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HomeMy WebLinkAboutRBPR-08-2016-24560.TIF y A ! THIS IS NOTA PERMIT Case # RBPR-08-2016-24560 ;5: ill - CATAWBA COUNTY HEALTH DEPARTMENT El' fD Qtros, 11. I !' " PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES /842 Si, Residential Building Plan Review - Building New o •o o . IMPROVEMENT - AUTH_CONST- NEW WELL 41: I-MCC( Contractor BUILD RIGHT CONSULTING, LLC. (WALTER JAMES ESTES III), PO BOX 367,TERRELL NC H:7049661496B:7044525789 C:7046410325 HOME:7049661496 BAINVEILLEHOLDINGS@GMA Owner PROGRESSIVE PROPERTY SOLUTIONS LLC, 4089 FALLEN PINE RD, SHERRILLS FORD NC 28 B:7046410325 NAME TO APPEAR ON PERMIT Progressive Property Solutions LLC SITE ADDRESS: 3920 MCGEE POINT RD, TERRELL NC 28682 PIN # 461714238515 NAME of SUBDIVISION: REDBUD FOREST Lot# 4 Section/Block PROPERTY SIZE: Square Feet Acres 1.35 DIRECTIONS: 150E/right Sherrills Ford Rd/right on Hob Ln/2nd lot on corner of Hob Ln & McGee Point Ln PRIMARY CONTACT: Owner SEWER TYPE: Septic Tank GALLONS PER DAY: 360 WATER SUPPLY: Private Well DESCRIBE WORK: 2 story dwelling w/attached garage future detached garage 24x28 SITE INFORMATION Do any of the following apply to the property for which this application is applied? If the answer to any of the questions below is"YES", then supporting documentation is required: Does this site contain any jurisdictional wetlands? No Does this site contain any existing wastewater systems? No Is any of the wastewater going to be generated on the site other than domestic sewage? No Is the site subject to approval by any other public agency? Yes Are there any easements or right-of-ways on this property? Yes Property Easements Description: Duke Power APPLICATION FOR: New Structure STRUCTURE TYPE: PRIMARY RESIDENCE FACILITY TYPE: Single Family Residence OTHER DESCRIPTION: DESCRIPTION OF vacant EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: NUMBER OF EXISTING BEDROOMS: #OF OCCUPANTS: PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 50 x 53 w/future detached garage 24x28 #OF NEW BEDROOMS:: 3 BASEMENT? No BASEMENT FIXTURES? No PLUMBING REQUIRED?Yes Desired system types(Improvement Permit or Authorization to Construct): ACCEPTED: ALTERNATIVE: CONVENTIONAL: OTHER: YES INNOVATIVE: ANY: Other described: 25% reduction APPLICATION FOR WELL CONSTRUCTION PROPOSED WELL TYPE: Individual Well REPLACE WELL?: NO E9-ehapplicatlon 08/23/2016 08:16 Page 1 of 4 p.aA CATAWBA COUNTY Case# RBPR-08-2016-24560 .7 i.�5 Public Health Department Subdivision REDBUD FOREST 2 0 a Environmental Health Division PIN4 � 461714238515 (3} PO Box 389, 100-A Southwest Blvd,Newton,NC 28658 /8,2 NAME ON PERMIT: PROGRESSIVE PROPERTY SOLUTIONS LLC ( ),4089 FALLEN PINE RD, SHERRILLS FORD NC 28673 Progressive Property Solutions LLC ( ) Site Address: 3920 MCGEE POINT RD,TERRELL NC 28682 Property Size: Square Feet Acres 1.35 Directions: 150E(right Sherrills Ford Rd/right on Hob Ln/2nd lot on corner of Hob Ln & McGee Point Ln Improvement Permits issued as a result of this information are valid for 5 years or may be non-expiring under certain specified conditions.An Authorization to Construct issued by this department is valid for(5)five years from the date issued and is not transferable; Improvement Permits and Well Permits are transferrable. Permits may be revoked if the information on this application,site plans or intended use changes for the proposed facility. I have read this application and certify that the information provided herein is true, complete and correct. Authorized county and state officials are granted right of entry to conduct necessary inspections to determine compliance with applicable laws and rules. I understand that I am solely responsible for the proper identification and labeling of all property lines and corners and making the site accessible so that a complete site evaluation can be performed. Date: Signature of Applicant or Agent An Environmental Health Specialist will contact you within 5 working days of application date. If you need further information or assistance please call 828-466-7291 AREA1 li FFFN)AME'bs MAULSiIinr w '� 4Ih gIij.IJP r�I''i�' 1 III #IIT,I!P , 11l(IIIp Iihilalr illi1111ItPUl _'ll[ II''' 14. ti i l iiJii�r d' ,ll �lhtou I h ]hDATE'I�IIUi, i�I FEE A'MOUNTt! Authorization to Construct Fee (New/Expansion) 08/22/2016 $150.00 Fee Improvement Permit Fee 08/22/2016 $150.00 mWell Permit & Inspection Fee 08/22/2016 $300.00 (��I � !1'11 1 1 1 ail i 1 i I I A i{I I II11 Ill l ilh r 'tl I,. 'Il'l 1� P115.00.41.1 ,d,�;� �I .rTOTALIH;.EESr i �,, li��fu iiJl �71k i � Ing It 7 ���.��,uw ,�, .0 t6 al��, �� ii uu!aL.:-u 1 im INW NaIrdiiGl k'4 e 1•;wil IlWwlll!miim,:ii iir ltaill161111111I9' a1lpijF ,:.•jlial FEES ARE NON-REFUNDABLE ONCE A SITE VISIT IS MADE OR WORK ON A PLAN REVIEW HAS COMMENCED SYSTEM REDESIGN AND/OR RETRIP WILL INCUR AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) E9-ehappl ication 08/23/2016 08:16 Page 2 of 4 /$A •G THIS IS NOT A PERMIT Case # RBPR-08-2016-24560 t' a CATAWBA COUNTY HEALTH DEPARTMENT ;c.;... *El �` �`? •• :al PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES 1842 SM Residential Building Plan Review - Building New *o 0 D rr. • IMPROVEMENT- AUTH_CONST- NEW WELL e cardia Contractor *BUILD RIGHT CONSULTING, LLC. (WALTER JAMES ESTES III), PO BOX 367,TERRELL NC : H:704966149613:7044525789 C:7046410325 HOME:7049661496 BAINVEILLEHOLDINGS@GMA Owner PROGRESSIVE PROPERTY SOLUTIONS LLC, 4089 FALLEN PINE RD, SHERRILLS FORD NC 28 B:7046410325 NAME TO APPEAR ON PERMIT Pro• ressive Pro •e Solutions LLC SITE ADDRESS: 3920 MCGEE POINT RD,TERRELL NC 28682 PIN # 461714238515 NAME of SUBDIVISION: REDBUD FOREST l.,ot# 4 Section/Block PROPERTY SIZE: Square Fcet_ Acres 1.35 DIRECTIONS: 150E/right Sherrills Ford Rd/right on Hob Ln/2nd lot on corner of Hob Ln & McGee Point Ln PRIMARY CONTACT: Owner SEWER TYPE: Septic Tank GALLONS PER DAY: 360 WATER SUPPLY: Private Well DESCRIBE WORK: 2 story dwelling w/attached garage SITE INFORMATION Do any of the following apply to the property for which this application is applied? If the answer to any of the questions below is"YES", then supporting documentation is required: Does this site contain any jurisdictional wetlands? No Does this site contain any existing wastewater systems? No Is any of the wastewater going to be generated on the site other than domestic sewage? No Is the site subject to approval by any other public agency? Yes Are there any easements or right-of-ways on this property? Yes Property Easements Description: Duke Power APPLICATION FOR: New Structure STRUCTURE TYPE: PRIMARY RESIDENCE FACILITY TYPE: Single Family Residence OTHER DESCRIPTION: DESCRIPTION OF vacant EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: NUMBER OF EXISTING BEDROOMS: #OF OCCUPANTS: PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 50 x 53 #OF NEW BEDROOMS:: 3 BASEMENT? No BASEMENT FIXTURES? No PLUMBING REQUIRED?Yes Desired system types(Improvement Permit or Authorization to Construct): ACCEPTED: ALTERNATIVE: CONVENTIONAL: OTHER: YES INNOVATIVE: ANY: Other described: 25% reduction APPLICATION FOR WELL CONSTRUCTION PROPOSED WELL TYPE: Individual Well REPLACE WELL?: NO E9-ehapplication 08/22/2016 16.16 Page 1 of 4 4S CATAWBACOUNTY Casee RBPR-08-2016-24560 �Li-!�'✓•Gz Public Health Department Subdivision REDBUD FOREST d '�`^r,�a- H Environmental Health Division PINK ^ K 461714238515 /8PO Box 389, 100-A Southwest Blvd. Newton. NC 28658 ss NAME ON PERMIT: PROGRESSIVE PROPERTY SOLUTIONS LLC ( ), 4089 FALLEN PINE RD, SHERRILLS FORD NC 28673 Progressive Property Solutions LLC ( ) Site Address: 3920 MCGEE POINT RD, TERRELL NC 28682 Property Size: Square Feet Acres 1.35 Directions: 150E/right Sherrills Ford Rd/right on Hob Ln/2nd lot on corner of Hob Ln & McGee Point Ln Improvement Permits issued as a result of this information are valid for 5 years or may be non-expiring under certain specified conditions.An Authorization to Construct issued by this department is valid for(5)five years from the date issued and is not transferable; Improvement Permits and Well Permits are transferrable. Permits may be revoked if the information on this application,site plans or intended use changes for the proposed facility. I have read this application and certify that the information provided herein is true, complete and correct. Authorized county and state officials are granted right of entry to conduct necessary inspections to determine compliance with applicable laws and- les. derstand that I am solely responsible for the proper identification and labeling of all property lines and corners and making the site accessibl o t ,fo mplete site evaluation can be performed. � Date: r2�1c Signature of Applicant or Agent /L �� An Environmental Health Specialist will contact you wit"'n 5 working days of application date. If you need further information or assistance please call 828-466-7291 AREA1 i 'FEENAME .,k 4 _ DATE ' FEE AMOUNT] Authorization to Construct Fee (New/Expansion) 08/22/2016 $150.00 Fee Improvement Permit Fee 08/22/2016 $150.00 Well Permit& Inspection Fee 08/22/2016 $300.00 TOTAL FEES $600.00. 1 FEES ARE NON-REFUNDABLE ONCE A SITE VISIT IS MADE OR WORK ON A PLAN REVIEW HAS COMMENCED SYSTEM REDESIGN AND/OR RETRIP WILL INCUR AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) E9-ehapplication 08/22/2016 16:16 Page 2 of 4 CATA'WlatBA THIS IS NOT A PERMIT _coounrl,L7��V—V ima ` CATAWBA COUNTY HEALTH DEPARTMENT „7�e. oApplication for Environmental Services Page 1 Improvement Permi Authorization to Cons ructSeptic Repair n Septic Malfunction ❑ Septic Expansion E New Well Permit ieplacement Well ❑ Well Abandonment❑ Well Repair ❑ Existing System Inspection (Pre-Approval Required) D Application is f �New �Construction Existing Facility n Property Address 2Q Mirky J lJl 1 r 2J Subdivision�jR ct !DWI FOC ELS). - Lot# 1 1 Acres Section/Block/Phase Driving Directions to Property .) 0 .e -I-o 2 or, S r,'iIS Forel KPJ. h,517k 6Th * Rob Ln. 1 e..54 on en, <z-e_e., Pi-, P--d,. ; I nfi cir 1Q-±4) NAME TO APPEAR ON PERMIT? Owner H Applicant ❑ Contractor Applicant Contact Information Name 3 enE 5f e s Address Phone • Cell Phone boy - /— 03 25 Owner Contact Information Name 2c p-53,�,.e , •PcopW }i 1.A1n5 U--c- -4 Address po c 3(67 Phone '70y - (pH I - 032S Cell Phone Contractor Contact Information Name .R;,.-) Ii 4. Address Phone Cell Phone WHO WILL BE THE PRIMARY CONTACT? XOwner ❑ Applicant ❑ Contractor Description of Existing Structures on Site N/ ,A,_# of Bedrooms *j' .3 Structure Dimensions 0 k S 3 # of Occupants Basement (l Yes No Basement Fixtures a YesSNo The Applicant shall notify the local health department upon submittal of this application if any of the following apply to the property in question. If the answer to any question is "yes", applicant must attach supporting documentation. 0 Yes tkNo Does the site contain any jurisdictional wetlands? ri Yes *No Does the site contain any existing wastewater systems? i 7 Yes No Is any wastewater going to be generated on the site other than domestic sewage? Yes No Is the site subject to approval by any other public agency? 7 Yes ®No Are there any easements or right of ways on this property? Describe�✓ke- ?"`"��r Existing water supply in use ❑ Individual Well ❑ Community Well ❑ Semi-Public Well H County/City/Township Water Line Is a public water supply available? ** ❑ Yes 'o If applying for an Improvement Permit or Authorization to Construct, Please Indicate Desired System Type(s): \_./ (systems can be ranked in order of your preference) nry 0 Accepted ❑ Alternative ❑ Conventional 0 Innovative Other ,� "-) ��- 0 Any CATAWBA THIS IS NOT A PERMIT co`sUNTy � CATAWBA COUNTY HEALTH DEPARTMENT man �e� Application for Environmental Services Page 2 Proposed Facility Typ ❑ Primary Residence�J�,New�IResidence ❑ Addition to Residence #of New Bedrooms *j 3 IV Project Description Q.-Q hou3e . Structure Dimensions So 5'3 # of Occupants Basement ❑ Yes/X No Basement Fixtures Yes r,31o, D Accessory Structure(s) Describe J,1`,Ko 'J -Ji3Q �r� btrafP, 7 yX #of New Bedrooms *I if applicable Structure D.nei ions # of Occupants Accessory Dwelling ❑ Yes No Plumbing ❑ Yes ro Describe Plumbing Needed Multi-Family Residence# Units #Bedrooms per Unit*j' Total # Bedrooms *1' Structure Dimensions Food Service Specify Type # Seats Floor Space-Entire Food Service Facility (Sq Ft) #Employees per Shift #of Shifts Dining Area(Sq. Ft.) ❑ Business Specific Type of Business Retail Floor Space # of Employees per Shift # of Shifts ❑ Other Facility Type Specify If Church# of Seats Kitchen ❑ Yes ❑ No If Daycare Specify Occupancy Application for Well Construction/Abandonment/Repair Proposed Well Type Xlndividual Well ❑ Semi-Public Well J I Community Well Abandonment Type ❑ Drilled ❑ Bored ❑ Dug ❑ Unknown Well Repair Requested ❑ Yes ❑ No Describe Calculated Design Flow, Commercial fi Additional information may be required to determine design flow from certain facilities. This value will be determined during consultation with on-site staff. *Any room that will be intended for sleeping at the time of construction or for future consideration should be noted as a bedroom and counted on all applications. The number of bedrooms will be confirmed by rooms identified on house plans as a bedroom at the time of building permit issuance. This may prevent the need for septic system size increase in the future. t If structure is plumbed but no bedrooms, calculated design flow is required, � ** If No,a well permit must be issued with the Authorization to Construct. SYSTEM REDESIGN AND/OR RETRIP WILL INCUR AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) Improvement Permits issued as a result of this information are valid for 5 years or may be non-expiring under certain specified conditions.An Authorization to Construct issued by this department is valid for(5)five years from the date issued and is not transferable; Improvement Permits and Well Permits are transferrable. Permits may be revoked if the information on this application, site plans or intended use changes for the proposed facility. I have read this application and certify that the information provided herein is true, complete and correct. Authorized county and state officials are granted right of entry to conduct necessary inspections to determine compliance with applicable laws and rules. I understand that I am solely responsible for the proper id tification and labeling of all property lines and comers and making the site accessible so that a complete site evaluation can be p- dmed. Signature of Owner or Agent Date — 22 Jap rimed Name of Owner or ent �}/An 6S Ps Catawba County Environmental Health • (----- \.0 2 570,98 ak co W :I\ ii‘TIVstcota w0c?‘ 9 i508.. $ _ 1111 co 6"s Bio e Nit _ - s 60 o IL 21 a ...11111ase.zo „ Allfr is ' m ^ 0 111; ry, i i73 a A O� N J lii rI, f . \\71, o ' l O i \ O S (// 3 Parcel: 461714238515, 3920 MCGEE POINT RD lin=80ft TERRELL, 28682 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 08/22/2016 Parcel Report Page 1 of 1 Parcel Report - Catawba County NC Parcel Information: Owner Information: Parcel ID: 461714238515 Owner: PROGRESSIVE PROPERTY Parcel Address: 3920 MCGEE POINT RD SOLUTIONS LLC City: TERRELL, 28682 Owner2: LRK(REID): 803314 Address: 4089 FALLEN PINE RD Deed Book/Page: 3319/0051 Address2: Subdivision: REDBUD FOREST City: SHERRILLS FORD Lots/Block: 4/ State/Zip: NC 28673-8374 Last Sale: Plat Book/Page: 68/148 School Information: School District: COUNTY Legal: LOT 4 PLAT 68-148 Calculated Acreage: 1.350 Elementary School: SHERRILLS FORD Middle School: MILL CREEK Tax Map: Township: MOUNTAIN CREEK High School: BANDYS State Road #: 1843 School Map Tax/Value Information: Tax Rates(pdf) Zoning Information: City Tax District: All in County Zoning District: COUNTY County Fire District: SHERRILLS FORD Zoningl: R-30 Building(s) Value: $0 Zoning2: Land Value: $38,400 Zoning3: Assessed Total Value: $38,400 Zoning Overlay: CRC-O,WP-O Year Built/Remodeled: / Small Area: SHERRILLS FORD Current Tax Bill Split Zoning Districts: / Zoning Agency Phone Numbers Miscellaneous: Firm Panel Date: Building Permits for this parcel. Firm Panel #: Building Details 2010 Census Block: 5031 WaterShed: WS-IV Critical Area 2010 Census Tract: 011504 Voter Precinct: P41 Agricultural District: Parcel Report Data Descriptions List all Owners Deed History Report Assessment Report 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. ©2016, Catawba County Government, North Carolina. All rights reserved.^ 21 7z1(12rn SCcQ b http://gis.catawbacountync.gov/nomap/parcel_report.php?key=461714238515&typ=P 8/22/2016 „;;\ �� CATAWBA COUNTY Case # WLS2008-00037 /9 f I �t-,j,.s Public Health Department r° -j4imvironmental Health Division Subdivision `1114 Wit / PO Box 389.. 100-A Southwest BlvdNewton,NC 28658 SecUBUPh/Lot# 4 (828)465-8270 FAX(828)465-8276 TDD(828)465-8200 PINI! 911461714238219-4 Applicant/Owner KENNETH POPE Site Address: 4116 MCGEE POINT RD paS4ed c(-- Properly Size: SF 1.495 ACRES Directions: 16S/ 150 E/RT SHERRILLS FORD RD/RT MCGEE PT/SEE CORNER MARKER (REDBUD FOREST) AT CORNER OF HOB LN& MCGEE PT Improvement Permit Permit Valid For: Five years No Expiration Q Facility(Residential): House v4 House X Mobile Home Multi-Family Bedrooms _4_ New? ✓ Addition? Projected Daily Flow g.p.d Water Supply Private Well? Public? Semi-Public? Basement: Y Basement Plumbing: Y IiolTuh/Spa: Y Special Fixtures(explain): Proposed Wastewater System: /_�-/J�--5 ��a�/_ _ �_�j Type: _ e• Proposed Repair: PB �$ - _”/�-U,• OJ�z+a� "f / �> za- Permit Conditions:'W><�C /u ri= —fit L /! --uL Gu=e o�itttd _'ys Asn cGci dd/e0r Owner or Legal Representative Signature: r..� < Date: V 3? ce Authorized State Agent: /-1..;"-Cr/ �S• Date: , . a r The issuance of this permit by the Health Depart mem 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 'Lyes and Rules for Sewage Treatment and Disposal Svslem.s' (ISA NCAC ISA .1900). Neither Catawba County nor the Environmental Health Specialist warrants that the septic tank system will continue to function satisfactorily for:my given period of time. Authorization to Construct Wastewater System (Required for Building Permit), * See sire phut and additional attachments( ). Proposed Wastewater System: Type: Wastewater Flow g.p.d New Repair Expansion Soil LTAR: g.p.d./ft2 Type of Facility: Basement: A' Basement Plumbing: Y HotTub/Spa: Y Special Fixtures(explain): Wastewater System Requirements Tank Size: Septic Tank gal Pump Tank gal Grease Trap gal Drainfield: Total Area: sq fl Total Length: ft Maximum Trench Depth in Trench Width ft Minimum Soil Cover in Minimum Trench Seperation ft Distribution: Distribution Box Serial Distribution_ Pressure Manifold LPP_ Other Additional Specifications: Authorized State Agent: Date: Permit Expiration Date: /have read and accept the specifications and all conditions of this permit as indicated. Owner or Legal Representative Signature: Date: - ---_-- Form B •dlrrlr•m,A'i,mi VrrtS,rm,,pl —` CATAWBA COUNTY 3°r°�' ° Case# W LS200S-00037 etc,.,( Public Health Department (. u ' 4 j Environmental Health Division Subdivision Vv: �// PO Box 389, 100-A Southwest 13141.Newton.NC 28658 Sect/BL/Ph/Lot# 4 \--C;. ;---/ (828)465-8270 FAX(828)465-8276 TDD(828)465-8200 PIN# 911461714238219-4 Applicant/Owner KENNETH POPE Site Address: 4116 MCGEE POINT RD Property Si SF T49 ACRES Directions: 16S/ 150 E/ RT SHERRILLS FORD RD/ RT MCGEE PT/SEE CORNER MARKER (REDBUD FOREST)AT CORNER OF HOB LN& MCGEE PT ® Improvement Permit 0 Authorization To Construct El Well Permit SITE PLAN r /Vela_ : I vfeJeu)- r ..1, = �_ C 05y._so nc' C' aNPo 'o �-- �'G 73C— V`Z0 � c R lZ ter' Zit 1 v, 5). tt1 _) k' t G >' ( \D d . \I 314, � 1 / 00 ' = Scale System components represent approximate contours only. The contractor must flag the system prior to beginning the installation to ensure that proper grade is maintained. Do not install system under wet conditions. This permit is subject of revocation if the site plan or site conditions are altered. Authorized State Agent Date Form C rAriel.mm 4\FnnwVliLnnn.WI RA, 1 Z Q� 3'3 I.----r- , ... ... Ne `�tet/in " S R/W °ovea Ro o.- 0515(5 \ iZlil ' -r. N 33,3 �, ''r•,� ' 8�¢> : .9„:„......."71.:, . )1(....... 4..4V et. ' en.s'^ ' CJ4 1 1 ow .-I-,.... at V "a - Parke r� }� t ° -,-' o a U''s ! 91 toy y�6 . co -' m o pPP:��j .0(5 3 of a i i �et�`1) 12y \ \ o o •o ! ! a s. '' L ` 1, ao' SFr. \\ ��� \, \ t3 �;ti \\ - \:1 1. Q it Ni cyt 1 \'l / 1 USS �J • :\ : w i CrY \ N \ r' \ CSS ! s.W OL 2, CT e5`, ,� \ at, ,\ N` InCar 1 n cam \ of • \ to. W Q� Dk °,fl 953.. Page 346 rn —.___ _ • • - . -Th- _ L1Ile —'—\ _ rmiSS1OIl • DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES • DIVISION OF ENVIRONMENTAL HEALTH •ONSITE WASTEWATER SECTION PROPERTY ID : #k: SOIL/SITE EVALUATION COUNTY: (,tlriv. for ON-SITE WASTEWATER SYSTEM OAR APPLICATION DATE ADDRESS: PROPOSED FACILITY: PROPOSED DESIGN FLOW(.1949): PROPEDRTY SEE UAT7 D; $ y o i LOCATION OF SITE; D.Pd FSud 6 4(0 . WATER SUPPLY Private 0 PublicPROPERTY RECORDED: • LUATION Spring 0 Other EVA /NETEiOD: � Auger Boring rt 0 Cut TYPE OF WASTEWATER Sewage D Industrial Process El t fixed .. ......... : ..:::::::::::::::--[:::::::t .............::.: ,:: ::::::ifffl::::.:::::::::......:::::::_::::.::::::.:_::..::::::::::::::::::-::.::::::::::::::::::: :Ej..::;:::::::::::::!::;:::::::::::iii iiiiThiiiiiii_::::::::::::: ::: :::::::::::.... jiki:ki.!i..:..�; Ei - MI::;iiti.EM iS.b ...:::.:::::::::::::: :::::::¢i::::i:i:: ..i iiiiiliiiiRii€ iii-i ii:Iiiiii :31 tii ii:: ii !i_i i u-.th i4iiiigifl ifp;k::!!::: s!::'::::::::a:::::......:.............:::: ::::::::::::::::::::.........:_-........................ ... .., . ... .. :: ::: : ::::.... :::::::::::::......_::::::::::::::-::::,... 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I •DESCRIPTION TNIIALSYSTEM RE?AiltSYnM OTHER FACTORS(.1946): sam�-ella SITE CLASSIFICATION(.1948): - EVALUATED BY: LSI1 1A, l tt t i e r OTEIER(S)PRESENT: PCOMWfENT'S: • 3 ' DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES DIVISION OF ENVIRONMENTAL HEALTH Sheet '-• 3 of ON-SITE WASTEWATER SECTION PROPERTY ID#: SOIL/SITE EVALUATION COUNTY. rn#nU ra • for ON-SITE WASTEWATER SYSTEM OWNER: APPLICATIONDATE ADDRESS: ADDRSID FACILTIY: DATE EVALUATED;3 4 O t LOCATION OF SITE; r) „ ,,, ud PROPOSED DESIGN FLOW(.1949): PROPERTY SIZE: to 5 PROPERTY RECORDED: WATER SUPPLY: [3/Private 0 Public 0 Well 0 Spring 0 Other • EVALUATION METHOD: O Auger Boring WPit O Cut TYPE OF WASTEWATER: ESewage 0 Industrial Process 0 Mixed - lii€ii`!ii€t::[[t t�t:. :iii@:i =s:t::.ttt:is fiHii iteii,,iy:::tt:::iif:t::::':!_ii ii;iii t::iiitit::ii :iiti:::tiiii: :[ 'i[ ::t::::::::::::::_:i Iiii `ii:::::::::::::::::::iiiiiElj !!itEi:tilt:iit:: ::ttt:::l:;i d:i..a.::::'ti ...::-. .. .:t . t.'=.fr,iii: . i t ft "::.�;,;t:.; ,a:: i!iii .. .............(,1441j............................................................ ... .. .: :::::::::::::::: :::::::::::::::::::::::::::::::::::: ;:tii: ::t:• .194EElii. ._ FTi.E_�`A.CTOR5 SG1.EE ZOR 1941' 1941 SOIL 1943 1955 1944 a Bosr01vt DEPTx STRUC I/ILE> .�...CONSISTE. CE/ WETNESS/ $O ..„.„,:£ . ... ::SLORR Af : I't*I}..: .. . .T:Ex^i'17P.E.... .........ryt�E S4P.k0. ::RES.TR .. .. . PiALOGY :C[3fAR DEPTE. ;: .. CLh.SS.:. €` .' H>5R2Z I 'iEiEI'A`R;'i' . roo--s SS H I • i . I CTN. I. .SL-• I C,11 / S ,G,- • I S• • 33-5 IsbkS/ ' �- PS . I • SI SL 3 . 1 • • 3 I • 4 . I .. H • DESCRIPTION Lvsrml SYSTEM R PAIR SYSTEM OTHER FACTORS(.1946): • larlaSITE CLASSM-ICATION(.1948): iltaalEVALUATED BY: StkScut AA i II P OTHER(S)PRESENT; COMMENTS: , 3 • ` 3