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�lA , CATAWBA COUNTY Case 4 IMPV-05-2016-072905
•
.0 EA I / Public Health Department Subdivision
< ..1J,�il Environmental health Division PINti 460801256925
�l o PO Box 389, 100-A Southwest Blvd,Newton,NC 28658 LOT# 1
NAME ON PERMIT: CHRISTINE CURCIO, 1833 JAYA DR, SHERRILLS FORD NC 28673-7290
Site Address: 2676 MT. PLEASANT RD, SHERRILLS FORD NC 28673
Property Size: Square Feet:60,112.80 Acres:1.38
Directions: Hwy 16 S, to Hwy 150, Go East on Hwy 150, Left onto Mt. Pleasant Rd, Property is on the Right.
Owner/Authorized Representative Acknowledgement of Permit Receipt
Cl I certify that I am the owner or authorized agent (owner's authorization required) representing the owner of the
property described above.
CCAs the property owner or authorized representative, I have received the above referenced permit(s) as
requested in the application for service EHPR-04-2016-23743 by the following method(s):
_ Received in Person
'acsimile Transmittal (Return form with signature required)
Electronic Image Transmittal/ E-mail (Return receipt required)
CCAs 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: 05/31/2016 Chi � n
Owner/Authorized Representative Signature l U4tw CUhL10'
06-06-2016 nnN
Date
Documentation of Permit(s) Transmittal
(permit transmitted by electronic or other means)
Permit transt it d ±y '. �. _ , U acme of person sen ing permit)
Signature .p , 18 tN` t At. Date/Time 4 _/69 12r 15
Method: Fax US Mail Other
Own 's request to send by the above indicated method of transmittal in lieu of signature
-C a _ r , ,s , Cc r10_6)gY� net
We want to hear from you. Please take a few moments to comp!' our customer service survey at:
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e 6pei mit 0513112016 09:51 Page 3 of 3
}-c A CATAWBA COUNTY Case# IMPV-05-2016-072905
ft' . Public Health Department Subdivision
:�di Environmental Health Division
PL 01 460801256925
�`"� PO Box 389, 100-A Southwest Blvd,Newton.NC 28658 LOT# 1
/g.2 n
NAME ON PERMIT: CHRISTINE CURCIO, 1833 JAYA DR, SHERRILLS FORD NC 28673-7290
Site Address: 2676 MT. PLEASANT RD, SHERRILLS FORD NC 28673
Property Size: Square Peet:60,112.80 Acres:1.38
Directions: Hwy 16 S, to Hwy 150, Go East on Hwy 150, Left onto Mt. Pleasant Rd, Property is on the Right.
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
property described above.
As the property owner or authorized representative, I have received the above referenced permit(s) as
iC requested in the application for service EHPR-04-2016-23743 by the following method(s):
Received in Person
Eacsimile Transmittal (Return form with signature required)
lectronic 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 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: 05/31/2016
Owner/Authorized Representative Signature
Date
Documentation of Permit(s) Transmittal
(permit transmitted by electronic or other means)
in
(� o
Permit trans it d Ply �Y 9 Jt\O I` ctme of person sending permit)
Signature C1 1 ��11 Date/Time �i/J�g) \ Z: 15
Method: Fax mail US Mail Other
Own 's request to send by the above indicated method of transmittal in lieu of signature
a i , , a et in 0_O ,ant
We want to hear from you. Please take a few moments to comp!' our customer service survey at:
http://www.surveymonkey.com/s/EHCustomerService
ehpennit 05/31/2016 09:51 Page 3 of3
^�A CATAWBA COUNTY U l :p; • e 0 Case# IMPV-05-2016-072905
.Q' ' Public Health Department Subdivision
aEl .G .
4 - ,. a Environmental Health Division PIN# 460801256925
Lo PO Box 389. 100-A Southwest Blvd,Newton. NC 28658 �'r_13 13 • LOIN 1
18.2 ,� }: r ci
NAME ON PERMIT: CHRISTINE CURCIO, 1833 JAYA DR, SHERRILLS FORD NC 28673-7290
Site Address: 2676 MT. PLEASANT RD, SHERRILLS FORD NC 28673
Property Size: Square Feet:60,112.80 Acres:1.38
Directions: Hwy 16 S, to Hwy 150, Go East on Hwy 150, Left onto Mt. Pleasant Rd, Property is on the Right.
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: IIIG -OTHER NON-CONY TRENCH SYSTEMS
Permit Conditions: Keep all parts of septic system and repair area minimum: 100'from any well,10' from property lines,
15' from any pool, 5' from home including decks and patios. Lines to be installed on contour. Do not
grade drive or fill over system or repair area or permit will be revoked. Applicant mentioned a future
pool and detached garage during evaluation. Told Mrs Curcio that lot is to be surveyed to include
home, pool, and garage prior to issuance of authorization to construct or well permit.
REPAIR SYSTEM SPECIFICATIONS
Repair System Required? Required
Proposed Wastewater System: 50% REDUCTION
Type: IVA-ANY SYSTEM WITH LPP DISTRIBUTION
PUMP REQUIRED ***** OPERATOR REQUIRED
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 Reties for Sevacte Treatment and Disposal Spstenes' (I5A 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.
Jason Boyd 05/31/2016
AUTHORIZED STATE AGENT APPROVAL DATE
05/28/2021
Permit Expiration Date:
No grading or construction activity is allowed in areas designated for system and repair without approval of the Health Department.
ebpennit 05/31/2016 09:51 Page 1 of 3
laj\3Anc„..z Permit it EHPR 4-16-23743
CATAWBA COUNTY
Name Christine Curcio
Public Health Department
Q °';,r'vie` `y Environmental Health Division Address 2676 Mt Pleasant Rd Sherrills
J Q �!l� PO Box 389, 100A Southwest Blvd, Newton NC 28658 Ford NC
/842 sM (828)465-8270 Fax (828)465-8276 TDD(828)465-8200
PIN# 460801256925
Site Plan Improvement Permit
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Department of Environment, Health,and Natural Resources Sheet:
Division of Environmental Health Property ID:
On-site Wastewater Section Lot#:
SOIL/SITE EVALUATION File#:
for ON-SITE WASTEWATER SYSTEM AppID: EHPR-4-16-23743
Owner: Christine Curcio Applicant:
Address: 2676 mt Pleasant Rd Sherrills Ford NC Date Evaluated: 5/24/2016
Proposed Facility: 4 BR Home Design Flow(.1949) 480 Property Size:
Location of Site: Property Recorded:
Water Supply: pvt well [ [Spring [ ]Other
Evaluation Method: pits by Charles Beatty [ I Cut
Type of Wastewater. X Sewage [ I Industrial Process [ ]Mixed
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1 LL 3-5% 0-6” topsoil
6-20" SCL 48" PS.3
20-48" SC SS,SP,SEXP,FR
2 same as 1 48" PS.3
3 0-6" topsoil
6-48" SC SS SP SEXP FR 48" PS 3
4
Description Initial System Repair System Other Factors(.1946):
Available Space(.1945) PS PS Soil Evaluation By: Jason Boyd
System Type(s) IIIG 25% IVA 50% Others Present: Christine Curcio Charles Beatty Mr Curcio
Site LTAR .3 .3 Site Classification(.1948): PS
Site Evaluation By:
Others Present:
Sheet:
COMMENTS: FILE#:
Landscape Position Group Texture .1955 LTAR Structure
R-Ridge I S-Sand 1.2-0.8 SG-Single Grain
55-Shoulder Slope LS-Loamy Sand M-Massive
LS-Linear Slope CR-Crumb
FS-Foot Slope II SL-Sandy Loam 0.8-0.6 GR-Granular
NS-Nose Slope L-Loam SBK-Subangular Blocky
HS-Head Slope ABK-Angular Blocky
CC-Concave Slope III SI-Silt 0.6-0.3 PL-Platy
CV-Convex Slope SICL-Silty Clay PR-Prismatic
T-Terrace Loam
FP-Flood Plain CL-Clay Loam
SCL-Sandy Clay
Loam
IV SC-Sandy Clay 0.4-0.1
SIC-Silty Clay
C-Clay
Consistence Consistence Mineralogy
Moist Wet SEXP-Slightly Expansive
VFR-Very Friable NS-Non-Sticky EXP-Expansive
FR-Friable SS-Slightly Sticky
FI-Firm S-Sticky
VFI-Very Firm VS-Very Sticky
EFI-Extremely Firm NP-Non-Plastic
SP-Slightly Plastic
P-Plastic
VP-Very Plastic
Sketch of Soil Evaluation Locations