HomeMy WebLinkAboutAUTH-06-2016-073521.TIF /gip' CATAWBA COUNTY Case 4
r. ki y_ Public Health Department Subdivision CLEAR SPRINGS
d —, s: ''- Environmental Health Division PIN# 374519514340
M%�) PO Box 389. 100-A Southwest Blvd,Newton,NC 28658 LOT# 1
18342 eM
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
, Owner/Authorized Representative Acknowledgement of Permit Receipt
1� ' I certify that I am the owner or authorized agent (owner's authorization required) representing the owner of the
.roperty described above.
As the property owner or authorized representative, I have received the above referenced permit(s) as
o 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 I8A .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 , - 1 permitted.
Permit Issue Date: 06/15/2016
5Owner/Au orized 'epresentative Signature Z/
Sr
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
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ehpermia 06/15/2016 10:17 Page 3 of 3
��ts• CATAWBA COUNTY 0. 4o1 r f 0 Case# AUTH-06-2016-073521
:.., ° �f Public Health Department r€ 'tilt Subdivision CLEAR SPRINGS
Q .. _
< __., `fie Environmental 1{ealth Division - • 4. PIN# CLEAR51 SPRINGS`'-um `/ PO Box 389, 100-A Southwest Blvd,Newton,NC 28658 .0�_ .. '� LOT# 3174519514340
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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
Authorization to Construct Permit
Authorization to Construct Wastewater System (Required for Building Permit)
* See site plan and number of additional attachments ( ).
Proposed Wastewater System: 25% REDUCTION Wastewater Flow 360 g.p.d
Type: I1IG -OTHER NON-CON V TRENCH SYSTEMS
Soil LTAR: 0.3 g.p.d./ft2
Permit Category: Expansion
Type of Facility: Primary Residence - mobile home
Basement? No Basement Plumbing? Bedrooms: 3
Wastewater System Requirements
Tank Size: Existing Tank Unknown Size Pump Tank gal Grease Trap _gal
Dosing Volume gal Pump Specs: GPM @ TDH
Pressure Head ft Draw Down in
Drainfield: Total Area: 528 sq ft Total Length: 176 ft Maximum Trench Depth 36 in
Aggregate Depth in Trench Width 3 ft
Minimum Soil Cover 12 in Minimum Trench Separation 9 ft on center
Number of Drain Lines 4
Distribution: Distribution Box
Pre Treatment: NONE
Additional Specifications:
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? Required System Class: IIIG Proposed System: 25% REDUCTION
Distribution Type:: Serial Soil LTAR: - 0.3 g.p.d.ift2
PUMP *MAY BE* REQUIRED
civet iii 06/15/2016 10:17 Page I of4
rq• • CATAWBA COUNTY Case# AUTH-06-2016-073521
r ^ �G Public Health Department Subdivision CLEAR SPRINGS
y4 ,L 1 Environmental Health Division PIN# 374519514340
`4h�/ PO Box 389, 100-A Southwest Blvd,Newton,NC 28658 LOT# 1
"J fl
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
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 18A.1900). Neither Catawba County nor the Environmental Health Specialist warrants that the septic tank system will
continue to function satisfactorily for any viven neriod of time.
Megen McBride 06/15/2016
AUTHORIZED STATE AGENT APPROVAL DATE
Permit Expiration Date: 06/15/2021
No grading or construction activity is allowed in areas designated for system and repair without approval of the Health Department.
ehpemiit 06/I5/2016 10:17 Page 2 of 4
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