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Home My WebLink AboutAUTH-04-2016-070921.TIF v 8„o CATAWBA COUNTY Case# AUTH-04-2016-070921 T Public Health Department Subdivision ® L 367803405064 6 3„�,,,Environmental Health Division PIN#\s-� - �^ ,PO Box 389, 100-A Southwest Blvd,Newton,NC 28658 LOT# 2 tg.2 :M NAME ON PERMIT: WILLIAM JONES, 4449 S NC 16 HWY, MAIDEN NC 28650 Site Address: 4449 S NC 16 HWY, MAIDEN NC 28650 Property Size: Square Feet: 140,263.20 Acres:3.22 Directions: 16S on right just before Pine Leaf Dr Owner/Authorized Representative Acknowledgement of Permit Receipt Acertify 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 RBPR-04-2016-23557 by the following method(s): 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: 04/07/2016 • --- Owner/Authorized Representative Signature ,71t) tin, / • • Date // - 0 '7 /4, 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 ehpemiit 04/07/2016 08:49 Page 4 of4 �-6 CATAVVBA COUNTY 0 , Q Case# AUTH-04-2016-070921 ^-.t. G Public Health Department +' �. , -I Subdivision 1 367803405064 < — ,� Environmental Health Division PIN# \ ® PO Box 389. 100-A Southwest Blvd,Newton,NC 286 58 ��OyY ` O 1• CI .% LOTk 2 Igq :u 5�I JA. ig O G Or- ..O NAME ON PERMIT: WILLIAM JONES, 4449 S NC 16 HWY, MAIDEN NC 28650 Site Address: 4449 S NC 16 HWY, MAIDEN NC 28650 Property Size: Square Feet: 140,263.20 Acres:3.22 Directions: 16S on right just before Pine Leaf Dr Authorization to Construct Permit Authorization to Construct Wastewater System (Required for Building Permit) * See site plan and number of additional attachments ( ). Proposed Wastewater System: 25% REDUCTION Wastewater Flow 240 g.p.d Type: IIIG -OTHER NON-CONY TRENCH SYSTEMS Soil LTAR: .3 g.p.d./ft2 Permit Category: New Septic Type of Facility: Primary Residence - Basement? No Basement Plumbing?No Bedrooms: 2 Wastewater System Requirements Tank Size: New Tank 1,000 gal Pump Tank gal Grease Trap gal Dosing Volume gal Pump Specs: GPM @ TDH Pressure Head ft Draw Down in Drainfield: Total Area: 600 sq ft Total Length: 200 ft Maximum Trench Depth 30 in Aggregate Depth in Trench Width 3 ft Minimum Soil Cover 12 in Minimum Trench Separation 9 ft on center Number of Drain Lines 4 Distribution: Serial Pre Treatment: NONE Additional Specifications: Keep all parts of septic system and any future repair system minimum 50' from any well,10' from property line,20' from home( to allow for future sun room). Lines to be installed on contour. Do not grade drive or fill over system or repair area. 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. »»> DO NOT INSTALL SYSTEM UNDER WET CONDITIONS ««< Proposed Repair System Class: IIIG Proposed System: 25% REDUCTION Distribution Type:: Serial Soil LIAR: .3 g.p.d./ft2 chpennit 04/07/2016 08:49 Page I of4 s�wA CATAWBA COUNTY Case# AUTH-04-2016-070921 C+�®2 Public Health Department Subdivision < f s^� Environmental Health Division PIN# 367803405064 -4, PO Box 389, 100-A Southwest Blvd,Newton,NC 28658 LOT# 2 /842 sm NAME ON PERMIT: WILLIAM JONES, 4449 S NC 16 HWY, MAIDEN NC 28650 Site Address: 4449 S NC 16 HWY, MAIDEN NC 28650 Property Size: Square Feet: 140,263.20 Acres:3.22 Directions: 16S on right just before Pine Leaf Dr 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 Authorization to Construct Permit is subject to revocation if the site plan,plat or the intended use changes,or if site conditions are altered. The Authorization to Construct 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 Sewaee 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 neriod of time. Jason Boyd 04/07/2016 AUTHORIZED STATE AGENT APPROVAL DATE Permit Expiration Date: 04/07/2021 No grading or construction activity is allowed in areas designated for system and repair without approval of the Health Department. ehperinit 04/07/2016 08:49 Page 2 of4 cSM Permit# RBPR-4-16-23557 74CATAWBA COUNTY Public Health Department Name William Jones Environmental Health Division Address 4449 Hwy 16 S Maiden NC PO Box 389, )00A Southwest Blvd,Newton NC 28658 PIN# 367803405064 (828)465-8270 Fax (828)465-8276 TDD(828)465-8200 Site Plan Authorization to Construct 17y' ii (N (b La ��4 0 rRD SS I rca r A 3 nos, 0 Y p r T 19 o o(,0(, �t,t, 15r' go LJ "•., r � Ei a Ll \ J, Nc.,� \ 2'Jp I-1v Ml. (c)F.317 ' H 1,0 c_d1 L r`" 1 2• RI-r-7.-, 44,0 / S�• 2, ( 1 . 63 IMP` ' 34'a. ----1 GA 1 4L3 A I 9- 5 to 2,_ 30 • - - Zo " Pro.-1 T41-c. I yOML "1-O cII ', Sy s ft. -. Pal Lt ,! c.,•_., re- (`+) 565,7, > S., r,. ,y5+e_ , c.0) 1,t, (10S 61 DP ass, .-) nn 11 Scale - I o b 6 y.5*-- ,---• Depannent ci -nvhonnent,Health,and Natural Resources Sheet: Division of Environmenlal Healll: Properly ID: Orusite Wastewater Section Lot x: SOILJSITE EVALUATION File K: for ON-SITE WASTEWATER SYSTEM ApplD: EHPR-6-15-21710 Owner: William June§ Applicant: Address: 4449 Hwy 19 S Maiden NO Date Evaluated: 6/4/2015 Proposed Facility: 2 BR hcme Design Flow(.1949) 240 Properly Size: Location of Site: Property Recorded: Water Supply. pvl•:reil ( 'Spring ( )O:her Evaluation Method: pits by ci,vner ( I Cut Type of Wastewater: X Sewage I I Industrial Process ( j Mixed tl ' 01 i I i z.m 1tp�i�or i e'' 141,1' u• 4 i I�1p�'LI] 4.71. 0iiclt,� rzyl v 1 '�f . .:I{p'�'1 (+�4. h'f Apr �(` I (II Ill h'ti L 1 i' :.,;. �,2,i0 ael ilti ilta�l '�illi t11V,:ir t � :.1,41}Qiel l lylpl k - is I�A121 �s,i)if1 .44!' t;' ;04;47,10^,'T ��'�. t'�a� .I4�Y� .ti �y�k .� � � 1 mr�� 'IP� � � � I 1 �. 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I� } � f .rc 0;9�;�16 sot, P,nUNt� IIP,ROFILE�FAETORSPr- . nl rut,1pn 1 -"1 ,..dli ' r '1401 '�� 1L IvJ ! - 4 Ipin)tytiia rS Kllrt q;;lla� ?Ii&Ili9: L4'122i11fgiis i. tl8�,nlll"� :p'lll;1'ctfzl115i i°ta�a'.yj� r iA I?. ib, dndsc-pl e ize';iti t -1g4C; ',AiA i D PtI X y' P a t y., W. .-' t v 194 tl IliN 1� 4 }' ro'le tfd'i ,L 1 �+ , x"11 caL.;." vHCrizcni 9 zimrs1 u t w 'ii�. la iR 1�1ilin lilt ��4, Snr,1 ..ytil.(� t il1943T .3 14 fi55Sil + 1944•„ fir Pro tleti •I�pr� 'E'sl it 41E,os'hon '9t �{�Depihall Struelur/il �� ilLt�iiL,eons'slencel 4:�l) i v�ry��s 'Itrenesslr ri ea,' r1tl'aP'Sa ih�11111�1 r Sapio�l Reslrw�i 1 Py�p�.a eless"I� ,:•b3ri��.? $."Slope .A•11['.(INr)i�s S,aTexture`�I� �11IillFiidKlin_rao9Yr'`�,vir,di:4:0 ' V7106��d0N: y, :Deptli19(IN�) 1ldiclass- 1 IIWIHon2;A}BIZ' 1BILTAREI:;,f• 1 LL 2% 0-18'• topsoil 1 10-24" SOL 5S SP SEXP FH 24-72" SC S5 SP SEXP FR 72•' PS.3 2 _ same as 1 PS.3 3 same as 1,2 ?Si 4 5 6 7 i I Description initial System I Repair System - Other reClorS(.1040): - t ;Available Space(.1945) PS PS Soil Evaluation By: Jason gnyg 'System Tyree(s) IIIG 1110 Others Present: William Jones Site LIAR .3 .3 Site Classification(.10451: aiS Site Evaluation By: Others Present: Shoe!: COMMENTS: Moving existing home for hny 16 widening FILE P: Landscape Position Group Texture .19$5 LTAR Structure R-Ridge I S-Sand 1.2-0.8 SG-Single Grain SS-Shoulder Slope LS-Loamy Sand M-Massive LS-Linear Slope CR-Crumb FS-Fool Slope II SL-Sandy Loam 0.8-0.5 CR-Granular NS-Nose Slope L-Loam 5BK-Subangular Blocky HS-Head Slope ABK-Angular Blocky CC-Coccave Slope III SI-Silt 0.6-0.3 PL•Plaly CV-Convex Slope SICL-Silty Clay PR-Prismalic T-1 etr ace Loam FP-Flood Plain CL-Clay Loam SCL-Sandy Clay Loam IV SC-Sandy Clay 0.4-0.1 SIC-Silly Clay C-Clay Consistence Consistence Mineral qy Muis Wet SEXP•Sliyhdy Expansive ' VFR-Very Friable NS-Non-Sticky EXP-Expansive FR-Fdable SS-Slightly Slicky FI-'ri:m S-Sticky VFI-Very Firm VS-Very Sticky EFI-Extremey Finn NP-Non-Plastic SP-Slightly Plastic P•Pla slit VP-Very Plastic Sketch of Soil Evaluation Locations vy b S s f R"''D S Y• 11— l v U y cz L bb I 1