HomeMy WebLinkAboutIMPV-03-2016-070599.TIF e3TAW8A COUNT% Case . _
\CCA el ' ealt.11 D•
Lpartahmt Subdivision BROOKSTONE
ILl bwiionmental Health Di%istun l'1Ns 370915626650
-po!3o.389, 00-A Southwest Blvd.Newton. NC 2865l3 I 57
NAME ON PERMIT: *HARRILL CONSTRUCTION COMPANY, ALEX s., 617 N CENTER ST HICKORY
NC 28601-
Site Address: 1508 BROOKSTONEOR, HICKORY NC 28502
Property Size:. Square Frey 38,768.40 Acres.°89
Directions: Off Zion Church Rd I Right into Subdivision - straight in develop - property on left
OWner/Authorized Represehtative Acknowledgement of Permit-Receipt
asili,:ree'rtily:that I am the owner at authorized agent .,/() tier's authorizatioh re:wired) representing the owner of the
property desaribed above.
Thtf". As.the property owner or authorized representative, I have received the above referenced permit(s) as
requestedfn the application for service R3PR-03-2015-21066
by the following rnethod(s):
Received in Person
Facsimile.Transmittal (Return form with signature required)
*Electronic linage Transmittal/ E-mail (Return receipt required)
PO;
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 Lasss and Rules for Sewage Treatment and Disposal Systems‘(15A NCAC 18A 1900), and/or
Well`Constrpetion 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;
Pefinit Issue Date: 03/30/2016
Owner/Authorized Representative Signature (-141/49/17
Date 1/4—/6
Documentation of Permit(s) Transmittal
(perrnit transmitted by electronic or other means)
Permit transmitted by (name of person Sending pernth)
Signature Dine/Time
Method: .Fat Email US Mail Other
• " Owner's request to send by the above indicated method of transmittal in lieu of signature
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chreri;ii: 030012016 09.0o Page 3 of 3
- 1''f Case#
/y-�\3A CATA\\'BA COUNTY 0 i - 0 IMPV-03-2016-070599
T G Public Health Department •� �� g. Subdivision BROOKSTONE
� � Environmental Health Division Iti ti` '72'. PIN# 370015626650
\��� PO Box 389. 100-A Southwest Blvd,Newton.NC 28658 1 LOT# 57
kie
NAME ON PERMIT: *HARRILL CONSTRUCTION COMPANY, ALEX S., 617 N CENTER ST, HICKORY
NC 28601-
Site Address: 1508 BROOKSTONE DR, HICKORY NC 28602
Property Size: Square Feet:38,768.40 Acres:0.89
Directions: Off Zion Church Rd / Right into Subdivision - straight in develop- property on left
Improvement Permit
Facility: Primary Residence - house
Permit Category: New Septic Bedrooms 4
WATER SUPPLY: Public Water
Basement? Yes 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: 50% REDUCTION
Type: IIIB - SYSTEM W/SINGLE EFFLUENT PUMP
PUMP REQUIRED
Permit Conditions:
REPAIR SYSTEM SPECIFICATIONS
Repair System Required? Required
Proposed Wastewater System: DRIP IRRIGATION
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 I3uilding 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 SewaLe 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.
Megen McBride 03/30/2016
AUTHORIZED STATE AGENT APPROVAL DATE
Permit Expiration Date: 03/29/2021
No grading or construction activity is allowed in areas designated for system and repair without approval of the Health Department.
ehI omit 03/30/2016 09:06 Page I 013
J-P, M, 41)1Z-D3-)015-2-10615.
1508 BcooKS+one, Dr, Hickory
�Ins4all looa3ailonse�lic {uu„�C, 1000,o11on pOmpka4L, and )7o-f{. of 5O;o Rrducfi'on-T43Pal.
Pump {o prP.sur2 manifold . 6 -y5f� -Erenclnes; &- y1' Schedule 4o4c,PS or Manifold.
* 10 panel blocks r -gent►- - (,0 -1-4 (
Tnsk11 drainfleiA on Conioor,
Sey}rc sysem mus-I be- loofa. -From any Well 50-fl. from creek, Ibf{. (,o,,. vu4rr lines,
10-1 -From Proper4y Ines, &P. -Frorl S�rvctureS, IS11 -From basermer1 c✓♦s and ou-f- of
any r%rht- of-war or easernen+,
t final !trade o{ Sep-lic, area Mv4 &Ned Suf-race we cr of{ and away -Gory, sep is them.
'r Do no� dri4e, grade, cu}, or fill over Se fhc area I rerir area. Pro-kcl- arer,5 dur;r
house cons+luc� nn . /kny 01'ter�-ion of se?-`rc, areas will fesu[ In rpJO(a};or of d5.
t [louse, will connect b Public .ja-4er
72 .2
se{Dock
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C
6.
seflik Repair Area
LP ST PT Drii;Driiatfon
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pfoposed
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61.ge
`{0.75'
(3(ookStone pr. +0 roeUlitun
I = 50
DFSAB'IMENr OF ENVIRONMENT AND NATURAL RESOURCE Ate_of—
DIVISION OF ENVIRONMENTAL HEALTH PROPERTY ID it:
ON-SITE WASTEWATER SECTION COUNTY:
SOIIJSITE EVALUATION
Nev or ON-SITE WASTEWATER SY$TEM►i
OWNER: Nei l-alfftd4 (h\'itvc4cn APPLICATION DATE 4+1115 RBRR-03-zoIS-,Iofh.
ADDRESS: DATE EVALUATED: 0121115
PROPOSED FACILITY: o PRO,pOSED DESIGN FLOW(.1949): 4g IS PROPERTY SITE: 0,89 acres
LOCATTONOFSITE: 1501 Brooks n(, Ur. klccP-01 PROPERTY RECORDED:
WATER.SUPPLY: 0 Private W Public 0 Well 0 spring 0 other
EVALUATION METHOD: 0 Auger Boxing w Pit 0 Cut
TYPE OF WASTEWATER: ® m
Scwagc 0 Induszl P,xesa 0 Mixed
. .
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PS
• 0.3
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DESCAIPTTOA IPIMAL rain( REPAIR SYSTEM OTHER FACTORS(.1946):
Mailable p r.(.1945) fS PS SITE CLASSIFICATION(.1946):
S»Typt) 5 be, d r. EVALUATED BY: (Amex I .thrl dei
e OTHER(S)PRESENT:
Site LTAR 0:3 0,35-•6.1 5
• COMMENTS:
N80 9pd 0,3 LTAR 501. Ked.
b-95{1 -fienctts
D-0 A of elm/4-on
too {}, of z^ Sufpl7 l nt S0440, ;'su?L lint.-- 3.77
fl.-frenck IV pRnelS loo, 0,0377 x /ODA sit( eo y = 3.77 FH
x hr.
coo }o� t‘s
1 PH
60 x 3,b alb x 0 l
75' �b� dosin ud�
�n ipa,c� 3 _, )5,77
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