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Home My WebLink AboutIMPV-08-2016-075857.TIF c8• • CATAWBA COUNTY Y 1 y Public Health Department Subdivision SHERWOOD SHORES <. '® Environmental Health Division PIN# 461902752332 "' - PO Box 389, 100-A Southwest Blvd,Newton,NC 28658 LOT# 4 & 5 Igo^ 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 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 fe t property described above. K As the property owner or authorized representative, I have received the above referenced permit(s) as reques/.\./ ed intheapplication for service RBPR-07-2016-24242 by the following method(s): `� Received in Person Facsimile Transmittal (Return form with signature required) Electronic Image Transmittal/E-mail (Return receipt required) XAs 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 OSA 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 ( /, 7,___________ Date ' 3le 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 We want to hear from you. Please take a few moments to complete our customer service survey at: http://www.surveymonkey.com/s/EHCustomerService ehpermit 08/19/2016 09:34 t� CATAWBA COUNTY ❑� �R .6Ie Case# IMPV-08-2016-075857 Q'� G Public Health Department . . mli • r Subdivision SHERWOOD SHORES ~ t® `' PIN# < '^—•r i Environmental Health Division r i tt� ri 461902752332 yIR \ ® PO Box 389, 100-A Southwest Blvd,Newton.NC 28658 711-... s _ El LOT# 4 & 5 AI Tfy ❑° RF o oS 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 Improvement Permit Facility: Primary Residence - House Permit Category: New Septic Bedrooms 3 WATER SUPPLY: Private Well Basement? No Basement Plumbing? 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: *Do not grade, drive, or fill over any septic area. REPAIR SYSTEM SPECIFICATIONS Repair System Required? Required Proposed Wastewater System: 50% REDUCTION 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 Ru/es for Sewage Treatment and Disposal Systems' (ISA NCAC IBA .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. Robbie Phelps 08/17/2016 AUTHORIZED STATE AGENT APPROVAL DATE Permit Expiration Date: 08/17/2021 No grading or construction activity is allowed in meas designated for system and repair without approval of the Health Department. ehpennit 08/19/2016 09:34 4 i-11- 6- 2o(6 - 075-gr3 Catawba County Environmental Health vif v- g- 201 - 07ctri, "41 101110111r 120 • {Ly@ f fc� IC 8s :10 „ z� i 4 �,i N,9 ___3.5r 9 P .-IS --- ..---- pis Ino" Illiiiiiiii S siik;t, a s4�/W ,,- P c_oi_a � rte " pOGlEGF° �' • • 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 08/1912016 Catawba County Environine'ntai H�eallh • � i ?„,....„,:i.HI . o a s • 0 • I • • vJ. CO • • , , . , / 7•:,....i ) ....r ':.: 11'': ..'.'7." r • -^" '' - UOG LAG VWL%! - - • 77 • • 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 pa,aonnai,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 0811912016 DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES next_of DIVISION OF ENVIRONMENTAL HEALTH PROPERTY ID ll: ON-SITE WASTEWATERSECIION COUNTY: SOI /SITE EVALUATION f 0 OD "� for ON-SITE WASTEWATER SYSTEM OWER NV a �� PLICATION DATE ADDRESS: "�r�A- rb„r q y DATE EVALUATED: K'2-I G PROPOSED FACILITY: 'S ha- PROPOSED DESIGN FLOW(.1949): 'S b 0 PROPERTY SIZE: LOCATION OF SITE: PROPERTY RECORDED: WATER SUPPLY: 0/Private 0 Public 0"--Well 0 spd°g 0 Oma EVALUATION METHOD: 0uger Boring [rPii U Cut TYPE OF WASTEWATER: .16 0 Industial Process O bruxed �__........... _. :::::--::_:-::::.. rte_.«:,,._-.,.- .. ........:.::: „ .:�;tv :[:a[:i� ;�;;:a:;;;";;�i; i;;ii ;:i�:,;ic�;ii�•;'t=��=EF�t:::L•':: g . • _= "_„: .. ....._.....__.._ (:1941.L`_...::...........___[[_...............__..... 4'3tonIMA TotS:::::::::::::_::::: ;::::::::-:'::::::` :... 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