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Home My WebLink AboutIMPV-04-2016-071080.TIF ,B CATAWBA COUNTY Case# c1 iPublic Health Department Subdivision r itf. < "° °r '� Environmental Health Division PIN# 265702567551 ^�� PO Box 389, 100-A Southwest Blvd,Newton,NC 28658 I,O'I'# 2 18.2 ,u 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 Owner/Authorized Representative Acknowledgement of Permit Receipt IUI certify that I am the owner or authorized agent(owner's authorization required) representing the owner of the property described above. -PI As the property owner or authorized representative, I have received the above referenced permit(s) as requested in the application for service RBPR-03-2016-23377 by the following method(s): _Received in Person Facsimile Transmittal (Return form with signature required) n / Electronic Image Transmittal/ E-mail (Return receipt required) _ Y'V As the property owner or authorized representative I have reviewed and understand the specific conditions 1 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 Ownertitthorized Representative Signa ure Date — C ` / 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 ehperm it 04/12/2016 14'.46 Page 3 of 3 ,gA & CATAWBA COUNTY ti � 0 # IMPV-04-2016-071080 .f L Public Health Department yam' �.. Subdivision k„., -4 Environmental health Division ,� �� r PIN# 265702567551 (842 PO Box 389, 100-A Southwest Blvd, Newton, NC 28658 . G —f-G i LOT# 2 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 Improvement Permit Facility: Primary Residence 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: Type: IIIG -OTHER NON-CONY TRENCH SYSTEMS PUMP *MAY BE* 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. 'Phis 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. Steven Price 04/12/2016 AUTHORIZED STATE AGENT APPROVAL DATE. 04/12/2021 Permit Expiration Date: No grading or construction activity is allowed in areas designated for system and repair without approval of the Health Department. chperink 04/12/2016 14:46 Page 1 of 3 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. Top ^c S �z � s nc� I:4-1 lii 0-4 ko„sc G c1 13r; @ n1gfc —Co EIP I M 8'6\ JQ uo } coo A v 17 I 11 MW ' 1 o_ ty63 7 (S� ti DEPARTMENT OF HEALTH AND HUMAN SERVICES DIVISION OF PUBLIC HEALTH,ENVIRONMENTAL HEALTH SECTION Sheet af_l ON-SITE WATER PROTECTION BRANCH "AWL _ 6 3_4)/6 - 233 77 PROPERTY ID k: SOIL/SITE EVALUATION COUNTY: for ON-SITE WASTEWATER SYSTEM (Complete all fields in full) OWNER: <4I 7 G-1-4 ADDRESS: .3((o 2._ rk_ /8 Hwy joie DATE DATE PROPOSED FACILITY: PROPOSED DESIGN FLOW(.1949): z.elo PROPERTY SIZELUATED: LOCATION OF SITE: WATER SUPPLY: ❑Private ❑Public 12r,Well ❑Spring ❑Other PROPERTY RECORDED: EVALUATION METHOD: l ,Auger Boring ❑Pit ❑Cut TYPE OF WASTEWATER: ik Sewage ❑Industrial Process ❑Mixed P R 0 SOIL MORPHOLOGY OTHER F (.1941) PROFILE FACTORS 1 .1940 L E LANDSCAPE HORIZON POSITION/ DEPTH PROFILE q SLOPE% (IN.) .1942 1 .1941 .1941 SOIL .1943 .1956 .1944 CLASS STRUCTURE/ CONSISTENCE/ WETNESS/ SOIL SAPRO RESTR &LTAR TEXTURE MINERALOGY COLOR DEPTH CLASS HORIZ O-s 33L s� ■a=i sti GY•1 LS S9 56e r JhxE ". e lA1At S, ,,q vq (5 1 Ci Y- U S6L c fl St p at J Li-33 w56L Ct 6c-Sc 33 to °Sdt ct_ :/ o -(r salt Scc de, 5E 6D.LA( am_ O I-5 15-34 snrL c A Se- „g N+ Ni PS 2 3'� 36 -Yg 's6k cL N SC c hL, o , Z,f "/k+G n • 0 -S Ilk Scc. VFr SC c.,, j1 FS yr- if A A-Mc- c_ vlit se' '0 k 15 cr x N A— A/4 3 .,y (, -37 s6L c pi SE d. zi 37- Hv '51k CL r--/ se 6 — U "'Mk VFrSE ca—TA (S t/- 3( 561. C- Fit J e- _ Am- Y6 ,,NA- Aid- c. , a 4 �o� 3/- (ix silk, CL OSE "/-'4 DESCRIPTION INITIAL SYSTEM REPAIR SYSTEM OTHER FACTORS(.1946): Available Space(.1945) Pf P.--r CLASSIFICATION(.1948): 1 EVALUATED BY: S ^'i System Type(s) 2,„3...--% 64-4-1-. ?It AI OTHER(S)PRESENT: Site LTAR 8_ Z� B- ZT COMMENTS: Updated February 2014 eQie 03- 2c% - 23377 Catawba County Environmental Health /-zi/ \ I \ / 7. r"-----7 / ,,7:7<7,--------------- ________X<----------1 1 I \ 1 i / ! 1 / (--- 7..---_______- _-- _ ig \ �f , r'1 ;/ , / X55"/` i5i�\ 7--- - / A f ' l "N-.,,,,c �� ,\ K r- use , �' --_�� J Kit 1 s 2 I ; OPP---- -- 1 ' \\'\\*I \\:\\* --/ / ,---------7 Pi 3.b@ asiE / / l �� I e 0 t z4S@ .0 in i PL f'" �..— Q3 z%SAC 58.5$ / / ( �.� � Pl if(v z7s'e s,.5.r �j / e \ i .` ems�) ,fie 4 u tr. �— \\\ 1 I ,\ V 33odC e / . /1 I /-410 (, \ at ��—spy— ,.��L ._/-7l �/� , , i K\• I 411 ,, \ \• `' c 1\ \ \ <K-\ �� - Parcel: 265702567551, 3402 NC 18 HWY VALE, 1in=150ft 28168