Loading...
HomeMy WebLinkAboutRBPR-09-2016-24693.TIF $1.S3A THIS IS NOT A PERMIT Case# RBPR-09-2016-24693 ET a CATAWBA COUNTY HEALTH DEPARTMENT �0 PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES aF w /842 4A Residential Building Plan Review - Building Newir } * } AUTH_CONST - NEW WELL d•;q:• {,ry•}; b:111R���1 J yy� Contractor *GREY GATE PROPERTIES, LLC (BRUCE SUNDGREN), 1519 OAK PARK CT, IRON STATION N 28080 C:7042014822 SUNDGREN76@HOTMAIL.COM Owner GREY GATE PROPERTIES LLC. 1519 OAK PARK CT, IRON STATION NC 28080 B:704-240-4242 NAME TO APPEAR ON PERMIT GREY GATE PROPERTIES LLC SITE ADDRESS: 3806 E MAIDEN RD, MAIDEN NC 28650 PIN # 366604843529 NAME of SUBDIVISION: Lot# 2 Section/Block PROPERTY SIZE: Square Feet Acres 0.74 DIRECTIONS: 321 South, left on W Main St, Continue onto E Maiden Rd, Property across from Caleb Rd PRIMARY CONTACT: Contractor SEWER TYPE: Septic Tank GALLONS PER DAY: 360 WATER SUPPLY: Private Well DESCRIBE WORK: New, 60x60, one story single family dwelling, 3 bedrooms, no basement, attached garage w no bonus room. 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? No APPLICATION FOR: New Structure STRUCTURE TYPE: PRIMARY RESIDENCE FACILITY TYPE: Single Family Residence OTHER DESCRIPTION: DESCRIPTION OF EXISTING STRUCTURES ON SITE(IF ANY) DIM EXISTING STRUCTURE: NUMBER OF EXISTING BEDROOMS: 0 #OF OCCUPANTS: 5 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 60x60 single family dwelling #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: INNOVATIVE: ANY: YES Other described: APPLICATION FOR WELL CONSTRUCTION PROPOSED WELL TYPE: Individual Well REPLACE WELL?: NO E9-ehappheaiion 09/08/2016 15:00 Page 1 of 4 `cry,A CATAWBA COUNTY Case# RBPR-09-2016-24693 An 2 Public Health Department Subdivision ---�- —1 Environmental Health Division PIM 366604843529 ®r PO Box 389, 100-A Southwest Blvd,Newton,NC 28658 /8.2 :M NAME ON PERMIT: GREY GATE PROPERTIES LLC ( ), 1519 OAK PARK CT,IRON STATION NC 28080 GREY GATE PROPERTIES LLC ( ) Site Address: 3806 E MAIDEN RD, MAIDEN NC 28650 Property Size: Square Feet Acres 0.74 Directions: 321 South, left on W Main St, Continue onto E Maiden Rd, Property across from Caleb Rd Improvement Permits issued as a result of this information are valid for 5 years or may be non-expiring under certain spec -d co ditions.An Authorization to Construct issued by this department is valid for(5)five years from the date issued and is n. transferab-; Improv-ment Permits --.4Nell Permits are transferrable. Permits may be revoked if the information on this application,site plans or int: .ed use ch. ges for he proposed : i y. I have read this application and certify that the information provided herein is true, complete and co - ••uthorized .ounty,and statee .. ials are granted right of entry to conduct necessary inspections to determine compliance with applicable laws and understand jr-t4 am sole 'responsible for the proper identification orad I Atelingpf all property lines and corners and making the site accessi�b� •-t a compleetSi f rev.St'. can be performed. Date: / — '/ — Signature of Applicant or Agent �/J,i ' An Environmental Health Specialist will contact you withit - workingday 'ofappl' . tan�T If you need further information or assistanc=please call 828 '1 AREA1 "FEENAME DATE FF,E AMOUNT Authorization to Construct Fee (New/Expansion) 09/08/2016 $150.00 Fee Well Permit & Inspection Fee 09/08/2016 $300.00 I` 527TOTAL FEES- c0 .. .. 00 ,. �.:... . . . 11 L,.._.,.-..,,-. ESE ...... ... a... _.,-...�..�...-..._.........v_.._... .... ..-....,_V 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) 69-chappl icatiun 09/08/2016 15:00 Page 2 of 4 CATAWBA THIS IS NOT A PERMIT cairn CATAWBA CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services Page 1 Improvement Permit L Authorization to Construct Septic Repair ❑ Septic Malfunction 0 Septic Expansion ❑ New Well Permit® Replacement Well 0 Well Abandonment❑ Well Repair 0 Existing System Inspection(Pre-Approval Required) 0 Application is for New Construction ❑ Existing Facility ❑ Property Address 5130 /OA,t'x,C 4-b, Subdivision /lii9 r'7fo c- C ,-,2u( O Lot# Acres W • Section/Block/Phase Driving Directions to Property / s. jr) 14+9 Cr,oTi AP W(A 12f.J gp. "?7,617077 /�l 2(4.5 NAME TO APPEAR ON PERMIT? .%Owner Applicant 0 Contractor Applicant Contact Information Name &el/ &/.?cr ?%Z1af£im,3 LCC Address Jc)/�J 044 1,9/4er C'%. -7 7niv 5-,-;/%?CN A3c &Rojo Phone /764l -,7c/p - ya7vG, Cell Phone 'Ivy _ 'G/- 4/k�oZ Owner Contact Information Name Address Phone Cell Phone Contractor Contact Information_ Name/;cy U//i%t 12CPC'e'T/E5 C4C Address./5/9 OA/e Ase (Jr 2 4-t; 52;'7-7c' �G. oz Re_.> Phone .toy- -7yd- 7V,Z Cell Phone 90 <j _ 44,2-.7 WHO WILL BE THE PRIMARY CONTACT? Owner ©pplicant 0 Contractor Description of Existing Structures on Site /VOnJ5 tvettxt r #of Bedrooms st '3 Structure Dimensions X #of Occupants 5 j Basement 0 Yes [WNo Basement Fixtures Q Yes Kno The Applicant shall notify the local health department upon submittal of this application if any of the following apply to the property question. If the answer to any question is`yes", applicant must attach supporting documentation. El Yes tNo Does the site contain any jurisdictional wetlands? ® Yes EXI4 Does the site contain any existing wastewater systems? ® Yes El/ho Is any wastewater going to be generated on the site other than domestic sewage? Yes fel!o Is the site subject to approval by any other public agency? D Yes 04 Are there any easements or right of ways on this property? .Describe Existing water supply in use U Individual Well U Community Well. ❑Semi-Public Well ❑ County/City/Township Water Line Is a public water supply available? ** 0 Yes No 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) 0 Accepted 0 Alternative 0 Conventional 0 Innovative LEIOtherQ26j `0 2f Pan-7000 Any CATATHIS IS NOT A PERMIT ' VB COUNrt :_.-- . CATAWBA COUNTY HEALTH DEPARTMENT - ;,,,nCarann Application for Environmental Services Page 2 Proposed Facility Type �/ • ❑ Primary Residence [+� New Residence ❑ Addition to Residence #of New Bedrooms *t ' 3 Project Description NI f to C- - bre./l: Tion Structure Dimensions Coe X /1/20 #of Occupants 5 Basement ❑ Yes Er Basement Fixtures 0 Yes DYNo • Accessory Structure(s) Describe • #of New Bedrooms *t if applicable Structure Dimensions #of Occupants Accessory Dwelling 0 Yes ❑ No Plumbing"❑Yes ❑ No Describe Plumbing Needed • Multi-Family Residence#Units #Bedrooms per Unit t Total#Bedrooms *t Structure Dimensions _ ❑ Food Service Specify Type . . #Seats Floor Space-Entire Food Service Facility (Sq Ft) l ,• #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 0 No If Daycare Specify Occupancy Application for Well Construction/Abandonment/Repair - Proposed Well Type ©a Individual Well 0 Semi-Public Well 0 Community Well Abandonment Type [ Drilled 0 Bored 0 Dug 0 Unknown Well Repair Requested 0 Yes L'IIo Describe Calculated Design Flow,Commercial t 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 lime 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 applicition, : 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 theproper identification d-abeling offall property lines and corners and making the site accessible so that a complete site evaluation canb erformed: ✓ ' i �' -,•- //� Signature of Owner or Agent � n '" ‘4...------- Date 9'�- �to Printed Name of Owner or Age �/r1lGf r ["s2025"•1/43 Catawba County Environmental Health ..,„, N, ani'hi, .. h m�jhu .4I� I�I(iI (1'.i l j.: ry It. . ,,,co.if" tiOytIEµr� 7tli h cs N�Fu4t I�, aI pft.: le, liii lr?f d I �'�'ili�tiil1. co �l o •1 N It) 1111. O)la Pc O * cW0 ^ IS IN �9 I� I C °,t:' i -f-, � . � 30 got � P ��O o P _.--, Parcel: 366604843698, 3814 E MAIDEN RD lin=60ft MAIDEN, 28650 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 09/08/2016 Parcel Report Page 1 of 1 Parcel Report - Catawba County NC Parcel Information: Owner Information: Parcel ID: 366604843698 Owner: GREY GATE PROPERTIES LLC Parcel Address: 3814 E MAIDEN RD Owner2: City: MAIDEN, 28650 Address: 1519 OAK PARK CT LRK(REID): 201306 Address2: Deed Book/Page: 3278/0989 City: IRON STATION Subdivision: State/Zip: NC 28080-9357 Lots/Block: 3/ Last Sale: School Information: School District: COUNTY Plat Book/Page: 65/50 Elementary School: TUTTLE Legal: LOT 3 PLAT 65-50 Middle School: MAIDEN Calculated Acreage: .910 High School: MAIDEN Tax Map: School Map Township: CALDWELL State Road #: 1855 TaxNalue Information: Tax Rates(pdf) Zoning Information: City Tax District: All in County Zoning District: COUNTY County Fire District: BANDYS Zoningl: R-40 Building(s) Value: $0 Zoning2: Land Value: $12,500 Zoning3: Assessed Total Value: $12,500 Zoning Overlay: Year Built/Remodeled: / Small Area: BALLS CREEK Current Tax Bill Split Zoning Districts: / Zoning Agency Phone Numbers Miscellaneous: Firm Panel Date: 2007-09-05 Building Permits for this parcel. Firm Panel #: 3710366600J Building Details 2010 Census Block: 4008 WaterShed: 2010 Census Tract: 011602 Voter Precinct: P9 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. J- n° , \NP SWC 3 13dgm 9a& lda http://gis.catawbacountync.gov/nomap/parcel_report.php?key=366604843698&typ=P 9/8/2016 • ■ i� "--"I .f a Case t; CATAU'B.aCOl1N'I'1' ❑; � ❑ IA•1PV-0I-2015-057380 ita_� ��' Public Health Department 3 -, + 5► Subdivision �' % moi:} 73 '- PIN 366604843698 �< sy Environmental Health Division , PO 13 os 389, 100-A Southwest Blvd, Newton. NC 28658 , LOTH ti11 NAME ON PERMIT: GREY GATE PROPERTIES LLC, 1519 OAK PARK CT, IRON STATION NC 28080 Site Address: 3814 E MAIDEN RD, MAIDEN NC 28650 Property Size: Square Feel 390639.60 Acres .910 Directions: 321 South left on W Main St continue onto E Maiden Rd, property across from Caleb Rd Improvement Permit Facility: Accessory Structure Permit Category: New Septic Bedrooms 3 WATER SUPPLY: Private Well Basement? No Basement Plumbing? No 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: Keep all parts of septic system and repair system minimum: 50' from any well,10' from property lines, 5' from home including decks or patios. Lines to be installed on contour. Do not grade drive or fill over system or repair area or permit will be revoked. Evidence of water infiltration into pits at time of evaluation will require a curtain drain to divert subsurface water away from system. Curtain drain to be minimum: 15' from drain lines up slope from system. REPAIR SYSTEM SPECIFICATIONS Repair System Required? Required Proposed Wastewater System: 25% REDUCTION Type: IIIG - OTHER NON-CONV 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 oithis 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/Lonine 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 effected by a change in ownership of the property. This permit was issued in compliance with the provisions of the North Carolina 'Laws and Rules jar Se,,'a e Treatment and Disposal Systems' (ISA NCAC IAA .1900). Neither Catawba County nor the Environmental Health Specialist warrants that the septic tank system will continue to function salisfa etorily for any given period of time. Jason Boyd 01/29/2015 ACM 1012IZED STATE AGENT APPROVAL DAIE Permit Expiration Date: 01/29/2020 Aro grading or construction activity is allowed in areas designated for system and repair without approval of the Health Department. ehpermit 01/30/2015 09:23 Page 1 of3 v*).13A r CATAWBA COUNTY Permit# EHPR-1-tS-20728 Q G Name Gray Gate Properties LLC �, L Public Health Department Address 3822 E Maiden Rd Maiden NC < w;. ,S Environmental Health Division PJNx 366604843698 °:.#44 PO Box 389, I00A Southwest Blvd, Nestton NC 28658 — I$, 2 sm (828)465-8270 Fax (828)465.8276 TDD(828)465-3200 Lot 3 Site Plan Improvement Permit / ^ jrc ,n (, o )✓ o h 5 c ,J w e l--r Rt..., 4 , t\- I Sys}" ^ D .1 v‘ . l\- (� }' vn tA } J � a ?-S5° c ' {- S aor;r /nSPQ,,} i . -. y„, }" 1 4d * C ,iri-. i +s i.+ rc �1 12.a_d/ u , r47a o SYs�—r ID' (-., ollvcr{- S v � 5vr1F-ec,� I-- 'j.5 (°2` Si., � .,c. -dr a•.", y Fri n ti ' 6Gt S-LiS{ - � I , i5 Qsw. Li • J, 3R G o pc,,,, C0 ' 15' 1 .T IStn„•' SSI (- � 'A 2 lc- S0 A. `_ So fro P�1,H,:r j .¢� 99 :VR ' gz "+- 111/4"` ‘ ..).--'nIC' J Scale I Department of Environment,Health,and Natural Resources Sheet: Division of Environmental Health Property to. On-site Wastewater Section Lot#: SOIL/SITE EVALUATION File X: for ON-SITE WASTEWATER SYSTEM AppID: EHPR-1-15-20728 Owner: Grey.Gale Properties LLC Applicant: Address: 3814 E Maiden Rd _ Date Evaluated: 1/28/2015 Proposed Facility: 3 3R Home Design Row(.1949) 360 god Property Size: Location of Site: Lot 3 Progeny Recorded'. Water Supply: pvt well [ ]Spring J J Other Evaluation Method: pits by Bobby Dellinger [ ]Cut Type of Wastewater: X Sewage [ J Industria!Process [ 3 Mixed P - r.. r R O SOIL MORPHOLOGY b F '1941 PROFILE FACTORS 1 ..1940 .1942 L Landscape ;Horizon •.1941 - .1941 Soil .1943 .1956 .'..1944 Profile E Position/ : Depth j •Structure/ Consistence Wetness/•. Soil` .Sa pro - - Reslr Class A Slope% ; (IN.) . ;,Texture Mineralogy Color,,..1 Depth-(IN.) Class -: Horiz 8 LTAR 1 LL 4-6% 0-6" topsoil PS.3 6-36" SCL 36"-48" SC SS SP SEXP FR 48" 2 same as 1 approx 24"water infil 45" PS.3 3 same as 1 and 2 PS 3 4 5 6 7 Description Initial System Repair System Other Factors(.1946): Available Space(.1945) PS PS Soil Evaluation By: Jason Boyd System Type(s) IIIG IIIG Others Present: Bobby DPllinrter Site LTAR .3 .3 Site Classification(.1948): PS Site Evaluation By: Others Present Sheet: COMMENTS: FILE#: Landscape Position Group Texture .1955 LTAR Structure R-Ridge I S-Sand 1.2-0.8 SG-Single Grain 55-Shoulder Slope LS-Loamy Sand M-Massive LS-Linear Slope CR-Crumb FS-Poet Slope II SL-Sar.dy Loam 0.8-0.6 GR-Granular NS-Nose Slope L-Loam SBK-Subangular Blocky HS-Head Slope ABK-Angular Blocky CC-Concave Slope III SI-Silt 0.5-0.3 PL-Platy CV-Convex Slope SICL-Silty Clay PR-Prismatic T-Terrace Loam FP-Flood Plain CL-Clay Loam SCL-Sandy Clay Loam IV SC-Sandy Clay 0.4-0.1 SIC-Silty Clay C-Clay Consistence Consistence Mineralogy Moist Wet SEXP-Slightly Expansive VFR-Very Friable NS-Non-Sticky EXP-Expansive FR-Friable S5-Slightly Sticky FI-Firm S-Sticky VR-Very Firm VS-Very Sticky EPI-Extreme) Firm NP-Non-Plastic SP-Slightly Plastic P-Plastic VP-Very Plastic Sketch of Soil Evaluation Locations A/ 1 1 ti-0, I I r � lee VD tl WC- \ J c CATAWBA COUNTY Public Health Department Case# WLS2006-01852 I: t Fj ) Environmental Health Division Subdivision GEMINI HOMES. INC C),Irt•,.: t'/ PO Box 389.100-A Southwest Blvd.Newton.NC 2865R Sect/BIJPh/Lot# 3 (828 t 465-8270 FAX(828)465-8276 TDD i 828)465-8200 PIN# • - 91136(604845823-3 Applicant/Owner GEMINI HOMES CS}t'd 5C Site Address: E MAIDEN RD LOT 3 MAIDEN NC Property Size: SF .9111 ACRES Directions: HWY 321 S/TO MAIDEN TURN LF/GO TO E MAIDEN RD/LT ON LEFT ACROSS FROM CALEB RD �( Improvement Permit e Permit Valid For: Five years X No Expiration Facility(Residential): House House X Mobile Home Multi-Family Bedrooms 4 New? Sc Addition? Projected Daily Flow /iCC g.p.d Water SupplyPrivate Well? Public? Semi-Public? Basement: N Basement Plumbing: Hottlub/Spa: N Special Fixtures(explain): Proposed Wastewater System: 9 5 �o �UAC'1L " Type: 3 G Proposed Repair: r)50 I `C t.thtcr• 3 Cr- Permit TPermit Conditions: Owner or Legal Represents re Signatu Date: g — /o —a? Authorized State Agent: AV.-Cr/8.-C S .... / Date: /— 8-- 7 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' (ISA NCAC ISA.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. Authorization to Construct Wastewater System (Required for Building Permit) * See site plan 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. N Basement Plumbing: N Ho1Tub)Spa: N Special Fixtures(explain): Wastewater System Requirements Tank Size: Septic Tank gal Pump Tank gal Grease Trap gal Draintield: Total Area: sq ft Total Length. ft Maximum Trench Depth in Trench Width ft Minimum Soil Cover Minimum Trench Seperation It Distribution: Distribution Box SeritihDistribution Pressure Manifold LPP_ Other Additional Specifications: Authorized State Agent: Date: Permit Expiration Date: 1 have read and accept the specifications and all conditions of this permit as indicated. • Owner or Legal Representative Signature: Date: Form B \Ttd,,,, Vth,',VPoL�nou..m re/ CATAWBA COUNTY `I`µi r'u1111C Health Department Case# WLS2W6-01852 p` t Environmental Health Division Subdivision �;A.'�°"_ ��,•� GEMINI HOMES. INC ' ;�1`' ' PO Box 389.100-A Southwest Blvd,Newton.NC .28658 Sect/BL/Ph/Lot# 3 (828)465-8270 FAX 052%1465-8276 TDD(828)465-8200 PIN# 911366604845823-3 Applicant/Owner GEMINI HOMES Site Address: E MAIDEN RD LOT 3 MAIDEN NC Property S SF .911 ACRES Le '3 Directions: HWY 321 S/TO MAIDEN TURN LE/GO D F LAIDEN RD/ LT ON LEFT ACROSS FROM CALEB RD f0/ ® Improvement Permit CI Author zation To Construct IZI Well Permit SITE PLAN \ 4 ---- rA 1:i� I ��_ a5 5ci Re c%�^ ti i(v 75 a _Zo rplite4- Pre-- V I .f • - i- G oa' Scale .J�,wolf, I 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 an or site conditions are altered. Au rued State ent pate Form C • DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES Sheet / of / DIVISION OF ENVIRONMENTAL HEALTH PROPERTY II)W:4F0.437 ON-SITE WASTEWATER SECTION COUNTY: C' 1 SOIL/SITE EVALUATION OWNER: Stt DS {M' KR, APPLICATION N-SITE WA�3TEwTIOOND R SSYSTEIVTE /t-//- L ADDRESS: 34 31? /'i$i.y.on-- F C'll/mr I DATE EVALUATED: /-S- 1 PROPOSED FACILITY:/'L.44+- PROPOSED DESIGN FLOW(.1949): if 1rd PROPERTY SIZE: • N!/ LOCATION OF SITE: Zr,- U4-.a L ft- Lor 3 PROPERTY RECORDED: WATER SUPPLY: tvate 0 Public 0 Well 0 Spring 0 Other EVALUATION METHOD: 0 Auger Boring At 0 Cut TYPE OF WASTEWATER: newage 0 Industrial Process 0 Mixed Al ..._ .. ...... So L MO$PfbLOGY::! OTHIMR :: :: i A. P (1941):::::: is pIIOFIEESACTORS .::. L .. t940 £ LAND, _HOW-- .......................................... ......... !. -,; 1942 .. SCAPE ZON ' ' 1941- 1941 SO1L ;1943 1956 1944 PROFILE:: e POSITION/.. :DEPTH.: STRUCTURE/ CONSISTENCE) WE` $ESS/ SOIL SAPRO RESTR CLAS5.... ::SLOPE! .:!(IN) TEXTURE- --MINERALOGY COLOR DEPTHCLAS$ y ::::HOIDz . :;,&LTAR FI v -6 rite c{ i-x 6'IV s13 / s<2- ,-r 597 y rS 1 3- tel/ 5 I 1 0-110 (? rt, • C L, re,- r 1 c(---/ iouti 561.. sca Fr (D-(172 �� I> I 2i, _5 s"--- 1 4 DESCRIPTION INITIAL SYSTEM REPAIR SYSTEM OTHER FACTORS(.1946): Available Space(.1945) j .5 SITE CLASSIFICATION(.1948): it S System Types) d..5")U 0 S LQ EVALUATED BY: CJ 7P OTHER(S)PRESENT: Site LTAR , 35 , j S COMMENTS: LEGEND use the following standard abbreviations SOIL CONVENTIONAL LPP MINERALOGY/ LANDSCAPE POSITION GROUP TEXTURE .1955 LTAR' .1957 LTAR' CONSISTENCE STRUCTURE CC(Concave Slope) I S(Sand) 1.2-0.8 0.6-0.4 NEXP(Non-expansive) O(Single Gam) CV(Convex Slope) LS(Loamy Sand) SEXP(Slightly Expansive) M(Massive) D(Drainage Way) EXP(Expansive) CR(Crumb) DS(Debris Slump) H SL(Sandy Loam) 0.8-0.6 0.4-0.3 CR( (Granular) Blocky) FP(Flood Plain) L(Loam) FS(Foot Slope) ABK(Angular Blocky) H(Head Slope) III SCL(Sandy Clay Loam) 0.6-0.3 0.3-0.15 PL(Platy) L(Linear Slope) SiL(Silt Loam) PR(Prismatic) N(Nose Slope) CL(Clay Loam) R(Ridge) S1CL(Silty Clay Loam) MOIST S(Shoulder Slope) Si(Silt) T(Terrace) VFR(Very Friable) NS(Non-sticky) IV SC(Sandy Clay) 0.4-0.1 0.2-0.05 FR(Friable) 55(Slightly Sticky) SiC(Silty Clay) Fl(Finn) S(Sticky) C(Clay) VII(Very Finn v.Very Sticky) VS(very Sticky) 0(Organic) None ED(Extremely firm) NP(Non-plastic) SP(Slightly Plastic) 'Adjust LTAR due to depth,consistence,structure,soil wetness,landscape,position,wastewater flow and quality. P(Plastic) NOTES VP(Very Plastic) HORIZON DEPTH In inches below natural soil surface DEPTH OF FILL In inches from land surface RESTRICTIVE HORIZON Thickness and depth from land surface SAPROLITE S(suitable)or U(tmsuitable) SOIL WETNESS Inches from land surface to free water or inches from land surface to soil colon with chi-min 2 or less-record Munsell color chip designation CLASSIFICATION S(Suitable),PS(ProvisiorWly Suitable),orU(Unsuitable) Evaluation of saprolite shall be by pits. Long-term Acceptance Rate(LTAR):gal/day/ft' Show profile locations and other site features(dimensions,reference or benchmark,and North). 7 l` ' J ...3 i I . . I L., L ' ' _____....:: . ; . DENR(###1001) Review(N####)