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HomeMy WebLinkAboutIMPV-05-2016-071886.TIF •, • CATA\WBA COUNTY Cn`e� IMP V-05-2016-071886• 3111 Public Health Department Subdivision 4 < 140` " Environmental Health Division PINk 376402950465 �f- PO Box 389. 100-A Southwest Blvd.Newton. NC 28658 1.011/1 NAME ON PERMIT: JAMIE & APRIL PHARES, 5692 ADOLPHUS ST, CATAWBA NC 28609 Site Address: 5186 CORBAN ST, CLAREMONT NC 28610 Property Size: Square Feet:497,455.20 Acres:11.42 Directions: 321 North, Right onto Conover Blvd, Left onto Oxford School Rd, Left onto Riverbend, Right onto Bolick, Left onto Corban St&property is at the end on upper Right corner. Owner/Authorized Representative Acknowledgement of Permit Receipt cA' I 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-03-2016.23422 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 1844 .1900), and/or Well Construction Standards (ISA 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: 05/03/2016 �� Owner/Authorized Representative Signature �) (l.erw) (21(, „ I l Date a) tnl)u Documentation of Permit(s) Transmittal (permit transmitted by electronic or other means) Permit transmitted by Oats Lit ' ( v come of person sending permit) , _ a �tSh(P © 1 Signature j, 1f�H • Date/Time u Method: Fax mail US Mail Other Owne 's request to send by the above indicated method of transmittal in lieu of signature q��oL&� We want to hear fro o Please take a few moments to complete our customer service survey at: http://www.surveymonkey.com/s/EHCustomerService chpci mit 05/03/2016 09:24 Page 3 of 3 ,6,A CATAWBA COUNTY 0 ••- : 1''• 0 Case# IMPV-05-2016-071886 .Q' �, Public Health Department • � � Subdivision 4 ' ® �; Environmental Health Division '= ' .•- PING 376402950465 PO Box 389, 100-A Southwest Blvd,Newton,NC 28658 in sir � "' LO'r# /842 6 iC • - �. {A0 O • NAME ON PERMIT: JAMIE & APRIL PHARES, 5692 ADOLPHUS ST, CATAWBA NC 28609 Site Address: 5186 CORBAN ST, CLAREMONT NC 28610 Property Size: Square Feet:497,455.20 Acres:11.42 Directions: 321 North, Right onto Conover Blvd, Left onto Oxford School Rd, Left onto Riverbend, Right onto Bolick, Left onto Corban St& property is at the end on upper Right corner. Improvement Permit Facility: Primary Residence - modular home Permit Category: New Septic Bedrooms 3 WATER SUPPLY: Private Well Basement? No Basement Plumbing? No 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: 1IIG - OTHER NON-CONY TRENCH SYSTEMS Permit Conditions: REPAIR SYSTEM SPECIFICATIONS Repair System Required? Required Proposed Wastewater System: 25% REDUCTION Type: 1IIG -OTHER NON-CONY TRENCH SYSTEMS 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 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. Megen McBride 05/03/2016 AUTHORIZED STATE AGENT APPROVAL DATE Permit Expiration Date: 05/03/2021 No grading or construction activity is allowed in areas designated for system and repair without approval of the Health Department. thiamin 05/03/2016 09:24 Page I of 3 I P RPR-D3-1016-1311» 5186 Corban Si-, Cate-Mon- ' 4'1141 5 r4 IS no4 ir"{erndrd - for Sepkic s`js eri r; ,u a 'ah. I1 -sr Do no4 drive, °roes', c) of f 1 Net Pthe rr'IA• \ . Pke°' eou-51,b/10o 1\01 li kat Propose yqE Wo 14,14 3 ae31xn 31 x 76 z r ! •30 fast' . bsi b ic peW 6 • Arta 00' 730' 60fl Cor6n54 lajW In= • DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES Shed__cf_ DIVISION OF ENVIRONMENTAL HEALTH PROPERTY ID#: ON-SITE WASTEWATER SECTION COUNTY: SOIUSITE EVALUATION for ON-SITE WASTEWATER SYSTEM OWNER: emit Al Aril Phan s APPLUCATIONDATE 3 17 Ib c -w --o3-zo16-z3422 ADDRESS: DATE EVALUATED:y-71-/6 PROPOSEDFACIIITY: 3 BR MoclvIAr PROPOSED DESIGN FLOW(.1949): 3L0 . PROPERTY S22: II:4b aCrts LOCATION OF SITE 5176 CD(6av 54JJortMa•} PROPERTY RECORDED: WATER SUPPLY: ® Private 0 Public S Well 0 Spring 0 Other EVALUATION METHOD: 0 Auger Baring 13 Pit 0 Cut • TYPE OF WASTEWATER: 51 Sewage 0 Industrial hams 0 Mixed ::iF. ,:::.i: '. ;;';z;;;¢;t7ii:;i€a:S,::,ii;' ;i2, .;:-[ .ir.... ;; is sc::::r_::e:::_::EE::_:s=::::::::::::::::_i:(1141J;'=!..........._.......:........ . ...._:::::: ;TROFELR ACTE)k5::....__..._......._:::::::::::::......:-:::: ::::::::::......: !:5. _....TGkA.,[ � ......_. :.-:.::.;._._ :::.:.:::-::: :_:-::.-__.9.1;..............:........5`4411 ..::_ =;1=_ Q�_-; ::- _rip,-..,,,,,' �4!i cl::'P t6F?a 'i' iitki1Ff. DEPT3t 5 ....Rr VINSitT£NCr! ::3WIII _ Scgn _ PPP:1 AY$ aiiii-` 's�r . 'iris ... t '> 14).li EAW.OA tQzOa Deer[ :ASS t (3Rtx 0-1 1 L tr.S5,.Sex? . . • 107. 9 ;6 sbk LL r.SS,stxg 3g _ Ps 1 L 76.36 usbk CL Mica ft,SS. Sbcp -- ont s,at 4 - l-t J .{as „kris tff v4R 0-3 o-lq. .S61CCL I �r ss: Sexp ' PiC-34 •+S1,k Lt- I {-t;55, Sex() 2 3ti-97 wSWk CC-45Af I -ft.SS. Setg__, Li — — 044 Am-ER . 0.3 1 3 slept a5i? — PS . — - p3 4 • MESC:RUMEN D'' 'SYSTEM I REPAIR SYSTEM OTHER FACTORS(.1946): Available Space(.1945) PS PS SITE CLASSIFICATION(.1948):_ EVALUATED kCBAI S Typ:(s) IC) 1119 OS)PRESENT: - SiteLTAR (J-3 0.3 COMMENTS: 4 T ao 90. 40 { proposed 38R- 116' F— - -300 GO' 12.10 Corb r\ SE. (N4osc ) :