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CONSTRUCTION For Office Use Only
s -r AUTHORIZATION 'CDP File Number 3 6 3 1 7
Catawba County Public Health Department County ID Number: EHPR-11-09-2532
13 Environmental Health Division Evaluated For: NEW
j Q ~ l
d ` s P.O Box 389, 100-A Southwest Blvd
Township: a0-1I-b!
Newton NC 28658 PERMIT VAL UNTIL
Phone: (828)-465-8270 Fax: (828) 465-8276 1 1 a 0/ a 0 1 4
Applicant: Robin Shaw ti //,Properly Owner;
Address: 5038 Steamer Place Address:
City: Granite Falls City:
State/Zip: NC 28630 State/Zip:
Phone 9: (828) 244-8354 Phone
Property Location & Site Information
Address/Road 9: Subdivision: Abernathy Park Phase: Lot: 60
5162 Orchard Park Dr.
Hickory NC 28602 Directions
Structure: SINGLE FAMILY
# of Bedrooms: 3
# of People.
'Watef Supply- COMMUNITY
System ect tca tons
Minimum Trench Depth:
Inches
*Site Classification'. PS Minimum Soil Cover.
Inches
. 3 6 0 Maximum T rench Depth: a 4
Inches
Soil Application Rate: 3 Maximum Soil Cover:
Inches
`System Classification/Description: 'Distribution Type: GRAVITY
TYPE III G. OTHER NON-CONV. TRENCH SYSTEMS
Septic Tank:
1 0 0 0 Gallons
'Proposed System: 25% REDUCTION 1-Piece: O Yes Q No
Nitrification Field 9 0 0 Pump Required: OYes )No Qlviay Be Required
Sq ft.
No. Drain Lines 4 Pump Tank: Gallons
1-Piece: C)Yes (:)No
Total Trench Length: 3 0 0
ft. GPfvl-vs-- ft. TDH
Trench Spacing: 9 Q Inches O.C.
Feet O.C. Dosing Volume: _ Gallons
Trench Width: _ 3 k Feet Inches
Aggregate Depth: Grease Trap. Gallons
1 a inches
Pre-Treatment: ONSF OTS-1 OTS-11
Septic Tank Installer Grade Level Required: (DI Oil OIII (.HIV
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CDP`Flle'NLimber 36317 County ID Number: EHPR-i 1-09-2532
❑ Open Pump System Sheet
Repair System Required:AYes ONo ONO, but has Available Space
System
Trench Spacing: Inches O.C.
fication: PS - Feet O.C.
Trench Width: 8Inches
w: 3 6 0 _ Feet
rDes
:
plication Rate: 3 Aggregate Depth inches
Soil Ap
'System Classification/Description: Minimum Trench Depth: Inches
TYPE III E. PPBPS GRAVITY DOSED SYSTEM Minimum Soil Cover:
Inches
Maximum Trench Depth:
}Proposed System: 50% REDUCTION Inches
Maximum Soil Cover:
Nitrification Field Inches
sq. ft.
No. Drain Lines 'Distribution Types GRAVITY
Total Trench Length: ft Pump Required: OYes (DNo May Be Required
Pre-Treatment: ONSF OTS-1 OTS-II
'Site Modifications
No grading or construction activity is allowed in areas designated for system and repair without approval of Health Department.
'Permit Conditions
The issuance of this permit by the Health Department in no way guarantees the issuance of other permits. The permit holder
is responsible for checking with appropriate governing bodies in meeting their requirements.
This Authorization for Wastewater system Construction shall be valid for a person equal to the period of validity of the Improvement Permit not
to exceed five years, and may be issued atthe sametime the improvement Permit issued (NCGS 130A-336(b)). If theinstallation has not been
completed during the period of validity ottee Construction Permit the information submitted In theappiication for a permit or Construction
Authorization is found to have been incorrect falsified or changed, or the site is altered, the permit or Construction Authorization shall became
invalid, and may be suspended or revoked (.1937(g)). The person owning or controlling the system shall be responsible for assuring compliance
with the laws, rules, and permit conditions regarding system location, installation, operation, maintenance, monitoring, reporting and repair
(1938(b)).
Applicant/Legal Reps. Signature Required? Yes ONO ~~11
Applicant/Legal Reps. Signature Date: l O~ 3 / (J y
,Issued By, 1896 - Lucas Sears Date of Issue: 1 1 / a 0 / a 0 0 9
Authorized State Agent: c7 Malfunction Log Oyes
Hand Drawing Olmport Drawing Total Time (HKMM)
**Site Plan/Drawing attached.**
};ours tainutes
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CDP File Number: 36317 County ID Number: EHPR-11-09-2532
Drawing Type: Construction Authorization Date: 1 1 / /
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