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Home My WebLink AboutIMPV-05-2016-071851.TIF ze Case#A cATAwBACOUNTY IMPV-0S-2016-07 4 8 5 1 :T rr:If 24.„ Public Health Department Subdivision —#1.Li 4 " ,,c,- Environmental Health Division PIN/ 268901474296 e PO Box 389, 100-A Southwest Blvd,Newton,NC 28658 LOT/ 1 /842/sy NAME ON PERMIT: CHARLES SIMMONS, 1010 CREEKSIDE DR, HIGH POINT NC 27262-7027 Site Address: 6856 GREEDY HWY, HICKORY NC 28602 Property Size: Square Feet:69,696.00 Acres:1.6 Directions: HWY 127 South, to Greedy Hwy Owner/Authorized Representative Acknowledgement of Permit Receipt f)t t— I certify that I am the owner or authorized agent (owner's authorization required) representing the owner of the property described above. s DL,f—As the property owner or authorized representative, I have received the above referenced permit(s) as requested in the application for service EHPR-03-2016-23306 by the following method(s): Received in Person Facsimile Transmittal (Return form with signature required) Electronic Image Transmittal/E-mail (Return receipt required) Npit 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: 05/02/2016 / Owner/Authorized Representative Signature /11111K -se Date (' 8 .- /G 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 chow n of 05/23/2016 10:53 Page 3 of 3 CATAWBA COUNTY 0:.44117 0-r..• 0 Case it IMPV-05-2016-071851 r. f 2 Public Health Department ':q ` Subdivision d -Qy ti Environmental Health Division It :�}` - •e 'a-• PIN# 268901474296 PO Box 389, 100-A Southwest Blvd,Newton,NC 28658 �� • G X LOT/I 1 lg.2 su - • • A• aFF } r O O • NAME ON PERMIT: CHARLES SIMMONS, 1010 CREEKSIDE DR, HIGH POINT NC 27262-7027 Site Address: 6856 GREEDY HWY, HICKORY NC 28602 Property Size: Square Feet: 69,696.00 Acres:1.6 Directions: HWY 127 South, to Greedy Hwy Improvement Permit Facility: Primary Residence Permit Category: New Septic Bedrooms 3 WATER SUPPLY: Private Well Basement? Yes Basement Plumbing?Yes 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: 25% REDUCTION Type: 111G -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. Steven Price 05/02/2016 AUTHORIZED STATE AGENT APPROVAL DATE 04/30/2021 Permit Expiration Date: No grading or construction activity is allowed in areas designated for system and repair without approval of the Health Department. ehpcmril 05/23/2016 10:53 Page 1 of 3 EHPR 03-2016-23306 6856 GREEDY HWY,HICKORY • Do not cut, drive, fill, or grade over septic or repair areas. • This permit is not intended for septic installation purposes. • Final grade of septic area must shed surface water off and away from system. • Proposed subdivision of existing lot. Lot lines have not been proposed and are not marked in the field. Any subdivided lot will have to include both the initial and repair areas in full and the existing house location. Lot must be recorded prior to issuance of AC. zsz % °`p„r ■ e ,asp 110,E 2s-% $UX1,D 703' 1'roo .tN DEPARTMENT OF HEALTH AND x � • ''' HUMAN SERVICES DIVISION OF PUBLIC HEAL ONSITE WATER PROTECTI N BRANCH HEALTH SECTION Old 6 3_a'!b— 233a 6 Sheet of Z PROPERTY ID H. SOIL/SITE EVALUATION COUNTY:_Catawba_ for ON-SITE WASTEWATER SYSTEM (Complete all fields in full) OWNER: Cii.c,le f S, ADDRESS: PROPOSED FACILITY: _ APPLICATION DATE PROPOSED DESIGN FLOW .1949 : DATE EVALUATED: LOCATION OF SITE:_6� G„a 4, ( ) PROPERTY Ste;—_ WATER SUPPLY: ❑Private ❑Public � llWe 0 Spring ❑Other PROPERTY RECORDED: EVALUATION METHOD: ❑Au_er Boring $Pit ❑Cut TYPE OF WASTEWATER: 2tSewage ❑Industrial Process ❑Mixed P R o F SOIL MORPHOLOGY OTHER I (.1941) PROFILE FACTORS L .1940 E LANDSCAPE HORIZON POSITION/ DEPTH PROFILE it SLOPE % (LW.) .1942 .1941 .1941 SOIL .1943 .1956 .1944 CLASS STRUCTURE/ CONSISTENCE/ WETNESS! SOIL SAPRO RESTR &LTAR TEXTURE MINERALOGY COLOR DEPTH CLASS HORIZ 1"-K u561- Sc_ fri( Sl L5' e-3/ s6(< c v 14 SC _ W L(Z ev/4. 410 ES 1 (194 1-`fL 1-,50.. c.L fiC Sr l).3 s—t2 "36€ Sc. - SC 22 1 L^ 3o Sat C l _r .t- tf't - A- IS 2 '� N is-04 - `.s4t, I=,eScr 3 o -(( `la i L ,c--z Sc' LS 11-3G S6fc c � SC wk `t2 Al A- MI- PS 3 ISM 36 -`12 t'#c Cc / Sc — l) .3 "�sP 0 -1C) u .E � � pi.. S� LS 3u- y 5 Fit sC A/4 tit r✓G N/J PS 4 -u °4 DESCRIPTION INITIAL SYSTEM REPAIR SYSTEM OTHER FACTORS(.1946): v SITE CLASSIFICATION(.1948): IS Available Space(.1945) PS if System Type(s) 2-5t 4.. 2 EVALUATED BY: 5 ,� OTI IER(S)PRESENT: Site LTAR 0. 3 O. 3 COMMENTS: J. 1* 6 .'.. 1-2,N•4, SOIL/SITE EVALUATION 03- 20(6 — 23304. Sheet?of 2 (Continuation Sheet-Complete all field in full) DEPARTMENT OF HEALTH AND HUMAN SERVICES PROPERTY ID it: DIVISION OF PUBLIC HEALTH DATE OF EVALUATION: ENVIRONMENTAL HEALTH SECTION COUNTY: 6-4-.65 ON-SITE WATER PROTECTION BRANCH I, o' SOIL MORPHOLOGY .. OTHER F,: ' - (1941) PROFILE FACTORS L :1940 -i - g;; LANDSCAPE HORIZ .• _ _ .1942 POSITION/ ON 1941 • - .1941 SOIL .1943 � .1956 .1944 PROFILE H SLOPE% =DEPTH STRUCTURE!- , CONSISTENCE!' WETNESS/ SOIL, SAPRO -. RESTR `'CLASS TEXTURE MINERALOGY:. COLOR _DEPTH .CLASS HORIZ "&I;TAR" a 1-36E cL A.( scr /� Ps (-S (a-3f S6Ic C S r H ti S et) F Al tso4 0-3 • LS o i4 56k LC 162 so- �1 17-36 36t SC W 1(3 w� /✓.'4 7-14 JG-43 us6E c- Fit st 0. 3 /r5p COMMENTS: Updated February 2014 .-. :.5'. r yrr..r m,a ss ' . '.. .: ..,y.2.xas.� uV � � ii?Sks. >., :..r s4+a��_'74'h+'t . ,;°-„,J ,.. �. '� „_' .,:,. + C h1 c3— Za(6 - 2-33D 1 . re J 3 N j o j b b Cr, in r \ m Q S