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Home My WebLink AboutAUTH-06-2016-073181.TIF w,A e CATAWBA COUNTY Case# AUTH-06-20 16-073 1 81 i ft Public Health Department Subdivision 4 "—`tg ,;; Environmental Health Division PIN# 367904821727 ^'+�' PO Box 389. 100-A Southwest Blvd,Newton.NC 28658 LOT# /842/+u NAME ON PERMIT: TRACIE FORREST, 1804 BUFFALO SHOALS RD, CATAWBA NC 28609 Site Address: 1804 BUFFALO SHOALS RD, CATAWBA NC 28609 Property Size: Square Feet:82,328.40 Acres:1.89 Directions: Hwy 16 South, Left on Buffalo Shoals Rd, Go about 2 miles & house is on the Right just after Feed Lot Rd. Owner/Authorized Representative Acknowledgement of Permit Receipt .....iN 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-05-2016-23846 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: 06/07/2016 .fie Owner/Authorized Representative Signature Date Documentation of Permit(s) Transmittal (permit transmitted b 'lectronic or other means) c. Permit transm'ttes by `/ .1� - k (name of person sendi g(permit) Signature �I �f , �(�l Date/Time CO. W S I 1 ' b Method: Fax N mail US Mail Other Owner's request ! send by the above indicated method of transmittal in lieu of signature ItYLCAlb 1 `►,e �e 4 e2 We want to hear from you. Please t a few moments to complete our customer service survey at: http://www.surveymonkey.com/s/EHCustomerService ehpennit 06/08/2016 11:16 Page 4 of 4 gA CATAWBA COUNTY A .;3:. D Case# AUTH-06-2016-073181 3-: �G Public Health Department • Y Subdivision• t 4 Environmental Health Division • � PIN# 367904821727 i� PO Box 389, 100-A Southwest Blvd,Newton,NC 28658 ti LO"p# 18.2 s. "- 1 0 . 80 slit NAME ON PERMIT: TRACIE FORREST, 1804 BUFFALO SHOALS RD, CATAWBA NC 28609 Site Address: 1804 BUFFALO SHOALS RD, CATAWBA NC 28609 Property Size: Square Feet: 82,328.40 Acres:1.89 Directions: Hwy 16 South, Left on Buffalo Shoals Rd, Go about 2 miles & house is on the Right just after Feed Lot Rd. Authorization to Construct Permit Authorization to Construct Wastewater System (Required for Building Permits * 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 LIAR: 0.3 g.p.d./ft2 Permit Category: Repairs Type of Facility: Primary Residence - House Basement? Yes Basement Plumbing?No Bedrooms: 3 Wastewater System Requirements Tank Size: New 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: 900 sq ft Total Length: 300 ft Maximum Trench Depth 24 in Aggregate Depth in Trench Width 3 ft Minimum Soil Cover 6 in Minimum Trench Separation 9 ft on center Number of Drain Lines 4 Distribution: Serial Pre Treatment: NONE Additional Specifications: 'Install all parts of the septic system at least 65 feet from the well. 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. »»> DO NOT INSTALL SYSTEM UNDER WET CONDITIONS ««< Proposed Repair Repair System Required? System Class: Proposed System: Distribution Type:: Soil LTAR: g.p.d./ft2 ehpermit 06/08/2016 11:16 Page 1 of 4 A,A CATAWBA COUNTY Case# AUTH-06-2016-073181 j • Public Health Department Subdivision < „��e�t .„5, Environmental Health Division PIN# 367904821727 D`'''t- PO Box 389, 100-A Southwest Blvd,Newton,NC 28658 LOP/ 1g42 is NAME ON PERMIT: TRACIE FORREST, 1804 BUFFALO SHOALS RD, CATAWBA NC 28609 Site Address: 1804 BUFFALO SHOALS RD, CATAWBA NC 28609 Property Size: Square Feet:82,328.40 Acres:1.89 Directions: Hwy 16 South, Left on Buffalo Shoals Rd, Go about 2 miles & house is on the Right just after Feed Lot Rd. 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 ISA.1900). Neither Catawba County nor the Environmental Health Specialist warrants that the septic tank system will continue to function satisfactorily for any given neriod of time Robbie Phelps 06/07/2016 AUTHORIZED STATE AGENT APPROVAL DATE Permit Expiration Date: 06/07/2021 No grading or construction activity is allowed in areas designated for system and repair without approval of the Health Department. ehpenuit 06/08/2016 11:16 Page 2 of 4 Catawba County Environmental Health 40-4- 06-20[6 . 07 (g ( 04 i /149:11 r5- A,4 S �� t N. N. t, ., "? -s -‘ 6s Weu 7) ` gab • • • • • • • • Parcel: 367904821727, 1804 BUFFALO SHOALS 1in=60ft RD CATAWBA, 28609 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 06/07/2016 DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES DIVISION OF ENVIRONMENTAL HEALTH She _oj__ PROPERTY ON-SITE WASIEWATERSEC ION COUNTY: : Y: SOIUSI.1'E EVALUATION for ON-SITE WASTEWATER SYSTEM OWNER rGC r errs •PLICATION DATE ADDRESS: /Q 0W (>. V e o a, r DATE EVALUATED: 6-7-1 PROPOSED FACILITY: "1 '>R PROPOSED DESIGN FLAW(.1949): 7L C . PROPERTY SITE: LOCATION OF SITE: PROPERTY RECORDED: WATER SUPPLY: 0 Private ErPi:hl{r arWeD 0 Spring 0 Other EVALUATIONMETHOD: 0 Auger Baring Q'Pit U Cut TYPE OF WASIEWATER Q sewage {]Iadnstia1Ptocea o Hued i=_==--:r.:a ^ii2ec:c=::::::;::r.=�_:._..____ =�::__::=::==:c::o::-.................... -rcp:r__c::::::_�:::::_:::__:::::._._..-..__.._....._!.. Ti; _ = :__--T-=iii < ::a:sa` :i_:iii::`:°____ '__.: :::_=:°__=:s:::::._......'[:=:.... �____.-::::-:. :-_::_;::-_-::::::__ '= 7AMar_ :eT30Rk!` [=is=:_-= :="i __€=_t= __.._..._t:.:_.......___...__:` 34s .._. ...... --a::� a_ - - r'; lT1S114117aTE �:1aEPT'H STT;lIC'E(1RFJ >"Ok515,TENE!3" H' 40 Sptlrb H� T;ES"TR- :.fa) Tit CURS M11:C ,OOY equ}a AEETEC GI ASS 4 »ss may. o-I0 St L Lrlh Fr _._-- I, to -A0 C rah Pr rr r� • 1 -tug, �o-44 r-4�h � � Pr 0- L r�II ``. ... I. f E-1 0 SCL vt frrirp 2_._ b NN-5t br\ F SF `t8 (,;.Io 3t -4g I`/'J)Jp 0 - Yl fCU LLrbA • 12-40 ;eh rr rr.i? 3 5- ibt(o No-4b tier he( '27 �Ir 4 e� p s- ia a a DESOUPTION ATrIAL SYSTEM LEPAm SYSTEM OTHER FACTORS(J946): Available Space(.1945) r SUE CLASSIFICATION(.194S): rr yy�fit) 2'S°l0 EVALUATED BY: OTHER(S)PRESENT: Site LIAR -r) COMMENTS: �. . r �. �i1C71 - lf�.�it� . ,,,. V a e . O - /i H C • .. `3J a�� • • • • i - . C9 : • • • ti • 10"MJ AJ, a Parcel: 367904821727, 1804 BUFFALO SHOALS 1 in=60ft RD CATAWBA, 28609 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 pei30nnel,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 06107(2016