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HomeMy WebLinkAboutIMPV-07-2016-074587.TIF 41,A M CATAWBA COUNTY Case/ I�C� .��,� Public Health Department Subdivision 4 H Environmental Health Division PIN// 269801274107 Ig42 PO Box 389. 100-A Southwest Blvd. Newton,NC 28658 LOT/ :. NAME ON PERMIT: TERRY LIDEY, 3719 RHONEY FARM RD, VALE, NC 28168 Site Address: 6021 W NC 10 HWY, HICKORY NC 28602 Property Size: Square Peet: 229,561.20 Acres:5.27 Directions: Hwy 10 W, just past Plateau Rd, property on left Owner/Authorized Representative Acknowledgement of Permit Receipt 1I certify that I am the owner or authorized agent (owner's authorization required) representing the owner of the property described above. 11^4 the pro erty owner or authorized representative, I have received the above referenced permit(s) as requested int e application for service RBPR-06-2016-24094 by the following method(s): Received in Person Facsimile Transmittal (Return form with signature required) Electronic Image Transmittal/E-mail (Return receipt required) •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: 07/15/2016 �+ 3Owner/Authorized Representative Signature /�r Date 1'1(6\\V 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 ehper mit 07/15/2016 09:15 CATARBA COUNTY Q- I ' � Ei Case# IMPV-07-2016-074587 ¢- ,G Public Health Department T • ` Cr Subdivision �. „�,� Environmental Health Division r' ti,. 1.� PIN# 269801274107 G `(\ '°l®d PO Box 389, 100-A Southwest Blvd,Newton.NC 28658 !A I 0 -_� '� I OT# /842 sy. r r eta 1 Y NAME ON PERMIT: TERRY LIDEY, 3719 RHONEY FARM RD, VALE, NC 28168 Site Address: 6021 W NC 10 HWY, HICKORY NC 28602 Property Size: Square Feet:229,561.20 Acres:5.27 Directions: Hwy 10 W, just past Plateau Rd, property on left Improvement Permit Facility: Primary Residence - modular home Permit Category: New Septic Bedrooms 3 WATER SUPPLY: Private Well Basement? No Basement Plumbing? No 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: IIIG - 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 Building 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 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 period of time. Megen McBride 07/15/2016 AUTHORIZED STATE AGENT APPROVAL DATE 07/15/2021 Permit Expiration Date: No grading or construction activity is allowed in areas designated for system and repair without approval of the Health Department. ehpcnnil 07/15/2016 09:16 1f, ( G, `,JaL POK-Ob-)O1h-)11091 *Tn4ol to=o5 ,a;. 'L Ser{-ic 4-ank. Rol ZOU-f of 2s2, f uir. ii)n ; 11- 75--CJ- fef c�k $ 1�.r� ( ; , lE. , i v[SScdt rc, -Egt� or, Lolz-1O0( * Ser lic Ell-le,,,4 ,^^''t',.:154 M:e,. /00-11 . -1-r-ori 1 e(I r._v; r` ;�;.� S, � , . -: rL'il < , t"va oraa IncluG4i„ot J�� ant)! pocckes I t-P, • -rre7 , pro er ` ',✓�e and e f'- iv � s, d o�� c-� r;.,r•,-, , ;��,� � � �,�f �C r,�,?,�;jw. I -r• 4' ;v rio* ante, a0-4e, cu , of T! (I ovCI „ :,C._ 0rrM5 i - P I 1 � p� R R j� t' Ir p fi i _ sep4 c Re9:�r Arrgt I j a5Yu Rdiiuciiory t 1 44 ' ! 75 x40` 1 1 I \{ { 1 le,e, [e(31- � _'`---• I '� j! V�e.11, iniusA l,e, Ct I n a a_ $ �l �,, F-4-1,x6 _Tonlc I I ' - (00 .ft,. crow cjJUr- s jc Ierns ���' { i ' 1- r0 0 eG ' j — )-5k1 crm�W skruc ie jndvcucto, prof s r Ox 5$. I ookuor x3o a ( 1 1 I pora4 e; year yp �s _ 6x6 N{gch!i .' 5t T-1. -riom p( 'ei j f PneS Go;gole I 1 1 I yet) t r t Du-,I C ( 05 1 11 yita,3TAy, I j I i weai t Nrea - 1 d I �I It�i I 1 I 4 I; Y 1 C T� 3'l.R�' t ' I \11 % v D,"-3ARTMt' T OF ENVIRONMENT AND NATURAL RESOURCES . Shed_of_, DIVISION OP ENVIRONMENTAL HEALTH PROPERTY ID 8: ON-SITE WASTEWATERSECTION COUNTY: SOIL/SITE EVALUATION -r L,� for ON-S1 It WASTEWATER SYSTEM OWNER: eIII I , e', APPLICATION DATE GUIV116 RBPR-06-Doi,-;vn9N ADDRESS: 1 I DATE EVALUATED: 7-11-1h PROPOSED FACILITY; a.B 9- H o.kse- PROPOSED DESIGN FLOW(.1949): ISO . PROPERTY SIZE: 5•al c efts LOCATION OF Sift: bo?I ■N NC. ID Hay, H(ckor, PROPERTY RECORDED: WA ER SUPPLY: iii Private 0 Public Q Well 0 Spring 0 Other EVALUATION METHOD: 0 Auger Boring Q Pit 0 C:rL TYPE OF WASTEWATER: © Scwngc 0 Industrial Procss 0 Vinod r • _.., .". :.$(`!ritmO$i'aOZOGy. ..........._.__. - -13lHsN:R� t:' :(3941)...... E:PRO ILER`ACEORS C9Q _.. _.. II-'I.11D+ HOST 194 -. . . .. 3942 .-- SOIL 1942 I 2nd 1 CAr'J°r - SON 194i ... . ilt-00 : e. :Posrnow: SDEPTR . STRtitAlltwf............£0NSISrENCEI t wt1?tPtSf SOIL S4P.RO BESTIt CLASS '.i. : ...Si;OPIi.Al ii-::::{IIitS......._:.....„TEXTURE .. ....- M1hERALOGY.....r' CO7:0Z ::[ DEP.3A.: =CLASS:._ ....liOF12:.:. .. fiilLii 0'r, Gr I. I -fr.“, cup 61-N slo;= Li . '4(,>}. sexc • PS 1 5�0 1 - - . , I I 0 -1 I.L._ 7-D4 ,:;- Cf ;,.:�. xr. (J� 2 ?11 -tl s,,- r.; -i 5' 9 - — Rocl_ 0� . 0.5 lai-lax deli i,4 tot+ lceo a$-3E J, { 0-1 aV L J 7-A9 sW CI- wi w,ti Ma;,5e5. PS 3 _ `I — 38 .LJ% SbIC- CL wl SAP CJ 4 DESCRIPTION I INTO-AL SYSTEM REPAIR SYSTEM OTHER FACTORS(J946): Available Sparc(.1945) I 11- SITE CLASSIFICATION(.1948):{ 1? EVALUATED BY: PtP61r'.R 1��`-', �I�lit-l'. System Typxs) 1Th—Lt ` l-a _ OiHCR(S)PRESENT: Site LTAR 0, j I 0. 3 COMMENTS: