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Home My WebLink AboutIMPV-03-2016-070483.TIF 0 :.4644301 MHC712 09:40:32 a.m. 03-30-2016 1 /1 1 C,ATAWBA COUNTY Case it 1MPV-03-2016-070483 .. fit Public Health Department Subdivision LEAFWOOD `o, ,c Environmental Health Division PINf1 269702884161 PO Box 389. IOU-.A Southwest Blvd.Newton,NC 28658 LOT# 20 NAME ON PERMIT: RON BUCHANAN, , Site Address: 3508 LEAF WOOD LN, VALE NC 28168 Property Size: Square Feet:27,442.60 Acres:0.63 Directions: 10 W, left on Plateau Rd, left on Leafwood, lot 20 on left i 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. -1,-, �jv As the property owner or authorized representative, I have received the above referenced pennit(s)as requested in the application for service EHPR-03-2016-23312 by the following method(s): ' Received in Person Facsimile Transmittal (Return form with signature required) 2 Electronic Image Transmittal/ E-mail (Return receipt required)4/ As the property owner or authorized representative I have reviewed and understand the specific conditions o '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: 03/28!2016 V' I Owner/Authorized Representative Signature 4:400r - I011111P Date 3 .- I Documentation of Permit(s) Transmittal (permit transmitted by electronic or other means) Permit transmitted bySkn UC ih MTh Th (name of person sending permit) SignatureY(i(,Z /wl/L rll Date/Time 3/?q//LO @ I 1 '20 Method: Fax jmailUS Mail Other Owner's request to end y 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 , i chpermit 03/29/2016 11:18 Page 3 of 3 1.:. -1:.;..6 `n�A � CATAWBA COUNTY a all. a Case# IMPV-03-2016-070483 f' P.t. Z Public Health Department 171;4. . ` W} Subdivision LEAFWOOD Environmental Health Division ' s PIN;i 269702884151 Y I,o"I# 20 15' slii M PO Box 389, 100-A Southwest Blvd,Newton,NC 28658 '� : ' �' i ;• 8 1 s r±.d' rris CI NAME ON PERMIT: RON BUCHANAN, , Site Address: 3508 LEAFWOOD LN, VALE NC 28168 Property Size: Square Feet: 27,442.80 Acres:0.63 Directions: 10 W, left on Plateau Rd, left on Leafwood, lot 20 on 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: 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' (ISA 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 03/28/2016 AUTHORIZED STATE AGENT APPROVAL DATE 03/25/2021 Permit Expiration Date: No grading or construction activity is allowed in areas designated for system and repair without approval of the Health Department. chpermit 03/29/2016 I I:18 Page 1 of 3 EHPR 03-2016-23312 3508 LEAFWOOD LN,NEWTON • Do not cut, drive, fill, or grade over septic or repair areas. • This permit is not intended for septic installation purposes. t}'OS �V+c /.'mar 4L. �/� St c u—;i5 SI t ✓iVft Lic,JC Uc 4V M.6;L. t1..�� c ..,,..4- he ,+�>,c. {L.�-. 7o .+ �--- n+ fcfcr y (C2. v <� a r �a k c` cs v i h4 7 Q� ° ,256 2<d iw - SYSlc� o, 35 XYa to 2%. i 0-/x yoi 2° ,CT3 2Tr l SO 1\ I)DEPARTMENT OF HEALTH AND HUMAN SERVICES Li/ ,Q 03-234-(- 233/ 7 Sheer ( of , DIVISION Of PUBLIC HEALTH,ENVIRONMENTAL HEALTH SECTION PROPERTY ID 4: ON-SITE WATER PROTECTION BRANCH COUNTY: Cc-h- s SOIIJSITE EVALUATION for ON-SITE WASTEWATER SYSI'EM It La.. (Complete all fields in full) OWNER: ^ ` APPLICATION DATE ADDRESS: J....1-DS Le,i.1)s1 tie"(-• DATE EVALUATED: PROPOSED FACILITY: 3 a r PROPOSED DESIGN FLOW(.1949): PROPERTY SIZE: LOCATION OF SITE: PROPERTY RECORDED: WATER SUPPLY: U Private U Public XWell U Spring U Other EVALUATION METHOD: U Auger Boring L>PiI U Cut TYPE OF WASTEWATER: Sewage U Industrial Process U Mixed • • . • P R SOIL MORPHOLOGY OTHER 0 F (.1941) PROFILE FACTORS 1 .1940 L LANDSCAPE HORIZON POSITION/ DEPTH 1942 PROFILE # SLOPE% (IN•) .1941 .1941 SOIL .1943 .1956 ,1944 CLASS STRUCTURE/ CONSISTENCE/ WETNESS/ SOIL SAPRO RESTR &LTAR TEXTURE MINERALOGY COLOR DEPTH CLASS IIORIZ o — 2S S6 7c C F2 SC 4/4 ti� GS// ' tig S3/C CL (--:-.Z - l e O-1 1 (BTU U/S.-, err D — 20 seic CL /cg ,SC LS z, -33 s6ic c i14.c -c 6.-7 rd 33 g¢ 10 A- (S ro ./ o. z7r 2 4� 33- 4K �c(c D _g ilik ScL F2 se- 3m ^ yf$ e- 36 s6/c c F 1 Sir -c(.., 7o r��1- NA /PS ® igti 36- 7o 'ktt CL F, SE e/°y417t. D. 27r 3-°4 6 -z3 sok c ice re- ;✓,r 3 rS 2,3 -Lj I�s6k- cL FL St✓ e, low A//r ✓t/ef DS 4 f'.6 Yell,J • 0. 2 71— w G3c sbs • DESCRIPTION ' INI'T'IAL SYSTEM REPAIR SYSTEM OTHER FACTORS(.1946): Available Space(.1945) Tex PS SI'Z'E CLASSIFICATION(.1948): `Q EVALUATED BY: `S4°"^ 1^`4 System Type(s) lit tei . 2j'� 61 OTHER(S)PRESENT: Site LTAR y, 17j D. 27 COMMENTS: