HomeMy WebLinkAboutIMPV-06-2016-073520.TIF 1t1• CATAWBA COUNTY Case# '
.� % Public Health Department Subdivision CLEAR SPRINGS
d Environmental Health Division PIN 374519514340
j� PO Box 389, 100-A Southwest Blvd,Newton,NC 28658 LOT# 1
78.2 sM
NAME ON PERMIT: RODRIGO GARZA, 5366 SPRINGS RD, CONOVER NC 28613
Site Address: 5366 SPRINGS RD, CONOVER NC 28613
Property Size: Square Peel:24,393.60 Acres:0.56
Directions: 1-40 W to exit 126, McDonald Pwy &take right to Springs RD and Turn Right drive 2-3 miles -property on the
right after Lee Cline RD
, 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
eroperty described above.
As the property owner or authorized representative, I have received the above referenced permit(s) as
i requested in the application for service RBPR-05-2016-23902 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 • - I permitted.
Permit Issue Date: 06/15/2016
/
5Owner/Au orized •epresentative Signature IllOior
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
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chpe mit 06/15/2016 10:17 Page 3 of3
' Case#
,a• � CATAwBA COUNTY 0 � d } 0 IMPV-06-2016-073520
Public Health Department * Subdivision CLEAR SPRINGS 13 4 H Environmental Health Division PIN# 374519514340
\'"a�j PO Box 389, 100-A Southwest Blvd,Newton,NC 28658 { � '� LO"I'# 1
8
ra O •
or.
NAME ON PERMIT: RODRIGO GARZA, 5366 SPRINGS RD, CONOVER NC 28613
Site Address: 5366 SPRINGS RD, CONOVER NC 28613
Property Size: Square Feet:24,393.60 Acres:0.56
Directions: 1-40 W to exit 126, McDonald Pwy& take right to Springs RD and Turn Right drive 2-3 miles -property on the
right after Lee Cline RD
Improvement Permit
Facility: Primary Residence - mobile home
Permit Category: Expansion Bedrooms 3
WATER SUPPLY: Private Well
Basement? No Basement Plumbing?
INITIAL SYSTEM SPECIFICATIONS
Permit Valid: Expires In Five Years: _X_ No Expiration:
Projected Daily Flow 360 g.p.d
Proposed Wastewater System: 25% REDUCTION
Type: IIIG -OTHER NON-CONY TRENCH SYSTEMS
Permit Conditions: Existing system is a gravel bed. System to be expanded using 25% reduction trenches.
Recommend interceptor drain for repair system when needed.
REPAIR SYSTEM SPECIFICATIONS
Repair System Required? Required
Proposed Wastewater System: 25% REDUCTION
Type: IIIG -OTHER NON-CONY TRENCH SYSTEMS
PUMP *MAY BE* REQUIRED
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 I 8A .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.
Megen McBride _ 06/15/2016
AUTHORIZED STATE AGENT APPROVAL DATE
06/15/2021
Permit Expiration Date:
No grading or construction activity is allowed in areas designated for system and repair without approval of the Health Department.
ehpermit 06/15/2016 10:17 Page I of3
T, NC, Exrs\or■ + 41t hardonne '
RB? 05-)Ob-)390;
5366 Sprin9S M. Conoie(
400. -to 05e e)65-Vino‘ Sepl ic 401n14. SO to a5 i4 is 10 Do all ons, In --ctck and s(oaocaily sour
If ;1 is -Found -ko be, Q}herwist co promised install new ID6a�ailon
— a new lame ai4}r,boAion box, -ceea \\ed and new -krenc�es as %own.
�ns-I II ('�
* Se�-{j� syskerI rn0s-1 be, OA le0} 5D-F� -6om yells to Fl.-from proteriv lines, B-0. TI-orn
S{rucore5-inclVdin decks t Porcl1es. c areas. f /
Du no; d(;4Q, 131 , cv�, OC -1:1 \ oJec 9
Drive Way I
do 50 a5 sllowh. No Jehicvlar +Ace perai-�ek on SeiC sys{eM l rear area,
m.
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7°
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s 50. well
•
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a
zindonec� yo -new r^H
mvs{ be aI INA
�` hsIal` 17611. of ��x6 a5S \z well
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-ke,nProposed new 38R `s°
11e5• is Iheilt Hunt ]Jx3$ F
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5 nx, ,ToAK
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DEPAL7Marr OPENVIRONMENT AND NATURAL RESOURCES • Sheet_of—
DIVISION OF ENVIRONMENTAL HEALTH PROPERTY ID#:
ON-SITE WASTEWATERSECIION COUNTY:
SOIL/SITE EVALUATION
•
n /' for ON-SITE WASTEWATER SYSThM
OWNER: I Octri4O GQI2Q APPLICATION DATE kit, ►28Pk os- 16)390
ADDPESS J DATE EVALUATED: 6-7-1b
PROPOSED 3 BRMd PROPOSED DESIGN FLOW(.1949): 360 PROPERTY SIZE: 0,56 CVO
LOCATION OF •
SITE 5366 SpriIS Rd_ fAnover PROPERTY RECORDED:
WATER SUPPLY: S Private 9 Public ® Weil 0 Spring 0 Other
EVALUATION METHOD: 0 Auger Boring I� Pit U Cut
TYPE OFWASTEWAIFR: Sewuge 0 TndustrialPmcss Mixed
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DESCRIPTION INITIAL SYSTEM REPAIIt SYSTEM OTEER FACTORS(.1940:
Aiaimb,e spaee(.I�� PS SITE CLASSIFICATION(.1948)::
Sydem Typ•{c) 9raJel 1E EVALUATED BY: P ei\Atk �(t at
1 °THERM PRESENT: Shaw f�bPe
. . slte LTAR 0.3 0.3
' COMMEwTS:
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bosNny ravel 6ea 35x a1 = 735D' : 490°' }1at-ccnrn4on4
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7io° x 0.75= 53?.5 117g' aF a510 Rea:
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