HomeMy WebLinkAboutAUTH-04-2016-071596.TIF • CATAWBA COUNTY Case# AUI-H-04-2016-071596
rai 2 Public Health Department Subdivision
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H Environmental Health Division PIN# 375012860375
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PO Box 389, 100-A Southwest Blvd,Newton,NC 28658 LOT#
NAME ON PERMIT: LINDA MILLER, 2242 BETHANY CHURCH RD, NEWTON NC 28658
Site Address: 2981 EMMANUEL CHURCH RD, CONOVER NC 28613
Property Size: Square Feet: 22,651.20 Acres:0.52
Directions: Hwy 10 East, LEft onto Emmanual Church Rd, 1st house on Left
(� Owner/Authorized Representative Acknowledgement of Permit Receipt
,cJ�'f certify that I am the owner or authorized agent(owner's authorization required) representing the owner of the
property described above.
As the property owner or authorized representative, I have received the above referenced permit(s) as
requested in the application for service EHPR-04-2016-23690 by the following method(s):
r7 Received in Person
Facsimile Transmittal (Return form with signature required)
Electronic Image Transmittal/E-mail (Return receipt required)
j YSt 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: 04/26/2016 �� � L
Owner/Authorized Representative Signature in
Date
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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chpennil 04/26/2016 10:41 Page 4 of4
/�A • CATAWBA COUNTY ti��++o, �� Case# AUTH-04-2016-071596
•..7-f ti 2 Public Health Department s, Subdivision
< v K Environmental Health Division 73%... PINT! 375012860375
�® PO Box 389. 100-A Southwest Blvd,Newton,NC 28658 r —lido o.% LOT#
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NAME ON PERMIT: LINDA MILLER, 2242 BETHANY CHURCH RD, NEWTON NC 28658
Site Address: 2981 EMMANUEL CHURCH RD, CONOVER NC 28613
Property Size: Square Feet:22,651.20 Acres:0.52
Directions: Hwy 10 East, LEft onto Emmanual Church Rd, 1st house on Left
Authorization to Construct Permit
Authorization to Construct Wastewater System (Required for Building Permit)
* See site plan and number of additional attachments ( ).
Proposed Wastewater System: Wastewater Flow 240 g.p.d
Type: **** no system class assigned **** ()
Soil LTAR: g.p.d./ft2
Permit Category: Repairs
Type of Facility: Primary Residence -
Basetnent? 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: 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:
Pre Treatment: NONE
Additional Specifications: tank only replacement
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 LTAR: g.p.d./ft2
ehpermit 04/26/2016 10:41 Page 1 of
o5A CATAWBA COUNTY Case# AUTH-04-2016-071596
$Amy Public Health Department Subdivision
GV0I 'C Environmental Health Division PIN# 375012860375
PO Box 389. 100-A Southwest Blvd.Newton.NC 28658 LOT#
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NAME ON PERMIT: LINDA MILLER, 2242 BETHANY CHURCH RD, NEWTON NC 28658
Site Address: 2981 EMMANUEL CHURCH RD, CONOVER NC 28613
Property Size: Square Feet: 22,651.20 Acres:0.52
Directions: Hwy 10 East, LEft onto Emmanual Church Rd, 1st 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 I3uilding 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' (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 neriod of time.
Steven Price 04/26/2016
AUTHORIZED STATE AGENT APPROVAL DATE
Permit Expiration Date: 04/26/2021
No grading or construction activity is allowed in areas designated for system and repair without approval of the Health Department.
ehpermit 04/26/2016 10:41 Page 2 of4
EHPR 04-2016-23690
2981 EMMANUEL CHURCH RD. CONOVER
• Do not cut; drive, fill, or grade over septic or repair areas.
• Septic Tank must be 10 ft from property lines; 50 ft from wells; 5 ft from building
foundations and appurtenances; and out of right-of-ways and easements.
• Install a new 1,000 gallon septic tank for a tank only repair due to cracks in existing
septic tank.
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