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Home My WebLink AboutIMPV-08-2016-076136.TIF 3,A CATAWBA COUNTY Case# IMPV-08-2016-076136 .litilic, Public Health Department Subdivision ADVENT ACRES H Environmental Health Division PIN# 277004608702 �` ip. PG Box 389. 100-A Southwest Blvd,Newton,NC 28658 LOT# 33 1842 ,u NAME ON PERMIT: JACK WILSON, 7305 HEMPHILL RD, CATAWBA NC 28609 Site Address: 7305 HEMPHILL RD, HICKORY NC 28602 Property Size: Square Feet: 134,164.80 Acres:3.08 Directions: 40 WEST EXIT 121, TOP OF RAMP TURN RIGHT ON 33RD ST SW KEEP STRAIGHT ONTO OLD SHELBY RD KEEP LEFT ON OLD SHELBY RD TURN LEFT ON HEMPHILL RD z. 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 p operty described above. As the property owner or authorized representative, I have received the above referenced permit(s) as r quested in the application for service RBPR-07-2016-24313 by the following method(s): Received in Person Facsimile Transmittal (Return form with signature required) Electronic Image Transmittal/ E-mail (Return receipt required) As 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 suppl - permitted. Permit Issue Date: 08/25/2016 Owner/Authorized Representative Signature ///,ar Date ` 9< h J Documentation Permit(s) Transmittal (permit transmitted i y electronic or other means) Permit transmitted by (name of person 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 dine'in 08/25/2016 10:36 RBPR 07-2016-24313 7305 Hemphill Rd, 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. • New 2 bedroom mobile home proposed. Will connect to existing septic system. • Existing septic system was visually functioning 8/17/2016, however no guarantee can be given as to its longevity. • New home, including decks and porches must be 5 ft from septic system and 25 ft from well. gS' 4 3� iaQ dal r� = tool �A vti• • CATAWBA COUNTY lap ' , i b❑� caw0 IMPV-08-2016-076136 iT } Public Health Department Fl ` Subdivision ADVENT ACRES o. �i Environmental Health Division �,'L-L, �y PINII 277004608702 /14411. � ti 0 r2 "4• PO Box 389. 100-A Southwest Blvd,Newton. NC 28658 r. LO'I# 33 /842 w a--. 8 Or-€:O al I rim NAME ON PERMIT: JACK WILSON, 7305 HEMPHILL RD, CATAWBA NC 28609 Site Address: 7305 HEMPHILL RD, HICKORY NC 28602 Property Size: Square Feet: 134,164.80 Acres:3.08 Directions: 40 WEST EXIT 121, TOP OF RAMP TURN RIGHT ON 33RD ST SW KEEP STRAIGHT ONTO OLD SHELBY RD KEEP LEFT ON OLD SHELBY RD TURN LEFT ON HEMPHILL RD Improvement Permit Facility: Primary Residence Permit Category: Other Bedrooms 2 WATER SUPPLY: Private Well Basement? No Basement Plumbing? No INITIAL SYSTEM SPECIFICATIONS Permit Valid: Expires In Five Years: No Expiration: _X_ Projected Daily Flow 240 g.p.d Proposed Wastewater System: CONVENTIONAL Type: IIA-CONV SYSTEM (SINGLE-FAMILY OR 480 GPD OR LESS) Permit Conditions: New MH will utilize existing system permitted in 2000. #8290 REPAIR SYSTEM SPECIFICATIONS Repair System Required? Required Proposed Wastewater System: DRIP IRRIGATION Type: IVA- ANY SYSTEM WITI-I LPP DISTRIBUTION PUMP 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 I3uilding 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 Rules for Sewage Treatment and Disposal Systems' (15A NCAC I8A.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 08/25/2016 AUTI-IORIZED STATE AGENT APPROVAL DATE 08/25/2021 Permit Expiration Date: No grading or construction activity is allowed in areas designated for system and repair without approval of the Health Department. ehpamit 08/25/2016 10:36 RBPR 07-2016-24313 7305 Hemphill Rd, 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. • New 2 bedroom mobile home proposed. Will connect to existing septic system. • Existing septic system was visually functioning 8/17/2016, however no guarantee can be given as to its longevity. • New home, including decks and porches must be 5 ft from septic system and 25 ft from well. gS' 4 3� iaQ dal r� = tool �A DEPARTMENT OF HEALTH AND HUMAN SERVICES 46re. 07- 7ot6 - 2.43/3 Sheet l of r DIVISION OF PUBLIC HEALTH,ENVIRONMENTAL HEALTH SECTION PROPERTY ID#: ON-SITE WATER PROTECf1ON BRANCH COUNTY: Catawba SOIL/SITE EVALUATION for ON-SITE WASTEWATER SYSTEM (Complete all fields in full) OWNER: w ISom _ APPLICATION DATE ADDRESS: DATE EVALUATED: g,7-17 PROPOSED FACILITY: PROP SED DESIGN FLOW(.1949): PROPERTY SIZE: LOCATION OF SITE: 7:oj hE.7,L..>/ PROPERTY RECORDED: WATER SUPPLY: 0 Private ❑Public M Well 0 Spring 0 Other EVALUATION METHOD: 0 Aur Boring . Pit 0 Cut TYPE OF WASTEWATER: OrSewage 0 Industrial Process 0 Mixed •0 SOIL MORPHOLOGY OTHER P (.1941) PROFILE FACTORS .1940 ▪ LANDSCAPE HORIZON POSITION/ DEPTH .1942 PROFILE # SLOPE% (IN.) .1941 .1941 SOIL .1943 .1936 .1944 CLASS STRUCTURE/ CONSISTENCE/ WETNESS/ SOIL SAPRO RESIR &LTAR TEXTURE MINERALOGY COLOR DEPTH CLASS 11ORIZ o , us6/c S« (c Ser S5 q it s cc rr Z2 wit,/ NA PS P,vg 1 a. /5— /S 22 L/4 t Cc�� /St Sr 2 z- W.r we p.„ • a -g '-'sot SLL fit SC -/7 « /=,L ftr ,U A- 1 P t-c..v N4 (5 4 2 fit )K- 3o Li,< , )S w • o—B L'S slc sc_ n/L- - .S 8- z3 s6cc- sc- 1C c re ' Nfr -z3 t1/0 .tri /9-f �,,n 3 1Jt z3-yo t.../L/Q o. (S • 4 • DESCRIVFION INITIAL SYSTEM REPAIR SYSTEM OTHER FACTORS(.1946): Available Space(.1945) SITE CLASSIFICATION(.1948): (7 <.s P5 �t EVALUATED BY: System Type(s) (' U n./1 r OTHER(S)PRESENT: Site LTAR t 0, lS COMMENTS: 4dc r-. rlry file DEPARTMENT OF HEALTH AND HUMAN SERVICES 46re. 07- 7ot6 - 2.43/3 Sheet l of r DIVISION OF PUBLIC HEALTH,ENVIRONMENTAL HEALTH SECTION PROPERTY ID#: ON-SITE WATER PROTECf1ON BRANCH COUNTY: Catawba SOIL/SITE EVALUATION for ON-SITE WASTEWATER SYSTEM (Complete all fields in full) OWNER: w ISom _ APPLICATION DATE ADDRESS: DATE EVALUATED: g,7-17 PROPOSED FACILITY: PROP SED DESIGN FLOW(.1949): PROPERTY SIZE: LOCATION OF SITE: 7:oj hE.7,L..>/ PROPERTY RECORDED: WATER SUPPLY: 0 Private ❑Public M Well 0 Spring 0 Other EVALUATION METHOD: 0 Aur Boring . Pit 0 Cut TYPE OF WASTEWATER: OrSewage 0 Industrial Process 0 Mixed •0 SOIL MORPHOLOGY OTHER P (.1941) PROFILE FACTORS .1940 ▪ LANDSCAPE HORIZON POSITION/ DEPTH .1942 PROFILE # SLOPE% (IN.) .1941 .1941 SOIL .1943 .1936 .1944 CLASS STRUCTURE/ CONSISTENCE/ WETNESS/ SOIL SAPRO RESIR &LTAR TEXTURE MINERALOGY COLOR DEPTH CLASS 11ORIZ o , us6/c S« (c Ser S5 q it s cc rr Z2 wit,/ NA PS P,vg 1 a. /5— /S 22 L/4 t Cc�� /St Sr 2 z- W.r we p.„ • a -g '-'sot SLL fit SC -/7 « /=,L ftr ,U A- 1 P t-c..v N4 (5 4 2 fit )K- 3o Li,< , )S w • o—B L'S slc sc_ n/L- - .S 8- z3 s6cc- sc- 1C c re ' Nfr -z3 t1/0 .tri /9-f �,,n 3 1Jt z3-yo t.../L/Q o. (S • 4 • DESCRIVFION INITIAL SYSTEM REPAIR SYSTEM OTHER FACTORS(.1946): Available Space(.1945) SITE CLASSIFICATION(.1948): (7 <.s P5 �t EVALUATED BY: System Type(s) (' U n./1 r OTHER(S)PRESENT: Site LTAR t 0, lS COMMENTS: 4dc r-. rlry file