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Home My WebLink AboutAUTH-03-2016-070328.TIF 4y CATAWBA COUNTY Case#2 AUTH-03-2016-070328•1 G � � Public Health Department Subdivision SHAMROCK PARK MAP 3 6 ''ij , .�r � Environmental Health Division PIN# 375119624271 PO Box 389, 100-A Southwest Blvd,Newton,NC 28658 LOT# 6 & 7 &ADJ 1g.2 sw NAME ON PERMIT: PAUL GAITHER, 2637 TIFFANY ST, CONOVER NC 28613 Site Address: 2637 TIFFANY ST, CONOVER NC 28613 Property Size: Square Feet: 55,321.20 Acres:1.27 Directions: Keistler Dairy Road, into Shamrock Park, Left onto Tiffany St, Last lot on the Right Owner/Authorized Representative Acknowledgement of Permit Receipt 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 pennit(s) as requested in the application for service EHPR-02-2016-23295 by the following method(s): Received in Person .....1 Facsimile Transmittal (Return form with signature required) Electronic Image Transmittal/E-mail (Return receipt required) .,j As the property owner or authorized representative I have reviewed and understand the specific conditions I 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: 03/22/2016 ' "----., Owner/Authorized Representative Signature Date Documentation of Permit(s) Transmittal (permit transmitted by electronic or other means) t r Permit transm tted by c \/,��I 1 1\ (name ofperssoon sending permit) Signature I I IA "�t Mu 9 Date/Time)/??/f L'C q.i�0 Method: Fax Email US Mail Other Owner's rest to send by the above indicated method of transmittal in lieu of signature `-W-z We want to hear from you. Please take a few moments to complete our customer service survey at: http://www.surveymonkey.com/s/EHCustomerService ehpermit 03/22/2016 14:36 Page 4 of4 /�vA CATAWBA COUNTY D i j 0 Case# AUTH-03-20 1 6-07 03 2 8 /Q Public Health Department r "�S' g' Subdivision SHAMROCK PARK MAP 3 4(...-A-f Y Environmental Health Division �� l• PING 375119624271 h+ PO Box 389. 100-A Southwest Blvd,Newton, NC 28658 " LOT# 6 & 7 &ADJ R42/sx IL r NAME ON PERMIT: PAUL GAITHER, 2637 TIFFANY ST, CONOVER NC 28613 Site Address: 2637 TIFFANY ST, CONOVER NC 28613 Property Size: Square Feet:55,321.20 Acres:1.27 Directions: Keistler Dairy Road, into Shamrock Park, Left onto Tiffany St, Last lot on the 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: 111G - OTHER NON-CONY TRENCH SYSTEMS Soil LTAR: 0.35 g.p,d.lft2 Permit Category: Repairs Type of Facility: Primary Residence - Basement? 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: 1,032 sq ft Total Length: 258 ft Maximum Trench Depth 30 in Aggregate Depth in Trench Width 3 ft Minimum Soil Cover 12 in Minimum Trench Separation g ft on center Number of Drain Lines 5 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: Proposed System: Distribution Type:: Soil LTAR: g.p.d./ft2 ehperinit 03/22/2016 14:36 Page I of4 �g • CATAWBA COUNTY Case# AUTH-03-2016-070328 �L Public Health Department Subdivision SHAMROCK PARK MAP 3 � : *P9 'c; Environmental Health Division PIN 375119624271 xaf- PO Box 389, 100-A Southwest Blvd,Newton,NC 28658 LOT# 6 & 7 &ADJ Ni 42 ,. NAME ON PERMIT: PAUL GAITHER, 2637 TIFFANY ST, CONOVER NC 28613 Site Address: 2637 TIFFANY ST, CONOVER NC 28613 Property Size: Square Feet:55,321.20 Acres:1.27 Directions: Keistler Dairy Road, into Shamrock Park, Left onto Tiffany St, Last lot on the 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 'Lm,'s and Rules for Sewaee Treatment and Disposal Systems' (ISA NCAC ISA .1900). Neither Catawba County nor the Environmental Ilealth Specialist warrants that the septic tank system will continue to function satisfactorily for any riven period of time. Steven Price 03/22/2016 AUTHORIZED STATE AGENT APPROVAL DATE Permit Expiration Date: 03/22/2021 No grading or construction activity is allowed in areas designated for system and repair without approval of the Health Department. ehpermit 03/22/2016 14:36 Page 2 of4 &lie oa- z.,/6- 23-Zft 2(37 774, 4. 9- cno ✓lob C 4 ear c cil or ejc<cle o v st ettcS S_/k� S'}.f MuS A' At �p r!- {Y++ pN�e'x`1 ins ,� ��- M1vti, IA, 8, / r .�.,� c�:1-C-t an a. 0„ off' ritf- 0E-m..11..75 o..d ccs-e..-,c.i-s. S t: s ja:C 0 o-. La aM1-1--owi (D 2.14, U yb As 70', & 7Y, YS/ A ✓meJ So kc 4-`-IL i s Ce6 v,- - u P " of > id serh-c. 71r--. P-�„ }-o b e So d -- d K s A b k,c,c S II ye l y i-v ocS ide.,eaJ 4.4 CI 4:ti e.J(1 m j--' /k i.,s, I • S letrc m✓ in e ra,‘ eGtf I 4..71- or /k o' 237 , Path � rY. I 6 I l69 it 1 m�m cr.,Cx4 , Sr Rw 1a,y 11 IZo fla j (20' t y ,. � .,m' . S.j rri': :, i v�R e r v. '. ,'": 'Y •,,,�. ' u. ��s-- .. x .L �". � � .- 1" .K ' LsS' i k'�. �i... us+� :Tti�"}rdMb I<}}i`.#w -wr: km'.;:4;5 '...'..>0 ;.. DEPARTMENT OF HEALTH AND HUMAN SERVICES e(fre2 OZ- /It- 2.32-gr Sheet of___ . DIVISION OF PUBLIC HEALTH,ENVIRONMENTAL HEAL'T'H SECTION PROPERTY ID#: ON-SITE WATER PROTECTION BRANCH COUNTY: SOIL/SITE EVALUATION for ON-SITE WASTEWATER SYSTEM /� /� (Complete all fields in full) OWNER: 7 41 4( C<c k"� _ APPLICATION DATE ADDRESS: 2637 j'f4,-.-1 5 mow DATE EVALUATED: 3/„ PROPOSED FACILITY: PROPOSED DESIGN,FLOW(.1949): 36o PROPERTY SIZE: LOCATION OF SITE: PROPERTY RECORDED: WATER SUPPLY: ❑Private tgPublic ❑Well ❑Spring ❑Other EVALUATION METHOD: ❑Aup�er Boring aPit ❑Cut TYPE OF WASTEWATER: 'Sewage ❑Industrial Process '❑Mixed • • • • P R SOIL MORPHOLOGY OTHER 0 P (.1941) PROFILE FACTORS • .1940 L LANDSCAPE HORIZON • POSITION/ DEPTH 1942 PROFILE # SLOPE% (w•) .1941 .1941 SOIL .1943 .1956 .1944 CLASS STRUC'T'URE/ CONSISTENCE, WETNESS/ SOIL SAPRO RESTR &LTAR TEXTURE MINERALOGY COLOR DEPTH CLASS HORIZ O-37- 561c, C _ T� Sc LS 3z-,3 ' 56k c r_. fee sr' Pi - .53 '1/4 Aid- o. 3 r of I 0 - 3o S4 c F2 SE 1.-5 3o-53 •-sb( Ct. /-,cj't' /✓ s13 p4- ✓ r (95 2 /oZ - - 0, 3� 3 4 DESCRIPTION INITIN.SYSTEM REPAIR SYSTEM OTHER FACTORS(.1946): /5 Available Space(.1945) 95 ,� _S s rcr r SITE CLASSIFICATION(.1948): n EVALUA'T'ED BY: 5h, & System Type(s) -t-ft 4g. OTHER(S)PRESENT: Site LIAR D, 35- COMMENTS: '1lnSr'klffa aslSatk7S,7s�i:}•tt Ar`Y�'r.rrHW4.a ' utf.tb:?iYL.7iEOa.9n:d.nsC'Afii�>:v.;4 pwctww*s.wxma`nww.a ..v..•. ... , .,-. . . ,.-..-,.,,_..a ..u.,,..