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Home My WebLink AboutIMPV-06-2016-073373.TIF +,A • CATAWBA COUNTY Case# `f' e ,z Public Health Department Subdivision 4 ti Environmental Health Division PIN# 366802564758 y�` K PO Box 389, 100-A Southwest Blvd,Newton,NC 28658 LOT# NAME ON PERMIT: CONNIE HARRILL, 3563 S NC 16 HWY, MAIDEN NC 28650 Site Address: 3563 S NC 16 HWY, MAIDEN NC 28650 Property Size: Square Feet: 150,282.00 Acres:3.45 Directions: Take HWY 16 south, go thru 8 stop lights then about a mile after the 8th stop light. Blue house on hill on the right 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. / ` �.3 As the property owner or authorized representative, I have received the above referenced permit(s) as requested in h e application for service RBPR-05-2016-23809 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: 06/10/2016 Owner/Authorized Representative Signature 1. ,' , ,' ) e-. e-- Date t[' --a i - j Le 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 elipermit 06/13/2016 09:48 Page 3 of3 SBA CATAWBA COUNTY 0 •ti ' • 0 Case# IMPV-0 6-20 1 6-0 73 3 7 3 .Q' E.t.^; % Public Health Department c • • dt Subdivision NEI'—'",t ' Environmental Health Division , � • • • PINfl 366802564758 VC.T u PO Box 389, 100-A Southwest Blvd,Newton.NC 28658 ° ' O •% LOT# VC.Ty NAME ON PERMIT: CONNIE HARRILL, 3563 S NC 16 HWY, MAIDEN NC 28650 Site Address: 3563 S NC 16 HWY, MAIDEN NC 28650 Property Size: Square Feet: 150,282.00 Acres:3.45 Directions: Take HWY 16 south, go thru 8 stop lights then about a mile after the 8th stop light. Blue house on hill on the right Improvement Permit Facility: Primary Residence - House Permit Category: New Septic Bedrooms 5 WATER SUPPLY: Private Well Basement? No Basement Plumbing? INITIAL SYSTEM SPECIFICATIONS Permit Valid: Expires In Five Years: _X_ No Expiration: Projected Daily Flow 600 g.p.d Proposed Wastewater System: 25%'REDUCTION i 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 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 06/10/2016 AUTHORIZED STALE 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. chpermit 06/13/2016 09:48 Page 1 of 3 r ArN,-b -2016-o7V575' Catawba County Environrnenta Health (3149 3At, rs17 a r e S ti5 r \° tit �'y ♦ ys y Pc qr „iyC Parcel: 366802564758, 3563 S NC 16 HWY 1in=80ft MAIDEN, 28650 Thatnanmpurt product erne preplan from the Catawba Canty.NC feo"Ped lntoer.e.rServiaa Canine County ins erode su Ie4ats . _ 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 vodka/in awry data contained on this user.-The County of Costarebe,its employees.agents,and ... personnel,disclaim,and shall not be held liable for any and all damages,loss or liability.whether direct hid ect 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 0&1012016 DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES - S7rcd_of_ DIVISION OF ENVIRONMENTAL HEALTH PROPERTY ID 4: ONSIIE WASTEWATEaSECIUON COUNTY: SOILISI'1•E EVALUATION /' `/ for ON-SITE WASTEWATER SYSTEM OWNER:_ l on!s Tea C.it APPLICATION DATE ADDPPCS: \61, 5 A-C /F w DATE EVALUATED: 1-3-{1 PROPOSED FACILITY: S IS 12- PROPOSED DESIGN FLOW(.1949): -Afo PROPERTY S171 LOCATION OF SITE PROPERTY RECORDED: WATER SUPPLY; rptivate O Public WWeI 0 spring U Other EVALUATION 0. -Pit U Auger Baring q Pit U Cut TYPE OF WASTEWATER: YU- age 0 I�ratrial Process U hexed =Y __ __ .4:1..-1:v. :c:.�..... c. .t:ui:..n_v __ _____ . . ....____.r_.._..: .� __ _ i4 ........_. .. .. .. _ _ ..:.... .._...._... _.. . . ... .. .. .. . C_.......:...._—.. 'am:.:rvmv.v ...d.d6i.�..:...v.::.:an BliiE nN'dh.a.:v: �_.__._..._.L.._. .�::_�'�:�:Y:::s yy.� 'y �y�µyyJ�y�:�n _.......nuinriviin�_.........__1 �:u�]..�..__.......—.... __ �.a.�l\1CIll!II_Wi!.YV�_.:. ::-: S f _........_.� :j::j:::::::_ .. � '...:: i:: i:_-:::-::.=iii i:: ex_.� i^ WW1: " .:: •:•_':iii :::c::: :-:.::::•i-[:--r2.:- ::.:: __ _ :_;#__:•.: __ v _ee � :::c =_TiOIeC:_ �=::[FIE:E .EE°��'�eee::r..:-_:::SIPi'i[__:F:e:::::::�__e_:___P.'14�'rr._.vw_.._--__[ '5EE_3 „=E[!o c—e::v::=_:_' ' _-.-_d[AR�=s i�LW== -: ::...._1iNi=•=-�==_ :_`'€ ��:i.- _.=_:: :e_ �:��a o_ i; lY..k?- r :� aa: 4��:°i.='— - ...._...._. .. -):sis7 ., i' =POSTAONE �SE8Tf1' -' �t� U _'::_'._ �� M 6pTb- 5iPR9¢ Rte# CEASS : ciss : =Via: :-- ta -. °. . °_M '::_. ; csyn Axs C� �4t . a: a c::_ 1, 0 6 t ,.,L\ r- L SYR J-'z( L r6K tf✓ „ivy j� 1 24-42- C ts- j n R CC r t J So • -( 2 1 5 42--5-1 s7 Gr Fr r o- 6 . -L . wri It t P^ L- 6-2q c rhh P-4 sir/ 2 s c' 24-49 C -F :,i(.4, a Fr err?* if ri i -} rr L o -IL c1- wok . fr AL-11 , c rb h re Jr'1y 3 LS'l" 94-41 C_ r}h f- ripe y�.tr,w • , cc( ,a n r o4 L tr • L1ro(o l—I LL TI. k t ,-r Tr 2 4 tl--2"7 (. rb h f e ✓v pi, 7 27—4`Z 6 5-S h Fr Jr le 1/.r- 4�+{P L rd( ra ,.." ha 1 DESCRIPTION AWOL L SYSTEM RIP AIR sYSTEN OTHER FACTORS(.1946): Aan'1iblc Spada(.1945) J- SITE CLASSIFICATION(.1946): f f r��TYW(•I 2:34 is `Lfdli OT.HER(S)PRESENT:_ �r6Sk (71tbr Site LIAR i3 .ZS COMMEM'S: Catawba County Environmental Health �. • �. N.' s ACT sy ` ,Q O • — ---- • _ �J" " 5 • �l S • o 41. . • V 40 '. . • • • • 1027 .._1020 ....._... ._ Parcel: 366802564758, 3563 S NC 16 HWY 1in=80ft MAIDEN, 28650 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 06/1012016