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Home My WebLink AboutIMPV-09-2016-076678.TIF agA • CATAWBA COUNTY Case# 7,Ain? Public Health Department Subdivision "--" - -1 Environmental Health Division PIN# 362706302357 - 0 PO Box 389. 100-A Southwest Blvd.Newton.NC 28658 LOT# A I•.2 w NAME ON PERMIT: ZANE MICHAELS, PO BOX 993, DALLAS NC 28034 Site Address: 2783 ELBOW RD, NEWTON NC 28658 Property Size: Square Feet:435,600.00 Acres:10 Directions: 321 TO STARTOWN RD RIGHT ON ELBOW RD, LAND ON RIGHT PAST FARM & LAKE 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 .....04 property described above. Fc---A, As the property owner or authorized representative. I have received the above referenced permit(s) as requested iq the application for service RBPR-08-2016-24408 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 supply well permitted. Permit Issue Date: 09/12/2016 Owner/Authorized Representative Signature , i . '7 �se L� Date P—/ y 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 We want to hear from you. Please take a few moments to complete our customer service survey at: http://www.surveymonkey.com/s/ERCustomerService chperm it 09/12/2016 09:09 viA • CATAWBA COUNTY EN I ' 1`- rse Case# IMPV-09-2016-076678 <QCin Public Health Department Subdivision • r} , IfiarrigA Environmental Health Division 362706302357 PO Box 389. 100-A Southwest Blvd,Newton,NC 28658 iO •`O itO r LOT/4A . si t Er 1-1.9 .-44 NAME ON PERMIT: ZANE MICHAELS, PO BOX 993, DALLAS NC 28034 Site Address: 2783 ELBOW RD, NEWTON NC 28658 Property Size: Square Feet:435,600.00 Acres:10 Directions: 321 TO STARTOWN RD RIGHT ON ELBOW RD, LAND ON RIGHT PAST FARM & LAKE Improvement Permit Facility: Primary Residence - House Permit Category: New Septic Bedrooms 3 WATER SUPPLY: Private Well Basement? No Basement Plumbing? 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: REPAIR SYSTEM SPECIFICATIONS Repair System Required? Required Proposed Wastewater System: 25% REDUCTION Type: IIIG -OTHER NON-CONN 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' (ISA 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 09/12/2016 AUTHORIZED STATE AGENT APPROVAL DATE 09/10/2021 Permit Expiration Date: No grading or construction activity is allowed in areas designated for system and repair without approval of the Health Department. chpermit 09/12/2016 09:09 Catawba County Environmental Health ,4A- 5- 2o! 6 - 07668° VIII `l 2 0(6 - x7667`1 1L ' ( I ly , • • s90 n o rc*7 a L it o, Parcel: 362706302357, 2783 ELBOW RD tin=80ft NEWTON, 28658 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 09111/2016 1 p, o C rCh 3 q,0 - l (Z LL N, )k /r o- t S-. I ,.,.4k C ,275 I• L% �\ I