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Home My WebLink AboutIMPV-05-2016-072357.TIF CATAWBA COUNTY Case# _ .T �iG Public Health Department Subdivision � ,�®� Environmental Health Division I'IN# 269910265270 V .-� PO Box 389. 100-A Southwest Blvd,Newton.NC 28658 L0T# /842 r NAME ON PERMIT: RICHARD RIOS, 6533 BAKERS VIEW DR, VALE NC 28168 Site Address: 4912 S NC 127 HWY, HICKORY NC 28602 Property Size: Square Feet:80,150.40 Acres:1.84 Directions: HWY 127 SM TURN LEFT ONTO WALNUT GROVE LN, TURN IMMEIDATELY LEFT INTO THE PARKING LOT Owner/Authorized Representative Acknowledgement of Permit Receipt aI certify that I am the owner or authorized agent(owner's authorization required) representing the owner of the property described above. F Asill the property owner or authorized representative, I have received the above referenced permit(s) as requested in the application for service CBPR-04-2016-23722 by the following method(s): 7Received in Person Facsimile Transmittal (Return form with signature required) /f 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 r 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: 05/13/2016 f�>' Owner/Authorized Representative Signature �i`� t ii/X 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 We want to hear from you. Please take a few moments to complete our customer service survey at: http://www.surveymonkey.com/s/EHCustomerservice ehpennit 05/13/2016 10:07 Page 3 of3 •cY, CATAWBA COUNTY o 71/270- • o Case# IMPV-05-2016-072357 .N'P.f'1� Public Health Department 11.• Subdivision d 0�5 H Health Division r • •'. } PIN# 269910265270 '•ty-° PO Box 389, 100-A Southwest Blvd,Newton.NC 28658 • 0 •o r LO"f# /842 ,« .• — - r � r• G G . NAME ON PERMIT: RICHARD RIOS, 6533 BAKERS VIEW DR, VALE NC 28168 Site Address: 4912 S NC 127 HWY, HICKORY NC 28602 Property Size: Square Feet:80,150.40 Acres:1.84 Directions: HWY 127 SM TURN LEFT ONTO WALNUT GROVE LN, TURN IMMEIDATELY LEFT INTO THE PARKING LOT Improvement Permit Facility: Business - metal building for storage and office with half bath (sink and toilet onl Permit Category: New Septic Bedrooms 0 WATER SUPPLY: Public Water Basement? No Basement Plumbing? INITIAL SYSTEM SPECIFICATIONS Permit Valid: Expires In Five Years: _X_ No Expiration: Projected Daily Flow 100 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: 25% REDUCTION Type: 1110 -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 flaws 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 far 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. Megen McBride 05/13/2016 AUTHORIZED STATE AGENT APPROVAL DATE 05/13/2021 Permit Expiration Date: No grading or construction activity is allowed in areas designated for system and repair without approval of the Health Department. chpermil 05/13/2016 10:07 Page 1 of TP, Ac, G$PR-Dy-)ol6-)37;) 411) S NC, 1a7 Hwy, +l;ckocy t .lnstull !boo @A 16 sepf is tam< and 90 of 2570 Reduction ' )- 11511. -kenel�es. 4- a s-lall drain-Geld on coniar. * Sep-tic sis}em mu 5-i be, a-I least 50{a. from wells, lb-ft. -from water lines, Ib-14 •from profer41 lines, 541 -Iwo sirveivies, lcKee) Sys4em ouk of rti- f_vois, e°SPMeo-s, and areas Sullec: h, velaKular 4atifC. po not drive, grade, cut, 4U over Ser{ic areas. I + Building Will �CConned- -fa Public, viocler. in.35• /6 I Sept Sit+ern for exwki^� aftlartt is repair 6uslrress Repair#tct 4'ef 16• Ix /r., /�ppUgncc 9e,,th r�x a Pvm ni • �� 7L' a',.rd ro lab 11 d Is' sep ;1K iNw I run ui, ‘52 I sti< 135 1 Tank I proposed I Buiillld in I• (� 6aN Ex�s}inq Bus;MSS v Nn. Appla�e RePvr 0. effitle: ()avert Qgrkinq y_ -- J85.T3: J — S Nc Ian Hwy 1" 6b. DEPARTMENT OP ENVIRONMENT AND NATURAL RESOURCES Sheet of DIVISION OP ENVIRONMENTAL HEALTH PROPERTY ID 8: ON-SITE WASTEWATER SECTION COUNTY: SOIL/SITE EVALUATION for ON-SITE WASTEWATER SYSTEM OWNER I4 G6wrd Rios APPLICATION DATE Y-D5-16 G8 PR-0'(-Do l6-)37» ADDRESS: DATE EVALUATED: 5-11-U, PROPOSED FACILITY: o{{ict4-7z k$, PROPOSED DESIGN FLOW(.1949): 100 . PROPERTY Sr:a I.St acre s LOCATION OF SITE `191} S NG pi If l4/ ti 401 PROPERTY RECORDED: 'WATER SUPPLY: 0 Private ii Public 10 Well 0 Spring 0 Other EVALUATION M rEOD: 0 Auger Baring S Pit 0 Cut TYPE OF WASTEWATER: Q Sewage 0 Industrial Proems 0 Mixed _. ._r:_:__ _...._..............._.._........1111... ...._._...._......._..._.....:._...::::::::::=iii: -- __ - - _- - .._.. ...._.__....: :_:........._.;.._..__._............_..:..........._ ..........._1111 - - __ - - -- ......_.... 1111... .. ...._.�..._-v.._::e:::::::..::..a._=�::::��-:ii'^viii _i_: . �}..; _-m:::::::::::c"- _._1___111 _._..........._...._._._..._,..._.......__.._........................_. .-_::!:::: ..._.._..._.....,.. _ _ '- --'-_......... .... :-._'---... .._uml....._.....1111.__..._..............._.__ '-''''' .. .... _W ::::All ...- .:.:.-111.._ c_.7::T.:C:::: _..;....-::r•. __........:...::..:....._^ :::::_ __:::::::::::e:u._...;_....._._..__: ` ::r_v--'-r:z.__.:.::r __............-...` _,.. . _1111 8 �_ :::-,::::__::�:::__._.....:.................................... y ::::1111._ ,...... ... - - - .._. .....:.. 1111. .. �£� � ke�.-. :H..BI' ..._ _..._ _.. .........-_.....:347::::x::.::_::___-:::::::: :::;� + or5irl septic ?err^F f'rorn 1981 SkovJcd a well or silt. I was 110-1- 4,19le 4o lout-cc-4a+ wit. 5(131(6 NnvetYrtion Walt. Dvwher, Rrckarci RV05- (t he Said �Ihere are no Wells or' `k►^e Pr°Pe / bee aoSD � �ce nP bl cv� i. Ile. aSuweca Y od Well had 'ben, Gbardaaed `ears ao. t i `gI � 6111^11 tick (=I ,`, ell• r /so. i _yo• .o _No i #4 —. ( 5�^cSS Parma pink;nt) SMC InRwy 6\)0 --10Wc)