HomeMy WebLinkAboutIMPV-06-2016-073685.TIF ,q CATAWBA COUNTY Case# IMPV-06-2016-073685
Public Health Department Subdivision ERNEST M HOUSTON
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4 ,o tl Environmental Health Division PINIt 374407589492
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PO Box 389, 100-A Southwest Blvd,Nzwton.NC 28658 LOT# 23
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NAME ON PERMIT: JOHNNY BOWKLEY, 4887 RALEIGH ST, CONOVER NC 28613
Site Address: 1602 GLIMMERING SAND LN, CONOVER NC 28613
Property Size: Square Feet:22,651.20 Acres:0.52
Directions: Springs Rd / left Eckard Rd / left at twin brick Columns (Glimering Sands) 2nd lot on left
Owner/Authorized Representative Acknowledgement of Permit Receipt
1 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
requested i he application for service RBPR-03-2016-23392 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 o authorized representative I revie understand
of the permit issued, and wner further or understand that all ti applicable have regulatory wed requirements and specithe fied specific under the conditions th
Nor
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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: 06/20/2016 // /
N> Owner/Authorized Representative Signature add( X 1 611
Date 7-(--/S '
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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ehpemtil 06/20/2016 10:45 Page 3 of 3
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s�A CATAWBA COUNTY 0 �� � 0 Case ft IMPV-06-2016-073685
¢-A�G Public Health Department F �`ti .•' Subdivision ERNEST
374407589492
M HOUSTON
4 - i"' Environmental Health Division i'lla 37 PILAU 374407589492
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-r-5444° PO Box 389, 100-A Southwest Blvd,Newton.NC 28658 �r- LO 14 23
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NAME ON PERMIT: JOHNNY BOWKLEY, 4887 RALEIGH ST, CONOVER NC 28613
Site Address: 1602 GLIMMERING SAND LN, CONOVER NC 28613
Property Size: Square Feet: 22,651.20 Acres:0.52
Directions: Springs Rd / left Eckard Rd / left at twin brick Columns (Glimering Sands) 2nd lot on left
Improvement Permit
Facility:
Permit Category: Other Bedrooms 2
WATER SUPPLY: Community 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 **** 0
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/Zonine 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' (I5A NCAC ISA .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 06/20/2016
AUTHORIZED STATE AGENT APPROVAL DATE
Permit Expiration Date: 06/18/2021
No grading or construction activity is allowed in areas designated for system and repair without approval of the Health Department.
ehpermit 06/20/2016 10:45 Page 1 of 3
RBPR 03-2016-23392
1602 Glimmering Sands Ln, Conover
• 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 2 bedroom mobile home proposed. Will connect to existing septic system.
• Existing septic system was visually functioning 6/10/2016, 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.
• Surface water must be diverted away from septic system.
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DEPARTMENT OF HEALTH AND HUMAN SERVICES Sheet / of
DIVISION OF PUBLIC HEALTH,ENVIRONMENTAL HEALTH SECTION elf)( b 3- M/t, — 23 3`72 PROPERTY ID F:
ON-SITE WATER PROTECTION BRANCH COUNTY:Catawba
SOIL/SITE EVALUATION
for ON-SITE WASTEWATER SYSTEM
..(( (Complete all fields in full)
OWNER: —ie"l'-`l Sco— _ APPLICATION DATE
ADDRESS: DATE EVALUATED: 4
PROPOSED FACILITY: PROPOSED DESIGN FLOW(.1949): PROPERTY SIZE:
LOCATION OF SITE: /6o2- Cii -.u-. Stets LPN PROPERTY RECORDED:
WATER SUPPLY: ❑Private ❑Public .Well ❑ Spring ❑Other
EVALUATION METHOD: ❑Auger Boring U&Pit ❑Cut TYPE OF WASTEWATER: ;Vs Sewage ❑Industrial Process ❑ Mixed
• • • r
R - .SOIL MORPHOLOGY :- OTHER
. (gI941) . YROFIL FACTORS
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- LANDSCAPE HORIZON ._: - .,. .
-; ;PROFILE
,POSITION/. DEP'PH 1942 - - t
N^ SLOPE%- (ti\ . :1941. . - .1941- .- __ SOIL ::.; 1943:; :1956' '' .1944. 'CLASS - -
STRUCTURE/ CONSISTENCE/ WETNESS/" SOIL; SAPRO, AU S'I'R &LIAR.
. . TEXTURE MINERALOGY • COLOR',,. -t DEPTH F`CI ASS ;-HORIZ'-
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DESCRIPTION INITIAL SYSTEM REPAIR SYSTEM O'P7-IER FACTORS (.1946):
SITE CLASSIFICATION (.1948): it
Available Space(.1945) :431-4,3 e-5
System Type(s) Gq/� EVALUATED BY: /2^
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OTHER(S)PRESENT:
Site LIAR Q. i-C
COMMENTS:
Updated February 2014
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Parcel: 374407589492, 1602 GLIMMERING 1in=40ft
SAND LN CONOVER, 28613
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Copyright 2014 Catawba County NC
06/16/2016