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Home My WebLink AboutIMPV-07-2016-075127.TIF �s A CATAWBA COUNTY Case# IMPV-07-2016-075127 (Q g►il GL Public Health Department Subdivision d ' a:"+h: ^C Environmental Health Division PIN# 370414248378 v rq PO Box 389, 100-A Southwest Blvd,Newton,NC 28658 LOT# /g 2 5M NAME ON PERMIT: JOHN CHRISTENSEN, 25030 MCINTOSH RD, Site Address: 1070 25TH AVE DR NW, HICKORY NC 28601 Property Size: Square Feet: 39,204.00 Acres:0.9 Directions: right 127 N in Hickory/go left on 25th Ave NW go .7 miles turn right on 25th Ave Dr Nw /go .5 miles to 1070 25th AVe Dr NW 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 permit(s) as requested in the application for service RBPR-06-2016-24170 , by the following method(s): Received in Person Facsimile Transmittal (Return form with signature required) / Electronic Image Transmittal/E-mail (Return receipt required) KAs 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: 07/29/2016 Owner/Authorized Representative Signature %ate Documentation of Permit(s) Transmittal (permit transmitted by electronic or other means) Permit transmitted by (name of person sending permit) Signature 4111-1:1- OL Date/Time D I(1 116 Method: Fax J Email US Mail Other Owner's request to send by the above indicated method of transmittal in lieu of signature jebNb&liGe' 0_6404,epek, We want to hear from you. Please take a few moments to complete our customer service survey at: http://www.surveymonkey.com/s/EHCustomerService ehnerroit 07/29/2016 12:29 e,A CATAWBA COUNTY Ern o!,,F•pp,F* .❑e Case%i IMPV-07-2016-075127 • • .Tf it y Public Health Department ..1-11. Subdivision < y y Environmental Health Division i ti . PIN# 370414248378 wit PO Box 389, 100-A Southwest Blvd,Newton.NC 28658 D LOT# Ig,2 “' - r ill o to ❑� • r. NAME ON PERMIT: JOHN CHRISTENSEN, 25030 MCINTOSH RD, Site Address: 1070 25TH AVE DR NW, HICKORY NC 28601 Property Size: Square Feet: 39,204.00 Acres:0.9 Directions: right 127 N in Hickory/go left on 25th Ave NW go .7 miles turn right on 25th Ave Dr Nw /go .5 miles to 1070 25th AVe Dr NW Improvement Permit Facility: Primary Residence Permit Category: New Septic 13edrooms 3 WATER SUPPLY: Public Water Basement? No 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: 50% REDUCTION Type: IIIB - SYSTEM W/SINGLE EFFLUENT PUMP PUMP REQUIRED Permit Conditions: REPAIR SYSTEM SPECIFICATIONS Repair System Required? Required Proposed Wastewater System: 50% REDUCTION Type: IIIB - SYSTEM W/SINGLE EFFLUENT PUMP PUMP REQUIRED Landscaping or other site alterations that potentially dived 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 Rales for Sewage Treatment and Disposal Systems' (ISA NCAC 18A.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 07/29/2016 AUTHORIZED STATE AGENT APPROVAL DATE Permit Expiration Date: 07/29/2021 No grading or construction activity is allowed in areas designatedfor system and repair without approval of the Health Department. ehpermil 07/29/2016 12:29 RBPR 06-2016-24170 1070 25'"Ave Dr NW, Hickory • Do not cut, drive,fill, or grade over septic or repair areas. • This is an improvement permit only and is not intended for septic installation purposes. �a� g8 Add J.. '\ 27c r 297 r 5,04— „is-kw ts4-- Ociar 6, P„--P ay. or Sy DEPARTMENT OH HEALTH AND HUMAN SERVICES Sheet (of 7 DIVISION OF PUBLIC HEALTH,ENVIRONMENTAL HEALTH SECTION PROPERTY ID#: ON-SITE WATER PROTECTION BRANCH I`-o�� 0 G �pI co - 2`{f 70 COUNTY:_Catawba_ SOIL/SITE EVALUATION for ON-SITE WASTEWATER SYSTEM . f / (Complete all fields in full) OWNER: v`4•4-5 Imo-°12r er _ APPLICATION DATE ADDRESS: DATE EVALUATED: 7/ZZ PROPOSED FACILITY: PROPOSED DESIGN FLOW(.1949): PROPERTY SIZE: LOCATION OF SITE: /070 2 Dr )V J PROPERTY RECORDED: WATER SUPPLY: 0 Private 1A.Public 0 Well 0 Spring U Other EVALUATION METHOD: 0 Au1er Boring A Pit 0 Cut TYPE OF WASTEWATER: 4 Sewage 0 Industrial Process U Mixed zo s ` 2 '' SOIL MORPHOLOGY 'OTHER r �-I �g (.1941) ZPROFILE,FACTORS i ",, ;194402'y ; "'"-114 ,, ' ' „,'„ ,," ` 'I „f" �+ g LANDSCAPEbs AORIZONs - " yV „' : li+�`t ,PROFILE_"- # ,1941 .1941,3 ,LSOILr r� 1943 = '-, 1956 '11944 ' CLASS 1 t "^zT' 1xtily STRUCTURE/: ., CONSISTENCE/ WETNESS/ '`-c-‘501-1- 2- iSAPRO= -RESTR &LTAR-:, ' „ �� ''?-TEXTURE MINERALOGY '.;COLOR D PTH 'CCASS `HORIZ k.,1 0-(0 "INC SC- rig _J- ‘./ of 1 1 D'G 27- `l y °'s 6/c I'� le o -4 ` &_ Fi fe 'S 364- PS 6, („.3 ( S6/c- CL I-i SE' >t) 4- It.)A- 41,11- 3 2 2"be. 31 - tic "'sblc cc NL JV 0, T Loy O -C "fa(c so- ii SCr t _sr- 30 s6E- CL >�/f �� ` F u— " 4 "... �S 3 Z,G 33-1,s ,-sit CL /Y 5c / �J 0 3s • 0 -6 "36k $C.L FE .Se- p -.S 6 _"'8 saic ct. 1-7-t Scr NU4 l - tow_ n/ 4 / S 4 St 2-S- hU wsalc- c r ft se o_ h- �4(5., DESCRIPTION INITIAL SYSTEM REPAIR SYSTEM OTHER FACTORS(.1946): /' ES Available Space(.1945) S /� SITE CLASSIFICATION(.1948): �� System Type(s) 2Z 44 6 de OTHER(EVALUATER 'mac OTHER(S)PRESENT: Site LIAR O.3S— 0_ 3j COMMEN'T'S: Updated February 2014 n R6P‘ cc,(o-Zot6 - 22-f( 7O Catawba County EnvironmentalgHealth et b 6"7-1"1377 " t u .47�se" 55 Yj.r �. 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'r IC Parcel: 370414248378, 1070 25TH AVE DR NW lin=50ft HICKORY, 28601 This map/report product was prepared from the Catawba County,NC Geospatlal Information Services. Catawba County has made substantial efforts to ensure the accuracy of location and labeling information contained on this map or data on[his report.Catawba Countypromotes 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