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Home My WebLink AboutIMPV-09-2016-076682.TIF C'Ary�!J,AQ CATAWBA COUNTY Case# ,{ Public Health Department Subdivision .<, —'75 het „�', Environmental Health Division PILAU 368804746467 ah- 'PO Box 389. 100-A Southwest Blvd, Newton,NC 28658 LOT# 3 lg42 sx. NAME ON PERMIT: PAUL NELSON, 2865 MATHIS CHURCH RD, CATAWBA NC 28609 Site Address: 2853 MATHIS CHURCH RD, CATAWBA NC 28609 Property Size: Square Feet:257,396.04 Acres:5.909 Directions: HWY 16 S LEFT ON BUFFALO SHOALS RD RIGHT ON LITTLE MOUNTAIN RD LEFT ON MATHIS CHURCH RD BESIDE 2850 MATHIS CHURCH RD ON LEFT SIDE Owner/Authorized Representative Acknowledgement of Permit Receipt eJ I certify that I am the owner or authorized agent(owner's authorization required) representing the owner of the erty described above. L. As the property owner or authorized representative, I have received the above referenced permit(s) as `requested in the application for service RBPR-08-2016-24511 by the following method(s): JReceived 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/Author'zed Representative Signatureac, Date ,. 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/EHCustomerService ehpermit 09/12/2016 09:19 7•. gA CATAWBA COUNTY �e Casc# IMPV-09-2016-076682 Public Health Department 1F� ! •• Subdivision 2VC-1'1:0%1V1 K, Environmental Health Division 'i+ PIN# 368804746467 PO Box 389, 100-A Southwest Blvd,Newlon.NC 28658 h � '% LOT# 3 4 i D.77 O, NAME ON PERMIT: PAUL NELSON, 2865 MATHIS CHURCH RD, CATAWBA NC 28609 Site Address: 2853 MATHIS CHURCH RD, CATAWBA NC 28609 Property Size: Square Feet:257,396.04 Acres:5.909 Directions: HWY 16 S LEFT ON BUFFALO SHOALS RD RIGHT ON LITTLE MOUNTAIN RD LEFT ON MATHIS CHURCH RD BESIDE 2850 MATHIS CHURCH RD ON LEFT SIDE Improvement Permit Facility: Primary Residence 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: See AC for permit conditions REPAIR SYSTEM SPECIFICATIONS Repair System Required? Required Proposed Wastewater System: 25% REDUCTION Type: LIIG -OTHER NON-CONN TRENCH SYSTEMS PUMP *MAY BE* 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 ol'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. Jason Boyd 09/12/2016 AUTHORIZED STATE AGENT APPROVAL DATE Permit Expiration Date: 09/10/2021 No grading or construction activity is allowed in areas designated for system and repair without approval of the Health Department. ehpermit 09/12/2016 09:19 �f Permit# RBPR-8-16-24511 CATAWBA COUNTY �� y 1G Name Paul Nelson 2 Public Health Department Address 2853 Mathis Church Rd Catawba ft-1 V P3r ri '< Environmental Health Division C;.ik PO Box 389, 100A Southwest Blvd, Newton NC 28658 NC 84.P 2 SM (828)465-8270 Fax (828)465-8276 TDD(828)465-8200 PIN# 368804746467 Site Plan Authorization to Construct I0 °' 5 amt,; A ..t 2seu,, Li G 5 .a7� C6 , 5„„ l LO erL C-rra) 9-�' u,� �ll a r"-% 0.-4--,0 7r Z c. [ .--.Q. I,J W / �e�fl to c/ o w 4 •-c . G c;r. c. N f � 1 Z' J Peel S5 nnn as L-~� - S' 00 1 1 $ I IQ 1 a- 3b' , eQ 1,L,... ' T 7 - " W _ - - --- - _ 3 u ./ I S dr.' '11/4") 0)-7r/ Luo- PP aS'a 4a_J , 77, Liss J 7V ( sa . g4 - (3-2 •ga ' iii c.+ c , _s C L, -, rc-Ls 4 ) / lc , - --- L , (- -- Lo + ^arc th_d p riot ir0 2v c (.,-ie � ' ^ P Scale — 6 O „ s l- b o t36---,...) a -(e 31.-/-E- we ICJ t c y ProM 5vst--*-n Department of Environment,Health,and Natural Resources Sheet: Division of Environmental Health Property ID: On-site Wastewater Section Lot it SOIL/SITE EVALUATION File#: for ON-SITE WASTEWATER SYSTEM AppID: RBPR-8-16-24511 Owner: Paul Nelson Applicant: Address: 2853 Mathis Church Rd Catawba NC Date Evaluated: 9/712016 Proposed Facility: 3 BR home Design Flow(.1949) 360 Property Size: Location of Site: Property Recorded: Water Supply: pvt well [ ]Spring [ 1 Other Evaluation Method: pits with bullzdoner by grader(Randy Sipe??) [ ]Cut Type of Wastewater: X Sewage [ ]Industrial Process [ ]Mixed ;lilt' 11 iW 's'.Stj�N1 ulqq !: �Io of -rrllil ! { 1 �' ' : u ! 4 °. yJl u,Er1,�I'+I�r'i ttn h. -t. i� N a::�,f� 'I r 1 '11!�, 11 I'l�(t ( I'1 li.��{1 _l�l ('��If� !'ii ,: II ' 111 ' ) I ']tu NI 'µ'"�'.'t$ 11°i� {c '' +� "� 1 ii R �� :+p t � i ;' l Y Y c. iir I {I..i i01 tl III 1I II ll1p I t' 111 ( I 'il) ]u ,4)1111 rih��i y !, y ` d lal ;4e NI �14'"hj r �: jl jrlt lI SOIL O�iIRIP�:HOILOGYi�I�1ik2 isa�. jllpi _ �1) �{„Ib, iikf.'4. :n' r, ' �e �I p� [•tile- 1 ,f b+� r1rll ii K e u I I r ! I I' -1 fp I I ( li 1311 I I Iti1+!*M: r IG I .411:11;:,114 S I ly I �pe t yNl t I hl I ( � t ] G'I { t 61 si Fllf a 1,(1 : , �� 'I I�Npil� mii t'iil ��941�,QI�u �1:�� , , Kiiiiti ��I ,i',�e •PROEILEIfF;4CTORSYat�itai�� a �� l h ',; �(�lf;I g.J40d��1�1 I, tl'�� i�11�iN l��l1y�I.) �'1t1��!. 'r ” " ' I l'1111�i%I• 194w 1,.u' { :HI�I I iii 71Ci In f I �I{11.yii I t' � ..a' ��i��(di"2 lIl ;{{t,,i 1,[tandscaperr [Horizon{� � 19411f' 11�� ,1 - 1941'4�'H1'.Sr . Iii i� 'I''. N'.', I :lit II i;44,by tl So11 1943 a 1956 1944 r l l ,tiiiy`,l, 1 IE "t' 91 Postlonl'I ;�D'�ep F Structueha I, 1({�j+ Cg�onsistence` I 1st ' Wetness�('i l I i1 ,.,'1Sol� ian o `i:�„F2estr .. ,61031',;:l I1:.,,;11pg{M.V � . " %kts\S ea l.'�9 iii � 1 tdro l chit 1„ iI'i' s net1X11i D pth NrV; ' CIa4 � 'N var .,]I rll (#, „�,�ilk 11;6,SIo e%L, WIIIN�I �_;��Text`u're m 1 lilt Mi`neralo j�� „uI�Colorl 111]till ��De th IN �*;;�Class ,.(,, Horiz„ Nti A� 8 L'^TARS Ih•,1 1 LL 2% 0-48" SC SS SEXP SP FR 48" PS.3 2 0-6" topsoil 48" PS.3 6-30" SCL SS SEXP SP FR 30-48" SC 3 4 Description Initial System Repair System Other Factors(.1946): Available Space(.1945) PS PS Soil Evaluation By: Jason Boyd System Type(s) IIIG IIID Others Present: Paul Nelson, Mrs Nelson,grader Site LTAR .3 .3 Site Classification(.1948): PS Site Evaluation By: Others Present: Sheet. COMMENTS: Lot graded for home and positive drainage prior to evaluation FILE#. Landscape Position Group Texture .1955 LTAR Structure R-Ridge I S-Sand 1.2-0.8 SG-Single Grain SS-Shoulder Slope LS-Loamy Sand M-Massive LS-Linear Slope CR-Crumb FS-Foot Slope II SL-Sandy 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 0.6-0.3 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 SS-Slightly Sticky Fl-Firm S-Sticky VFI-Very Firm VS-Very Sticky EFI-Extremely Firm NP-Non-Plastic SP-Slightly Plastic P-Plastic VP-Very Plastic Sketch of Soil Evaluation Locations S : 0 \ - -� S &-�