HomeMy WebLinkAboutAUTH-05-2016-072690.TIF :Al. CATAWBA COUNTY Case AUTH-05-2016-072690
. ! Public Health Department Subdivision
•
< 01 Y Environmental Health Division PIN/ 374418416543
PO Box 389, 100-A Southwest Blvd,Newton.NC 28658 LOTH
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NAME ON PERMIT: SEAN PAGE, 4865 LEE CLINE RD, CONOVER NC 28613
Site Address; 4865 LEE CLINE RD, CONOVER NC 28613
Property Size: Square Feet:43,560.00 Acres:1
Directions: County Home Rd, Turn onto Lee Cline Road, Go past C6 Farm Rd about 1/2 mile on the 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
d
Nyc property described above.
C.PAs the property owner or authorized representative, I have received the above referenced perrnit(s) as
requested in the application for service EHPR-04-2016-23724 by the following method(s):
N in Received in Person
Facsimile Transmittal (Return form with signature required)
Electronic Image Transmittal/ E-mail (Return receipt required)
7C CPAs 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: 0512412016
) Owner/Authorized Representative Signature 1,[ Q` rQ
/ Date (l^(_2 ra0l (e nv (�
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
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ehpennit 0512412016 11144 Page 4 or4
� CATAN�'BA COUNTY � 0 Case# AUTH-05-2016-072690
.7 AI G Public Health Department r �S� Subdivision
< 121W _ i ti } PINA
Environmental Health Division ? ism.+ 1y 374418416543
PO Box 389, 100-A Southwest Blvd,Newton,NC 28658 Oar r0 i O +C LOT#
.o o
NAME ON PERMIT: SEAN PAGE, 4865 LEE CLINE RD, CONOVER NC 28613
Site Address: 4865 LEE CLINE RD, CONOVER NC 28613
Property Size: Square Feet:43,560.00 Acres:1
Directions: County Home Rd, Turn onto Lee Cline Road, Go past CB Farm Rd about 1/2 mile on the Left.
Authorization to Construct Permit
Authorization to Construct Wastewater System (Required for Building Permit)
* See site plan and number of additional attachments ( ).
Proposed Wastewater System: 25% REDUCTION Wastewater Flow 360 g.p.d
Type: IIIG -OTHER NON-CONY TRENCH SYSTEMS
Soil LTAR: 0.375 g.p.d./ft2
Permit Category: Repairs
Type of Facility: Primary Residence - house
Basement? Yes Basement Plumbing? Yes Bedrooms: 3
Wastewater System Requirements
Tank Size: Existing Tank 1,000 gal Pump Tank gal Grease Trap gal
Dosing Volume gal Pump Specs: GPM @ TDH
Pressure Head ft Draw Down in
Drainfield: Total Area: 240 sq ft Total Length: 80 ft Maximum Trench Depth 36 in
Aggregate Depth in Trench Width 3 ft
Minimum Soil Cover 12 in Minimum Trench Separation g ft on center
Number of Drain Lines 1
Distribution: Serial
Pre Treatment: NONE
Additional Specifications:
Landscaping or other site alterations that potentially dived 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.
»»> DO NOT INSTALL SYSTEM UNDER WET CONDITIONS ««<
Proposed Repair
Repair System Required? Required System Class: IVA Proposed System: 50% REDUCTION
Distribution Type:: LPP Soil LIAR: 0.3 g.p.d./ft2
PUMP REQUIRED ***** OPERATOR REQUIRED
;Alper III 05/24/2016 10 44 Page 1 514
,yA3. � CATAWBA COUNTY Case# AUTH-05-2016-072690
ca.1 s 2 Public Health Department Subdivision
C Environmental Health Division PIN# 374418416543
Tl ` ^ PO Box 389, 100-A Southwest Blvd, Newton,NC 28658 LOT#
Ig.2 m
NAME ON PERMIT: SEAN PAGE, 4865 LEE CLINE RD, CONOVER NC 28613
Site Address: 4865 LEE CLINE RD, CONOVER NC 28613
Property Size: Square Feet:43,560.00 Acres:1
Directions: County Home Rd, Turn onto Lee Cline Road, Go past CB Farm Rd about 1/2 mile on the Left.
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 Authorization to Construct Permit is subject to revocation if the site plan,plat or the intended use changes,or if site
conditions are altered. The Authorization to Construct 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 05/24/2016
AUTHORIZED STATE AGENT APPROVAL DAI'L
Permit Expiration Date: 05/24/2021
No grading or construction activity is allowed in areas designated for system and repair without approval of the Health Department.
ehpcnnit 05/24/2016 10:44 Page 2 of4
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DFPARTMENTOPENVIRONMENT'AND NATURAL RESOURCES Shed of
DIVISION OP ENVIRONMENTAL HEALTH PROPERTY ID X:
ON-SITE WASTEWATER SECTION COUNTY:
SOIIJSITE EVALUATION
for ON-SITE WASTEWATER SYS M
OWNERS APPLICATION DATE4�)j ENpR-C9-)0 I6 x377
ADDRESS: I DATE EVALUATED:•5-4.I6
PROPOSED FAC LTry: 3 8 R VIo%t_L PROPOSED DESIGN FLOW(.1949): 360 PROPERTY SIZE: I Dal,
LOCATION OFSIT.E 4865 Meant, U, (moiler PROPERTY RECORDED:
WATER SUPPLY: 9 Private El Public ® Wen U Spring LI Other
EVALUATION METHOD: Auger Ewing U Pit O Cut
TYPE OF WASTEWATER EI Sewage Industrial Plows' [ 7aat
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DESCRIPTION A'II7AL SYSTEM REPAIR SYSIFN OTHER FACTORS(.1946):
Arer'hSi S (.1945) PS SITE CLASSIFICATION(.194 ::.-.
s Iys(c) f�II a EVALUKIFD BY:I'1nDA6rk an e,
11F OTHER(S)PRESENT:
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