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HomeMy WebLinkAboutIMPV-12-09-3194.TIF IMPROVEMENT PERMIT For Office UseOnly Catawba County Public Health Department *CDP File Number 3 6 7 0 6 Environmental Health Division County ID Number: EHPR-11-09-2850 Evaluated For: NEW P.O Box 389, 100-A Southwest Blvd Newton NC 28658 Township:..~t,°`r~, Phone: (828)-465-8270 Fax: (828) 465-8276 r PERMIT vAuo UNTIL: 12/1/2014 "NOTE TO INSPECTIONS DIVISION: Building Permits cannot be issued with this Improvement Permit. Applicant: Mildred Moore Property Owner: Address: P.O. Box 672 Address: City: Hildebran 7 City: Staterlip: NC 28673 State2ip: ~_Pone. Phone Property Location & Site Information Address/Road Subdivision: Charlottes Crossing Phase: Lot: 5 2485 Genelia Dr. Claremont NC 28610 Directions Structure: SINGLE FAMILY # of Bedrooms: 3 # of People: 'Water Supply: PUBLIC System Specifications Initial stem *Site Classification: PS Minimum Trench Depth: a 4 Inches Design Flow: 3 6 0 Maximum Trench Depth: 3 0 Inches Soil Application Rate: 0 3 Septic Tank: 1 0 0 0 Gallons 1-Piece: QYes QNo 'System Class ification/Description: TYPE III G. OTHER NON-CONY. TRENCH SYSTEMS Pump Required: QYes Q No Q May Be Required Pump Tank: Gallons 'Proposed System: 25%REQUCTION 1-Piece: QYes QNo Repair System Required: *Yes ONo ONo, but has Available Space Repair System 'Site Classification: PS Minimum Trench Depth: a 4 Inches Soil Application Rate: 0 a 7 5 Maximum Trench Depth: 3 0 Inches 'System Classification/Description: Pump Required: QYes *No Q Maybe Required TYPE III G. OTHER NON-CONY, TRENCH SYSTEMS Pum p Tank: Gallons 'Proposed System: 25% REDUCTION Page 1 of 3 COP File Number .36706 County ID Number: EHPR-11-09-2850 =Site Modifications ❑ Open Fill Sheet No grading or construction activity is allowed in areas designated for system and repair without approval of Health Department. 'Permit Conditions The issuance of this permit by the Health Department in no way guarantees the issuance of other permits. The permit holder is responsible for checking with appropriate governing bodies in meeting their requirements. The Improvement Permit shall be valid for 5 years from date of issue with a site plan (means a drawing not necessarily drawn to Site Plan scale that shows the existing and proposed property lines with dimensions, the location of thefacility and appurtenances, the 0 site for the proposed Wastewater system, and the location otwater supplies and surfacewaters). Plat The Improvement Permit shall be valid without expiration with plat (means a property surveyed prepared by a registered land surveyor, drawn to a scale of one inch equals no more than 60 feet, that includes: the specific location of the proposed facility O and appurtenances, the site for the proposed Wastewater system, and the location of water supplies and surface waters. Plat also means, for subdivision lots approved by the local planning authority and recorded with the county register of deeds, a copy of the recorded subdivisions plat that is accompanied by a site plan that is drawn to scale). The Department and Local Health Department may impose conditions on the issuance and may revoke the permits for failure of the system to satisfy the conditions, the rules, or this article. This permit is subject to revocation if the site plan, plat, or intended use changes (NCGS 130A-335(f)). The person owning or controlling the system shall be responsible for assuring compliance with the laws, rules, and permit conditions regarding system location, installation, operation, maintenance, monitoring, reporting, and repair (.1938(b)). Applicant/Legal Reps. Signature Required? Oyes ONO Applicant/Legal Reps. Signature.-- Date: 69- 'Issued By: A-JV144 Date of Issue: 1 a / 0 1 / a 0 0 9 Authorized State Agent: OValid without Expiration? OHand Drawing *Import Drawing **Site Plan/Drawing attached.** TotalTime:(HH1At-A) Hours Iii inutes Page 2 of 3 CDP File Number: 36706 County File Number: E"PR-i'-os-zaso Drawing Type: Improvement Permit Date: 0 1/ x 0 0 9 Click below to import an image from an external location: _0S( 2s3 r e5 C T J.~1~ 7 ~ n ti / X, f r 49 Page 3 of 3 NCDENR , , Division of Environmental Health On-Site Wastewater Section 'Date: i s/ e a! a 0 0 9 Soil/Site Evaluation 'File 3 6 7 0 6 For On-Site Wastewater System PIN EHPR-11-09-2850 `Owner Proposed Facility SINGLE FAMILY Proposed Design Flow (.1949) 3 6 0 Location of Site 2485 Genelia Dr. Property Size 2 Water Supply PUBLIC Evaluation Method Pit Horizon SOIL MORPHOLOGY Lan1a cape .1941 Other Profile Profile# POS Depth Factors Slope % (IN) Mineralogy Matrix Mottle Texture Structure Consistence Color Color 1 0-21 CL sbk fr ss sp .1942 wet. % 21-42 CL sbk fr ss np +sap&mic .1943 Depth 4 a GPS Saprolite: (in) 42-58 S abk fr SAP .1944 Rest. Horizon .1947 Class EHS Profile LTAR 0 . 3 a 0-26 CL sbk fr ss sp .1942 wet. % 26-43 SCL sbk fr ss sp .1943 Depth 4 3 GPS Saprolite:(in) 43-48 fr SAP .1944 Rest. Horizon .1947 Class EHS Copy rofile Profile 0 3 LTAR _ 3 0-10 SL sbk fr ss sp .1942 wet. % 10-48 Sic sbk fr s sp .1943 Depth 4 8 GPS Saprolite:(in) 1944 Rest. Horizon .1947 Class EHS Copy Profile IProfile LTAR 0 . Z? 7 5 .1942 wet. % .1943 Depth GPS Saprolite:(in) .1944 Rest. Horizon .1947 Class EHS e Copy Profile rLTTroArR[ .1942 . 'Yet. % .1943 Depth GPS Saprolite:(in) .1944 Rest. Horizon .1947 Class EHS Copy ro(ile IProfile LTAR Available Space (.1945) Other Factors(. 1946) Site Classification (.1948)Ps Initial LTAR: 0 3 Repair LTAR: 0. 2 7 5 Others Present: Comments: Evaluated By: Phelps, Robert NCDENR . Division" of'Environmental Health On-Site Wastewater Section Date: 1 a 0 a l a 0 0 9 Soil/Site Evaluation File 3 6 7 0 6 For On-Site Wastewater System PIN E H P R - 1 1- 0 9 1940 Horizon SOIL MORPHOLOGY Profile# Landscape Depth .1941 Other Profile POS Slope % (IN) Mineralogy Matrix Mottle Factors Texture Structure Consistence Color Color 1942 Wet. % 1943 Depth GPS Saprolite:(in) 1944 Rest. Horizon .1947 Class EHS Copy P fiI Profile VAR .1942 Wet. % .1943 Depth GPS Saprolae:(m) 1944 Rest. Horizon EHS .1947 Class cop Ott Profile LTAR .1942 Wet. % .1943 Depth GPS Saprolite:00 .1944 Rest. Horizon EHS .1947 Class to I Copy rOtt IProfile LTAR .1942 Wet. % 1943 Depth GPs Saprolite:(in) .1944 Rest. Horizon EHS 1947 Class Copy Protil Profile LTAR .1942 Wet. % .1943 Depth GPS Saprolite:(in) .1944 Rest Horizon .1947 Class EHS Copy~ro},I Profile- LTAR Comments: Attach Image The "Open Drawing Form" button, opens the the drawing form. 0 The "Import" button, attaches the drawing, or other image into the space below. l s Open Drawing Form © v d Profile: 1 Q X Y Z Profile: 2 Q X Y Z Profile: 3 Q X Y Z Profile: Q X Y Z Profile: Q X Y Z Profile: Q X Y Z Profile: Q X Y Z Profile: Q X Y Z Profile: Q X Y Z Profile: Q X Y Z