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Home My WebLink AboutIMPV-04-2016-071349.TIF yiuA� CATAWUA COUNTY Case# v . t p i. Public Health Department Subdivision OLD MILL SUBDIV X01 s; Environmental Health Division PIN# 461901294697 %.4.3„ ,/ 1'0 Box 389. 100-A Southwest Blvd,Newton,NC 28658 LOTit 13 NAME ON PERMIT: SARAH LYTTON TATE, 1790 SW POWDER SPRINGS RD, MARIETTA GA 300644154 Site Address: 1317 KNEBWORTH LN, CATAWBANC 28609 Property Size: Square Feet:22,651.20 Acres:0.52 Directions: Mollys Backbone from Mumbo Rd, Left on Rowe St, Right on Knebworth Lane & lot is on the Right. Owner/Authorized Representative Acknowledgement of Permit Receipt I certify that 1 am the owner or authorized agent(owner's authorization required) representing the owner of the Nicproperty described above. N ..( As the property owner or authorized representative, I have received the above referenced permit(s) as requested in the application for service EHPR-10-2015-22595 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: 04/18/2016 2 wner/Authorized Representative Signature --- /:: ,---r J✓L i 11 c`---- Date 4—) 7-234 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 chpemdt 04/19/2016 08:58 Page 3 o13 - h�A CATAWBA COUNTY 0 ' f Case(] IMPV-04-20 1 6-071 349 _T r Public Health Department 7yRt• ti -a' Subdivision OLD MILL SUBDIV < . �'�.o.'- 4) Environmental Health Division r -F5} Lr PIN# 461901294697 °vfa PO Box 389. 100-A Southwest Blvd. Newton,NC 28658 0 _ o.. r Jon r 13 /842 sy k 4'f - O - :c NAME ON PERMIT: SARAH LYTTON TATE, 1790 SW POWDER SPRINGS RD, MARIETTA GA 300644154 Site Address: 1317 KNEBWORTH LN, CATAWBA NC 28609 Property Size: Square Feet: 22,651.20 Acres:0.52 Directions: Mollys Backbone from Mumbo Rd, Left on Rowe St, Right on Knebworth Lane & lot is on the Right. Improvement Permit Facility: Primary Residence - House Permit Category: New Septic Bedrooms 4 WATER SUPPLY: Private Well Basement? Yes Basement Plumbing? Yes INITIAL SYSTEM SPECIFICATIONS Permit Valid: Expires In Five Years: _X_ No Expiration: Projected Daily Flow 480 g.p.d Proposed Wastewater System: 50% REDUCTION Type: IVA-ANY SYSTEM WITH LPP DISTRIBUTION PUMP REQUIRED ***** OPERATOR REQUIRED Permit Conditions: *The well must be abandoned before the Authorization to Construct can be issued. "Do not drive grade, or fill or any designated septic area. 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 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 Ru/es for Sewage Treatment and Disposal Systems' (15A 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 period of time. Robbie Phelps 04/18/2016 AUTHORIZED STATE AGENT APPROVAL DATE 04/16/2021 Permit Expiration Date: No grading or construction activity-is allowed in areas designated for system and repair without approval of the Health Department. chpennit 04/19/2016 08:58 Page 1 of3 Moir- -lo( - 0713yi H -(14 - 4 -1016 - o713S0 w aria^ Ln oil to 5roA ' 4to°'r �'‘14 A T ( n 0♦ y Sis AA' '! . LPC VP`s 4i, 0D qtr, prcpar• t A , 6 lti avi i_ So b.n^�"t tam WS p,t) N O. 0 5ennui 61 Cs S, v_ No I , Cc I �7- G ^^^ � . \ mS''® /Z \ % A � ' ~ § ) $q y� » , \ ) | \.0,,A- a \\� f \ | . | | . !,| P Z y, § / / \; J • \ \a / ƒ ? j4 1 .g j § |% ( n \ 1 | 1 :k \ �; \ \! . 00,# \ ~4. \•~ § � /m; \ X \ ( f & ¥ /� } ) \i| \ > - , e b | ' ® % ~ ^ `�\ � ` � \�\� � - I d %� • � ! ‘fIN . ; | 19 ! |! | - . ! Si A i / n“k § r | ! q® ! ° \ I � � I — G \ ; f) , { | j / > ^ . \ � DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES • Ste of DIVISION OF ENVIRONMENTAL HEALTH PROPERTY ON-SITE WASTEWATERSECITON COUNTY: SOIIJS1.1'E EVALUATION for ON-SITE WASTEWATER SYSTEM OWNER: u' l` t`f�- APPLICATION DATE • ADDRESS: 131/ nil,i.y th Lri DATE EVALUATED: It-z2-15 PROPOSED FACILITY: tf 412- PROPOSED DESIGN FLOW(.1949): 4 a'0 . PROPERTY RUT- LOCATION OF SITE: PROPERTY RECORDED: WATER SUPPLY: grai.mh Q Public ft-Well 0 Spring 0 Omer EVALUATION METHOD: 0 Auger Bering 0'i it 0 Cut MHOS WASTEWATER: Sewage 0 Imiustdal Pmts Q Mixed .._....----._.__...... ......__.._...... El a - - - - - - - .._..... S5Y(ITtYiI t) 1,.r::,:..,:..:,n,� ;::;:'=Lim :......f ___:__ i:i[ ![_:"!�=[[S d93Ij_ _ ;'=... -c'-=: :_....._........:::-:: :11.110 IFS FACTO ItS....._:::�_:::_...................:.:::::. ::iF2 =tt::�::::att::::__;:__�:_:_-_::_:;:--_:.............._......... '[::ci144�[_.=.=_!ttt:-_=..-s.=.=: •e=::!::a .._:�'•::-:... ._._........_ __ _........ : ., :: ::`....:-- �:......_;::: ::— .. ... ..__.._._ - ::::[ _:::-:: _:::: __- sa: $94,14:',:;;;;;;ZSItt , ,:,X95 ,-:;ir.:4liiiii =ii :�� ??:�° ::-:: �If4L. �..:_._ ._._._�:3 ,�,,»,: e.,; OST't7.pl4f' : FTH sY?Eti<-'TEIRTJ :_iYSk ,SI'. 'Y.f1 N' ?Sf WM: S,;MCk - $fr5ii 3 '7a4p?L! i DT G -.....: Tea........ .°iONari4kOVI - KQ1...: 5 ARE- 0-3 0 rcc 1 -I L k.,ll� - • 1 f�'4S I� r61'l l 1'3 •11'1 °C Lis—q8 V✓ in 53K .. • Y 7 r L 5� 2 I' 7- ) I C ,rlh • f4 (ti.I 0 "sI-X14 C +r•n Sh Pr S 44 4Y Jr s k • • 3 - 4 • DESCRZTION ATIIAL SYSTEM REPAIR SYSTEM OTHER FACTORS(.1946): Avaihble Spa¢(.1945) s- LT" SITE CLASSIFICATION(.1946): 1'✓ Systrm Typta) 5 0'11 s!)d l EVALUATED BY: a a L�:i OTHER(S)PRESENT: • Site LIAR -i) CON:MEWLS: • Catawba County Environmental Health 259.38 ,\ 1,69° • \\I 3O 362 0 t xxre , OA •a Z o es rZ 044 . 0 21g20 $ 29.77 S �' 0 l 215• t s I a Illa \ 28.30 a . A \,.., • ,®a ,5 /• Parcel: 461901294697, 1317 KNEBWORTH LN 1in=50ft CATAWBA, 28609 This map/report product was prepared from the Catawba County,NC Gerspatial Information Services. Catawba County has made substantial efforts to ensure the accuracy of location and labeling information contained on this map or data on this report.Catawba County promotes and recommends the independent verfication of any data contained on this map/report product by the user.The County of Catawba,its employees,agents,and personnel,disclaim,and shall not be held liable for any and all damages,loss or liability,whether direct,indirect or consequential which arises or may arise from this map/report product or the use thereof by any person or entity. Copyright 2014 Catawba County NC 04/18/2016 w nofrA h'oM. ... 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