HomeMy WebLinkAboutIMPV-09-2016-076491.TIF �q CATAWBA COUNTY
T P; Public Health Department Subdivision
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Q ""`' � 9 Environmental Health Division PIN# 365605189139
� "'1. PO Box 389, 100-A Southwest Blvd,Newton,NC 28658 L0T# 2 A
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NAME ON PERMIT: ROCKY HILTON, 847 OAK ST, NEWTON NC 28658
Site Address: 2237 E MAIDEN RD, MAIDEN NC 28677
Property Size: Square Feet:435,600.00 Acres:10.00
Directions: E Main St toward E Maiden Rd, Property across from Withers Rd
Owner/Authorized Representative Acknowledgement of Permit Receipt
\/(1171-Certify that I am the owner or authorized agent(owner's authorization required) representing the owner of the
property described above.
' s the property owner or authorized representative, I have received the above referenced permit(s) as
requested in the application for service RBPR-07-2016-24344 by the following method(s):
V Received in Person
Facsimile Transmittal (Return form with signature required)
Electronic Image Transmittal/ E-mail (Return receipt required)
All'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 supply well permitted.
Permit Issue Date: 09/06/2016
Owner/Authorized Representative Signature (2c� -----____
Date — 7 — /(0
Documentation of Permit(s) Transmittal
(permit transmitted by 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
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ehpermit 09/07/2016 16:07
,4g,A •a CATAWBA COUNTY 0 '�o -t�l�0 Case# IMPV-09 2016 076491
N GL Public Health Department .y _ '\ :Jai. Subdivision
Environmental Health Division r - ',c,` ',.„:1 PIN# 365605189139
�� PO Box 389, 100-A Southwest Blvd,Newton,NC 28658 i LOT# 2 A
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NAME ON PERMIT: ROCKY HILTON, 847 OAK ST, NEWTON NC 28658
Site Address: 2237 E MAIDEN RD, MAIDEN NC 28677
Property Size: Square Feet:435,600.00 Acres:10.00
Directions: E Main St toward E Maiden Rd, Property across from Withers Rd
Improvement Permit
Facility: Primary Residence - house
Permit Category: New Septic Bedrooms 4
WATER SUPPLY: Private Well
Basement? No Basement Plumbing? No
INITIAL SYSTEM SPECIFICATIONS
Permit Valid: Expires In Five Years: _X_ No Expiration:
Projected Daily Flow 480 g.p.d
Proposed Wastewater System: 25% REDUCTION
Type: IIIG-OTHER NON-CONY TRENCH SYSTEMS
Permit Conditions: Do not grade, drive or fill over any septic area.
REPAIR SYSTEM SPECIFICATIONS
Repair System Required? Required
Proposed Wastewater System: 25% REDUCTION
Type: IIIG-OTHER NON-CONY TRENCH SYSTEMS
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 Rules for Sewage Treatment and Disposal Systems' (15A 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 period of time.
Robbie Phelps 09/06/2016
AUTHORIZED STATE AGENT APPROVAL DATE
Permit Expiration Date:
09/03/2021
No grading or construction activity is allowed in areas designated for system and repair without approval of the Health Department.
ehpermit 09/07/2016 16:05
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Parcel: 365605189139, 2237 E MAIDEN RD 1 in=80ft
MAIDEN, 28650
This map/report product was prepared from the Catawba County,NC Geospalial 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
09/06/2016
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Parcel: 365605189139, 2237 E MAIDEN RD lin=80ft
MAIDEN, 28650
This map/report product was prepared from the Catawba County.NC Geospallal 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
09/0612016
DEPARTMENT OF IIgv1&oNMENr AND NATURAL RESOURCES S1'c—of_.
DIVISION OF DNVIRONMENIAL HEALTH PROPERTY ID N:
ON-SHE WASIEWATERSECIION COUNTY:
SOIIJSITE EVALUATION
i', .I jor ON-SITE WASTEWATER SYSTEDi
OWNER: y r fah APPLICATIONDAlE DATE EVALUATED: a•--z.1
ADDRESS` • Z2 57 ��r✓�.r
PROPOSED FACILITY: rI 67- PROPOSED DESIGN FLAW(•1949):-112— PROPERTY SI7
LOCATION OF SITE PROPE%TY RECORDED
WATER SUPPLY: Private Public ftWcn 0 Sring [I Other
EVALUATION MEIEOD U Auger Boring ft Pit U Cut
TYPE OF WASIEWATEt. a Sewage o Indtataal Process 0 T+fixed
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