HomeMy WebLinkAboutAUTH-04-2016-071078.TIF CATAWBA COUNTY Case# AUTH-04-2016-071078
•
P en G Public Health Department Subdivision
P
4 2 Environmental Health Division PIN# 374520802483
®�r�� PO Box 389, 100-A Southwest Blvd,Newton,NC 28658 LOT#
1:4%+s
NAME ON PERMIT: CHUE CHOR XIONG, 2680 HWY 70, CONNELLY SPRINGS NC 28612
Site Address: 5731 ALAN D GOOD LN, CONOVER NC 28613
Property Size: Square Feet:79,279.20 Acres:1.82
Directions: Hwy 16 North, Springs Rd, 3/4 miles, left onto Alan D. Good Ln, about 1000 feet Property is on the Right.
Owner/Authorized Representative Acknowledgement of Permit Receipt
. C• I certify that I am the owner or authorized agent(owner's authorization required) representing the owner of the
property described above.
C.7- As the property owner or authorized representative, I have received the above referenced permit(s) as
requested in he application for service EHPR-03-2016-23514 by the following method(s):
Received in Person
Facsimile Transmittal (Return form with signature required)
Electronic Image Transmittal/ E-mail (Return receipt required)
Y. C5< 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
�� Owuer/Aut orized Representative Signature / " 7
Date , ' 72 h4
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
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ehpennit 04/12/2016 10:50 Page 4 of4
.8 • CATAWBA COUNTY 0 - 0' •/0 Case# AUTH-04-20 16-07 107 8
,.
aPublic Health Department +� Subdivision
< y ,c, Environmental Health Division s r PIN# 374520802483
I 42 PO Box 389, 100-A Southwest Blvd,Newton.NC 28658 cirri Lao
NAME ON PERMIT: CHUE CHOR XIONG, 2680 HWY 70, CONNELLY SPRINGS NC 28612
Site Address: 5731 ALAN D GOOD LN, CONOVER NC 28613
Property Size: Square Feet:79,279.20 Acres:1.82
Directions: Hwy 16 North, Springs Rd, 3/4 miles, left onto Alan D. Good Ln, about 1000 feet Property is on the Right.
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 360 g.p.d
Type: IIIG -OTHER NON-CONY TRENCH SYSTEMS
Soil LTAR: 0.25 g.p.d./ft2
Permit Category: Repairs
Type of Facility: Primary Residence - house
Basement? Yes Basement Plumbing? No Bedrooms: 3
Wastewater System Requirements
Tank Size: Existing 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: 1,080 sq ft Total Length: 360 ft Maximum Trench Depth 18 in
Aggregate Depth in Trench Width 3 ft
Minimum Soil Cover 6 in Minimum Trench Separation 8 ft on center
Number of Drain Lines 3
Distribution: Serial
Pre Treatment: NONE
Additional Specifications:
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 s stem installation or the sus•ension/revocation of existin. sermits.
»»> DO NOT INSTALL SYSTEM UNDER WET CONDITIONS ««<
Proposed Repair
System Class: Proposed System: Distribution Type::
Soil LIAR: g.p.d./ft2
ehpernit 04/12/2016 10:50 Page t of
03 CATAWBA COUNTY Case# AUTI{-04-2016-071078
tt c.itL
Public Health Department Subdivision
..7'
�',,, Environmental health Division
PI/V4 374520802483
`s PO Box 389. 100-A Southwest Blvd,Newton,NC 28658 LOT#
1!342 ,w
NAME ON PERMIT: CHUE CHOR XIONG, 2680 HWY 70, CONNELLY SPRINGS NC 28612
Site Address: 5731 ALAN D GOOD LN, CONOVER NC 28613
Property Size: Square Feet: 79,279.20 Acres:1.82
Directions: Hwy 16 North, Springs Rd, 3/4 miles, left onto Alan D. Good Ln, about 1000 feet Property is on the Right.
The issuance of this permit by the Health Department does not guarantee the issuance of other permits. Il 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 taws and Rules for Sewage Treatment and Disposal Systems' (I5A
NCAC ISA.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
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 10:50 Page 2 of 4
e\Gl'kep i{ EN? KD3-20It- 135I4
5731 Alan D Good Lb, Conover
* 6� to use exis}�n dank so Ion as i} is in kaC} and S-Irucluraily Sauna. Zf it ,s
found -}o be ot1erwCSe ?ION(Sea, ins4alj a new 10005Allah -}unk.
" TnsAall new 1 and f l4er in exls-}in9 rank. Ns connect excs+iag atainflOd -Frarv, Use.
Zvks4a1\ 360 -fl of )570 kedvc}jon l 3- lao-F4 . -Irencl\es or H- 90 -f -}renckes.
ZvlsIccll drain-Field on con-four. Mar n -kIP_cb de �l-tn IS iNckes,
Seeic 51skem must be. a1 Iposj 5041 -from well, }sc4. -&om baser.en+, 51 -Iroin
crawisrare deck, o-Fl -Front pry r-11 lines cod oink of rtk-of-gars and easemehtS .
Keep dralnfielJ up ke till as i ,cL aS possible.,
4 to no-i drive,, role, cut, or -FT11 over Ser4;c area.
379.55'
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' DEPA$1MENTOFENVIRONMENT AND NATURAL RESOURCES SAee1__o/_
DIVISION OF ENVIRONMENTAL HEALTH PROPERTY ID#:
ON-SITE WASTEWATER SECTION COUNTY:
SOIL/SITE EVALUATION
for ON-SITE WASTEWATER SYSTEM
OWNER: 0hVe Chor� ( j on9 APPLICATION DATE 3I3p 16� f p ..03-2o!4-2351q
ADDRESS: DATE EVALUATED: 'FII-16
PROPOSED FACILITY: ; P. HoUSC PROPOSED DESIGN FLow(.1949): 360 PROPERTY SIZE: l $2acrvs
LOCATION OF SITE: 5731 Akin <�ooe� Lrl, corloJeY PROPERTY RECORDED:
WATER SUPPLY: ® Private 0 Public 0 Well 0 Sting I Other
EVALUATION METHOD: O Auger Boring Pit LI Cut
TYPE OF WASTEWATER 9 Sewage 0 Industrial Pmras 0 Mixed
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DESCRIPTION SYSTI'M REPAIR SYSTEM OTHER FACTORS(.1946):
Avaabie Spar=(.1945)
PS
SITE CLASSIFICATIO qN(.1948):
•SyrtoTywR) 11.5 O� PPRRESENIT Je— M(Rrid¢ t �Ie*v P(CP,
• Site LIAR 0.35
COMMENTS:
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