HomeMy WebLinkAboutAUTH-04-2016-071121.TIF ,lA CATAWBA COUNTY Case#
.F�' ��,,��.",®� Public Health Department Subdivision
t
Q °-•w Environmental Health Division PIN# 265702567551
, / PO Box 389. 100-A Southwest Blvd,Newton.NC 28658 I.OT# 2
2?42 ,+
NAME ON PERMIT: TEDDY LAIL, 5026 CAROLINA MILL RD, HICKORY NC 28602
Site Address: 3402 NC 18 HWY, VALE NC 28168
Property Size: Square Feet:667,339.20 Acres:15.32
Directions: Hwy 10 to 18 take a right 2 miles on right
I Owner/Authorized Representative Acknowledgement of Permit Receipt
`(�, 1 V I certify that lam the owner or authorized agent(owner's authorization required) representing the owner of the
Ib property described above.
( —PI As the property owner or authorized representative, I have received the above referenced permit(s) as
N7--' requested in the application for service RBPR-03-2016-23377 , by the following method(s):
I Received in Person
Facsimile Transmittal (Return form with signature required)
l Electronic Image Transmittal/ E-mail (Return receipt required)
IT't/ 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.
: ::t Issu 04/12/2016
/Reprresentative Signa ure
Date ' LO " G6
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
ehpennit 04/12/2016 14:46 Page 3 of 3
4qA CATAWBA COUNTY 0 I -. - :-f 0 Case# AUTH-04-2016-071121 ii,.T tfi j, Public Health Department �, {�. Subdivision
Q *l Environmental Health Division 1 Le Subdivision
265702567551
`�\ 't' PO PO Bos 389. 100-A Southwest Blvd,Newton.NC 28658 - �,. LOT# 2
\842 s.. } + 1 r
rtbss-
' CI' NAME ON PERMIT: TEDDY LAIL, 5026 CAROLINA MILL RD, HICKORY NC 28602
Site Address: 3402 NC 18 HWY, VALE NC 28168
Property Size: Square Feet:667,339.20 Acres:15.32
Directions: Hwy 10 to 18 take a right 2 miles on 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 240 g.p.d
Type: IIIG -OTHER NON-CONY TRENCH SYSTEMS
Soil LTAR: 0.25 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: 720 sq ft Total Length: 240 ft Maximum Trench Depth 36 in
Aggregate Depth in Trench Width 3 ft
Minimum Soil Cover 12 in Minimum Trench Separation 9 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 system installation, or the suspension/revocation of existinq permits.
»»> DO NOT INSTALL SYSTEM UNDER WET CONDITIONS ««<
Proposed Repair
System Class: IIIG Proposed System: 25% REDUCTION Distribution Type:: Serial
Soil LIAR: 0.25 g,p.d./ft2
ehpermit 04/12/2016 14.45 Page I of 4
sqA CATAWBA COUNTY Casc# AUTH-04-2016-071121
f 1 Public Health Department Subdivision
Q � Environmental Health Division
. P11'tl 265702567551
PO Box 389, 100-A Southwest Blvd,Newton, NC 28658 LOT# 2
1842 sM
NAME ON PERMIT: TEDDY LAIL, 5026 CAROLINA MILL RD, HICKORY NC 28602
Site Address: 3402 NC 18 HWY, VALE NC 28168
Property Size: Square Feet:667,339.20 Acres:15.32
Directions: Hwy 10 to 18 take a right 2 miles on right
The issuance of this permit by the Health Department does not guarantee the issuance of other permits. It is the responsibility of the
applicant/propeny 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 Ru/es 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 elven period of time
Steven Price 04/12/2016
AUTHORIZED STATE AGENT APPROVAL DATE
Permit Expiration Date: 04/12/2021
No grading or construction activity is allotted in areas designated for system and repair without approval of the Health Department.
ehpennit 04/12/2016 14:48 Page 2 of 4
RBPR 03-2016-23377
3402 NC 18 HWY,VALE
• Do not cut, drive, fill, or grade over septic or repair areas.
• Septic system must be 10 ft from property lines; 50 ft from wells and streams; 5 ft from
building foundations and appurtenances; 10 ft from water lines; 15 ft from a cutbank; and
out of right-of-ways and easements.
• Install a 1,000 gallon septic tank and 240 linear feet of 25%reduction system; (3) 80 ft
lines on contour.
• Final grade of septic area must shed surface water off and away from system.
-r, l 544,ks necf o. I t 0-4 ko„sc G cl 33bI @ iJ 87' -tw... Elf
00
0�
�t Iymyl
o_
063'
In tib v�