT PALM TREE HEIGHTS /TO END OF ROAD/ RIGHT KIWI / 3 LOT ON RIGHT Owner/Authorized Representative Acknowledgement of Permit Receipt Cur I certify that I am the owner or authorized agent (owner's authorization required) representing the owner of the /X property described above. /iC As the property owner or authorized representative, I have received the above referenced permit(s) as requested in t e application for service RBPR-12-2015-22873 by the following method(s): 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 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: 03/16/2016 Owner/Autho ized Representative Signa re v I al Date (h Asi 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/EHCustomerService ehpennit 03/16/2016 14:33 Page 3 of 3 fig' CATAWBACOUNTY PI -o.r 0 Case# IMPV-03-2016-070114 Tr� ../\, Public Health Department f .4 Subdivision PALM TREE HEIGHTS PH ^ 1 � �: 4 r Environmental H {, ealth Division r • ti PIN# 268601096441 , ® PO Box 389, 100-A Southwest Blvd.Newton,NC 28658 ' _ 0 _ LOT# 53 184"h/SN -'' ' Ci o 4 NAME ON PERMIT: BEAM & SAIN, INC, PO BOX 70, VALE NC 28168-0070 Site Address: 4829 KIWI LN, VALE NC 28168 Property Size: Square Feet:20,037.60 Acres:0.46 Directions: 10W/ LEFT CAT SQUARE RD / LEFT PALM TREE HEIGHTS /TO END OF ROAD/ RIGHT KIWI /3 LOT ON RIGHT Improvement Permit -4 tj . -_ ' , i i TIAeS7LSTEM EXITfING`gt c : k Facility: Primary Residence - Mobile Home Permit Category: New Septic Bedrooms 3 WATER SUPPLY: Community Well Basement? No Basement Plumbing? INITIAL SYSTEM SPECIFICATIONS Permit Valid: Expires In Five Years: _X_ No Expiration: Projected Daily Flow 360 g.p.d Proposed Wastewater System: CONVENTIONAL Type: HA-CONY SYSTEM (SINGLE-FAMILY OR 480 GPD OR LESS) Permit Conditions: *Make sure the new mobile home is placed at least 5 feet from any part of the existing septic system and future repair area. 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. Robbie Phelps 03/16/2016 AUTHORIZED STATE AGENT APPROVAL DATE Permit Expiration Date: 03/16/2021 No grading or construction activity is allowed in areas designated for system and repair without approval of the Health Department. el-permit 03/16/2016 14:33 Page 1 of 3 N i Catawba County Environmental Health 5 — 3- 20/6_ 070114 71N ,.. . \ icl °0 1 con'cY \ II/ fl / e loC44.2..) We /��\ ado y/ 1LroJf i i rcAci O� N NFoo 95 , h et p S �o� > CI= S � fi r A •.y I \ l/■ �� ' \\ \39.9\CH\ 1 \ \ Y 1 vJ \ 1 h4,_ C n a' t 165Th O w //,' 'ate 1° / i / / /4 1.7s 4) / Parcel: 268601096441, 4829 KIWI LN VALE, 1in=5Oft 28168 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 0 3/1 51201 6 DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES Sheet_of_ DIVISION OF ENVIRONMENTAL HEALTH PROPERTY ID f1: ON-SITE WASTEWATER SECTION COUNTY: SOIL/SITE EVALUATION • for ON-SITE WASTEWATER SYSTEM Ogg: 122 141 B- f 4/4 APPLICATION DATE 22 d 7 2 ADDRESS: - if S 27 PI; ; LA DATE EVALUATED: 6 PROPOSED FAC I ITY: 15Olt PROPOSED DESIGN FLOW(.1949): 9 L o . PROPERTY SIZE: LOCATION OF SITE:, PROPERTY RECORDED: WATER SUPPLY: 0 Private WPublie EirloVell O Spin 0 Other EVALUATION METHOD: 0 Auger Boring ErPLt U Cut TYPE OF WASTEWATER_ &Sewage (] Industrial Psxeu 0 Mszed r T___ --- . d- a.ac� 5"' = _ ---an!c'a. i vo= c:_ k s .__. .....;:r= .._.._ nau:: mai.3�e:::::_v:::n^— :: c: :::: ::_::::: �!n!!::cG:agee{Fh!i;;f ;;::e= _ m;:F'!! 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It L] S , 3 44-gc s 4n f• • 7 3 4 • DEaurT10N ATiuL SYSTEM PEPA1Z SYSTEM OTHER FACTORS(.1946): Available Spare(.1945) ervril nr f SITE CLASSIFICATION(.1946): 717 Sy sa Typxs) 'S 0 a/` EVALUATED BY: ae 1-Li L. Jl&}7r OTHER(S)PRESENT: . SiteLIAR 'y COMMENTS: Catawba County Environmental Health • t ..--X'' ' N \ JVf L \...H -- X72 \ 3-...9 ,. .., ; •..9-..*.:/: T-‘5:1 . .. \ \:•\:- 2 re• 73'P y > hti. i 1 e> 3v, 1 1. t . CD 6 J a"m J • p.. J TJ 19 1.75 Parcel: 268601096441, 4829 KIWI LN VALE, 1in=50ft 28168 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 03/16/2016