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Home My WebLink AboutAUTH-04-2016-071543.TIF ,;.5,• . . CATAWBA COUNTY Case# AUTH-04-20 1 6-07 1 543 rf Ai G Public Health Department Subdivision t Environmental Health Division PINH 460605282928 \��' Y 18 PO Box 389, 100-A Southwest 131vd, Newton,NC 28658 LOT# 1842 sm NAME ON PERMIT: RICHARD GILBERT, 4440 SCALYBARK LN, SHERRILLS FORD NC 28673 Site Address: 4440 SCALYBARK LN, SHERRILLS FORD NC 28673 Property Size: Square Feet:21,780.00 Acres:0.5 Directions: HWy 150, Right on Fighting Creek, LEft on Scalybrook, Last house on Left Owner/Authorized Representative Acknowledgement of Permit Receipt NiE I certify that I am the owner or authorized agent(owner's authorization required) representing the owner of the property described above. I As the property owner or authorized representative, I have received the above referenced permit(s) as requested in the application for service EHPR-03-2016-23479 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 II\ 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: 04/25/2016 Owner/Authorized Representative Signature Date Documentation of Permit(s) Transmittal (permit transmitted by electronic or other means) c Permit tran-mi ted by L__At It , ,n (name of persons riding permit) //�� Signature �� Ill 1_:A Date/Time o CC) Method: Fax ail US Mail Other Owner's request to send by the above indicated method of transmittal in lieu of signature ,L0Lcioxiam We want o hear rom you. Please take a few moments to complete our customer service survey at: http://www.surveymonkey.com/s/EHCustomerservice elipennit 04/25/2016 09:12 Page 4 of4 SB • CATAWBA COUNTY 0 -p. — .f2 a Case AUTH-04-20 1 6-07 1 543 .C' P.y.Ih y Public Health Department Subdivision ^r N �K Environmental Health Division r PIN# 460605282926 ��" PO Box 389. 100-A Southwest Blvd,Newton.NC 28658 �k * Lon/,H.z ,h • LL 4i 0 . #• . oar NAME ON PERMIT: RICHARD GILBERT, 4440 SCALYBARK LN, SHERRILLS FORD NC 28673 Site Address: 4440 SCALYBARK LN, SHERRILLS FORD NC 28673 Property Size: Square Feet: 21,780.00 Acres:0.5 Directions: HWy 150, Right on Fighting Creek, LEft on Scalybrook, Last house on Left Authorization to Construct Permit Authorization to Construct Wastewater System (Required for Building Permit) * See site plan and number of additional attachments ( J. Proposed Wastewater System: `REPLACEMENT OF SEPTIC TANK ONLY* Wastewater Flow 240 g.p.d Type: IIIB - SYSTEM W/SINGLE EFFLUENT PUMP Soil LIAR: g.p.d./ft2 Permit Category: Repairs Type of Facility: Primary Residence - Basement? Yes Basement Plumbing? Yes Bedrooms: 2 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: sq ft Total Length: ft Maximum Trench Depth in Aggregate Depth in Trench Width ft Minimum Soil Cover in Minimum Trench Separation ft on center Number of Drain Lines Distribution: Pressure Manifold Pre Treatment: NONE PUMP REQUIRED Additional Specifications: Permit issued to relocate septic tank to allow for additions to home. Permit issued for repair of system in 2011 under EHPR-3-11-10164. Existing tank is to be pumped, crushed and removed to allow for placement of new tank parallel with house to allow for 5' setback to new home addition. New tank must be minimum: 50' from lake, 5' from any building foundation. Proposed addition is 63' from lake based on measurement with owner. A plastic tank may be installed due to possible difficulty in getting tank truck to lake side of home. Do not grade drive or fill over pump tank or drain field and keep equipment off drain field as much as possible. 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. »»> DO NOT INSTALL SYSTEM UNDER WET CONDITIONS «<<< Proposed Repair System Class: Proposed System: Distribution Type:: Soil LIAR: g.p.d./ft2 chpernut 04/25/2016 09.12 Page I of �yA � CATAWBA COUNTY Case# AUTH-04-201 6-07 1 543 .7' !.n Public Health Department Subdivision 4 —, HC Environmental Health Division PIN# 460605282928 °rr PO Box 389, 100-A Southwest Blvd,Newton.NC 28658 LOT# 18.2 w NAME ON PERMIT: RICHARD GILBERT, 4440 SCALYBARK LN, SHERRILLS FORD NC 28673 Site Address: 4440 SCALYBARK LN, SHERRILLS FORD NC 28673 Property Size: Square Feet:21,780.00 Acres:0.5 Directions: HWy 150, Right on Fighting Creek, LEft on Scalybrook, Last house on Left 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 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 Rules for Sewage Treatment and Disposal Systems' (ISA NCAC ISA.1900). Neither Catawba County nor the Environmental Health Specialist warrants that the septic tank system will continue to function satisfactorily for any niven period of time Jason Boyd 04/25/2016 AUTHORIZED STAVE AGENT APPROVAL DAVE Permit Expiration Date: 04/23/2021 No grading or construction activity is allowed in areas designated for system and repair without approval of the Health Department. :hpermii 04/25/2016 09:12 Page 2 of 4 fBp Permit# EHPR 3-16-23479 G CATAWBA COUNTY Name Richard Gilbert ,; r ia 2 Public Health Department ,�,, j Address 4440 Scalybark LN Sherrill's W0,47 Environmental Health Division U eGD PO Box 389, IOOA Southwest Blvd, Newton NC 28658 Ford NC /842 ,ni (828)465-8270 Fax (828)465-8276 TDD(828)465-8200 PIN# 460605282928 Site Plan Authorization to Construct Repair a65 ' Ca- cty (ocrk Lc .,e_ 0w5LL F . o(r) _I -01--- ,L, I Add. I A is:k;n .o \6 ��. I( ' N' --t I s' ar • , ` \C' f say, 1ts LA kt. 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