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Home My WebLink AboutIMPV-04-2016-071060.TIF ^g , A CATAWBA COUNTY Case# .T v rilli y Public Health Department Subdivision Q tio. ;# Environmental Health Division PIN# 375503225543 ''4- PO Box 389. 100-A Southwest Blvd,Newton,NC 28658 LOT# /842 o NAME ON PERMIT: DUSTIN LITTLE, 5120 RIVER BEND RD, CLAREMONT NC 28610 Site Address: 2252 SHANG LN, CONOVER NC 28613 Property Size: Square Feet: 128,502.00 Acres:2.95 Directions: 16N/past Springs Rd /approx 1/4 mile / right on Shang Ln/through Orange Gate 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 1' property described above. NNIE As the property owner or authorized representative, I have received the above referenced permit(s) as requested in the application for service RBPR-08-2014-19656 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: 04/12/2016 --Owner/Authorized Representative Signature Date Documentation of Permit(s) Transmittal (permit transmitted by electronic or other means) Permit trans¶.?'O99'lkU fitted by Litt tl , 1 , it (name of person se din.: permit Signature •t Date/Time 1 ./ 6 ‘DO Method: Fax mail US Mail Other Owner's request to send by the above indicated method of transmittal in lieu of signature n /s� We w to hear from you. a take a few m me� complete our customer service survey at: http://www.surveymonkey.com/s/EHCustomerService ehpermit 04/12/2016 08:48 Paee 4 of4 CATAWBACOUNTY Q Case# IMPV-04-2016-071060 v Subdivision � Public Health Department 1�[�`, •. �I� f= 1 PIN# 375503225543 , K Environmental Health Division ~ Y PO Box 389, 100-A Southwest Blvd.Newton,NC 28658 _,. , A LOT#.t O'I'# 842 rt Di : ON O NAME ON PERMIT: DUSTIN LITTLE, 5120 RIVER BEND RD, CLAREMONT NC 28610 Site Address: 2252 SHANG LN, CONOVER NC 28613 Property Size: Square Feet: 128,502.00 Acres:2.95 Directions: 16N/ past Springs Rd /approx 1/4 mile! right on Shang Ln/ through Orange Gate Improvement Permit Facility: Primary Residence - house Permit Category: New Septic Bedrooms 2 WATER SUPPLY: Private Well Basement? No Basement Plumbing? No INITIAL SYSTEM SPECIFICATIONS Permit Valid: Expires In Five Years: _X_ No Expiration: Projected Daily Flow 240 g.p.d Proposed Wastewater System: 25% REDUCTION Type: IIIG -OTHER NON-CONY TRENCH SYSTEMS Permit Conditions: REPAIR SYSTEM SPECIFICATIONS Repair System Required? Required Proposed Wastewater System: 25% REDUCTION Type: IIIB - SYSTEM W/SINGLE EFFLUENT PUMP PUMP 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 04/12/2016 AUTHORIZED STATE AGENT APPROVAL DATE Permit Expiration Date: 04/12/2021 No grading or construction activity is allowed in areas designated for system and repair without approval of the Health Department. • ehpermit 04/12/2016 08:49 Page 1 of3 TPiAC KBPR og-xi 4- !9656 x p Shan L+k, Conover + T s-lal1 1000�°jP�(!o,- Serk -IK,,k dmd 2Vof�-. off' 2570 redv4,'Dh. 3-co-Fm- Fret s. irks•l-mI dreti4eld oh Coy\ } X * cud c\eah-o 4 a-1 r,IaWa „4 o� S u P rP y lines be-LuveeY. -1,,,•.k a„d dYa■,,f1 elol. * Ser if/C- sic-kw, PA v54 bt a-1 lees+ loo�. .F,o,� was, 50{x. croon aPeks, 5-f . fri S"tfbec-I.005, lo-F4- -troll Prar lkzs, aka ,, aka, a is xcl�,d,' I II r�ry� -a� v��y3 a ease �e �,�� Se�t�� easer�er\-1 1 J / * Do h0-+ At'Je., 3ra , c A, or -R 0v2,( Serb'G are at or rPrir area. t Re orded seP}ic, Easernen-1• ,s .n. N 0 w 8.• ___.-------- B°• L.--- so• I / 'I,0• dean in m;ddlc I Tank a Bed m I\ ^ 30 F \ N Area 64 d Graded _ .Weil ' •re.Y O,. Area ew• ze�ficy,r i i5' C4 '35' p k<a �e PVMP:0:5,5. .yp. 7a 3j 1 Shan A\ v9u. DE?AATMEM OF ENVIRONMENT AND NATURAL RESOURCES • Sheet_ef__ DIVISION OF ENVIRONMENTAL HEALTH PROPERTY ID N: .ON-SITE WASIEWATERSECTION COUNTY: SOIL/Silt EVALUATION for ON-SITE WASTEWATER SYSTgm OWNER: QV5411O IC. APPLICATION DATE orli 01,1 Cuff 9ij u g�PR-TFO�l s f 9656 ADDRESS-. at PROPOSED FACILITY: D 0R4fOQSP. PROPOSED DESIGN FLOW(.1949): 2 0 PROPERTY gra2.15acres LOCAITON OF SITE:2151 Char (I\ CcnIP✓ PROPERTY RECORDED: WATER SUPPLY: 1 Private 0 M,blic ® wen 0 sag 0 Other ' EVALUATION METHOD: 0 Auger Boring $ P11 0 Cut TYPE OE WASTEWATER: Sewage 0 Industaal Process CI Mixed — : __:__-::::::':: ::: .s:..::-_ g1f3YG �L1R1'HiSi_.tSO'1:- e-iris€:=; :: ::::01R : :__ ::::r.::::: -:_:::: ::_=:i:iii_ii:=_: r.:::::::.:::::::: ..p, �1971 s :...._...._- - YT�i7FT�'1<�'iiL:Cf3Ft5:...........:._..... -- -.__. ..__ . . ._._ .... -,...__...--"---..__._.::::_::::::: ::::�—�:_._::-:::::::�:::=:::-::::344TH s= '.--_[< ;;ySSe€:=='€`_`--_•e�[ia=-._....._ _ ' _... _.._ - __ •HCAFgi:=-i.'.::: ::::..14d ; _ _- -P__tif.3941:-:=:;::::; --soft,...,,.. s ..._ ..... . ......._ :::... . .:_:::k kT,i,�i a -PDSItiOffi. DEPTH 41�C1 �__ . etXiN5154'.eN'C!'1' l'1'L1NI55{ 4QIk<. SxPSQ- 1;ec7iT rL�S` 3 =9 k-g _ '}: T MIE+ F :S2CY COLOR 1tgPA 0400 EI#RI &T.. 0-b ShK- L 'Cif, W. Sexp L 6 -31 Wsbk G • .ii,SS. 5exp 1 31-q) wsbkCLw► ,ieUaiMVHHts f,S,soy 5> P-76 -{)•53 vJ5i4-e1- wilt : &c? fl,ss,sexr 0.5 0-el. St , 1:-.- ... •, -. L frsS.Sexp 1 21-51 Wsbtct, - ucr1/41H vyt4;5'4 G� — PS . I 2 51-b? FJSbk L -Gasfspy - 0 >5 0-g Sit.l-- fr,55.wxp 8-39 ■5bkG -G c4. 5txp �� PS 3 Sri-qi_, :asbk ci.„4*,SAP e((,s5 sexp — — — 0,3 _ 0-11 sbkL -&,55,5exp 13-3(, v}sbk G -(r , S5, Sex? g Ps 4 Se-111I ws6C CL wi•+I,SA? -Fr.s5,ser — — 0,a5 wa-ter SeFTjrlq ink 1Si&tulall P"{ 9io rilini) Naga. 2)" DESCRIPTION ATIlAL SYSTEM REPAIR SYSTEM OTHER FACTORS(.1946): Available S I9d� �S SITE CLASSIFICATION ASSIFICATION(.1948): y�, SyuemTypeQ) err EVALUATED BY: Ret1P ��C&dt: Sir JenII1C•P. �� .it+-b9 . OTHER(S)PRESENT; " Posiln LrH-le. . She LIAR Q• 75 0: 35 COMMENTS: .�5 o To •well N4 I Sc k-)