HomeMy WebLinkAboutIMPV-04-2016-070969.TIF ;,PA CATAWBA COUNTY Case 4 _
.0 L y Puhlic Health Department Subdivision WYNSWEPT PH 1
< ,`% Environmental Health Division PIN// 367804517494
PO Box 389, 100-A Southwest Blvd,Newton,NC 28658 LOT# 29
1842 9
NAME ON PERMIT: *BEASON GENERAL CONTRACTORS, PO BOX 636, SHERRILLS FORD NC
28673-
Site Address: 4564 CAYTON DR, MAIDEN NC 28650
Property Size: Square Feet:34,848.00 Acres:0.8
Directions: take hwy 10 to hwy 16 South and turn left onto Cayton Drive, Property is .3 miles on the left
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.
As the property owner or authorized representative, I have received the above referenced permit(s) as
requested in the application for service RBPR-03-2016-23539 by the following method(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: 04/08/2016
` Owner/Authorized Representative Signature
Date
Documentation of Permit(s) Transmittal
(permit transmitted by electronic or other means)
I .
Permit transmi ed b tr �' , NI (name ofperson s• dingpermii
Signature i tYA/tt a el '_/ Date/Time 1/ (P011 ; 6
Method: Fax \Email US Mail Other
Owner's request to send by the above indicated method of transmittal in lieu of signature
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ehpennit 04108/2016 12:07 Page 3 of 3
"--vti Case#
•
1t3A CATAWBA COUNTY o 0 IMPV-04-2016-070969
, i[.}MC Public Health Department r •- �,• J' Subdivision WYNSWEPT PH 1
Q s '". Environmental Health Division �r PIN/4 367804517494
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'°dt PO Box 389, 100-A Southwest Blvd.Newton.NC 28658 iG —r LOT# 29
842 s. i. Li+- 0
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NAME ON PERMIT: "BEASON GENERAL CONTRACTORS, PO BOX 636, SHERRILLS FORD NC
28673-
Site Address: 4564 CAYTON DR, MAIDEN NC 28650
Property Size: Square Feet: 34,848.00 Acres:0.8
Directions: take hwy 10 to hwy 16 South and turn left onto Cayton Drive, Property is .3 miles on the left
Improvement Permit
Facility: Primary Residence
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: IIIB - SYSTEM W/SINGLE EFFLUENT PUMP
PUMP REQUIRED
Permit Conditions: See AC for 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 arc 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' (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.
Jason Boyd 04/08/2016
AUTHORIZED STATE.AGENT APPROVAL DATE
04/08/2021
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 12:07 Page 1 of 3
4.1.1\3A • CATAWBA COUNTY Permit# RBPR 3-16-23539
L Public Health Department Name Beason General Contractors
_. Address 4564 Cayton Drive Maiden NC
°` Environmental Health Division
's PO Box 389, 100A Southwest Blvd, Newton NC 28658 PIN# 367804517494
847, sw (828)465-8270 Fax (828)465-8276 TDD(828)465-8200 Lot 29
Site Plan Authorization to Construct
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• On-Site Wastewater Section • 'Date: 02 / 0 3 / am
Soil/Site Evaluation 'File#: a 4 s 1 6
For On-Site Wastewater System pip( #; 0 6. o 3 o 6 3
:`Owner DANNY EDWARDS HECHT DEVELOPMENT CO Proposed Facility SINGLE FAMILY
Proposed Design Flow(.19401 0 0 6 0 0 Location of Site 4564 PEMBROKE PINE ST
NEW WELL Pit
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Comments:
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Evaluated By: Boyd.Jason I
NCDENR
Division of Environmental Health
:'s On-Site Wastewater Section . Date: e / 9 3 / z o 0 9
Soil/Site Evaluation File#: 2 4 5 1 6
• For On-Site Wastewater System PIN #: a s o 1 a 6 3
.1941) Norizan I SOIL MORPHOLOGY
Profile# Landscape Depth .1941 Other Profile
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