The URL can be used to link to this page

Home My WebLink AboutIMPV-05-2016-072900.TIF Case ft Sta CATAWBA COUNTY IMPV-05-2016-072900• T Public Health Department Subdivision �`' � Erti ironmental Health Division PINT; 268704501375 � W: PO Box 389, 100-A Southwest Blvd,Newton,NC 28658 LOT# /842 NAME ON PERMIT: HOLLY LYNNE HALFORD, 2705 N CENTER ST APT 32, HICKORY NC 28601 Site Address: 4205 WILSON RD, VALE NC 28168 Property Size: Square Feet: 557,132.40 Acres:12.79 Directions: Hwy 10 west, Left onto Banoak Rd beside Banoak Elementary School, Travel about 1 mile, Left onto Wilson Rd, about .6 mile Right onto gravel driveway. Go to top of driveway, Go to the far Right at double silver gates. Owner/Authorized Representative Acknowledgement of Permit Receipt AkI certify that I am the owner or authorized agent(owner's authorization required) representing the owner of the property described above. Alk As the property owner or authorized representative, I have received the above referenced permit(s) as Y- requested in the application for service EHPR-04-2016-23587 by the following method(s): _Received in Person Facsimile Transmittal (Return form with signature required) Electronic Image Transmittal/ E-mail (Return receipt required) �/ 4, As the property owner or authorized representative I have reviewed and understand the specific conditions rof 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 crel 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 dim nuit 05/31/2016 13:17 Page 3 of3 SPA • CATAWBA COUNTY Q I �� . 0 Case# IMPV-05-2016-072900 `Q' Public Health Department T Subdivision alga Q Environmental Health Division 1 • • • r.- • • PIN# 268704501375 \ D- PO Box 389, 100-A Southwest Blvd,Newton, NC 28658 ' 0 �'D • - a ' LOT# 1842 ,u 4 •I IL Eli G • • NAME ON PERMIT: HOLLY LYNNE HALFORD, 2705 N CENTER ST APT 32, HICKORY NC 28601 Site Address: 4205 WILSON RD, VALE NC 28168 Property Size: Square Feet: 557,132.40 Acres:12.79 Directions: Hwy 10 west, Left onto Banoak Rd beside Banoak Elementary School, Travel about 1 mile, Left onto Wilson Rd, about .6 mile Right onto gravel driveway. Go to top of driveway, Go to the far Right at double silver gates. Improvement Permit Facility: Primary Residence Permit Category: New Septic Bedrooms 2 WATER SUPPLY: Private Well Basement? No Basement Plumbing? No INITIAL SYSTEM SPECIFICATIONS Permit Valid: Expires In Five Years: X_ No Expiration: Projected Daily Flow 240 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: IIIG -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 Sewaee 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 05/31/2016 AU'T'HORIZED STATE AGENT APPROVAL DATE 05/28/2021 Permit Expiration Date: Aro grading or construction activity is allowed in areas designated for system and repair without approval of the Health Department. elrpennit 05/31/2016 13:17 Page 1 of 3 EHPR 04-2016-23587 4205 Wilson Rd, Vale • Do not cut, drive, fill,or grade over septic or repair areas. • This is an improvement permit only and is not intended for septic installation purposes. VA/ tgC 10;tSoic &o, 2j 1'0 6taV _ jf , 0149444 ry. tit l 1 "4 DEPARTMENT OF HEALTH AND HUMAN SERVICES L74,1 oy- 246 _ Z3 Sheet [ of ( DIVISION OF PUBLIC HEALTH,ENVIRONMENTAL HEALTH SECTION PROPERTY ID N: ON-SITE WATER PROTECTION BRANCH COUNTY:_Catawba_ SOIL/SITE EVALUATION for ON-SITE WASTEWATER SYSTEM ' / (Complete all fields in full) OWNER: FA((i l‘.--d _ APPLICATION DATE ADDRESS: DATE EVALUATED: "7:./z.f PROPOSED FACILITY: 16V PROPOSED DESIGN FLOW(.1949): 2 Y PROPERTY SIZE: LOCATION OF SITE: /-Of W(Is-o., ,E4 PROPERTY RECORDED: WATER SUPPLY: ❑Private ❑Public X.Well ❑Spring ❑Other EVALUATION METHOD: ❑Auger Boring SPit ❑Cut TYPE OF WASTEWATER: X Sewage ❑Industrial Process ❑Mixed x SOIL MORPHOLOGY OTHER F (.1941) PROFILE FACTORS 1 g LANDSCAPE HORIZON �_- - =• ' POS1T10N/-"' 'DEPTH ..1942 '"` PROFILE ,:1941 `:1941 SOIL 1943-x'1956 1944 CLASS:' STRUCTURE/ ,i—CONSISTENCFJ WETNESS/ SOIL r %SAPRO, 'RESTRa, &LIAR i ' TEXTURE f ::' (MINERALOGY COLOR '-'DEPTH CLASS, .. .HORIZ ` , O -(S 6r SL fit SE sok tg- N L5 I S- 34 s61c. L SC Yts/ 1 /� .3y-it, W56k Gl- /-ie fe- eat b.2.75 /s.,, wI,6 - 0 - 1 Z iJS6k. .CC-c. M se Li, FS I z -3o r56(c C- fig SC ''-(k AJA- Iu4 �S 2 Jo— (Ik Viet CG74.1 Fit Se e Pat f.Hy 6,:I"2i-.S% .$1 CA'1{g fit Sc e-i.,1 t '/L O. 2-f o--(4 "56k .5c-t- ft Se yS 1 S /6-3° s k_ c f�� yY ,vim N� �1 }'e 6 /b...- 3 /p"1 3D"LC "5aca f% se Crh.ttl, +rtTfr `is- 4X '56L c.i_ (IL Sc L-. -I o.2r I0`I ' • o Ho c'5 Sc f y ft" b" - rS/ k -32- 3614- S"- r# ft- 4-(i( r✓s)- N A Ps 4 St. 32- 4-}r 56k c. /fcp 1'/ `1G 3fiH`l EV" A ere"" W 17 n-dii iL - YB wwbk c f/ se ski, ' 0.21- ..., 107c/ DESCRIPTION INITIAL SYSTEM REPAIR SYSTEM OTHER FACTORS(.1946): d Available Space(.1945) 1'/ 05 SITE CLASSIFICATION(.1948): / S System Type(s) 2.g% eJ Zj Z. �J EVALUATED BY: -S* �"r OTHER(S)PRESENT: Site(.TAR L t7C 0.2 75 COMMENTS'. Updated February 2014 C-"Ht2 oy - ?,.�t6 - Z35f7 Catawba County Environmental Health V°� Le«fs 15 'Cif Asti 8 1 Ae 41114 IShk, 7\ W444 - .411111 Ia‘41 . tp n . \ b £f o 411Pr i Parcel: 268704501375, 4205 WILSON RD VALE, 1 in=60ft 28168 I 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 i