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Home My WebLink AboutIMPV-06-2016-073319.TIF a`-B• CATAW BA COUNTY Case# IMPV-06-20 1 6-073 3 19 • r fan' ,, Public Health Department Subdivision < —� , Environmental Health Division PIN# 376119724327 \''-'t- PO Box 389, 100-A Southwest Blvd,Newton,NC 28658 LOT# 25 rg.2 .,,• NAME ON PERMIT: CYNTHIA MOOSE, 2010 35TH ST NE, HICKORY NC 28601 Site Address: 3770 MACKLIN ST, CLAREMONT NC 28610 Property Size: Square Feet:29,185.20 Acres:0.67 Directions: Hwy 10 East, left on Bethany Church Rd, Right on Boggs Rd, Left on Hogan Dr, left on Macklin, Lot on right wner/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 / quested in the application for service RBPR-O5-2016-23878 by the following method(s): I• 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: 06/10/2016 / ', / ' Owner/Authorized Representative Signature SSW 4•&, a. Date Documentation of Permit(s) Transmittal (permit transmitted by electronic or other means) Permit transmitted by (name ofperson 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 ehpennli 06/10/2016 13:34 Page 3 of3 „- ,Q,A CATA3vsACOUNTI' 0 RI 1:1••Cr 0 Casc# IMPV-06-20 16-073 3 1 9 ;P a"Q Public Health Department A.:. irt Subdivision wr Environmental Health Division PIN# 376119724327 "'b PO Box 389, 100-A Southwest Blvd,Newton,NC 28658 I _ �'x UAW 25•/842 sM - •! b. . x 0 r_0 O NAME ON PERMIT: CYNTHIA MOOSE, 2010 35TH ST NE, HICKORY NC 28601 Site Address: 3770 MACKLIN ST, CLAREMONT NC 28610 Property Size: Square Feet:29,185.20 Acres:0.67 Directions: Hwy 10 East, left on Bethany Church Rd, Right on Boggs Rd, Left on Hogan Dr, left on Macklin, Lot on right Improvement Permit• I;k> » xreaz:a” IIfCs IALjSYST�E'MIE'XIISTINGdhI''?` l li°°''s° :u'I I�:/JjI A' ;' u;'i ' Facility: Permit Category: Other Bedrooms 3 WATER SUPPLY: Private Well Basement? Basement Plumbing? INITIAL SYSTEM SPECIFICATIONS Permit Valid: Expires In Five Years: No Expiration: _X_ Projected Daily Flow g.p.d Proposed Wastewater System: Type: **** no system class assigned **** () 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 1SA.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 06/10/2016 AUTHORIZED STATE AGENT APPROVAL DATE Permit Expiration Date: 06/10/2021 No grading or construction activity is allowed in areas designated for system and repair without approval of the Health Department. ehpcmut 06/10/2016 13:34 Page 1 of3 RBPR 05-2016-23878 3770 Macklin St, Claremont • 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. • New 3 bedroom mobile home proposed. Will connect to existing septic system. • Existing septic system was visually functioning 6/1/2016, however no guarantee can be given as to its longevity. • New home, including decks and porches must be 5 ft from septic system and 25 ft from well. \k CV N �v 4. tV 1 .f' 97' 3S� 1� pt{ c�Ll L ' �I DEPARTMENT OF HEALTH AND HUMAN SERVICES J,7f��.L/J� _0�- (,— 23$i7� Sheet / o.f DIVISION OF PUBLIC HEALTH,ENVIRONMENTAL HEALTH SECTION/A .CJ PROPERTY ID#. ON-SITE WATER PROTECTION BRANCH COUNTY:Catawba_ SOIL/SITE EVALUATION for ON-SITE WASTEWATER SYSTEM aa (Complete all fields in lull) OWNER: et(-� :_ _ APPLICATION DATE '`r-L4 ADDRESS: DATE EVALUATED: G/, PROPOSED FACILITY: -72,- PROPOSED DESIGN FLOW(.1949): PROPERTY SIZE: LOCATION OF SITE: 3??o rk Ckl..- 3h PROPERTY RECORDED: WATER SUPPLY: ❑Private ❑Public ❑ Well ❑Spring ❑Other EVALUATION METHOD: ❑Auer Boring ❑Pit 0 Cut TYPE OF WASTEWATER: 0 Sewage 0 Industrial Process 0 Mixed 1; SOIL MORPHOLOGY OTHEIlt PROFILE'FAC TORS - g LAN) SCAPE HORIZON - i:PAOFD,E POSITIONI DEPTH - c ` a : 1942 - :� n SLOPE% (IN•),' 194( 1941 SOIL 1943 - !�1956 .1944 CLASS STRUCTURE// CONSISTENCE/ WETNESS/ SAPRO RESTR &LTAR TEXTURE :_ MINERALOGY COLOR DEPTH .,CLASS, ,DORM ;: _ O- . . ~S5t skL fic Jer tv/1- PS ? -21 Sot c t �r o et, o. 2S 1 zY-'fc A75 e C i`/ $E - ,- ir*i, �6-Go alb(- cc FA 3C • o- "i u5sat Sex ! ycf LS 7-34 S L GL t-ve sr �� 57) M4 446t, PJ 2 .S°4 3`[- sv wsot c Ft - o.3 • 3 • 4 DESCRIPTION INITIAL SYSTEM REPAIR SYSTEM OTHER FACTORS(.1946): �(C SITE CLASSIFICATION(.1948): P5 Available Space(.1945) `- �y I_S System Type(s) $r`,- I (p ��f` EVALUATED BY: OTHER(S)PRESENT: Site LTAR 0, ZS COMMENTS: Updated February 2014 Q64C 6S-- 2016- 235'-yg' Catawba County Environmental Health l rI- LcJ-7 IP ci /// j f 1 ( ( ( ( i ' /i , 4 / I; :/1..... d o cs ofal fr 1t 1%. 71-:.-7,31 ?V\ V A' 44/./ fee i li I I ff / /---_,.. 97.25 ft f < 1 35 4b. 59. , (J C 37.• j MACKLoIN ST �' 125.1: Parcel: 376119724327, 3770 MACKLIN ST 1in=50ft CLAREMONT, 28610 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