HomeMy WebLinkAboutIMPV-06-2016-074020.TIF ��A ' CATAWBA COUNTY Case#
.7 AR Public Health Department Subdivision
2 '^,�i "3 Environmental Health Division PIN# 361701270521
151 ^c •
PO Box 389. 100-A Southwest Blvd,Newton.NC 28658 LOT# PT 1-4
gq2 :y
NAME ON PERMIT: TERRELL SETZER, 1469 ZION CH RD, HICKORY NC 28601
Site Address: 4851 HICKORY LINCOLNTON HWY, LINCOLNTON NC 28092
Property Size: Square Feet: 769,269.60 Acres:17.66
Directions: Hwy 10 to Hickory Linc Hwy, turn left 3 miles on right
Owner/Authorized Representative Acknowledgement of Permit Receipt
4I 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-06-2016-24073 by the following method(s):
.Received in Person
Facsimile Transmittal (Return form with signature required)
Electronic Image Transmittal/ E-mail (Return receipt required)
-S As the property owner or authorized representative I have reviewed and understand the specific conditions
icof 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: 06/29/2016 /
el
Owner/Authorized Representative Signature /. / / -l - Nor
DateOq — /Er 4,
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
We want to hear from you. Please take a few moments to complete our customer service survey at:
http://www.surveymonkey.com/s/EHCustomerservice
elipennit 06/29/2016 08:48 Page 3 o13
yv,A r, CATAWBA COUNTY 0 0;1_4 0 Case# IMPV-06-2016-074020
SOL Public Health Department T 41): Subdivision
4 � �H Environmental Health Division �� PIN# 361701270521
sfm PO Box 389. 100-A Southwest Blvd.Newton. NC 28658 i• ,{{t LOT# PT 1-4
/842 ,u r. ? J-11:2re'. T
. 7� S ff Y
0 r� .
NAME ON PERMIT: TERRELL SETZER, 1469 ZION CH RD, HICKORY NC 28601
Site Address: 4851 HICKORY LINCOLNTON HWY, LINCOLNTON NC 28092
Property Size: Square Feet: 769,269.60 Acres:17.66
Directions: Hwy 10 to Hickory Linc Hwy, turn left 3 miles on right
Improvement Permit
Facility: Primary Residence - house
Permit Category: New Septic Bedrooms 3
WATER SUPPLY: Private Well
Basement? Yes Basement Plumbing? Yes
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: 11IG -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 13uilding 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 Somme 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.
Mogen McBride 06/29/2016
AUTHORIZED STATE AGENT APPROVAL DATE
Permit Expiration Date:
06/29/2021
No grading or construction activity is allowed in areas designated for system and repair without approval of the Health Department.
ehpemut 06/29/2016 08:48 Page I of 3
■
ZP,AG P--BP-01 -ao16-Dito73 L
4�5I Hicr col ((n}pY1 r1WY,Lncol4ltn
kInskalk l000ktillon ce&c -1-ank and 3o0{}. of 257o 12educ{iod ; 3- 1o0-fa. -krehcAes.
1`ns�all drwn- eld Oh con-tour_
See}ic system (►\v4 k loo-q.-from wek\s, lo-A- from Proper \Ines, 5f Corn
Stmt{ ieS , including decks i porckes, 15-1. -from basemen-1 cvis, and oo{- of
any r;5Lt_ o(- of easeniet't-l.
+ po no-1 dri4e, 55radR, coo, °` fill o'Jer Septic areas.
Fina rAd.c mysk shed Soc•Face U.laier ocf' and away -croM System.
* }{ouceu coAned to exis-tin3 well.
w
•130'
Tani(
1-10.
J.io.
proposed
3Bedroom —
Ho&.72177
^No'
ri
Ls
7
5 0
I
it
,D1111n9
' u
357'
ft,*01-j LirlcolnFon H1 1- 100
ik
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES Sheet_'V_
ES
DIVLSION OF ENVIRONMENTAL HEALTH PROPERTY ID#:
ON-SITE WASTEWATER SECTION COUNTY:
SOIL/S11•E EVALUATION
-{' I _l for ON-SITE WASTEWATER Svr D
OWNER: lei'rdI �etze' APPLICATION DATE b 9 16 PR Ob";0J�-24073
ADDRESS: DATE EVALUATED: 017316
PROPOSED FACILITY: 3 RRQqPOSED DESIGN FLOW(.1949): 3 GO
. PROPERTY SIZE: 17.6L aria-
LOCATION OF SITE:95I 41( nldr for }1 W L4r fOltiidn PROPERTY RECORDED:
WATER SUPPLY: V Private 0 Public V Well Spring [1 other
EVALUATION METHOD: 0 Auger Boring $ Pit 0 Cut
TYPE OF WASTEWAIEEL• Sewage U Indusmal P,ocrss 0 Mixed
' : ¢ :� :'.' ' i '5iiic a:-- -
• -_ - : -....,. .!; ;_,_,,._,:-., , -:.= �i_ 'E= = 'i-i;� � ;- _:a::d:=- ^ : ' i:at=ase-' -`�_ . : ` _ : : ii 23DFY LDl5 _ __ i' `,=.. .. .:29 3t-::_ : _ _ . - -: . :::
2£.1 r": _k�?�...SE2F::6c-....._'iH? ..._:_,....:�r.....::::. .:.:::._:=:Jgt::._..—.,:v:: 1.14,-•' s=:1:1:17,41'
5 4I_-; �-;j 36j' ;[#Sti, .iv.-_..._....._.._.
cs_:.=POSTiIOFC .DEP'Cfi . . 5T�(tlCtCllTtlf.i':i ": irt3M�55tEItiCF3 W�It{ SSi- SRI1- 5AriR0 Bt�Tk Cd:AS$
surk : {m). ._ :;.-;_m' n...-nt;oGr coto� Deem ass. IU3>tgc s�rnx
010 5r L- -iris. sue.._.._
L 10-53 c L 0 • {f,SS.Sof 53 — R
1 g7e Rcck ; .�sims 04 `U — 0.3
l (<509.)
d
6 - .9t t, .
0- fr.ss,Setp
G-31 - shk Cl- -Er.SS,,set
2 31-45 We-c ' •; ie.<, cexe _`15 —
0,3
(}-7 9r L -r,55, SCxp
1-21 sbk GL -0,SS .sexp y PS
3 )�-y� Sbk L- -F(,(S. P -- L) _ _
0.3
0-33 SbW U.+Pt+ 1 fr,ss, Se/
33-48 _ zhlz- L tr:ss :S (r N8 — 1 P
4 0.3
•
1
DESCRIIZION INITIAL SYSTEM "Pia Sli TEM OTHER FACTORS(.1946):
bauble Spas(.1945) PS SITE CLASSIFICATION(.1948):
bauble
sytt.inTypxo X12 11E9 EVALUATED S MckMLEnE Qek
• • Site LIAR D.3 0.3
COMMENTS:
O
-80/
-75' Io
O >
! V6pese&
VOMSC., 1 LS
elf 33o'
Hcertial Lincaih+or tlwy