HomeMy WebLinkAboutAUTH-06-2016-074072.TIF :1/43A CATAw8A COUNTY Case# AUTH-06-2016-074072
Public Health Department Subdivision WESTOVER WOODS
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Environmental Health Division 1'IN# 279116843195
\.,,.. it i PO Box 389. 100-A Southwest Blvd, Newton.NC 28658 LOT# 3
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NAME ON PERMIT: PAT DAVY, 5188 WRIGHT DR, HICKORY NC 28602
Site Address: 5188 WRIGHT DR, HICKORY NC 28602
Property Size: Square Feet: 19,602.00 Acres:0.45
Directions: 140 West to Hwy 321 South, Exit Hwy 127, Right onto Leslie Dr & go past BB&T bank, Left onot Wright Dr,
2nd house on the Right.
Owner/Authorized Representative Acknowledgement of Permit Receipt
�VI certify that I am the owner or authorized agent (owner's authorization required) representing the owner of the
• property described above.
.S, As the property owner or authorized representative, I have received the above referenced permit(s) as
requested in th• application for service EHPR-06-2016-24173 by the following method(s):
Received in Person
Facsimile Transmittal (Return form with signature required)
Electronic Image Transmittal/ E-mail (Return receipt required)
VAs 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 well permitted.
Permit Issue Date: 06/30/2016
-wner/A uthorized Representative Signatur-e --t_ ___ 7
Date G- 30-- zOI;,
6
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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ehpennit 06/30/2016 08:51 Page 4 of4
,,«A CATAWBA COUNTY p g_' 0 case# AUTH-06-2016-074072
:matt�., Public Health Department `7 -Ce Subdivision WESTOVER WOODS
< `i v�y /I Environmental Health Division
0:::. �: PIN# 279116843195
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cwb PO Box 389. 100-A Southwest Qh�d,Newton,NC 28658 _ i• r LO'I'N 3
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NAME ON PERMIT: PAT DAVY, 5188 WRIGHT DR, HICKORY NC 28602
Site Address: 5188 WRIGHT DR, HICKORY NC 28602
Property Size: Square Feet: 19,602.00 Acres:0.45
Directions: 140 West to Hwy 321 South, Exit Hwy 127, Right onto Leslie Dr & go past BB&T bank, Left onot Wright Dr,
2nd house on the Right.
Authorization to Construct Permit
Authorization to Construct Wastewater System (Required for Building Permit)
* See site plan and number of-additional attachments ( ).
Proposed Wastewater System: Wastewater Flow 360 g.p.d
Type: **** no system class assigned **** ()
Soil LTAR: g.p.d./ft2
Permit Category: Repairs
Type of Facility:
Basement? Basement Plumbing? Bedrooms: 3
Wastewater System Requirements
Tank Size: New 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: sq ft Total Length: ft Maximum Trench Depth in
Aggregate Depth in Trench Width ft
Minimum Soil Cover in Minimum Trench Separation ft on center
Number of Drain Lines
Distribution:
Pre Treatment: NONE
Additional Specifications: Septic Tank replacement only
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? System Class: Proposed System:
Distribution Type:: Soil LTAR: g.p.d./ft2
chpermil 06/30/2016 08:51 Page 1 of4
CATAWBA COUNTY Case# AUTH-06-2 0 1 6-0 74072
_7" Public Health Department Subdivision WESTOVER WOODS
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6 .��t Environmental Health Division PIN# 279116843195
4ri- PO Box 389. 100-A Southwest Blvd, Newton. NC 28658 LO'f# 3
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NAME ON PERMIT: PAT DAVY, 5188 WRIGHT DR, HICKORY NC 28602
Site Address: 5188 WRIGHT DR, HICKORY NC 28602
Property Size: Square Feet: 19,602.00 Acres:0.45
Directions: 140 West to Hwy 321 South, Exit Hwy 127, Right onto Leslie Dr & go past BB&T bank, Left onot Wright Dr,
2nd house on the Right.
The issuance of this permit by the Health Department does not guarantee the issuance or 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' (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 riven neriod of time
Steven Price 06/30/2016
AUTHORIZED STATE AGENT APPROVAL DATE
Permit Expiration Date: 06/30/2021
No grading or construction activity is allowed in areas designateel for system and repair without approval of the Health Department.
chprmiii 06/30/2016 08:51 Page 2 of4
EHPR 06-2016-24173
5188 Wright Dr, Hickory
• Permit for new 1,000 gallon septic tank only
• Old septic tank was found to have hole in lid during septic inspection for sale of home
and should be pumped out, crushed in place, and filled in.
• Septic tank must be 5 ft from building foundations and appurtenances; and out of right-
of-ways and easements.
• Do not cut, drive, fill,or grade over septic or repair areas.
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