HomeMy WebLinkAboutIMPV-12-09-3254.TIF
IMPROVEMENT PERMIT For Office Use Onl
Catawba County Public Health Department CDP File Number 3 6 9 1 1
j; County ID Number: EHPR-11-09-2822
Environmental Health Division
P.O Box 389, 100-A Southwest Blvd Evaluated For: NEW
Newton NC 28658 Township:
Phone: (828)-465-8270 Fax: (828) 465-8276 PERMIT VALID UNTIL 1121/10/2014
*NOTE TO INSPECTIONS DIVISION: Building Permits cannot be issued with this Improvement Permit.
Applicant: Ron A Joyce Property Owner: Ron A Joyce
Address: 1676 Buffet Circle Address: 1676 Buffet Circle
City: Hickory City: Hickory
State/Zip: NC 28601 State/Z ip: NC 28601
~_Phone. ~.Phone-
Property Locati& Site Information
Address/Road Subdivision: Berkshire Place Phase: Lot: 14
1676 Buffet Cir
Hickory NC 28603 Directions
Structure: SINGLE FAMILY
# of Bedrooms: 3
# of People:
*Water Supply: COMMUNITY
System Specifications
Initial System
*Site Classification: Ps Minimum Trench Depth: Inches
Design Flow: 3 6 0 Maximum Trench Depth: 1 a Inches
Soil Application Rate: 3 Septic Tank: 1 0 0 0
Gallons
1-Piece: QYes QNo
*System Classification/Description: Pump Required: QYes O No 1,
TYPE III G. OTHER NON-CONV. TRENCH SYSTEMS p May Be Required
Pump Tank: 1 0 0 0 Gallons
*Proposed System: 25°i° REDUCTION 1-Piece: QYes Q N o
Repair System Required: (9Yes ONo ONo, but has Available Space
Repair System
Site Classification: PS Minimum Trench Depth: Inches
Maximum Trench Depth: 1 g
Soil Application Rate: 3 Inches
*System Classifcatio n/Description: Pump Required: kpYes QNo Q May be Required
TYPE III G. OTHER NON-CONY. TRENCH SYSTEMS Pump Tank: 1 0 0 0 Gallons
*Proposed System: 25% REDUCTION
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CDP File Number 36911 County ID Number: EHPR-11-09-2822
*Site Modifications ❑ Open Fill Sheet
No grading or construction activity is allowed in areas designated for system and repair without approval of Health Department.
*Permit Conditions
The issuance of this permit by the Health Department in no way guarantees the issuance of other permits. The permit holder
is responsible for checking with appropriate governing bodies in meeting their requirements.
The improvement Permit shall be valid for 5 years from date of issue with a site plan (means a drawing not necessarily drawn to
Site Plan scale that shows the existing and proposed property lines with dimensions, the location of thefacility and appurtenances, the
site for the proposed Wastewater system, and the location of water supplies and surface waters).
Plat The Improvement Permit shall be valid without expiration with plat (means a property surveyed prepared by a registered land
surveyor, drawn to a scale of one inch equals no more than 60 feet, that includes: the specific location of the proposed facility
O
and appurtenances, the site for the proposed Wastewater system, and the location of water supplies and surface waters. Plat
also means, for subdivision lots approved by the local planning authority and recorded with the county register of deeds, a copy
of the recorded subdivisions plat that is accompanied by a site plan that is drawn to scale).
The Department and Local Health Department may impose conditions on the issuance and may revoke the permits for failure of
the system to satisfy the conditions, the rules, or this article This permit is subject to revocation if the site plan, plat, or intended
use changes (NCGS 13oA335(f)). The person owning or controlling the system shall be responsible for assuring compliance
with the laws, rules, and permit conditions regarding system location, installation, operation, maintenance, monitoring,
reporting, and repair (.1938(b)~
Applicant/Legal Reps. Signature R Ired? O es ONO
Applicant/Legal Reps. Signature: Date: 0 /
'Issued By: 1896 -Lucas Sears 0 Date of Issue: 1 a / 1 0 / a 0 0 9
Authorized State Agent: i OValid without Expiration?
OHand Drawing Olrtiport Drawing
**Site Plan/Drawing attached.** Total Time-.(HH:MM)
0 0 Hours Minutes
Page 2 of 3
CDP File Number: 36911 County ID Number: E"PR-11-09-2s22
Drawing Type: Construction Authorization Date: 1 2 / 0 8
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Drawing Scale: ON Ack = ft.
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