HomeMy WebLinkAboutAUTH-06-2016-073786.TIF ,�iA CATAW BA COUNTY Case#
� ,� Public I lcalth Department Subdivision SPRINGDALE
< H Environmental Health Division PIN# 360801499601
�.® Y PO Box 389. 100-A Southwest Blvd. Newton. NC 28658 LOT# 27
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NAME ON PERMIT: DAVID STUMBO, 4534 ATHENS DRIVE, NEWTON NC 28658
Site Address: 4535 ATHENS DR, NEWTON NC 28658
Property Size: Square Feet: 18,295.20 Acres:0.42
Directions: Turn Right on 70, turn on Northwest Blvd, turn on NC 10, W C Street, turn on Springdale DR, turn on Athens
DR
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.
As the property owner or authorized representative, I have received the above referenced permit(s) as
requested in the application for service RBPR-06-2016-24084 by the following method(s):
Received in Person
Facsimile Transmittal (Return form with signature required)
Electronic Image Transmittal/ E-mail (Return receipt required)
X _ 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: 06/22/2016
Owner/Authorized Representative Signature
� Date
Documentation of Permit(s) Transmittal
(permit transmitted by electronic or other means)
Permit transmitted sy 16 ke ,e rat1 (name of person se cling permit)
Signature 111 LitA. I Date/Time 2:y6
Method: Fax , Cmail US Mail Other
Owner's request to send by t to above indicated method of transmittal in lieu of signature
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chpemiit 06/22/2016 08:09 Page 3 of 3
nA CATAWBA COUNTY 0 NA.All.W.:1;0 Case# AUTH-06-2016-073786
T G Public Health Department
`s � � Subdivision SPRINGDALE•_, r• PIN#
4-
124�1I ,r Environmental Health Division 1+' L+a. 360801499601
\"°4l PO I3oz 389, 100-A Southrrest Blvd, Newton,NC 28658 co . • r_ i it LOT# 27
/gq2 :� •R. fry":Elite:
,
NAME ON PERMIT: DAVID STUMBO, 4534 ATHENS DRIVE, NEWTON NC 28658
Site Address: 4535 ATHENS DR, NEWTON NC 28658
Property Size: Square Feet: 18,295.20 Acres:0.42
Directions: Turn Right on 70, turn on Northwest Blvd, turn on NC 10, W C Street, turn on Springdale DR, turn on Athens
DR
Authorization to Construct Permit
Authorization to Construct Wastewater System (Required for Building Permit'
* See site plan and nunber of additional attachments( ).
Proposed Wastewater System: 25% REDUCTION Wastewater Flow 360 g.p.d
Type: IIIG - OTHER NON-CONY 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 1,000 gal Pump Tank gal Grease Trap gal
Dosing Volume gal Pump Specs: GPM @ TDH
Pressure Head ft Draw Down in
Drainfield: Total Area: 420 sq ft Total Length: 140 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 2
Distribution: Serial
Pre Treatment: NONE
Additional Specifications: Existing system is gravel trenches. System is to be expanded with 25% reduction.
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: NA Proposed System: 50% REDUCTION
Distribution Type:: LPP Soil LTAR: 0.3 g.p.d./ft2
PUMP REQUIRED ***** OPERATOR REQUIRED
ehpermit 06/22/2016 08:10 Page 1 of4
yrA CATAWBA COUNTY Case# AUTH-06-2016-073786
,� �
ti1 , Public Health Department Subdivision SPRINGDALE
4��Y H Environmental Health Division PIN# 360801499601
'eta PO Box 389. 100-A Southwest Blvd,Newton. NC 28658 LO'f# 27
fa./ ,.
NAME ON PERMIT: DAVID STUMBO, 4534 ATHENS DRIVE, NEWTON NC 28658
Site Address: 4535 ATHENS DR, NEWTON NC 28658
Property Size: Square Feet: 18,295.20 Acres:0.42
Directions: Turn Right on 70, turn on Northwest Blvd, turn on NC 10, W C Street, turn on Springdale DR, turn on Athens
DR
The issuance or 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 lithe 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 Given period of time.
Megen McBride 06/22/2016
AUTHORIZED STATE AGENT APPROVAL DATE
Permit Expiration Date: 06/22/2021
No grading or construction activity is allowed in areas designated for system and repair without approval of the Health Department.
ehpemtit 06/22/2016 08:10 Page 2 of 4
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