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Home My WebLink AboutIMPV-04-2016-070812.TIF ,g CATAWBA COUNTY Case# .7.4 z Public Health Department Subdivision Q °� Environmental Health Division PIN// 374419520150 PO Box 389, 100-A Southwest Blvd.Newton.NC 28658 LOT# 1842 6 NAME ON PERMIT: LARRY BAKER, 4924 LEE CLINE RD, CONOVER NC 28613 Site Address: 4918 LEE CLINE RD, CONOVER NC 28613 Property Size: Square Feet: 51,836.40 Acres:1.190 Directions: Hwy 16 North/Left on CB Farm Rd/Right on Lee Cline Rd/Lot on right Owner/Authorized Representative Acknowledgement of Permit Receipt 01 certify that I am the owner or authorized agent(owner's authorization required) representing the owner of the .N 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 RBPR-01-2016-23115 by the following method(s): Received in Person J 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 1 I 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: 04/05/2016 `_ Owner/Authorized Representative Signature --) ` e. Date ? S— 571 /6 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 04/05/2016 08:18 Page 3 of 3 Kit?A CATAWBA COUNTY o Case# IMPV-04-2016-070812 Public Health Department � Subdivision \ `' Environmental Health Division F' • •+ '3.1' PIN# 374419520150 PO Box 389, 100-A Southwest 131vd,Newton.NC 28658 •-� ,, 1,0'1'# r84%s" L -- j. • a r- ol , o -�^ r NAME ON PERMIT: LARRY BAKER, 4924 LEE CLINE RD, CONOVER NC 28613 Site Address: 4918 LEE CLINE RD, CONOVER NC 28613 Property Size: Square Feet: 51,836.40 Acres:1.190 Directions: Hwy 16 North/Left on CB Farm Rd/Right on Lee Cline Rd/Lot on right Improvement Permit Facility: Primary Residence - modular home Permit Category: New Septic Bedrooms 4 WATER SUPPLY: Private Well 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 - OTI-IER NON-CONY TRENCH SYSTEMS Permit Conditions: 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' (I5A 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 04/05/2016 AUTHORIZED SPATE AGENT APPROVAL DATE 04/05/2021 Permit Expiration Date: - ---No grading or construction activity is allowed in areas designated for system and repair without approval of the Health Department. ehpermit 04/05/2016 08:18 - Page 1 of 3 IPIAG R61 -of-aolb-x3115 19I6 Lee ant Rd, Cono4er t1nskall IboO\54llon Serb.° flank and 1100{4. g D550 red4c+ion ; 7- 57.q. Install drain-Feld pn con{or. +cehe�es, * Septic sys+ern musk 6e, a+ leas{ loaf!. -from well, 5-11. -f o proper{7 lines, 50.14. from creelcs, and ;o -from S{ecd,. ID fl. from �1� from exis+in9 drain{gelds. * Do no{ drije, lrade, cu4. or - l over Sep-t area or rani r are le rim) mob* horne, w;Il C-onnt4 40 tei5-ViLi, Welk on Ad art + ins-loler r''mb*k- tocc-f G erla of y�?y Lee Cline Rd, ekts-f ins gavel kJ av,d r kir iva doffed line rePeese4 1L J rwt r I:614w recorded septic. eaSemen+ `c4PldS. 's 3n' -r c •JO' J 1-7 s., proposed q `Beckorhmodvkr a y 2!4 ..o. �} min -o 1 x V S 1 a Hi:' . 704 _ _ A. 1 • ek 9/ % 1 I. . 1 I b. 11) I ' fee Une Rd. 1":60- DEPA rusarrOFENVIRONMENTANDNATURALRESOURCES Sheet of DMSION OF ENS RONb1ENCAL HEALTH PROPERTY ID it ON-SITE WASTEWATER SECTION COUNTY: SOIL/SITE EVALUATION for ON-SITE WASTEWATER SYS M OWNER I.Afc' BaR( APPLICATION DATE 11'9 lb eteg.-oi-2o16-D3115 ADDRESS: I DATE EVAGIIATED: a/21iHI PROPOSED FACILITY: 14 ER IVO4iA v PROPQSED DES7IN FLOW(.1949): k$0 - PROPERTY SITE 1.110 acres LOCATION OF SITE 49 it La. .lino 4 CDnoJe✓ PROPERTY RECORDED: WATER SUPPLY: A Private 0 Public g Well 0 S ' g 0 Other EVALUATION METHOD: 0 Auger Poring 0 Pit U Cut r comical av5e✓hbIFS Phase TYPE OF WASTEWATER: g Sewage 0 Industrial 0 IrExcd J . r • :: .. =:raic:r:o::::_ iiii_i =_i!: anrm::: :_ce= o . igi!nc'ii^ 'ii°ii?!ieoJUU„ F„ef i°e::: _i� � :':e ::`s..... • _r......... _..' RflYIiL'h.i+IGiil11+41�iS:-��:._..............:...._dFi ;;I..' ':R : ..._..... ..... ...._.. A-_...:...... ::3::::i::::::::::::::::::::ii'cvacei:iunu:u Ant........_.a:::F _. A 3!Q$ : :-:•::::-:;i4di4 :: .: '34 A�.11fr' p`..::.:.::::::: :eFj::_7ff '-'F.-: rosru >�TT ._::,5'T8FIIoTIJR1t::_: ':::cnxstrE+�nT� atrxrcsour st" SiAP& 4N:) - Taralr """'-'TtluIum.OSaY ...{X1 DEPTI ... C-.ASS 0-q0 SLKCL fr-S5, sop L' p ..- PS 1 1ofp ti — 0.3 0.4a SbK (1. t. i :fr:Ss,.Wip 2 - Ha - - PS • 03 0-ID ape Si- -fr,S5. Sere � 3 l0.4 SbY- -fr,sS. S'ex� /i� — __ PS 0.3 4 H 1 DESCRIPTION wrn.C.SYSTEM REPAIR_SYSTEM OTHER FACTORS(.1946): Available Space GINS) PS PC SITE CLASSIFICATION(.1948): p I _ ! System Typ;(f) h rT1TJ EVALUATED BY: I' t eiltA I � ei at.- 11L 11J-q OTHERS)PRESENT: ✓ . Silo LIAR O 0.31 COMMENTS: 1 I g Piton (t?;1°' 150. well I 1 005 i 1 / ■ 1 I et. S' I Lee Oh"(" 12-r • (No- -b ScAlt)