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Home My WebLink AboutIMPV-12-09-3277.TIF IMPROVEMENT PERMIT Forofficeuse only ti- 'CDP File Number 3 6 9 7 7 Catawba County Public Health Department County ID Number: EHPR-11-09-2921 Environmental Health Division P.O Box 389, 100-A Southwest Blvd Evaluated For: FLOW * ~ Newton NC 28658 Township:-_',AP~ - I) -fq " 77 Phone: (828)-465-8270 Fax: (828) 465-8276 PEW.41T VALID UNTIL 12/10/2014 `NOTE TO INSPECTIONS DIVISION: Building Permits cannot be issued with this Improvement Permit. Applicant: Carolyn Worley Property Owner: Carolyn Worley Address: Address: 6447 Alley Rd City: City: Catawba State/Zip: NC State/Zip: NC Phone: Phone 461-7119 Property & Site Information Address/Road 11: Subdivision: Phase: Lot: 6407 Alley Rd Catawba NC Directions Structure: SINGLE FAMILY # of Bedrooms: 3 4 of People: 2 'Water Supply: EXISTING WELL System Specifications initial System 'Site Classification: Minimum Trench Depth: 4 Inches Design Flow: 3 6 0 Maximum Trench Depth'. 3 6 Inches Soil Application Rate: Septic Tank: 0 - 3 5 Gallons 1-Piece: QYes QNo `System ClassificationtDescription: TYPE III G. OTHER NON-CONY. TRENCH SYSTEMS Pump Required: QYes Q No Q May Be Required Pump Tank: Gallons 'Proposed System: 25% REDUCTION 1-Piece: QYes QNo Repair System Required:OYes QNo ONo, but has Available Space Repair System 'Site Classification: PS Minimum Trench Depth: 0 4 Inches Soil Application Rate: 0 3 5 Maximum Trench Depth: 3 6 Inches 'System Classification/Description: Pump Required: QYes QNo * Maybe Required TYPE III G. OTHER NON-CONY, TRENCH SYSTEMS Pump Tank: 1 0 0 0 Gallons *Proposed System. 25% REDUCTION Page 1 of 3 CDP File Numtier 36977 County ID Number: EHPR-11-09-2921 *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. Site Plan The improvement Permit shall be valid for 5 years from date of issue with a site plan (means a drawing not necessarily drawn to scale that shows the existing and proposed property lines with dimensions, the location of the facility 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 morethan 60 feet, that includes: the specific location of the proposed facility 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 130A-335(f)). The person owning or controlling the system shalt 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 Required? t e ONO Applicant1Legal Reps. Signature; / Date: .r` 'Issued 8y: 1952-Phelps, Robert f / Date of Issue: 1 a / 1 0 D 0 0 9 Authorized State Agent: ":4' ~ OValid without Expiration? *Hand Drawing Qlmport Drawing **Site Plan/Drawing attached.** Total Time:(HH:MfA) 0 Hours rat mutes Page 2 of 3 CDP File Number. 36977 County ID Number: EHPR-11-09-2921 Drawing Type: Construction Authorization Date: 1 a 1 0/ a 0 0 9 OInch Drawing Scale: QBiock ( N /A a 3 s 0 v ~s r K Y . (IV 1 ga Page 3 of 3 NCDENR' Division of Environmental Health "Date: i s/ o s /;?009 On-Site Wastewater Section Soil/Site Evaluation 'File 3 6 9 7 7 For On-Site Wastewater System PAN 4: EHPR-11-09-2921 'Owner Carolyn Worley Proposed Facility SINGLE FAMILY Proposed Design Flow (,1949) 3 6 0 Location of Site 6407 Alley Rd Property Size Water Supply EXISTING WELL Evaluation Method Pit 1d940 Horizon SOIL MORPHOLOGY Prof€le# Landscape Depth 1941 Other Profile POS Mineralogy Matrix Mottle Factors Slope (IN) Texture Structure Consistence Color Color 0--12 CL sbk fr ss sp 1942 Wet. o1Q 12-34 Sic abk it ss sp 1943 Depth 4 8 GPS Saprolite. (in) 34-48 Sic +sap 1944 Rest. Horizon EHS .1947 Crass Profite LTAR 0 . 3 5 0-24 CL sbk it ss Sp 1942 Wet. ofo 24-48 SCL sbk fr ss Sp .1943 Depth 4 8 CPS Saprolite:(in) 48-50 sbk fr ns np sap 11944 Rest. Horizon f 1947 Crass EHS Copy roAle IProfile 0 3 5 LTAR - .1942 Wet. °ro 1943 Depth GPS saprohte_(m) 1944 Rest. Horizon f + 1947 Class EHS Copy rOftre IProfile LTAR .1942 Wet. % .1943 Depth GPS Saprolrte_(in) .1944 Rest. Horizon 1947 Class EHS Copy rohle Profile PAR .1942 Wet % 1943 Depth CPS Saprolitojin) .1944 Rest. Horizon 1947 Class EHS Copy rofile Profile PAR Available Space (1945) OtherFactors(.1946) Site Classification (1948) Initial LTAR: o . 3 5 Repair LTAR: o . 3 5 Others Present: Comments: Evaluated By: Phelps, Robert NCDENR - Division of Environmental Health On-Site Wastewater Section Date: i l e x I a a 0 9 Soil/Site Evaluation File 9: 3 6 9 7 7 For On-Site Wastewater System PIN 9: E H P R- 1 1- 0 9 1940 Horizon SOIL MORPHOLOGY Prottle+ Landscape Depth 1941 Other Profile Slope % (IN) Mineralogy Matrix Mottle Factors Texture Structure Consistence Color Color 1942 wet. % 1943 Depth CPS Saproliteain) 1944 Rest, Horizon EHS 1947 Class Copy~rofde Profile LIAR .1942 wet. % .1943 Depth CPS Saprolrte (in) .1944 Rest. Horizon ~jo EHS .1947 Class Copy-p-'r011 lei Profile LTAR 1942 wet. % 1943 Depth CPS Saprollte (in) .1944 Rest, Horizon EHS 1947 Class Copy rofde Profile LTAR .1942 wet. % .1943 Depth CPS Saprolite (in) .1944 Rest. Horizon 1947 Class EHS Copf6rotile Profile LTAR .1942 wet. % .1943 Depth CPS Saprotite.(in) .1944 Rest. Horizon EHS 1947 Class Copy~rofiI Profile LTAR Comments: • . • • Attach Image The "Open Drawing Form" button, opens the the drawing form. The "Import" button, attaches the drawing, or other image into the space below. Open Drawing Form lf E+ r;`1 Profile: 1! X Y Z Profile: 2 X Y Z Profile: X Y Z Profile: X Y Z Profile: X Y Z Profile: X Y Z Profile: X Y Z Profile X Y Z Profile: X Y Z Profile: X Y Z