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Home My WebLink AboutRBPR-06-2016-24078.TIF ,A THIS IS NOT A PERMIT Case # RBPR-06-2016-24078 hy m' � Ga CATAWBA COUNTY HEALTH DEPARTMENT •o ' 10 � �Iw'!�f PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES 1842 5M Residential Building Plan Review - Building New o irtmera.13 / AUTH_CONST- NEW WELL 0o 0 ZfiCel Contact Person AMERICA'S HOME PLACE (REX MINTON), 1206 GREENLAND DR, STATESVILLE NC 28677 B:7048724400 C:8283]37748 Contractor *AMERICA'S HOME PLACE/STATESVILLE (CHAD HOLLOWAY), 1206 GREENLAND DR, STATESVILLE NC 28677 8:704-872-4400 C:704-746-7094 MOBILE FOR CHADF:704-872-4408 CKHOLLOWAY @AMERICASHOMEPLACE.COM Owner MARILYN MCCASLIN,3652 OLIVER CROSS RD N, NEWTON NC 28658 NAME TO APPEAR ON PERMIT *AMERICA'S HOME PLACE/ STATESVILLE (Chad Holloway) SITE ADDRESS: 3654 N OLIVERS CROSS RD, NEWTON NC 28658 PIN # 366702880506 NAME of SUBDIVISION: Lot# 2 Section/Block PROPERTY SIZE: Square Feet Acres 0.94 DIRECTIONS: HWY 16 S, N OLIVERS CROSSROADS, LEFT PAST RUHAMA CHURCH RD WILL BE OPEN FIELD WITH MAILBOX #SIGN FOR 3652 PRIMARY CONTACT: Contact Person SEWER TYPE: Septic Tank GALLONS PER DAY: 360 WATER SUPPLY: Private Well DESCRIBE WORK: New 3 BdRm House SITE INFORMATION Do any of the following apply to the property for which this application is applied? If the answer to any of the questions below is"YES", then supporting documentation is required: Does this site contain any jurisdictional wetlands? No Does this site contain any existing wastewater systems? No Is any of the wastewater going to be generated on the site other than domestic sewage? No Is the site subject to approval by any other public agency? Yes Are there any easements or right-of-ways on this property? No APPLICATION FOR: New Structure STRUCTURE TYPE: PRIMARY RESIDENCE FACILITY TYPE: Single Family Residence OTHER DESCRIPTION: DESCRIPTION OF Vacant Lot EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: NUMBER OF EXISTING BEDROOMS: #OF OCCUPANTS: 1 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: House 62X50 #OF NEW BEDROOMS:: 3 BASEMENT? No BASEMENT FIXTURES? No PLUMBING REQUIRED? Desired system types(Improvement Permit or Authorization to Construct): ACCEPTED: ALTERNATIVE: CONVENTIONAL: OTHER: INNOVATIVE: ANY: YES Other described: APPLICATION FOR WELL CONSTRUCTION PROPOSED WELL TYPE: Individual Well REPLACE WELL?: NO E9-enapplication 06/10/2016 15:49 Page 1 of5 o' CATAWBA COUNTY Case a RBPR-06-2016-24078 r tli y Public Health Department Subdivision 2 mow^< Environmental Health Division PIN// 366702880506 �`+> / PO Box 389, 100-A Southwest Blvd,Newton.NC 28658 1842 sm NAME ON PERMIT: *AMERICA'S HOME PLACE/STATESVILLE (CHAD HOLLOWAY), 1206 GREENLAND DR, STATESVILI 28677 *AMERICAS HOME PLACE/STATESVILLE ( Chad Holloway) Site Address: 3654 N OLIVERS CROSS RD,NEWTON NC 28658 Property Size: Square Feet Acres 0.94 Directions: HWY 16 S, N OLIVERS CROSSROADS, LEFT PAST RUHAMA CHURCH RD WILL BE OPEN FIELD WITH MAILBOX #SIGN FOR 3652 Improvement Permits issued as a result of this information are valid for 5 years or may be non-expiring under certain specified conditions.An Authorization to Construct issued by this department is valid for(5)five years from the date issued and is not transferable; Improvement Permits and Well Permits are transferrable. Permits may be revoked if the information on this application,site plans or intended use changes for the proposed facility. I have read this application and certify that the information provided herein is true, complete and correct. Authorized county and state officials are granted right of entry to conduct necessary inspections to determine compliance with applicable laws and rules. I understand that I am solely responsible for the proper identification and labeling of all property lines and corners and making the site accessible so that a complete site evaluation can be performed. Date: Signature of Applicant or Agent An Environmental Health Specialist will contact you within 5 working days of application date. If you need further information or assistance please call 828-466-7291 AREA1 inl @Inl{I1 l,. L-77,71 'ItlIll I I{ , r8 #,$aip111111110 r'";Ni U1 rillillgllillhlllltimil TEEN�AME ,9 ;--'1“1 rrwo��l�l`Xi,q J 11Wlh:,r,;.';4.t t y, DATE 1;,hedI1I.�FEE'•AMOUNT,` Authorization to Construct Fee (New/Expansion) 06/10/2016 $150.00 Fee Well Permit & Inspection Fee 06/10/2016 $300.00 'y p,a I I TOTAEIFEESIlllilIMl1lll81lIfilll,�9lr, .:, V,Flii 2a k1lluillll _111killlVlllij 'r '$asolool 1 1., ,r _�,a �.� ,��„ :l i ', '''.1.41 , ,tli If' &�n,�iUWdi.'UtittwarriXa,a ''MUI ,.umtulsuuuuttu- '' tiilmuels v8U OMP :nnnenUiu11WIll G, FEES ARE NON—REFUNDABLE ONCE A SITE VISIT IS MADE OR WORK ON A PLAN REVIEW HAS COMMENCED SYSTEM REDESIGN AND/OR RETRIP WILL INCUR AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) E9-ehapplication 06/10/2016 15:49 Page 2 of 5 ��A •G THIS IS NOT A PERMIT Case # RBPR-06-2016-24078 d .. CATAWBA COUNTY HEALTH DEPARTMENT m c 7 5 w 7 . PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES �` /842 SM^ Residential Building Plan Review - Building New � •' r AUTH CONST - NEW WELL 19.4414451": Contractor *AMERICA'S HOME PLACE/STATESVILLE (CHAD HOLLOWAY), 1206 GREENLAND DR, STATESVILLE NC 28677 B:704-872-4400 C:704-746-7094 MOBILE FOR CHADF:704-872-4408 CKHOLLOWAY @AMERICASHOMEPLACE.COM Owner MARILYN MCCASLIN, 3652 OLIVER CROSS RD N.NEWTON NC 28658 NAME TO APPEAR ON PERMIT *AMERICA'S HOME PLACE/ STATESVILLE (Chad Holloway) SITE ADDRESS: 3654 N OLIVERS CROSS RD, NEWTON NC 28658 PIN # 366702880506 NAME of SUBDIVISION: Lot 6 Section/Block PROPERTY SIZE: Square Feet Acres 28.49 DIRECTIONS: HWY 16 S, N OLIVERS CROSSROADS, LEFT PAST RUHAMA CHURCH RD WILL BE OPEN FIELD WITH MAILBOX #SIGN FOR 3652 PRIMARY CONTACT: Contractor SEWER TYPE: Septic Tank GALLONS PER DAY: 360 WATER SUPPLY: Private Well DESCRIBE WORK: STARTING TO BUILD A NEW RESIDENTIAL DWELLING 3 BR SITE INFORMATION Do any of the following apply to the property for which this application is applied? If the answer to any of the questions below is"YES", then supporting documentation is required: Does this site contain any jurisdictional wetlands? No Does this site contain any existing wastewater systems? No Is any of the wastewater going to be generated on the site other than domestic sewage? No Is the site subject to approval by any other public agency? Yes Are there any easements or right-of-ways on this property? No APPLICATION FOR: New Structure STRUCTURE TYPE: PRIMARY RESIDENCE FACILITY TYPE: Single Family Residence OTHER DESCRIPTION: DESCRIPTION OF EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: NUMBER OF EXISTING BEDROOMS: #OF OCCUPANTS: PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 62X50 #OF NEW BEDROOMS:: 3 BASEMENT? No BASEMENT FIXTURES? No PLUMBING REQUIRED? Desired system types (Improvement Permit or Authorization to Construct): ACCEPTED: ALTERNATIVE: CONVENTIONAL: YES OTHER: INNOVATIVE: ANY: Other described: APPLICATION FOR WELL CONSTRUCTION PROPOSED WELL TYPE: Individual Well REPLACE WELL?: NO E9-chapplication 06/10/2016 14:33 Page 1 of 5 e)3A CATAWBA COUNTY case# RBPR-06-2016-24078 -r r 9� „ Public Health Department �4YY Subdivision <' or Z' Environmental Health Division PIN# 366702880506 "* - PO Box 389, 100-A Southwest Blvd.Newton,NC 28658 /842 M NAME ON PERMIT: *AMERICA'S HOME PLACE/STATESVILLE (CHAD HOLLOWAY), 1206 GREENLAND DR, STATESVIL 28677 `AMERICA'S HOME PLACE/ Site Address: 3654 N OLIVERS CROSS RD, NEWTON NC 28658 Property Size: Square Feet Acres 28.49 Directions: HWY 16 S, N OLIVERS CROSSROADS, LEFT PAST RUHAMA CHURCH RD WILL BE OPEN FIELD WITH MAILBOX #SIGN FOR 3652 Improvement Permits issued as a result of this information are valid for 5 years or may be non-expiring under certain specified conditions.An Authorization to Construct issued by this department is valid for(5)five years from the date issued and is not transferable; Improvement Permits and Well Permits are transferrable. Permits may be revoked if the information on this application, site plans or intended use changes for the proposed facility. I have read this application and certify that the information provided herein is true,complete and correct. Authorized county and state officials are granted right of entry to conduct necessary inspections to determine compliance with applicable laws and rules. I understand that I am solely responsible for the proper identificatio and labeling of all property lines and corners and making the site acssiblese,that a comple�evaluation can be performed. Date: CP-/C 4 Signature of Applicant orAeent 7 ` An Environmental Health Specialist will contact you within 5 working days of application date. If you need further information or assistance please call 828-466-7291 AREA1 • FEENAME DATE, FFE•AMOUNT Authorization to Construct Fee (New/Expansion) 06/10/2016 S150.00 Fee Well Permit & Inspection Fee 06/10/2016 5300.00 TOTAL FEES h S450 00..'• ' • y.. : F _. FEES ARE NON-REFUNDABLE ONCE A SITE VISIT IS MADE OR WORK ON A PLAN REVIEW HAS COMMENCED SYSTEM REDESIGN AND/OR RETRIP WILL INCUR AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) E9-chappl[cation 06/10/2016 14:34 Page 2 of 5 �� `r " S� THIS IS NOT A PERMIT ` �� CATAWBA COUNTY HEALTH DEPARTMENT counrr �• - ' o Application for Enviromnental Services Page 1 Improvement Permit❑ Authorization to onstruc Septic Repair❑ Septic Malfunction❑ Septic Expansion ❑ New Well Permit Replacement Well ❑ Well Abandonment❑ Well Repair ❑ Existing System Inspection (Pre-Approval Required) ❑ Application is for New Construction Existing Facility ❑ X Property Address , , 0 / -RS Cleats '4 Subdivision ,/e•�w A/C 2865S- Lot# Acres / Section/Block/Phase Driving Directions to Property f/G..y 4 S 0 0 4 7 1 4 /V01/-R, (9 !'eit S C ccrocd/Q^ /9-1--1,4 51- /a(-a...a CIwnL, A.d . 4.-) I . - o_! ... I A LC' . u.: . _ 5 iv [ ? NAME TO APPEAR ON PERMIT? ❑ Owner E. Applicant 129.Contractor Applicant Contact Information Name Address Phone Cell Phone Owner Contact Information Name 1'VtA21( C COX S Address 3652 At 6/he ea Gross RI e -'--(on kJ C Phone gZg-9V/6 - S2 2 7 Cell Phone Contractor Contact Information��11 1 ` 4 Name 2x Kt,ti�v, �4. 4C2iCA5 /-4pvv�e P/Ace ) Address /2o6oldea,..,44,4 ea u< S4$ktv lit( CeNC -214 Zg. 3/3 -77yp Phone . 'z$-3!3- ??VF WHO WILL BE THE PRIMARY CONTACT? ❑ Owner n Applicant 'Contractor Description of Existing Structures on Site VONt1 Li± # of Bedrooms *'r Structure Dimensions #of Occupants Basement ❑ Yes ❑ No Basement Fixtures Q Yes ® No The Applicant shall notify the local health department upon submittal of this application if any of the following apply to the property in question. If the answer to any question is "yes", applicant must attach supporting documentation. 0 Yes c-No Does the site contain any jurisdictional wetlands? 0 Yes ®-No Does the site contain any existing wastewater systems? CD Yes la< Is any wastewater going to be generated on the site other than domestic sewage? -Yes crFTo Is the site subject to approval by any other public agency? 0 Yes PIG Are there any easements or right of ways on this property? Describe Existing water supply in use ❑ Individual Well n Community Well ❑ Semi-Public Well I I County/City/Township Water Line Is a public water supply available? ** ❑ Yes No If applying for an Improvement Permit or Authorization to Construct,Please Indicate Desired System Type(s): j(systems can be ranked in order of your preference) ❑ Accepted ❑ Alternative IEI Conventional El Innovative ❑ Other ❑ Any c A'T'A g 7U THIS IS NOT A PERMIT a urcrt �/� A CATAWBA COUNTY HEALTH DEPARTMENT • Application for Environmental Services Page 2 Proposed Facility Type I I Primary Residence +' New Residence [ Addition^^to Residence # of New Bedrooms *j 3 , Project Description 3Lr ea _ e� oo 'r- 5.ti)It It%rn �y /}w e/fftel Structure Dimensions 62/5-0 # of Occupants Basement n Yes No Basement Fixtures Yes ® No In Accessory Structure(s) Describe #of New Bedrooms *t if applicable Structure Dimensions #of Occupants Accessory Dwelling ❑ Yes El No Plumbing ❑ Yes ❑ No Describe Plumbing Needed I Multi-Family Residence#Units #Bedrooms per Unit*t Total# Bedrooms *t Structure Dimensions in Food Service Specify Type # Seats Floor Space-Entire Food Service Facility (Sq Ft) #Employees per Shift #of Shifts Dining Area(Sq. Ft.) I I Business Specific Type of Business Retail Floor Space # of Employees per Shift # of Shifts U Other Facility Type Specify If Church# of Seats Kitchen n Yes n No If Daycare Specify Occupancy Application for Well Construction/Abandonment/Repair Proposed Well Type n Individual Well [ Semi-Public Well ❑ Community Well Abandonment Type [ Drilled ❑ Bored ❑ Dug n Unknown Well Repair Requested Yes ❑ No Describe Calculated Design Flow, Commercial t Additional information may be required to determine design flow from certain facilities. This value will be determined during consultation with on-site staff. *Any room that will be intended for sleeping at the time of construction or for future consideration should be noted as a bedroom and counted on all applications.The number of bedrooms will be confirmed by rooms identified on house plans as a bedroom at the time of building permit issuance. This may prevent the need for septic system size increase in the future. j If structure is plumbed but no bedrooms, calculated design flow is required. **If No,a well permit must be issued with the Authorization to Construct. SYSTEM REDESIGN AND/OR RETRIP WILL INCUR AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) Improvement Permits issued as a result of this information are valid for 5 years or may be non-expiring under certain specified conditions.An Authorization to Construct issued by this department is valid for(5)five years from the date issued and is not transferable;Improvement Permits and Well Permits are transferrable. Permits may be revoked if the information on this application, site plans or intended use changes for the proposed facility. I have read this application and certify that the information provided herein is true,complete and correct. Authorized county and state officials are granted right of entry to conduct necessary inspections to determine compliance with applicable laws and rules. I understand that I am solely responsible for the proper identification and labeling of all property lines and corners and making the site accessible so that a complete site evaluation can be performed. Signature of Owner or Agent Date 6-/d Printed Name of Owner or Agent Peg /VT/n ID.t • T411911' 5- 7_016 - 072°7,‘Y ‘C`1 N A /Awl Gnjr l�J 441%4440, a �C yr p� N ' r a f%4/ AI'4 us �tly�%r 4 y I 5 arz 'S'et New xT 4 S r-lw 6z' a . N JQ_ tik k"-G G� u A ea Lu /g/ - yr • :t i . .«...,.a+ m......... .,a.. • .. ... ' .3fu..'. .. Catawba County Environmental Health rAr ) . .,,, X141 a i e , • ; , o u r 0 1 I) ! rl . . 0 r.as I �u ii 1 M o . ' ti sit • /r- 24. � :.. •: EEI 18 .14 .qe, .. /11111 41,1/440lys,. Vt. eck7itl) 3 0" filliNk‘ . c --. IVIN.4.4". :1/2Ski, O i� ' tfr te„ : Ikt, o III N oQ arstrill;.,, i . :0 , � C ±o b O P V34.00 e- /` •` .•,...� .. �,` 1 'i /I .CI Parcel: 366702880506, 3652 N ()LIVERS tin=300ft CROSS RD NEWTON, 28658 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 06/10/2016 Parcel Report Page 1 of 1 Parcel Report - Catawba County NC Parcel Information: Owner Information: Parcel ID: 366702880506 Owner: MCCASLIN MARILYN P Parcel Address: 3652 N OLIVERS CROSS RD Owner2: null City: NEWTON, 28658 Address: 3652 N OLIVER CROSS RD LRK(REID): 4907 Address2: null Deed Book/Page: 1847/1084 City: NEWTON Subdivision: null State/Zip: NC 28658-8299 Lots/Block: null/ null Last Sale: School Information: School District: COUNTY Plat Book/Page: Legal: null Elementary School: TUTTLE Calculated Acreage: 28.490 Middle School: MAIDEN Tax Map: 005 K 03040 High School: MAIDEN Township: CALDWELL School Map State Road it: 1858 Tax/Value Information: Tax Rates(pdf) Zoning Information: City Tax District: All in County Zoning District: COUNTY County Fire District: BANDYS Zoningl: R-40 Building(s) Value: $161,500 Zoning2: null Land Value: $137,100 Zoning3: null Assessed Total Value: $298,600 Zoning Overlay: Year Built/Remodeled: 1977/null Small Area: BALLS CREEK \s"*ki Current Tax Bill Split Zoning Districts: null/null • Zoning Agency Phone Numbers Miscellaneous: Firm Panel Date: 2007-09-05 Building Permits for this parcel. Firm Panel it: 3710366600J Building Details 2010 Census Block: 2000 Watershed: 2010 Census Tract: 011601 S Voter Precinct: P1 Agricultural District: Proximity Parcel Report Data Descriptions List all Owners Deed History Report Assessment Report 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 hold 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. r _ ©2016, Catawba County Government, North Carolina. All rights reserved. ,rte -rL\ �s� J c�u N O1 r er� 5 ��1 �� fyVP�• LoT e 2 http://gis.catawbacountync.gov/nomap/parcel_report.php?key=366702880506&typ=P 6/10/2016 I „y,A "- rail 0 Case// IMPV-05-2016-072965 CATAWBA COUNTY 0 .- 7 rc ,y Public Health Department �_:fi- - Subdivision C - �T '' Environmental Health Division . C.:/1. --�+ 9� I'INt/ 366702880506 �1r PO Box 389. 100-A Southwest Blvd,Newton.NC 2865R �' �� e LOT# OW, s. 3'G?!;"Y,X-1 all . O _moo ..q' NAME ON PERMIT: AMERICA'S HOME PLACE, 1206 GREENLAND DR, STATESVILLE NC 28677 Site Address: 3654 N ()LIVERS CROSS RD, NEWTON NC 28658 Property Size: Square Feet:40,946.40 :Acres:.94 Directions: Hwy 16 South, North Oliver Crossroad, on the Left past Mt. Ruhama Church Rd, Will be open field with mailbox &#sign for 3652. Improvement Permit Facility: Primary Residence - House Permit Category: New Septic Bedrooms 3 WATER SUPPLY: Private Well Basement? No Basement Plumbing? INITIAL SYSTEM M SPECIFICATIONS Permit Valid: Expires In Five Years: X_ No Expiration: Projected Daily Flow 360 g.p.d Proposed Wastewater System: 25% REDUCTION Type: I I IG -OTHER NON-CONY'FRENCH SYSTEMS Permit Conditions. *Do not grade, fill, or drive over any designated septic area. 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, one 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 appl icanrpropem•owner to insure that all Catawba County P lane ing/Zon ina 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 C art)l ina 'Laws and Rules far Sewage Treatment and Disposal Systems' (15A NCAC I8A.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 S'T'ATE AGENT APPROVAL DATE 05/28/2021 Permit Expiration Date: No grading or construction activity is allowed in areas designated for srstenr and repair without approval of Health Department. ehpei niit 06/01/2016 09:01 Page I of"a TAIPV- s- 1016 - o72%t5- 6sv No (; y Croft C r '41 dq • 23- - b2 go y,VLF- - -AZT S nlw 62. a aN J a N "I Area 1SJ /gi , 4S j • :'.� R 3.i..�!kf�''[4�J '4),-4n... � rRRtG >,_w''_ -z .. �.1.44,:i..+.,. .. _ .. ...- :..•fl.' _ ...gf};g ,..:tom r. _. .. 11[''. 1; h•; _.pj..ff'i Ili; OItI? • V, o � • `` \ Parcel: 366702880506, 3652 N OLIVERS 1in=60ft CROSS RD NEWTON, 28658 I his map/report product was prepared from the Catawba County,NC Geospatal information Services. Catawba County has made substantial efforts to ensure the accuracy of location and labeling information contained on this map or data on Ibis report.Catawba County promotes and recommends the independent verification of any data contained on this map/reixnl product by the user.The County of Catawba,its employees,agents,and personnel,disclaim,and shall not be held liable for any and all darnng es,loss or liabity,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 05131/2316 f that: Pfe.Prt .p.y .t' >..y� ,fit .aG`6�,�'•. . �' ..f. �r . ' ...'. <.� . DEPARTMENT OP QJVIRONNENC AND NATURAL RESOURCES Shoot_vJ__ DIVISION OF ENVIRONMENTAL HEALTH PROPERTY ID*; ON-SITE WASTEWATERSECIION COUNTY: SOIL/Sll'E EVALUATION • for ON-SITE WASTEWATER SYSTEM . OWNER: sr,' /1 d4r/,1 _,PPLICATlON DATE ADDRESS: 'S 6}yLI A/ 0/'Lair C.-.o i DATE EVALUATED: S-2r-/6 PROPOSED FACILITY: 5 ( A- _ PROPOSED DESIGN FLOW(.1949): )& _ PROPERTY SIiZ: LOCATION OF SITE PROPERTY RECORDED: WATER SUPPLY: airiva3c 0 Public U'We0 O Spring o Other EVALUATION METHOD: 0 Aug a Baring chif U Cur TYPE OF WASTEWATER CI 9cwagc 3 Industia1 Pmcrs, Q Mixed__.. __._._......._ c::::vv:.:d iici5ii-:i5iii5eii:: c e-ii-vici ::::c=rc::::a:—._-.. :.::.+v:::_::r.:- _:_c.: c_ec:::c :_:cr_ — _ 1' SO1LMok?litA CL E; 4:1.±11:-ER':.: ::'r'-' " " — . (1941) PROFILIsFA C0I3S - 940 -:. POart:E° DEPTH 5 U['C J I ..._ iXiVS($TENCFI WE ;$ ' 5 Ur S $Q nPCI'A' j f.. :alOP6%,G: {Esa : ... TUT' tE p1I,1 ... OC? GRt [t .DP.YTA: _t:iASS " CTASS 3fi1AAR.'3 6-16 b- b Tr/� --=— ----• ,,� / C Ll ivi -S k F- ,, !! W.'/l�/'-'.` 1 L s /� �6_�2 Cr's6ln Fr ,!V R.An�w 1-76- -a) 32-50 C-1t '6 r1K Er r1.r, _ PAal • e _ 6 .._ :. I.. Prr z S°/o t -27 c , ‘11 i=; >v rr 2 2744 `1 xj' sal rr ft ,42 4g E 3 • I /o -b L I - L of h `-1 C. s L k Fr .J --,0 3 26,-4o 1ti 1 }1 s- . 13 • 40_5`1 C4-rip "XItrsr Fr .r1 if I . j . 4 Daacunox Ha.sysrEM LF'AIR SYSTEN OTHER FAL r ORS(.1946): •Anibb]c Spat(.1955) ,)- J SITE CTASSIFIC;ATION(.1946): 1 fir Stem Ty (s) 7_ Cu Q.r9(o EVALUATED BY: JL,L %— cit.}, OTHERS)PRESENT: . • Site LIAR r—5 , ') • COMMENTS: