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HomeMy WebLinkAboutIMPV-04-2016-071789.TIF 1SA fin \ CATAWBA COUNTY Case# _ _ Public Health Department Subdivision GEORGIA PARK G. Tye ,` Environmental Health Division PINK 366703234039 PO 13ox 389. 100-A Southwest Blvd.Newton,NC 28658 LOT# 7 /8. L sm NAME ON PERMIT: CLAYTON HOMES, PO BOX 132, TAYLORSVILLE NC 28681 Site Address: 3463 MELDONNA DR, MAIDEN NC 28650 Property Size: Square Feet:20,037.60 Acres:0.46 Directions: Hwy 16/ left Buffalo Shoals Rd / right Meldonna Dr/ lot 7 on left Owner/Authorized Representative Acknowledgement of Permit Receipt I certify that I am the owner or authorized agent(owner's authorization required) representing the owner of the roperty described above. VAs the property owner or authorized representative. I have received the above referenced permit(s) as equested in the pplication for service RBPR-02-2016-23283 by the following method(s): eceived in Person Facsimile Transmittal (Return form with signature required) pis.h) 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: 04/29/2016 ------ "'�' -,t Owner/Authorized Representative Signature '4 Date 5-10ij00 Documentation of Permit(s) Transmittal (permit transmitted by electronic or other means) Permit transmitted by (name of person sending permit) Signature bate/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 eltpermit 04/29/2016 11:14 Page 4 of4 yygA CATAWBA COUNTY El l r 5 0 Case# IMPV-04-2016-071789 C U� , Public Health Department 701:4"147.7.14.1 � Subdivision GEORGIA PARK ^• Environmental I-lealth Division 1:4 �3. r PIN# 366703234039 • PO 13ox 389. 100-A Southwest Blvd,Newton, NC 28658 i' LOT# 7 r_ . NAME ON PERMIT: CLAYTON HOMES, PO BOX 132, TAYLORSVILLE NC 28681 Site Address: 3463 MELDONNA DR, MAIDEN NC 28650 Property Size: Square Feet: 20,037.60 Acres:0.46 Directions: Hwy 16/ left Buffalo Shoals Rd / right Meldonna Dr/ lot 7 on left Improvement Permit Facility: Primary Residence - House Permit Category: New Septic Bedrooms 3 WATER SUPPLY: Private Well Basement? No Basement Plumbing? INITIAL SYSTEM SPECIFICATIONS Permit Valid: Expires In Five Years: _X_ No Expiration: Projected Daily Flow 360 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: 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 Rules for Sewage Treatment and Disposal Systems' (15A NCAC I8A .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 04/29/2016 AUTHORIZED STATE AGENT APPROVAL DATE 04/29/2021 Permit Expiration Date: No grading or construction activity is allowed in areas designated for system and repair without approval of the Health Department. Open]]it 04/29/2016 11:16 Page 1 of3 Avtii - 4-2aI1- o11lgl Catawba County Environmental Health w, ,,_ U-2016 - 0717 40 • ♦ 4151<OOti Nq 04, • . 4, s0_ h- d' %4.t`/i 47 cr. • p© � 3Q 2 c ....,,,.....„...„. .-....:70,- ,.... ..., 41:( '...' y1o� ZI. 2 (8. r. F. C. -:-.-- Yea So 7 4 /2veop1 crvr� g , /S,y. r; { . Pi II t6i lk�`pf��� tonll , • Parcel: 366703234039, 3463 MELDONNA DR tin=40ft MAIDEN, 28650 This map/report product was prepared from the Catawba County,NC Geospatial 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 verification 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 • 04/27/2016 DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES Stet-_ef_ DIVISION OF ENVIRONMENTAL HEALTH PROPERTY ID M: t N.SITE WASTEWATERSECDON COUNTY: SOIUSITE EVALUATION for ON-SITE WASTEWATER SYSTEM OWNER: J}o ht. 12.e. i G.f{- APPLICATION DATE ADDRESS: -)1-1 6 41.6 I rdo nor /9r DATE EVALUATED: N-4-16 PROPOSED FACILITY. 1 t- PROPOSED DESIGN FLOW(.1949): 160 . . PROPERTY SIZE: LOCATION OF SITE: PROPERTY RECORDED: WATER SUPPLY: 0 Private 0 Public 3'Wel U Spring U otlia EVALUATIONMEIHOD: 0 Auger Baring (hit U Cut TYPE OP WASTE WAla ErSowagc o Indust:649occa a Mixed ............. .. .... ........... .. .... ... .. ... -: _::: _ _";::ies f;:::5:a=_=....: :=- :.e>: :::�: :. ::. -- :...:::.:.__... :::::: :: :::_-_:.- ._.....__..._ ::::: �_=-'ii[:a [i_:i:[_[� .- -_::�_r°cc_:-;:_:_:��-aEE � :ar ,.._....:_� r::_ :.:::;z(INr_ :.r Q:91Lt-e= :::::, _���:ii:=-; _ :::._.SOTlsai= iaa�SG.'.-s- : ::r�ujj; :`:f_y litisititgig pxcPTSi ::<:::5 OCTOM!:::: ::: kSY'{ntri::_ iiW ._... !1 :_: 'i SAk ;8ri51't:i,ezaSSi:„ :. _ 'g r $9Olt_: ?.DWEEU �.atEY'AR?: O—, )C L v S,,ll Fr 0 6?-24 G 1 L (b 24-58 cltrAp a (r S 3 l rs —(. J{-L LI - ., I � 6-7o G fSk . Fr 1.1 3 2 L1 (�rrp rocky Fr 6 V e-1.4 SJ�' 1 r I� 24-No 3 5a10 _10-61.)_10-61.) C)+, / 4rIH _ l prPJJO do fir 4 DESCRIPTION DCrttAL SYSTEM REPAIR s1'S EM OTHER FACTORS(.1946): A'wuabie Space(.1945) S s SITE CLASSIFICATION(.1948): Y247- syucmType o 2 TT, 5o'4 EVALUATED BY: )4, bS'Lo ph{/y' TH r OER(S)PRESarn M,ev., 64 grit/ tit/ Site LIAR , '1) • 'r) COMMENTS: Catawba County Environmental Health • • o• . r i- Y : # 16.,-- _ _ _ S1 _. i _ . .. •1 • / , , at ., , .. . . . „.,.......„__ . • ,,,.. . __ . _. _.-----_____„,_ _-______, k J) .. i 76..al ' . *..." .�t - r, 1 • .. ---"---, ..„......k.,, .._ • t " e_ . + 1i • 7.r Parcel: 366703234039, 3463 MELDONNA DR lin=40ft MAIDEN, 28650 This map/report product was prepared from the Catawba County,NC Geospatial 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 verification 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 04/27(2016