HomeMy WebLinkAboutIMPV-07-2016-074862.TIF ,,.t3CATAWBA COUNTY Case# IMPV-07-2016-074862
vAl Public Health Department Subdivision WILSON PARK
< �p '- Environmental Health Division PIN# 376003420474
19 0PO Box 389, 100-A Southwest Blvd,Newton.NC 28658 LOT# 4
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NAME ON PERMIT: RAFAEL PEREZ, 1773 RING TAIL RD, CLAREMONT NC 28610
Site Address: 1757 RING TAIL RD, CLAREMONT NC 28610
Property Size: Square Feet:26,571.60 Acres:0.61
Directions: Hwy 10 East, right on Ringtail Rd, lot all the way down on right. (almost to Love Rd)
Owner/Authorized Representative Acknowledgement of Permit Receipt
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 permit(s) as
quested intheapplication for service RBPR-06-2016-24148 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: 07/22/2016
r / /
Owner/Authorized Representative Signature lEak'4,- i €4 /
Date li 221 1lr
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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chpennit 07/22/2016 10:01
(8,,A CATAWBA COUNTY Ee 'y o, j•:�❑e Case# IMPV-07-2016-074862
f' G Public Health Department
•• Subdivision WILSON PARK
4 :.il 1 ,H) Environmental Health Division i��-• L. PIM 376003420474
/ PO Box 389, 100-A Southwest Blvd.Newton,NC 28658 0• I G � LOT# 4
/842 sm F.1C• i - ' J f
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NAME ON PERMIT: RAFAEL PEREZ, 1773 RING TAIL RD, CLAREMONT NC 28610
Site Address: 1757 RING TAIL RD, CLAREMONT NC 28610
Property Size: Square Feet: 26,571.60 Acres:0.61
Directions: Hwy 10 East, right on Ringtail Rd, lot all the way down on right. (almost to Love Rd)
Improvement Permit
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1:t �t�:i;!:>yti�91 N..."1�, a;1!u`L`a .� ' �1t�I�uj�'�I�MTIAL SYSTEM�EIS,TINGi i G� `'u. � "��� rt' !���� !�i�- tll�!I! ,,i;l�.;:
Facility: Primary Residence
Permit Category: Other Bedrooms 2
WATER SUPPLY: Private Well
Basement? No Basement Plumbing? No
INITIAL SYSTEM SPECIFICATIONS
Permit Valid: Expires In Five Years: _X_ No Expiration:
Projected Daily Flow 240 g.p.d
Proposed Wastewater System: CONVENTIONAL
Type: IIA-CONV SYSTEM (SINGLE-FAMILY OR 480 GPD OR LESS)
•
Permit Conditions: Permit issued to verify setbacks and designate repair area for new 2 BR mobile home. Existing
permit#6940 is on file and system was approved for 2 BR with a .4 LTAR. Any future expansion of
repair of system will require backhoe pits prior to issuance of an Authorization to Construct to see if
soil depth is suitable to revise to a 25% reduction repair. Any future repair of system must be
I minimum: 100' from any well,10' from property lines, 5' from home. Lines to be installed on contour.
Do not grade drive or fill over existing system or future repair area. New proposed home has been
staked 61' from existingwell and 8' from tank in approximately same location as existinghome.
pP Y
REPAIR SYSTEM SPECIFICATIONS
Repair System Required? Required
Proposed Wastewater System: DRIP IRRIGATION
Type: IVA-ANY SYSTEM WITH LPP DISTRIBUTION
PUMP REQUIRED ***** OPERATOR REQUIRED
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' (ISA NCAC I8A .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.
Jason Boyd 07/22/2016
AUTHORIZED STATE AGENT APPROVAL DATE
07/22/2021
Permit Expiration Date:
No grading or construction activity is allowed in areas designated for system and repair without approval of the Health Department.
ehpemiii 07/22/2016 10:01
\3A C� CATAWBA COUNTY Permit# ' RBPR 6-16-24148
G Name Rafael Perez
.„7,- 'a n
Public Health Department
-
Address 1757 Ringtail Rd Claremont NC
4 o
s . Environmental Health Division
c-\wi �jp �iC PO Box 389, IOOA Southwest Blvd, Newton NC 28658 PIN# 376003420474
�/8-42 sN (828)465-8270 Fax (828)465-8276 TDD(828)465-8200
Site Plan Authorization to Construct
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Department of Environment, Health,and Natural Resources Sheet:
Division of Environmental Health Property ID:
On-site Wastewater Section Lot#:
SOIUSITE EVALUATION File#:
for ON-SITE WASTEWATER SYSTEM AppID: RBPR-6-16-24148
Owner: Rafael Perez Applicant:
Address: 1757 Ringtail Rd Claremont NC Date Evaluated: 7/21/2016
Proposed Facility: 2 BR home Design Flow(.1949) 240 Property Size:
Location of Site: Property Recorded:
Water Supply: pvt well [ ]Spring [ ]Other
Evaluation Method: auger boring by ehs [ ]Cut
Type of Wastewater: X Sewage [ ]Industrial Process [ ]Mixed
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uu 'it 7 i! F CSA l�'' SOIL MORPHOLOGYi � I7 I�r 4}�I'� X11 ,I+,r 4C !b, pi(.Ilird 'j�p' i' l ��ryr' , I i r.d .w '
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#, ^1�IN:Ntfi!'slope%'3 A il�(lN`)iil�i k.ezturell11111 I I i1;:e+C Mlrieralogy."i i4 }Ifi011,11���ill'Ii�Color" lI..�I:IX�Ll111 ID P!ttil(IN') d., Classt ,rwmr iiq 1 ,,"i�,°; ' j .¶1
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Description Initial System Repair System Other Factors(.1946):
Available Space(.1945) PS Soil Evaluation By: Jason Boyd
System Type(s) IIA exist IVA Drip Others Present:
Site LTAR .4 .3 Site Classification(.1948): PS
Site Evaluation By:
Others Present:
Sheet:
COMMENTS: FILE#:
Landscape Position Group Texture .1955 LTAR Structure
R-Ridge I S-Sand 1.2-0.8 SG-Single Grain
SS-Shoulder Slope LS-Loamy Sand M-Massive
LS-Linear Slope CR-Crumb
FS-Foot Slope 11 SL-Sandy Loam 0.8-0.6 GR-Granular
NS-Nose Slope L-Loam SBK-Subangular Blocky
HS-Head Slope ABK-Angular Blocky
CC-Concave Slope III SI-Silt 0.6-0.3 PL-Platy
CV-Convex Slope SICL-Silty Clay PR-Prismatic
T-Terrace Loam
FP-Flood Plain CL-Clay Loam
SCL-Sandy Clay
Loam
IV SC-Sandy Clay 0.4-0.1
SIC-Silty Clay
C-Clay
Consistence Consistence Mineralegy
Moist Wet SEXP-Slightly Expansive
VFR-Very Friable NS-Non-Sticky EXP-Expansive
FR-Friable SS-Slightly Sticky
FI-Firm S-Sticky
VFI-Very Firm VS-Very Sticky
ER-Extremely Firm NP-Non-Plastic
SP-Slightly Plastic
P-Plastic
VP-Very Plastic
Sketch of Soil Evaluation Locations