HomeMy WebLinkAboutAUTH-02-2016-069558.TIF ^gA • CATAWBA COUNTY Case#
i �.�`L Public Health Department Subdivision
4 —) Environmental Health Division PIN# 376004823814
PO Box 389, 100-A Southwest Blvd,Newton,NC 28658 LOT#
;8.2
NAME ON PERMIT: JEFFREY GILLIAM, 3799 LOVE RD, CLAREMONT NC 28610
Site Address: 3783 LOVE RD, CLAREMONT NC 28610
Property Size: Square Feet:2,185,405.20 Acres:50.17
Directions: Hwy 10 S, Right on Balls Creek RD at caution light, Right on Love RD, property is approx. 1 1/2 miles on left.
Owner/Authorized Representative Acknowledgement of Permit Receipt
Alli
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-02-2016-23216 by the following method(s):
Received in Person
Facsimile Transmittal (Return form with signature required)
Electronic Image Transmittal/ E-mail (Return receipt required)
.1_, :" 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: 02/26/2016
Owner/Authorized Representative Signature 1c arc
Date 0- a.‘- /6
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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ehpermit 02/26/2016 09:55 Page 4 of 4
CATAWBA COUNTY o 1 a i,0 Vr• D Case# AUTH-02-20 1 6-0695 5 8
iT .j. •2, Public Health Department Subdivision
Q c. 4 Environmental Health Division PIN# 376004823814
�J PO Bax 389, 100-A Southwest Blvd,Newton,NC 28658 ,y� _ LOT#su _ . g
'0 . '- O .
NAME ON PERMIT: JEFFREY GILLIAM, 3799 LOVE RD, CLAREMONT NC 28610
Site Address: 3783 LOVE RD, CLAREMONT NC 28610
Property Size: Square Feet:2,185,405.20 Acres:50.17
Directions: Hwy 10 S, Right on Balls Creek RD at caution light, Right on Love RD, property is approx. 1 1/2 miles on left.
Authorization to Construct Permit
Authorization to Construct Wastewater System (Required for Building Permit)
* See site plan and number of additional attachments( ).
Proposed Wastewater System: 25% REDUCTION Wastewater Flow 240 d
9•P•
Type: IIIG -OTHER NON-CONY TRENCH SYSTEMS
Soil LTAR: •3 g.p.d./ft2
Permit Category: New Septic
Type of Facility: Primary Residence-
Basement? No Basement Plumbing?No Bedrooms: 2
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: 600 sq ft Total Length: 200 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 3
Distribution: Serial
Pre Treatment: NONE
Additional Specifications: Keep all parts of septic system and any future repair system minimum: 100'from any well, 10'from
property lines,5' from home(low side),50' from creek. Lines to be installed on contour. Do not grade
drive or fill over system or repair. Met with contractor Bryan Miller and dug pits on 2/25/16.
Overhead utility line to be removed per Mr.Miller. See attached survey of property for additional
detail if needed.
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
System Class: IIIG Proposed System: 25% REDUCTION Distribution Type:: Serial
Soil LTAR: •3 g.p.d.lft2
ehpermit 02/26/2016 09:49 Page 1 of 4
�$• • CATAWBA COUNTY Case# AUTH-02-2016-069558
,T .f..n�'G Public Health Department Subdivision
(J �� Environmental Health Division PIN# 376004823814
PO Box 389, 100-A Southwest Blvd,Newton,NC 28658 LOT#
Ig. SM
NAME ON PERMIT: JEFFREY GILLIAM, 3799 LOVE RD, CLAREMONT NC 28610
Site Address: 3783 LOVE RD, CLAREMONT NC 28610
Property Size: Square Feet:2,185,405.20 Acres:50.17
Directions: Hwy 10 S, Right on Balls Creek RD at caution light, Right on Love RD, property is approx. 1 1/2 miles on left.
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 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 forSewajie 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 viyen neriod of time.
Jason Boyd 02/26/2016
AUTHORIZED STATE AGENT APPROVAL DATE
Permit Expiration Date: 02/25/2021
No grading or construction activity is allowed in areas designated for system and repair without approval of the Health Department.
ehpermit 02/26/2016 09:49 Page 2 of 4
$A • CATAWBA COUNTY Permit# RBPR-2-1 6-232 1 6
I-� Public Health Department Name Jeffrey Gilliam
L Environmental Health Division Address 3783 Love Rd Claremont NC
„ ', "C PIN# 376004823814
PO Box 389, 100A Southwest Blvd,Newton NC 28658
1$ 2 (828)465-8270 Fax (828)465-8276 TDD(828)465-8200
L-� � — IL)
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Parcel: 376004823814, 3799 LOVE RD 1 in=400ft
CLAREMONT, 28610
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02/26/2016