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HomeMy WebLinkAboutAUTH-03-2016-070552.TIF i r CATAWBA COUNTY Case RUTH-03-2016-070552 .l, Public Ilcelth Depanmenl Subdivision H L FOX PROPERTY � p Environmental Health Division PIN# 371408999158 * © r PO Box 389, 100-A Southwest Blvd,Newton,NC 28658 1,011 1 NAME ON PERMIT: CHRIS Sr ANN STAMEY, 4108 16TH ST NE, HICKORY NC 28601 Site Address: 4108 16TH ST NE, HICKORY NC 28601 Property Size: Square Feet:23,086.80 Acres:0.53 Directions: Hwy 127 North from Downtown towards Bethleham, Right onto Cloninger Mill Rd, At intersection turn Left onto 16th St NE, House is 8th on the Right w/ Blue front door. 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, l have received the above referenced permit(s)as requested in the application for service EHPR•03-2016-23307 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: 03/29/2016 gyita2=z.- 0 Owner/Authorized Representative Signature P ,t Date 3/,0)0! I Y/ Documentation of Permit(s)Transmittal (permit transmitted by electronic or other means) Permit transmitted by (name of person sendingpermil) Signature Date/Ti me 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 chpcnnir 03/3.02016 le:t t Page 4 on CATA\ BA COUNTY ryt s..g O Case ADM-03-20 16-070552 Public Health Department 5 F ,a Subdivision H L FOX PROPERTY f �-e) Environmental Health Division r 73.8 NC 28658 } PIN# 371408999158 PO Box 389. 100-A Southwest Blvd. Newton, t LOT# 1 /841. „� . • �t or {" Or— .O NAME ON PERMIT: CHRIS & ANN STAMEY, 4108 16TH ST NE, HICKORY NC 28601 Site Address: 4108 16TH ST NE, HICKORY NC 28601 Property Size: Square Feet:23,086.80 Acres:0.53 Directions: Hwy 127 North from Downtown towards Bethleham, Right onto Cloninger Mill Rd, At intersection turn Left onto 16th St NE, House is 8th on the Right w/ Blue front door. Authorization to Construct Permit Authorization to Construct Wastewater System (Required for Building Permit} * See site plan and number of additional attachments ( ). Proposed Wastewater System: 50% REDUCTION Wastewater Flow 360 g.p.d Type: 111E- PPBPS GRAVITY DOSED SYSTEM Soil LTAR: 0.3 g.p.d./ft2 Permit Category: Repairs Type of Facility: Primary Residence - Basement? Yes Basement Plumbing?Yes 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: 200 ft Maximum Trench Depth 48 in Aggregate Depth in Trench Width 2 ft Minimum Soil Cover 12 in Minimum Trench Separation 8 ft on center Number of Drain Lines 6 Distribution: Distribution Box 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 ehpernut 03/30/2016 10:09 Page 1 of4 ,gA CATAWBA COUNTY Case# AUTH-03-2016-070552 om t�+. G Public Health Department Subdivision H L FOX PROPERTY t � e' G In& "51 Environmental Health Division PIN/ 371408999158 h PO Box 389. 100-A Southwest Blvd, Newton, NC 28658 LOT# 1 tg.2 ,„ NAME ON PERMIT: CHRIS & ANN STAMEY, 4108 16TH ST NE, HICKORY NC 28601 Site Address: 4108 16TH ST NE, HICKORY NC 28601 Property Size: Square Feet:23,086.80 Acres:0.53 Directions: Hwy 127 North from Downtown towards Bethlehem, Right onto Cloninger Mill Rd, At intersection turn Left onto 16th St NE, House is 8th on the Right w/ Blue front door. 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 18.4.1900). Neither Catawba County nor the Environmental Health Specialist warrants that the septic tank system will continue to function satisfactorily for any viven oeriod of time. Steven Price 03/29/2016 AUTHORIZED STATE AGENT APPROVAL DATE Permit Expiration Date: 03/26/2021 No grading or construction actiyih,is allowed in areas designated for system and repair without approval of the Health Department. ehpermit 03/30/2016 10:09 Page 2 of 4 EHPR 03-2016-23307 4108 16th St NE,HICKORY • Do not cut, drive, fill, or grade over septic or repair areas. • Septic system must be 5 ft from property lines; 50 ft from wells and streams; 5 ft from building foundations and appurtenances; 10 ft from water lines; and out of right-of-ways and easements. • Install a new1,000 gallon septic tank unless existing tank is structurally sound and in good shape and can be fitted with a sanitary tee and filter. • Install 200 linear feet of PPBPS on contour. • Final grade of septic area must shed surface water off and away from system. 4 et R NI' N1 / N r PI 4 11 •� (g 1;+ lor:W3-0 o f>a" s \5'd it Ii N t=5v t k .,'£ '...: ...154A t4S(A;;;. .e i ixe,4 T4ix':d; . . ft2We'4 r}41*{$ 't' ,ifµtt °j` 1 rh ?"SW t 5 `� DEPARTMENT OF HEALTH AND HUMAN SERVICES DIVISION OF PUBLIC HEALTH,ENVIRONMENTAL HEALTH SECTION Shen of ON-SITE WATER PROTECTION BRANCH PROPERTY T t!: SOIL/SITE EVALUATION COUNTY: for ON-SITE WASTEWATER SYSTEM (Complete all fields in full) OWNER: CVl r 5 • f}r," 5l, c 7 APPLICATION DATE ADDRESS: Li(OP /6"" sr Ne- /fi'ck,y DATE 7 PROPOSED FACILITY: PROPOSED DESIGN FLOW(.1949): PROPERTY SIZE:EVALUATED: /7 LOCATION OF SITE: PROPERTY RECORDED: WATER SUPPLY: ❑Private XLPublic ❑Well ❑Spring ❑Other EVALUATION METHOD: ❑Auger Boring gPit ❑Cut TYPE OF WASTEWATER: Sewage ❑Industrial Process ❑Mixed e R o SOIL MORPHOLOGY OTHER F (.1941) PROFILE FACTORS L .1940 E LANDSCAPE HORIZON POSITION/ DEPTH PROFILE a SLOPE% (IN.) .1941 .1941 SOIL .1943 .1956 .1944 CLASS STRUCTURE/ CONSISTENCE) WETNESS/ SOIL SAPRO RESTR &LTAR TEXTURE MINERALOGY COLOR DEPTH CLASS HORIZ o—/r g-1( 5r...:1/41-.7/e w../ f N 4- iv 4- P /S-z3 cc sc I;e. rr N 4 4l 53 Se- * '� 36 z3— go A6k c f-4 —6/ "' 6k CL nt SE - ufsj o -/z G.-. (4, d c.q & •l NAL PS LS /Z.- L{. Sok c y' / SG NA- 10 (-(e)2 S'%� u -4n us6(c c- i ice r✓ 0, 3 • V0-II £o f ° Sc_ ft .sLs- • o • Z} sr 616 c Fig Ae LS 23- Sl° "5614_ sue. Sc N� S'lo do 0A4--- �S 3 .�� �/",� 3 4 DESCRIPTION INITIAL SYSTEM REPAIR SYSTEM OTHER FACTORS(.1946): SITE CLASSIFICATION(.1948): (5 Available Space(.1945) 0 ,/ rcl e 4r -) ° System Type(s) 15+� 4,J EVALUATED BY: �"y-`tt OTHER(S)PRESENT: Site LTAR O,3 COMMENTS: