HomeMy WebLinkAboutAUTH-03-2016-070384.TIF -111-1 413 • CATAWBA COUNTY Case#
ET rit�G Public Health Department Subdivision COUNTRY CLUB HEIGHT
t 372014330842
G 'lRrE�l ,�� Environmental Health Division PIN#
Ig 4 PO Box 389. 100-A Southwest Blvd, Newton, NC 28658 LOT# 9-17
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NAME ON PERMIT: ANA FILIP, 2087 MOSS FARM RD, HICKORY 28602
Site Address: 1067 SPRUCEWOOD LN, NEWTON NC 28658
Property Size: Square Feet: 33,105.60 Acres0.76
Directions: 10 E / right Startown RD / left Sandy Ford Rd/ right on Sprucewood Ln
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.
rAs the property owner or authorized representative. I have received the above referenced permit(s) as
requested in application for service RBPR-03-2016-23317 by the following method(s):
rReceived 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
Y" 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: 03/24/2016 �
4 G a*
Owner/Authorized Representative Signature
Date 33/2 V�/6
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
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ehpermit 03/24/2016 09:49 Page 3 of 3
c' A N. CNI'AWBA COUNTY 0 + r'=b 0 Case# AUTH-03-20 1 6-0703 84
v Public Health Department re:14; Subdivision COUNTRY CLUB HEIGHT1
3 372014330842
4 -c� Environmental Health Division �+ PIN#
"' - PO Box 389, 100-A Southwest Blvd, Newton,NC 28658 i• ,r LOTtt 9-17
/842 6
NAME ON PERMIT: ANA FILIP, 2087 MOSS FARM RD, HICKORY 28602
Site Address: 1067 SPRUCEWOOD LN, NEWTON NC 28658
Property Size: Square Feet:33,105.60 Acres:0.76
Directions: 10 E/ right Startown RD / left Sandy Ford Rd/ right on Sprucewood Ln
Authorization to Construct Permit
•
Authorization to Construct Wastewater System (Required for Building Permit).
* See site plan and number of additional amtchments ( ).
Proposed Wastewater System: 258/0 REDUCTION Wastewater Flow 480 g.p.d
Type: 11113 - SYSTEM AWSINGLE EFFLUENT PUMP
Soil LIAR: 0.3 g.p.d./ft2
Permit Category: New Septic
Type of Facility: Primary Residence -
Basement? No Basement Plumbing? No Bedrooms: 4
Wastewater System Requirements
Tank Size: New Tank 1,000 gal Pump Tank 1,000 gal Grease Trap gal
Dosing Volume 182 gal Pump Specs: 30.3 GPM @ 22.3 TDH
Pressure Head 2 ft Draw Down S'7 in
Drainfield: Total Area: 1,600 sq ft Total Length: 400 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 3
Distribution: Pressure Manifold
Pre Treatment: NONE
PUMP RIQUIRED
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: IIIB Proposed System: 50% REDUCTION Distribution Type::
Soil LIAR: 0.3 g.p.d./ft2
ehpennit 03/24/2016 09:50 Page 1 of4
ABA CATAWBA COUNTY Case# AUTH-03-2016-070384
s
Q' r,,'f �� Public Health Department Subdivision COUNTRY CLUB HEIGHT:
�t j ,- Environmental Health Division PIN# 372014330842
°'o" PO Box 389. 100-A Southwest Blvd_Newton, NC 28658 LOT# 9-17 ss\\1842
NAME ON PERMIT: ANA FILIP, 2087 MOSS FARM RD, HICKORY 28602
Site Address: 1067 SPRUCEWOOD LN, NEWTON NC 28658
Property Size: Square Feet: 33,105.60 Acres:0.76
Directions: 10 E / right Startown RD / left Sandy Ford Rd/ right on Sprucewood Ln
The issuance of this permit by the Health Department does not guarantee the issuance of other permits. It is the responsibility or 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 Rides 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 oiveu period of time.
Steven Price 03/24/2016
AUTHORIZED STATE AGENT APPROVAL DATE
Permit Expiration Date: 03/24/2021
No grading or construction activiy is allowed In areas designated for system and repair without approval of the Health Department.
ehpermit 03/24/2016 09:50 Page 2 of4
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