HomeMy WebLinkAboutIMPV-07-2016-074915.TIF 4C2\ink CATAWBA COUNTY Case#
lit y Public Health Department Subdivision
4 7fil,0 ,c Enwironmental Health Division PIN# 375208976640
Lay PO Box 389. 100-A Southwest Blvd,Newton,NC 28658 LOT#
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NAME ON PERMIT: DAVID TUCKER, 3458 N OXFORD ST, CLAREMONT NC 28610
Site Address: 3458 N OXFORD ST, CLAREMONT NC 28610
Property Size: Square Feet: 35,719.20 Acres:.820
Directions: 1-40 exit 135 North Oxford St, 1/2 mile on right second driveway past Keller St
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.
R As the property owner or authorized representative, I have received the above referenced permit(s) as
X requested in the application for service EHPR-06-2016-24023 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
T 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: 07/25/2016 1
Owner/Authorized Representative Signature < _ ,---) 1—'
Date 7. 2 / G,
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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v,A CATAWBA COUNTY e MI Case# IMPV-07-2016-074915
All jt Public Health Department c.7e -1:fr Subdivision
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P4�' �"1) Environmental Health Division i PIM/ 375208976640
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PO Box 389, 100-A Southwest Blvd,Newton.NC 28658 o
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NAME ON PERMIT: DAVID TUCKER, 3458 N OXFORD ST, CLAREMONT NC 28610
Site Address: 3458 N OXFORD ST, CLAREMONT NC 28610
Property Size: Square Feet: 35,719.20 Acres:.820
Directions: 1-40 exit 135 North Oxford St, 1/2 mile on right second driveway past Keller St
Improvement Permit
Facility: Primary Residence
Permit Category: Expansion Bedrooms 3
WATER SUPPLY: Public Water
Basement? Yes Basement Plumbing? No
INITIAL SYSTEM SPECIFICATIONS
Permit Valid: Expires In Five Years: _X_ No Expiration:
Projected Daily Flow 360 g.p.d
Proposed Wastewater System: 25% REDUCTION
Type: IIIG- OTHER NON-CONN TRENCH SYSTEMS
Permit Conditions:
REPAIR SYSTEM SPECIFICATIONS
Repair System Required? Required
Proposed Wastewater System: 25% REDUCTION
Type: IIIG -OTHER NON-CONN"TRENCH SYSTEMS
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
a..rove the initials stem installation or the suspension/revocation of existin. .ermits.
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.
Steven Price 07/25/2016
AU'T'HORIZED STATE AGENT APPROVAL DATE
Permit Expiration Date:
07/23/2021
No grading or construction activity is allowed in areas designated for.rrstem and repair without approval of the Health Department.
ehpenuit 07/25/2016 13:35
EHPR 06-2016-24023
3458 N Oxford St, Claremont
• Do not cut, drive, fill, or grade over septic or repair areas.
• Septic system must be 10 ft from property lines; 10 feet from water line and gas line; 50
ft from wells; 5 ft from foundations and appurtenances; and out of right-of-ways and
easements.
• Install a new 1,000 gallon septic tank.
• Install 300 linear feet of 25% reduction system; (5) 60 ft lines on contour with a
maximum trench depth of 30 inches.
• Final grade of septic area must shed surface water off and away from system.
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This map/report product was prepared from the Catawba County, NC Geospatial Information Services. Catawba County has made substantial efforts
to ensure the accuracy of location and labeling information contained on this map or data on this report.Catawba County promotes and recommends
the independent verification of any data contained on this map/report product by the user.The County of Catawba,its employees,agents.and
DEPARTMENT OF HEALTH AND HUMAN SERVICES 0ifl2 O(o �/6 2- 0 ,7 Sheet ( of 1
DIVISION OF PUBLIC HEALTH,ENVIRONMENTAL HEALTH SECTION t PROPERTY ID#:
ON-SITE WATER PROTECTION BRANCH COUNTY: Catawba
SOIL/SITE EVALUATION
for ON-SITE WASTEWATER SYSTEM
' (Complete all fields in full)
OWNER: .0cw rte
1 I "'1� _ APPLICATION DATE
ADDRESS: DATE EVALUATED:
PROPOSED FACILITY: PaOPOSED DESIGN FLOW(.1949): 2 r2.o PROPERTY SIZE:
LOCATION OF SITE: 393N A) o-- _ 6
4 Ts-I- -✓ - / PROPERTY RECORDED:
NATER SUPPLY: ❑Private •.Public ❑ Well ❑Spring D Other
EVALUATION METHOD: ❑Auger Boring )Pit ❑Cut TYPE OF WASTEWATER: 26 Sewage ❑ Industrial Process ❑Mixed
<SOIL.MORPHOLOGY OTHER -
F (:1941) PROFILE FACTORS'
-.,LANDSCAPE HORIZON - -- •
POSITION/. DEPTH ' ;192 . ;'" :ry PROFILE.
p - SLOPL%'. O') .1941 .1941 SOIL 1943 1956 1944 CLASS
STRUCTURE/URE/_. CONSISTENCE/" WETNESS/ SOIL ( 1'4SAPRO,'., RESTR '<AR
. TEXTURE' MINERALOGY COLOR- DEPTH` ,,CLASS' ^UORIZ- „s ,•
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DESCRIPTION INITIAL SYSTEM REPAIR SYSTEM OTHER FACTORS (.1946):
USITE05 Available Space(.1945) q/
CLASSIFICATION(.1948): -C
It. 0' EVALUATED BY: 45 ...�—
System Type(s)
`L5 [t.� 2� I. OTHER(S)PRESENT:
Site LTAR O , 3 0-5
COMMENTS:
Updated February 2014