HomeMy WebLinkAboutIMPV-05-2016-071853.TIF sv,• . CATAWBA COUNTY Case It
.�f.r:,f Public Health Department Subdivision
C '®V, Envtronmental Health Division PIN/f 373305092370
Tit Lot- PO Box 389. 100-A Southwest Blvd.Newton. NC 28658 LOT#
t• .2 SV
NAME ON PERMIT: JOHNSON REAL ESTATE GROUP, INC ., 711 E MAIN ST, CHERRYVILLE NC
28021
Site Address: 4617 CHARLOTTE ST, CONOVER NC 28613
Property Size: Square Feet: 168,577.20 Acres:3.87
Directions: Startown RD - McDonald HWY right on Springs RD NE, Right Charlotte ST (lot on right with sign 4621)
il icit 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
N{2 property described above.
lAs the property owner or authorized representative, I have received the above referenced permit(s) as
L
requested
i he application for service RBPR-03-2016-23454 by the following method(s):
Received in Person
Facsimile Transmittal (Return form with signature required)
Electronic Image Transmittal/ E-mail (Return receipt required)
NE2)___
�vAs 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 A900), 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: 05/02/2016 I
Owner/Authorized Representative Signature ` ` �1
Date S /i 1 /f 6
Documentation of Permit(s) Transmittal
(permit transmitted by electronic or other means)
Permit transmitted by (name of person sending perrnit)
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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-ss CATAWBA COUNTY 0 Case# IMPV-05-20 16-07 1 85 3
`T G Public Health Department g=• �} Subdivision
G �_, • Environmental Health Division r r • PIN# 373305092370
� PO Box 389, 100-A Southwest Blvd,Newton,NC 28658 1i't ° LOT#
8. S a ,
•
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NAME ON PERMIT: JOHNSON REAL ESTATE GROUP, INC ., 711 E MAIN ST, CHERRYVILLE NC
28021
Site Address: 4617 CHARLOTTE ST, CONOVER NC 28613
Property Size: Square Feet: 168,577.20 Acres:3.87
Directions: Startown RD - McDonald HWY right on Springs RD NE, Right Charlotte ST (lot on right with sign 4621)
Improvement Permit
Facility: Primary Residence
Permit Category: New Septic Bedrooms 4
WATER SUPPLY: Private Well
Basement? No Basement Plumbing? No
INITIAL SYSTEM SPECIFICATIONS
Permit Valid: Expires In Five Years: _X_ No Expiration:
Projected Daily Flow 480 g.p.d
Proposed Wastewater System: 25% REDUCTION
Type: 1110 -OTHER NON-CONY TRENCH SYSTEMS
Permit Conditions:
REPAIR SYSTEM SPECIFICATIONS
Repair System Required? Required
Proposed Wastewater System: 25% REDUCTION
Type: IIIG -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. II is the responsibility of the
applicant/propeny 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 Sewaxe Treatment and Disposal Systems' (I5A 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.
Steven Price 05/02/2016
AUTHORIZED IORIZED STATE AGENT APPROVAL DATE
04/30/2021
Permit Expiration Date:
No grading or construction activity is a//owed in areas designated for system and repair without approval of the Health Department.
elrpermit 05/11/2016 09:56 Page 1 of 3
RBPR 03-2016-23454
4617 CHARLOTTE ST, CONOVER
• Do not cut,drive, fill,or grade over septic or repair areas.
• Septic system must be 10 ft from property lines; 50 ft from wells and streams; 5 ft from
building foundations and appurtenances; and out of right-of-ways and easements.
• Install a 1,000 gallon septic tank and 440 linear feet of 25%reduction system;(4) 110 ft
lines on contour.
• Final grade of septic area must shed surface water off and away from system.
• Well must be 25 ft from structures and 50 ft from septic systems, and out of right-of-
ways and easements.
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Parcel: 373305092370, 4617 CHARLOTTE ST 1in=100ft
CONOVER, 28613
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
_. .. ., :: . „ to_v_;. . . .,. _ . _ ., .,♦. .
DEPARTMENT OF HEALTH AND HUMAN SERVICES Sheet t of /
DIVISION OF PUBLIC HEALTH,ENVIRONMENTAL HEALTH SECTION 49W o3— Zan.— 22 telt'y PROPERTY ID 4:
ON-SITE WATER PROTECTION BRANCH COUNTY:_ea.Lc`44_
SOIL/SITE EVALUATION
for ON-SITE WASTEWATER SYSTEM
` (Complete all fields in full)
OWNER: /IA _ APPLICATION DATE
ADDRESS: DATE EVALUATED:
PROPOSED FACILITY: Y6r PROPOSED DESIGN FLOW(.1949): PROPERTY SIZE:
LOCATION OF SITE: '- Lt C 0...-6!F S,- PROPERTY RECORDED:
WATER SUPPLY: ❑Private ❑Public H<Wcll ❑Spring G Other
p.EVALUATION METHOD: ❑Au er Boring it ❑Cut TYPE OF WASTEWATER: Ai Sewage ❑Industrial Process ❑Mixed
i' • r `.
R :r,N e x }'d} . r 'i 1
y .; SOIL MORPHOLOGY ' OTHER "I.,_, •c
NF`•:: 4=t 7941
� • ( ) . PROFILE FACTORS
I 1940 x eg°ys', . -
x`E
j = 'P,OSITIOPII -DEPTH p t nw' „ v 1942 .^'w. r„ 7• ,, w _ %' j PROFILE
.3 SLOPE% (IN); ° ,1941 1941 '`1943 1956 `:1944' CLASS' ,ti
`L 4iW-,4 iSTRUCTURL/P 4"CONSISTENCE/ WETNESS/:n:, SOIL: . :SAPRO '"p t<AR"- ',il sRESTR
,: T'r .;" '�+' 4: TEXTURE ', MINERALOGY;.. -C649.1.1.:'::- . 'DEPTH . `CLASSs '.HORI7r ' '•g'
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DESCRIPTION INITIAL SYSTEM REPAIR SYSTEM OTHER FACTORS(.1946):
Available Space(.1945) Qf Qr SITE CLASSIFICATION(.1948): IS
Icy' n ,- EVALUATED BY: r c,,.-. /°--
System Type(s) /h t. Fut 44 O'CHER(S)PRESENT:
Site LTAR OA21( p, 225—
COMMENTS:
Updated February 2014