HomeMy WebLinkAboutAUTH-08-2016-075883.TIF ,p CATAWBA COUNTY
FT L Public Health Department Subdivision SHERWOOD SHORES
d . a Environmental Health Division PIN# 461902752332
� PO Box 389, 100-A Southwest Blvd,Newton,NC 28658LOT# 4 & 5
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NAME ON PERMIT: GEORGE CRENSHAW, PO BOX 1421, MOORESVILLE NC 28115
Site Address: 8800 DOG LEG RD, SHERRILLS FORD NC 28673
Property Size: Square Feet:41,817.60 Acres:.96
Directions: MOLLYS BACKBONE TO AZAELA LEFT ONTO HOME PLACE SIGN
Owner/Authorized Representative Acknowledgement of Permit Receipt
i/V I certify that I am the owner or authorized agent(owner's authorization required) representing the owner of the
property described above.
K As the property owner or authorized representative, I have received the above referenced permit(s) as
lrequested in the application for service RBPR-07-2016-24242 by the following method(s):
\I/Received in Person
Facsimile Transmittal (Return form with signature required)
Electronic Image Transmittal/E-mail (Return receipt required)
7( 4.As the property owner or authorized representative I have reviewed and understand the specific conditions
f 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: 08/17/2016
Owner/Authorized Representative Signature f /, ,c_____________,_
"-) Date et-23 4
Documentation of Permit(s) Transmittal
(permit transmitted by electronic or other means)
Permit transmitted by (name ofperson 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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ehpennit 08/19/2016 09:34
CATAWBA COUNTY Ee ,. . i Case# AUTH-08-2016-075883
n Public Health Department `i �g Subdivision SHERWOOD SHORES
< .._.�; s `' Environmental Health Division I `'l r3.' . PIN# 461902752332
�' �� PO Box 389, 100-A Southwest Blvd,Newton,NC 28658 G 1;1 LOT# 48, 5
•
NAME ON PERMIT: GEORGE CRENSHAW, PO BOX 1421, MOORESVILLE NC 28115
Site Address: 8800 DOG LEG RD, SHERRILLS FORD NC 28673
Property Size: Square Feet.41,817.60 Acres:.96
Directions: MOLLYS BACKBONE TO AZAELA LEFT ONTO HOME PLACE SIGN
Authorization to Construct Permit
Authorization to Construct Wastewater System (Required for Building Permit)
* See site plan and number of additional attachments ( ).
Proposed Wastewater System: 25% REDUCTION Wastewater Flow 360 g.p.d
Type: IIIG -OTHER NON-CONN TRENCH SYSTEMS
Soil LTAR: 0.3 g.p.d./ft2
Permit Category: New Septic
Type of Facility: Primary Residence - House
Basement? No Basement Numbing? 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 900 sq ft Total Length: 300 ft Maximum Trench Depth 36 in
Aggregate Depth in Trench Width 3 ft
Minimum Soil Cover 12 in Minimum Trench Separation 9 ft on center
Number of Drain Lines 4
Distribution: Serial
Pre Treatment: NONE
Additional Specifications: *Do not drive, grade, or fill over any septic area.
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
Repair System Required? Required System Class: IVA Proposed System: 50% REDUCTION
Distribution Type:: LPP Soil LTAR: 0.3 g.p.d./ft2
PUMP REQUIRED ***** OPERATOR REQUIRED
ehpennit 08/19/2016 09:34
sg•
\ CATAWBA COUNTY Case# AUTH-08-2016-075883
A Public Health Department Subdivision SHERWOOD SHORES
d wo Environmental Health Division PIN# 461902752332
�" PO Box 389, 100-A Southwest Blvd,Newton,NC 28658 LOU/ 4 & 5
/842 w
NAME ON PERMIT: GEORGE CRENSHAW, PO BOX 1421, MOORESVILLE NC 28115
Site Address: 8800 DOG LEG RD, SHERRILLS FORD NC 28673
Property Size: Square Feet:41,817.60 Acres:.96
Directions: MOLLYS BACKBONE TO AZAELA LEFT ONTO HOME PLACE SIGN
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' (15.4 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 neriod of time.
Robbie Phelps 08/18/2016
AUTHORIZED STAFF AGENT APPROVAL DATE
Permit Expiration Date: 08/18/2021
No grading or construction activity is allowed in areas designated for system and repair without approval of the Health Department.
ehpennit 08/19/2016 09:34
74t,I-1/— 6- 20(6 - 07r883
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Parcel: 461902752332, 8800 DOG LEG RD lin=50ft
SHERRILLS FORD, 28673
This maplreport 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
personnel,disclaim,and shall not be held liable for any and all damages,loss or liability,whether direct,indirect or consequential which arises or may
arise from this map/report product or the use thereof by any person or entity.
Copyright 2014 Catawba County NC
08119/2016
t,atawNba. County Environment<.,i Heath,
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Parcel: 461902752332, 8800 DOG LEG RD lin=50ft
SHERRILLS FORD, 28673
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
personnel,disclaim,and shall not be held liable for any and all damages,loss or liability,whether direct,indirect or consequential which arises or may
arise from this map/report product or the use thereof by any person or entity.
Copyright 2014 Catawba County NC
08(19(2016
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES Shed- ef_
DIVISION OF ENVIRONMENTAL HEALTH PROPERTY ID X:
ON-SLTE WASTEWATERSECIION COUNTY:
SOIL/SITE EVALUATION
$8ep a Cay for ON-SITE WASTEWATER� � ESYSTEM
OWNER
ADDRESS- Cameo_ Gran r1•‘,1,- DATE EVALUATED: K2-1 6
PROPOSED FACILITY: 'S bit PROPOSED DESIGN FLOW(.1949): 'S 6 0 PROPERTY SITE
LOCATION OF SPIE/ PROPERTY RECORDED:
WATER SUPPLY: H Private 0 Public ❑ Wy ell 0 S, ng 0 Other
EVALUATIONMETHOD: 14I.ugerBo:mg [flit U Cut
TYPE OF WASTEWATER: Sc-wage 0 Industrial Proxss
0 Mixed -
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COMMENTS:
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