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Home My WebLink AboutAUTH-02-2016-069586.TIF iP CATAWBA COUNTY Case# ,• .0 ®L Public Health Department Subdivision Q F "1 Environmental Health Division PIN# 367804525501 ' ® ^: PO Box 389, 100-A Southwest Blvd,Newton,NC 28658 LOT# 2 /842 :. NAME ON PERMIT: JEFFERY GOODSON, 678 MOCK MILL RD, STATESVILLE NC 28677 Site Address: 4573 BURLWOOD PL, CATAWBA NC 28609 Property Size: Square Feet:24,393.60 Acres:0.56 Directions: Hwy 16 to Drum Rd/turn left on Buffalo Shoals Rd/right on Little Mtn Rd/right on Beverly Hills Dr/left on Burlwood PI/2nd trailer on right Owner/Authorized Representative Acknowledgement of Permit Receipt ( 671 certify that I am the owner or authorized agent(owner's authorization required) representing the owner of the property described above. iN C(17 As the property owner or authorized representative, I have received the above referenced permit(s) as requested in the application for service RBPR-12-2015-22934 by the following method(s): JReceived in Person Facsimile Transmittal (Return form with signature required) `/ Electronic Image Transmittal/ E-mail (Return receipt required) l l-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 1SA .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 ��i )Owner/Authorized Representative Signature /y Date 2 - GQ /g' 1C� 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 We want to hear from you. Please take a few moments to complete our customer service survey at: http://www.surveymonkey.com/s/EHCustomerService chpermit 02/29/2016 08:09 Page 3 of 3 4 CATAWBA COUNTY El -'t r 0 Case# AUTH-02-2016-069586 .t� )" Subdivision ,if f t Public Health Department ' �. 4 ` 4 environmental Flealth Division + �: PIN# 367804525501 o, `c 'S PO Bos 389, 100-A South rest Blvd,Newton,NC 28658 O'� LOT# 2 1g42 :v i } g _o NAME ON PERMIT: JEFFERY GOODSON, 678 MOCK MILL RD, STATESVILLE NC 28677 Site Address: 4573 BURLWOOD PL, CATAWBA NC 28609 Property Size: Square Feet:24,393.60 Acres:0.56 Directions: Hwy 16 to Drum Rd/turn left on Buffalo Shoals Rd/right on Little Mtn Rd/right on Beverly Hills Dr/left on Burlwood PI/2nd trailer on 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: 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 - House Basement? No 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: 678 sq ft Total Length: 226 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 5 Distribution: Serial Pre Treatment: NONE Additional Specifications: *Abandon the existing tank and install a new tank. *Disconnect the 100' existing gravel trench that is to close to the property line. *Install all parts of the septic system at least 50 ft from any well, 5 ft from the house, and 10 ft from the property lines. 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: IVA Proposed System: 50% REDUCTION Distribution Type:: LPP Soil LTAR: 0.3 g.p.d./ft2 PUMP REQUIRED ***** OPERATOR REQUIRED ehpennit 02/29/2016 08:10 Page 1 of,1 CATAWBA COUNTY Case# AUTI-1-02-2016-069586 1. 11qi Public Health Department Subdivision < im " Environmental Health Division PIN# 367804525501 \\ �, PO Box 389. 100-A Southwest Blvd,Newton,NC 28658 LOT# 2 /842 s. NAME ON PERMIT: JEFFERY GOODSON, 678 MOCK MILL RD, STATESVILLE NC 28677 Site Address: 4573 BURLWOOD PL, CATAWBA NC 28609 Property Size: Square Feet:24,393.60 Acres:0.56 Directions: Hwy 16 to Drum Rd/turn left on Buffalo Shoals Rd/right on Little Mtn Rd/right on Beverly Hills Dr/left on Burlwood PI/2nd trailer on right 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 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 neriod of time. Robbie Phelps 02/26/2016 AUTHORIZED STATE AGENT APPROVAL DArE 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. ehpennit 02/29/2016 08:10 Page 2 of 4 Catawba County Environmental Health A,,t 11 -Z -7o/6 - 069586 gLRLW o00 PL (147) 3v 730.00 75.25 w4 l,1 �,„tb alxhr/o 8 a 7� e w • ) n R f vY / f 42 h our J / . , l • (758 Z.<"-.- C C t 7 b/'/`O / OI, / 0 4 / S . 72s.0 f I NpgLe QR 737.80 Parcel: 367804525501, 4573 BURLWOOD PL 1in=40ft CATAWBA, 28609 This map/report product was prepared from the Catawba County,NC Geospatial Information Services. Catawba County has made substantial efforts to ensure the accuracy of location and labeling information contained on this map or data on this report.Catawba County promotes and recommends the independent verification of any data contained on this map/report product by the user.The County of Catawba,its employees,agents,and personnel,disclaim,and shall not be held liable for any and all damages,loss or liability,whether direct,indirect or consequential which arises or may arise from this map/report product or the use thereof by any person or entity. Copyright 2014 Catawba County NC 02/2612016