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Home My WebLink AboutIMPV-05-2016-072814.TIF CATAWBA COUNTY Case# IMPV-05-2016-072814 .f'at; Public Health Department Subdivision 4 ; a'H Environmental Health Division PINT/ 461714430376 at 2 PO Box 389. 100-A Southwest Blvd,Newton.NC 28658 LOT# 8• :M NAME ON PERMIT: KATHY SANDIFER, 114 W DEBBY RD, SHELBY NC 28152 Site Address: 3963 FLAT ROCK RD, TERRELL NC 28682 Property Size: Square Feet: 31,798.80 Acres:0.73 Directions: Hwy 150 E, right Sherrills Ford Rd, corner of Sherrills Ford Rd and Flat Rock Rd 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 requested in the application for service EHPR-04-2016-23547 by the following method(s): Received in Person Facsimile Transmittal (Return form with signature required) 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 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) Permit transmitted by (name of person sending permi!) 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 elipennit 05/31/2016 11:08 Page 3 of 3 •- �� \ CATAWBA COUNTY �o_J } Q Case# IMPV-05-2016-072814 � \ Public Health Department �y ti ..15' Subdivision „�, Environmental Health Division f . ` ••r PIN# 461714430376 � PO Box 389, 100-A Southwest Blvd,Newton,NC 28658 • LOU t fra, 78 2 ,u am" itr fy .a -28 •c• CI III.71 NAME ON PERMIT: KATHY SANDIFER, 114 W DEBBY RD, SHELBY NC 28152 Site Address: 3963 FLAT ROCK RD, TERRELL NC 28682 Property Size: Square Feet: 31,798.80 Acres:0.73 Directions: Hwy 150 E, right Sherrills Ford Rd, corner of Sherrills Ford Rd and Flat Rock Rd Improvement Permit Facility: Primary Residence - House Permit Category: New Septic I3edrooms_ 3 WATER SUPPLY: Private Well Basement? Yes Basement Plumbing? No 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: IIIB - SYSTEM W/SINGLE EFFLUENT PUMP PUMP REQUIRED Permit Conditions: *Do not grade, fill, or drive over any septic area. *Do not grade for the basement before the Authorization to Construct permit is issued. *Before the Authorization to Construct permit can be issued, the lot must be cleared with the house surveyed in place so the exact location of the septic drain field can be verified. 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 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. Robbie Phelps 05/31/2016 AUTHORIZED STATE AGENT APPROVAL DATE Permit Expiration Date: 05/28/2021 No grading or construction activity is allowed in areas designated for system and repair without approval of the Health Department. ehpennit 05/31/2016 11:08 Page I of3 Catawba County Environmental Health jhrV— oS--lo(6-0 72gIIf 4., l stip C / \ jLo- 0 v� t r 's2 ;h S , r-, Y iC .lifr„ 6o �o-lY w' AGP h' .^� a P t ^O N ' ,.. �0,^) 5.1.‘ 7: Parcel: 461714430376, 3963 FLAT ROCK RD lin=50ft TERRELL, 28682 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 personnel,disclaim,and shall not be held liable for any and all damages,loss or liability,whether direct,indirect or consequential which arises or may arise from this map/report product or the use thereof by any person or entity. Copyright 2014 Catawba County NC 05/26/2016 .1 . ' 1" X a V . .'kT >.yr. t" H ry� "" it a a ,.A ,,. ,kv _ ,'�2.+ °1.. 'l°t-h'z. . . ,... a. .�.._ ., - s - _ s• 4� DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES Shed/of DIVISION OF ENVIRONMENTAL HEALTH PROPERTY ID it ON-SITE WASTEWATERSECDON COUNTY: SOUJSITE EVALUATION or ON-SITE WAS rEWATER SYSTEM OWNER KAh fun a 'PLICATIONDATE ADDRESS: n, k t 7 DATE EVALUATED: it 5-1( -14 PROPOSED FACILITY: % h IL PROPOSED DESIGN FLOW(1949): 56 a PROPERTY SZE: LOCATION OF SITE PROPNTY RECORDED: WATER SUPPLY: B'Perate 0 Public EWeII o Spring 0 Other EVALUATION METHOD: C,Auger Boring 0'Pii 0 cut TYPE OF WASTEWATER H Sewage 0 Inthat ial Process 0 Mixed :::::::::::_::::: : :::::::::: :::ss_ __ ; : : ::_ =::ate«r__: : ::::_:__. ... r»oxrLacs4rts 3'-_...._-_ ;iia::::::ei2ieieeeie 4Ii: ._� ::EDxG!_ ¢::=assts:_[€'::�-_._._•_�:_;__:-_.:-:::_:__::=_:ae_:S9.tf__= ..:.:==e:- �_=€€____ €-_-isi=i_� _€_-: =t it __;_i _=i��;i_ `_!__' _sPO�I1PI4fi :31F.�....PT7>(?'.[3eiii'.S'T.....[YE!•UR%2,�„_::::::: .,,_i1S�b515C'sNC}3I 'ii�' o,��.,4,�f�.i:::r....__.._.-_ . '..�,,,,xQic�va4,_'S,t.�.. i?:3"x'ISl`$$iiE ri,-sir :..:€ T p > 3A #�.= ct9lu�k- r#4 afr. , 0 17 CL tI rP %-l(aln 17-W L4T.r ' rSf f ).1 35-s P _t, ..r9( Fr 3S' • r t q -I(Ilu D -2$ C-t- rrSh'.... I' it Sr r� 2f( l.ck 2 et ft p D-1( Jet. t„r6h /=r —U I. 11-'51 C j-4 If 3 L- e; 'U-47 C +;E w,L Fr trip, Ll e 3 r Pf I o-?i rcL n-rck Pr t1/4 11-21 4 2°I"is c l- S„ _rik / r ,) )4 11 d t 3 1 - e:r Pr DESCRIPTION II.•r11At SYSTEM REPAIR SYSrF1,1 OTHER FACTORS(.1946): Amiable Space(.1945) SITE CLASSIFICATION(.1946): SW= Yin j Qs p Nr Z EVALUATED BY: OTHER(S)PRESENT: Site LIAR COMMENTS: DEPA:YTMF C OF ENVIRONMENT AND NATURAL RESOURCES s'� °f Z DIVISION OF ENVIRONMENTAL 1UEALTH PROPERTY ID& ON-SITE WASTEWATER SECTION COUNTY: SOIL/SUE EVALUATION LL I for ON-STYE WASTEWATER SYSTEM OWNER: (ln-h4 SwnO��r PLICATIONDATE ADDRESS- `3 N b`5 -(n o c DATE EVALUATED. Y=(/.-i' PROPOSED FACRITY: `4 D n PROPOSED DESIGN FLOW(•1949): 3 o PROPERTY SIZE LOCATION OF SITE,, PROPERTY RECORDED: WATER SUPPLY: IT Private 0 Public (?Well 0 Spring 0 Other EVAL3TATIONMETHOD: Q�Anger B®g 0 Pit 0 Cur AS15R' TScapc ] hoc=TYPE v F WA3ER: ... .._..__.__.._...._......__........_ .c..........._.......__......_-............___.:ice:.:ii' -- __ - - - - -- - ...........- F=::Fe- t' - ---.. ._. -(1943}-==-._-... ..._ .. -- ... _.._ .._ sY.C1A€v .c_iiSiiSc14��: [_[:{:r: v::=3�i-1:c.—:::.cis:=---ITq)�93�2 °=[F^Ri^ ;'_-`j;ti� t Vii.:' .. ..:::(�$(1� ' aiji; j--- s .3rEPT8: -,; AmaneF tRg Ok�ISYF3IG"1y ; ;;:cc =SST — 0-(L SC L rShr ci-i (°(, 1z-SS C -t-i ..i4h fr s) r�, _ S 3 S 3 r-48 5 Ar F, . - E _6 `- ...�Ttk.,.... Pr of-((°(p (-kas E cro, . vrr Ir ,p 2 6 If D-L c �-sA o .,,N rr r, i� • 4$ i t L 4y, Q- 6 L rr9 N F I 1 r �'� °� 6-1-to [. ,I 6 h Er rr i° -7 1 to-41 64 Sri, nrbh re yr✓p i 7 L nn cot D rIAL SYSTEM cEPAOr SYSTEM OTHER FACTORS(.19x6): 1 Mythic Space(.1945) S 5- SIZE CLASSI$CATION(.1948): 1°r •SS'�TYX(t) 2 S°% 5 D°�a EVALUATED BY: p-,bt(n pkh r OTHERS)PRESENT: Site LIAR , 3 ,3 COMMENTS: !ti nlinl✓.., fire..f,A c4i1+ -eir l-tic ia,fi�.4 ft-F+., it 2>'' 4-4fir t3arinj 7 war Piny/ c log- h (;f 2 '(-n ✓sixty rock (AK)Atilt: » s#9 Q'n+iy :' -4 al fe „4. Catawba County Environmental Health it � L // / le I i ,. it/ 7 i , , , 1 J i �J I % r/ f / sy� l / / I galk re / Fp1 .o/ o A k /�� , �� %N� Si" iTiv#b ��A �e 0 vs vs' / V TMSfr f _VI" 4t. . ,. i / /f // }7 � `�`,.•- 8/02 Parcel: 461714430376, 3963 FLAT ROCK RD 1in=50ft TERRELL, 28682 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 peirsonnel,disclaim,and shall not be held liable for any and all damages,loss or liability,whether direct,indirect or consequential which arises or may arise from this map/report product or the use thereof by any person or entity. Copyright 2014 Catawba County NC 05/31/2016 ,d.R . .