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Home My WebLink AboutIMPV-03-2016-070548.TIF 44A ' CATAWBA COUNTY Case#2 IMPV-03-2016-070548 c. Public Health Department Subdivision ROXBURY FIELDS *to,. - Environmental Health Division PIN#1 375501351758 � Y PO Box 389. 100-A Southwest Blvd,Newton, NC 28658 LOPS 2 1842 ,, NAME ON PERMIT: LAVINE SCROGER, 383 N THOMAS LN, STONY POINT NC 28678 Site Address: 6245 ROCKY RD, CLAREMONT NC 28610 Property Size: Square Feet: 21,780.00 Acres:0.5 Directions: 140 East, Exit 132, LEft at 2nd light, Right onto Hwy 16 & go about 7 or 8 miles, Right onto River Bend Rd, Left onto Rocky Rd, 1st vacant lot on the Left. Owner/Authorized Representative Acknowledgement of Permit Receipt I certify that I am the owner or authorized agent(owner's authorization required) representing the owner of the property described above. As the property owner or authorized representative, I have received the above referenced permit(s) as requested in the application for service EHPR-02-2016-23254 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: 03/29/2016 Owner/Authorized Representative Signature Date 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 chpennit 03/29/2016 11:16 Page 3 of 3 ,qA CATAWBA COUNTY 0; I 0 Case 11 IMPV-03-2016-070548 .7 fill G Public Health Department £•. 1 ' Subdivision ROXBURY FIELDS < • 4-v Environmental Health Division 173.•1 PINr1 375501351758 PO 13ox 389. 100-A Southwest Blvd,Newton,NC 28658 ,{{r LOT# 2 /842 a err .,. T•� e NAME ON PERMIT: LAVINE SCROGER, 383 N THOMAS LN, STONY POINT NC 28678 Site Address: 6245 ROCKY RD, CLAREMONT NC 28610 Property Size: Square Feet: 21,780.00 Acres:0.5 Directions: 140 East, Exit 132, LEft at 2nd light, Right onto Hwy 16 & go about 7 or 8 miles, Right onto River Bend Rd, Left onto Rocky Rd, 1st vacant lot on the Left. Improvement Permit Facility: Primary Residence Permit Category: New Septic Bedrooms 3 WATER SUPPLY: Private Well Basement? No Basement Plumbing? No INITIAL SYSTEM SPECIFICATIONS Permit Valid: Expires In Five Years: _X_ No Expiration: Projected Daily Flow 360 g.p.d Proposed Wastewater System: 50% REDUCTION Type: IIIE - PPBPS GRAVITY DOSED SYSTEM Permit Conditions: REPAIR SYSTEM SPECIFICATIONS Repair System Required? Required Proposed Wastewater System: 50% REDUCTION Type: IIIE- PPBPS GRAVITY DOSED SYSTEM 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' (I5A NCAC I8A .1900). Neither Catawba County nor the Environmental Ilealth Specialist warrants that the septic tank system will continue to function satisfactorily for any given period of time. Steven Price 03/29/2016 AUTHORIZED STATE AGENT APPROVAL DATE 03/26/2021 Permit Expiration Date: No grading or construction activity is allowed in areas designated for system and repair without approval of the Health Department. ehpermit 03/29/2016 11:16 Page 1 of 3 EHPR 02-2016-23254 6245 ROCKY RD, CLAREMONT • Do not cut, drive, fill, or grade over septic or repair areas. • This permit is not intended for septic installation purposes. • Septic system must be 10 ft from property lines; 50 ft from wells and streams; 5 ft from building foundations and appurtenances; 10 ft from water lines; 15 ft from a cutbank; 15 ft from a basement; and out of right-of-ways and easements. f.36' - I i + zs1 J�6 ills a JPerk, j 4 I yI , ce V I y VI V. J , q I I ?pss:k_[ Fuses, �� - - ()Mk_to/' r „()Mk_- i t SID( IT DEPARTZMENT OF HEALTH AND HUMAN SERVICES P!? 0 2.- 20(6 - 23 2.5-Li Sheer_( of DIVISION OF PUBLIC HEALTH,ENVIRONMENTAL HEALTH SECTION PROPERTY ID tt: ON-SITE WATER PROTECTION BRANCH COUNTY: SOIL/SITE EVALUATION for ON-SITE WASTEWATER SYSTEM (Complete all fields in full) OWNER: l63�;h SU..it _ APPLICATION DATE ADDRESS: &1-Mc e-c.k\ Pte. Ci9it \- DATE EVALUATED: PROPOSED FACILITY: 3Cr PROPOSED DESIGN FLOW(.1949): PROPERTY SIZE: LOCATION OF SITE: PROPERTY RECORDED: WATER SUPPLY: ❑Private ❑Public tWell ❑ Spring ❑Other EVALUATION METHOD: U Auger Boring "j1-4 Pit ❑Cut TYPE OF WASTEWATER: Sewage ❑Industrial Process ❑Mixed e ► • • o P R SOIL MORPHOLOGY OTHER 0 F (.1941) PROFILE FACTORS 1 .1940 E LANDSCAPE HORIZON POSITION/ DEPTH 1942 PROFILE # SLOPE% (IN) .1941 .1941 SOIL .1943 .1956 .1944 CLASS STRUCTURE/ CONSISTENCE/ WETNESS/ SOIL SAPRO RESTR &LTAR TEXTURE MLNERALOGY COLOR DEPTH CLASS HORIZ c -lL Lisa S(i_ (/L- SE AlA- is Ls 1 23 She- C _Tic SE .S-Z7 414 1 L3- 31 z / D 5 �Oa /t$1=- C Nl .lam' y.,i,� ,tiNly 3(- .51i "36 L. Fie. SC • 6 rI uS6k Sc“ [ S6- �� N4 /CS LS i( - zz A-6k- c 1=e 1e- AAA- 2 1-2 3 0.-3 1 D'6- y N � c�l� r S6 31-52( 4S6tc Cl_. % PI - e-8r s<< 12 se- Nl& I fc_ Ly s6L C he Sr -S� NA NA �S 3 it z.Y-3$ L'A+Sk FA Se e l/S :`'i� ° �S 3'Y_ St 't,(ysL CL_ Ft Sc` • D - E, uSe sct_ f Se- Nln Is 4,- /( a - _F L J( Sb W n/A 'F Oa-39� u,, C rt JE C Yell., �. y as 39-3a ”' I` C SC DESCRIPTION INITIAL SYSTEM REPAIR SYSTEM OTHER FACTORS(.1946): /f SITE CLASSIFICATION(.1948): PS Available Space(.1945) Q f /� ` � I EVAI.UATEDBY: 5 ,,. /".-� System Type(s) -91)t !`�' St`i� — OTHER(S)PRESENT: Site LTAR D.. 75- O. 75 COMMENTS: 5. LEGEND (9Z-- ao(6 --. z3 z)--20 use the following standard abbreviations i. SOII. CONVENTIONAL LPP MINERALOGY/ LANDSCAPE POSITION GROUP TEXTURE .1955 LTAR* .1957 LTAR CONSISTENCE STRUCTURE CC(Concave Slope) I S(Sand) 1.2-0.8 0.6-0.4 SEXP(Slightly Expansive) Cr(Single Grain) CV(Convex Slope) LS(Loamy Sand) EXP(Expansive) M(Massive) D(Drainage Way) CR(Crumb) DS(Debris Slump) 11 SI,(Sandy Loam) 0.8-0.6 0.4-0.3 GR(Granular) FP(Flood Plain) I.(Loam) SBK(Subangular Blocky) FS(Foot Slope) ARK(Angular Blocky) H(Head Slope) III Si(Silt) 0.6-0.3 0.3-0.15 PL(Platy) L(Linear Slope) SiCI.(Silty Clay Loam) PR(Prismatic) N(Nose Slope) CL(Clay Loam) R(Ridge) SCL(Sandy Clay Loam) MOIST WET S(Shoulder Slope) Sil,(Silt Loam) T(Terrace) VPR(Very Friable) NS(oon-stieky) IV SC(Sandy Clay) 0.4-0.1 0.2-0.05 FR(Friable) SS(Slightly Sticky) SiC(Silty Clay) Fl(Firm) S(Sticky) C(Clay) VFI(Very Finn v.Very Sticky) VS(Very Sticky) 0(Organic) None None EEI(Extremely Fun) NP(Non-plastic) SP(Slightly Plastic) *Adjust LIAR due to depth.consistence,structure,soil wetness,landscape.position.wastewater flow and quality. P(Plastic) NOTES VP(Very Plastic) HORIZON DEPTH In inches below natural soil surface DEPTH OF FILL In inches from land surface RESTRICTIVE HORIZON Thickness and depth from land surface SAPROLITE S(suitable)or U(unsuitable) SOIL WETNESS Inches from land surface to lice water or inches from land surface to soil colors with chroma 2 or less-record Munsell color chip designation CLASSIFICATION S(Suitable),PS(Provisionally Suitable),or U(Unsuitable) Evaluation of saprolite shall be by pits. Long-term Acceptance Rate(LTAR):gal/day/ft2 Show profile locations and other site features(dimensions,reference or benchmark,and North). 171 tt, >1, ..�0 C( s n 'G .<__L---- --Cr Ntil . "— •