HomeMy WebLinkAboutAUTH-03-2016-070142.TIF Age\ . CATAWBA COUNTY Case# AUTH-03-2016-070142
.T if Public Health Department Subdivision
Q 0 'ac Environmental Health Division
1, PIN# 374309159477•°'i`* PO Box 389, 100-A Southwest Blvd,Newton,NC 28658 LOT# 2
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NAME ON PERMIT: JIMMY L. & SHIRLEY C. MOORE, 36 SULLIVAN POINT LN, TAYLORSVILLE NC
28681
Site Address: 4274 JA YOUNT FARM RD, CONOVER NC 28613
Property Size: Square Feet:74,052.00 Acres:1.7000
Directions: County Home Rd to JA Yount RD
�i� Owner/Authorized Representative Acknowledgement of Permit Receipt
0 n/ I certify that I am the owner or authorized agent(owner's authorization required) representing the owner of the
property described above.
,J. 9/YAs the property owner or authorized representative, I have received the above referenced permit(s) as
I requested in the application for service RBPR-03-2016-23298 by the following method(s):
_J/Received in Person
Facsimile Transmittal (Return form with signature required)
ms�ss//
Electronic Image Transmittal/ E-mail (Return receipt required)
7/X7-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: 03/17/2016
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��Qwner/Authorized>>R//epresentative Signature , a,Date /7' -/b
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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ehpennit 03/17/2016 11:25 Page 4 of 4
4 • CATAWBA COUNTY 0 • -. •f Ei Case# AUTH-03-2016-070142
(sift 2, Public Health Department T; r Subdivision
Q _ - q Y Environmental health Division f+ • .. 4; d. PIN# 374309159477
' - PO Box 389, 100-A Southwest Blvd,Newton, NC 28658 t 0 "} . LOIN 2
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NAME ON PERMIT: JIMMY L. & SHIRLEY C. MOORE, 36 SULLIVAN POINT LN, TAYLORSVILLE NC
28681
Site Address: 4274 JAYOUNT FARM RD, CONOVER NC 28613
Property Size: Square Feet: 74,052.00 Acres:1.7000
Directions: County Home Rd to JA Yount RD
Authorization to Construct Permit
Authorization to Construct Wastewater System (Required for Building Permit1
* See site plan and number of additional attachments ( 1.
Proposed Wastewater System: 25% REDUCTION Wastewater Flow 360 g.p.d
Type: IIIG-OTHER NON-CONY TRENCH SYSTEMS
Soil LIAR: 0.3 g.p.d./ft2
Permit Category: New Septic
Type of Facility: Primary Residence -
Basement? No Basement Plumbing?No 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: 1,200 sq ft Total Length: 300 ft Maximum Trench Depth 30 in
Aggregate Depth in Trench Width 3 ft
Minimum Soil Cover 6 in Minimum Trench Separation g ft on center
Number of Drain Lines 3
Distribution: Serial
Pre Treatment: NONE
Additional Specifications:
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:: Pressure Manifold
Soil LTAR: 0.3 g.p.d.lft2
PUMP REQUIRED
ehpennit 03/17/2016 11:25 Page 1 of4
p8 CATAWBA COUNTY Case# AUTH-03-2016-070142
Public Health Department Subdivision
d •t Environmental Health Division PIN/I 374309159477
I'M� PO Box 389, 100-A Southwest Blvd,Newton,NC 28658 LOT# 2
NAME ON PERMIT: JIMMY L. & SHIRLEY C. MOORE, 36 SULLIVAN POINT LN, TAYLORSVILLE NC
28681
Site Address: 4274 JAYOUNT FARM RD, CONOVER NC 28613
Property Size: Square Feet:74,052.00 Acres:1.7000
Directions: County Home Rd to JA Yount RD
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
Steven Price 03/17/2016
AUTHORIZED STATE AGENT APPROVAL DATE
Permit Expiration Date: 03/17/2021
No grading or construction activity is allowed in areas designated for system and repair without approval of the Health Department.
ehpennit 03/17/2016 11:25 Page 2 of
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