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Home My WebLink AboutIMPV-04-2016-070763.TIF ,P CATAWBA COUNTY Case4 IMPV-04-2016-070763 T"gam ,.G Public Health Department Subdivision 1 - Environmental Health Division I'IN# 367604926377 PO Box 389, 100-A Southwest Blvd,Newton,NC 28658 LOT# 1842 o NAME ON PERMIT: JEFFREY & ASHLEY HARTSOE, 222 BRENTWOOD DR, MAIDEN NC 28650 Site Address: 4955 LEBANON RD, MAIDEN NC 28650 Property Size: Square Feet:645,559.20 Acres:14.82 Directions: East Maiden Rd towards Hwy 150, Left onto Lenanon Church Rd, Property on Right about 1/2 mile down the road. 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 / prropert rt described above. , 5/•As the property owner or authorized representative. I have received the above referenced permit(s) as I !requested in the application for service EHPR-03-2016-23315 by the following method(s): JReceived in Person Facsimile Transmittal (Return form with signature required) Electronic Image Transmittal/E-mail (Return receipt required) s.( ,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: 04/04/2016 �� Owner/Authorized Representative SignatureSi,,,,'�. ' Date 0 / r gyp 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 ehperinit 04/08/2016 10:41 Page 3 of 3 ,(t_a CATAWBA COUNTY 0 pi - _ r''.60 Case rl IMPV-04-2016-070763 tjfl Public Health Department Subdivision Q ® Environmental Health Division � " _ 5 PIN# 367604926377 Y \' ® PO Box 389, 100-A Southwest Blvd, Newton.NC 28658 Cti ds LOT# 842 s. r -1 r { r La aL k CI .. • .v NAME ON PERMIT: JEFFREY & ASHLEY HARTSOE, 222 BRENTWOOD DR, MAIDEN NC 28650 Site Address: 4955 LEBANON RD, MAIDEN NC 28650 Property Size: Square Feet: 645,559.20 Acres:14.82 Directions: East Maiden Rd towards Hwy 150, Left onto Lenanon Church Rd, Property on Right about 1/2 mile down the road. 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: Keep all parts of septic system and any future repair system minimum: 10' from property lines, 5' from home including decks or porches, 100' from any well. Lines to be installed on contour. Do not grade drive or fill over system or repair area or permit will be revoked. 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 flaws 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 Rides tar 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. Jason Boyd 04/04/2016 AUTHORIZED STATE AGENT APPROVAL DATE 04/01/2021 Permit Expiration Date: No grading or construction activity is allowed in areas designated for system and repair without approval of the Health Department. ehpermit 04/08/2016 10:41 Page 1 of 3 Permit# EHPR 3-16-23315 G CATAWBA COUNTY:::A-'1?1,g, 'Z Public Health Department Name Jeffrey and Ashley Hansoe �' Environmental Health Division Address 4955 Lebanon Rd Maiden NC U7 PO Box 389, 100A Southwest Blvd, Newton NC 28658 PIN 367604926377 842 sM (828)465-5270 Fax (828)465-8276 TDD(828)465-8200 2, ber 1 • ' . ! i ement Permit Ile` Ito ' ( IZ 3 I s �- sit. 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( 5' e,r+ / C.nw-l' t , IS ' 0o t vo ' Scale I -- ‘ 6 La-� � �d -„, i<D Department of Environment, Health,and Natural Resources Sheet: Division of Environmental Health Property ID: On-site Wastewater Section Lot#: SOIL/SITE EVALUATION File#: for ON-SITE WASTEWATER SYSTEM AppID: EHPR-3-16-23315 Owner: Jeffrey and Ashley Hartsoe Applicant: Address: 4955 Lebanon Rd Maiden NC Date Evaluated: 3/18/2016 Proposed Facility: 3 BR home Design Flow(.1949) 360 qpd Property Size: Location of Site: Property Recorded: Water Supply: pvt well [ ]Spring [ ]Other Evaluation Method: pits by applicant [ ]Cut Type of Wastewater: X(Sewage . 1 [ ]Industrial Process [ ]Mixed,, �{, t Pr - Iz' ill t q ,�gl lt, &.,3u PC Cl c. 13 ; �'$ irffi , ��5 �`' l Icy!"f1*'v s:, 'lllgsi`.' t�1 5 efi 3 I i t J �E *: i R 7:74'4 Ie 1. at 7'4, , 1 t + + wI 'f k"' iq LI f� t a!k' � „A,r tort=' P +a a x -i xy s t n µ O 14'1 i� ry t`- � 4 o Swart RFrHOLOGY'aa'4P�'..,.4 e-�� a-s s b at '4'6+3u-- ..-# a dNrg , �di]3°a.'!. F . . #t.. i kIa i 1 ` ' :, 1941' &M UM Ifig � ().i.0 a r , PROFILE FACTORSs 'olgim s i 4 '` ` V. k6 I '1<T�. h 7n 1940' 3 �, it.0-v ° i +Ir��' rgil'j k vi r�'i1,4 it i 1942 . ,r. E's � +M'� +..,?,t.s{€.10;43 a' „ ; $i (�.1. as n: c + zo ': g� •'r' E F.p a , l+a *,*t * N ,� +" , Profile i1 z 0e L � � 3+�1Landsc�apen' Honrzon� 3® � 19411,'x` i � >�)?&1941�,!a:ca` � SoilFf , 1943 1956 ',t944 � F "5 �+ I to ce �'•��P I I . PUu l s+r a l rrsgPosi6ont,�5`j DepMh . r Structure/-, z.. + sGonsistencel , j ). Wel;ness/] 1� `,ri$oil;;.r l; Sapro r I�,ReisK'I th g",e Class s,r.., ; #. .ulas,Slp e% a5 + i Nih .u-_. p (IN}�,„ Texture^.„ei.4,,,,,;„Mineralogy ,>1 {.„,4„ „aColor , �., Depth°(IN), Class, E+rHorii`d" !n ,.b&,LTAR33- ; ; 1 LL 3-5% 0-6” topsoil 6-24” SCL SS,SP,SEXP,FR 48" PS.25 24-48" C 2 same as 1 48" PS.25 3 same as 1,2 48" PS.25 I Description Initial System Repair System Other Factors(.1946): Available Space(.1945) PS PS Soil Evaluation By: Jason Boyd System Type(s) IIIG IIIG Others Present: applicant and backhoe operator Site LIAR _ .25 .25 Site Classification(.1948): PS Site Evaluation By: Others Present: Sheet: COMMENTS: FILE#: Landscape Position Group Texture .1955 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-Foot Slope II SL-Sandy Loam 0.8-0.6 GR-Granular NS-Nose Slope L-Loam SBK-Subangular Blocky HS-Head Slope ABK-Angular Blocky CC-Concave Slope III SI-Silt 0.6-0.3 PL-Platy CV-Convex Slope SICL-Silty Clay PR-Prismatic T-Terrace Loam FP-Flood Plain CL-Clay Loam SCL-Sandy Clay Loam IV SC-Sandy Clay 0.4-0.1 SIC-Silty Clay C-Clay Consistence Consistence Mineralogy Moist Wet SEXP-Slightly Expansive VFR-Very Friable NS-Non-Sticky EXP-Expansive FR-Friable SS-Slightly Sticky FI-Firm S-Sticky VFI-Very Firm VS-Very Sticky EFI-Extremely Firm NP-Non-Plastic SP-Slightly Plastic P-Plastic VP-Very Plastic Sketch of Soil Evaluation Locations