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HomeMy WebLinkAboutEHPR-02-2016-23279.TIF $A ■� THIS IS NOT A PERMIT Case # EHPR-02-2016-23279 arc, H CATAWBA COUNTY HEALTH DEPARTMENT 0 o..2.10 '" PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES /842 sM Environmental Health Plan Review - OSWP tio?. • 13+ 4713 IMPROVEMENT ti:{. , 0e. . w Applicant DG HOME SERVICES LLC (DAN GOETZ), 1125 PHILLIPS LN, STATESVILLE NC 28625 H:7042017181 C:7042017181 HOME:7042017181 Owner NORBERTO& IRASEMA SANCHEZ, 1830 SUGARLOAF CLUB DR, DULUTH GA 30097 C:7048777138 NAME TO APPEAR ON PERMIT Norberto & Irasema Sanchez SITE ADDRESS: 8304 AEROMARINE BLVD, CATAWBA NC 28609 PIN # 471003310511 NAME of SUBDIVISION: LONG ISLAND AIRPORT PH 4 Lot# 1 Section/Block_ PROPERTY SIZE: Square Feet 87,555.60 Acres _ 2.01 DIRECTIONS: Hwy 150 East, Left on Sherrills Ford Rd, Right on Mollys Backbone, Right on Monbo, Right on Saunders, Right on Aeromarine Dr, House is the 1st on Right with a circle drive. PRIMARY CONTACT: Applicant SEWER TYPE: Septic Tank GALLONS PER DAY: 480 WATER SUPPLY: Private Well DESCRIBE WORK: IP to determine exact septic location, Expansion area & future repair area. Proposing to add Pool w/ concrete 85x46 & Cabana 50x26. Cabana will have a full bathroom: sink, toilet& Shower. Per MC will require an additional 120 gallons per day. Also finishing the basement to include another full bathroom. No addition to gallons per day per MC for basement finishing. Current home is 3 BdRms 360 gallons per day. With additional 120 gallons per day. Total 480 gallon per day. 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? Yes 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? No Are there any easements or right-of-ways on this property? No APPLICATION FOR: Existing Structure STRUCTURE TYPE: PRIMARY RESIDENCE FACILITY TYPE: House OTHER DESCRIPTION: DESCRIPTION OF House EXISTING STRUCTURES ON SITE(IF ANY) DIM EXISTING STRUCTURE: 80x80 NUMBER OF EXISTING BEDROOMS: 3 #OF OCCUPANTS: 5 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: Cabana 50x26, Pool w/Concrete 85x46 BASEMENT? Yes BASEMENT FIXTURES? Yes PLUMBING REQUIRED? Desired system types (Improvement Permit or Authorization to Construct): ACCEPTED: ALTERNATIVE: CONVENTIONAL: OTHER: INNOVATIVE: ANY: YES Other described: E9-ehapplication 02/25/2016 1456 Page I of 5 �y,A CATAWBA COUNTY Case# EHPR-02-2016-23279 -7&t i`ft Public Health Department Subdivision LONG ISLAND AIRPORT PH 4 .�'°"Y® , , Environmental Health Division PIN# 471003310511 >" v PO Box 389, 100-A Southwest Blvd, Newton.NC 28658 /842 ski NAME ON PERMIT: (NORBERTO& IRASEMA SANCHEZ), 1830 SUGARLOAF CLUB DR, DULUTH GA 30097 ( Norberto & Irasema Sanchez) Site Address: 8304 AEROMARINE BLVD, CATAWBA NC 28609 Property Size: Square Feet 87,555.60 Acres 2.01 Directions: Hwy 150 East, Left on Sherrills Ford Rd, Right on Mollys Backbone, Right on Monbo, Right on Saunders, Right on Aeromarine Dr, House is the 1st on Right with a circle drive. 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 application,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 the proper identification and labeling of all property lines and corners and making the site accessible so that a comp:t2.0.eval 9fion can be performed. Date: 22_ t CC, Signature of Applicant or Agent __C 5 An Environmental Health Specialist will contact you within 5 working days pplication date. If you need further information or assistance please call 828-466-7291 AREA1 **#*4**********************************************************************************************4******** t ac 1TM .. ias " Sr i P rr� l w M w^ e i; FEENAMEI 3 it a 44 DATEf 'FE OUNT i ..Improvement Permit Fee 02/25/2016 $150.00 11 P4ov� OTFEES v :slk a s inure.: r a . $15 i.. bv TAL 4Tf r si rS h•Asa . Ir 4: 0 OOga FI..I y 5 �......�S�sut .'.,....�....ti:Mr,,,HdN,.. e. r '.,cjur�d.R.■.,aG.:.v , .,.cP.r r..v_+^:t _ ..'.,'a...fi....uLd.OS$ ,>3, lt@.;Jt:3 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-ehapplication 02/25/2016 14:56 Page 2 of 5 CATAWBA THIS IS NOT A PERMIT counn CATAWBA COUNTY HEALTH DEPARTMENT a Application for Environmental Services Page I N h C oinw Improvement Permit Authorization to Construct❑ Septic Repair❑ Septic Malfunction ❑ Septic Expansion ❑ New Well Permit❑ Replacement Well n Well Abandonment❑ Well Repair ❑ Existing System Inspection (Pre-Approval Required) ❑ ( Application is for New Construction ❑ Existing Facility tt Property Address O, 3CI /Ego a. Q Subdivision Lode TC k-'r° /1/414P°A &1R Lot# Acres Section/Block/Phase Is Driving Directions to Property E-f uf; (S O E1 L SE— cc-) S e- sl.ytt Lcf F cj pso Est ov v^a Cc .s (3,-s ct&\3oc- c 4-Abs-o- o t.) ,vio k.J(3O 'i-s AL6 h� otr - Pc.% och argji it (1)--k,6 6(tT c c }'U/Lo wti+ifLl Fr oc-> (e r G Nl NAME TO APPEAR ON PERMIT? Owner ❑ Applicant ❑ Contractor f /' Applicant Contact Information Name GoC'm Address (Z s 5 Pr{i CC_ t 0-5 L A NC S TpTL--I V L-cE IJ C. Phone 704 — 2O L— ?t ■ Cell Phone '7Oc(- 201 — ?Is'( Owner Contact Information Name N(od)--&=(PTO (tlV/� XI*1\ 3.l1t-?'C1ic Address Coh2Lc ( 4- CL(-) & o ?.-, Phone Cell Phone 7 Oct y7? 7( e Contractor Contact Information Name License# Address Phone Cell Phone WHO WILL BE THE PRIMARY CONTACT? ❑ Owner ❑✓Applicant ❑ Contractor /" Description of Existing Structures on Site 2 sic fl CN CV f'-Jt G t'-G L. pa=✓ Nco ?R(0.+ o ham ` # of Bedrooms *j 3 Structure Dimensions 20' '> ?0' # of Occupants S Mal- Basement [Yes ❑ No Basement Fixtures ❑ Yes P^No L t,- " Of/ f — The Applicant shall notify the local health department upon submittal of this application if any of the following apply to the property in question. If the answer to any question is "yes", applicant must attach supporting documentation. ❑ Yes EiNo Does the site contain any jurisdictional wetlands? El/Yes ❑ No Does the site contain any existing wastewater systems? ❑ Yes E6lo Is any wastewater going to be generated on the site other than domestic sewage? ❑ Yes O"No Is the site subject to approval by any other public agency? ❑ Yes 6Z-No Are there any easements or right of ways on this property? Describe Existing water supply in use Z.Individual Well ❑ Community Well ❑ Semi-Public Well ❑ County/City/Township Water Line Is a public water supply available? ** ❑ Yes .5k/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) � V ❑ Accepted ❑ Alternative ❑ Conventional ❑ Innovative ❑ Other lla'Any po0L ? o_ cp CATAWBA THIS IS NOT A PERMIT . COUNTY CATAWBA COUNTY HEALTH DEPARTMENT . „,,,„c,,, Application for Environmental Services Page 2 Proposed Facility Type ❑ Primary Residence n New Residence n Addition to Re ice,*c # o New Bedrooms *j Project Description �fTt qa\-of - WJ t) h(z . Structure Dimensions # of Occupants Basement ❑ Yes n No Basement Fixtures n Yes ❑No III Accessory Structure(s) Describe Me IThe Ili U `�# J • # of New Bedrooms *t if applicable Structure Dimensions # of Occupants Accessory Dwelling es N Plumbing"Yes No Describe Plumbing Neede \\ � ❑ 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) # 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 n Yes No If Daycare Specify Occupancy Application for Well Construction/Abandonment/Repair Proposed Well Type ❑ Individual Well n Semi-Public Well n Community Well Abandonment Type n Drilled n Bored ❑ Dug n Unknown Well Repair Requested ❑ Yes ❑ No 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 time 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 application, 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 the proper identification and labeling of all property lines and corners and making the site accessible so that a complete site evaluation can be performed. Signature of Owner or Agent C5------9e ..47- Date 2 _ 2S— L& Printed Name of Owner or Agent B Ak-) tsL C & aLT2 Catawba County Environmental Health Ur , .a a n'J � S,QGy , 305.59 o `\' .,, 0 ./ s '7 53.56 Pr-t. c4 1..53 ■ t S-11 . 1 X60 � `/ 1.92 J' S J5, r / i ..., N l \is\ 29.35 $It4 t"`- IVA.� • 'phi a4 • Ott' s, p 1n' 01 t-. fi,. , f, Parcel: 471 00331 051 1 , 8304 AEROMARINE 1 in=60ft BLVD CATAWBA, 28609 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 02/25/2016 ` T , \ \ • ,- . '0 \ ''�„- EDGE OF WOODS . `y �/ _ ..� `? v I 862.63 U +&5: 3 4h: J � \856 69 •..77'�((j�• Cl 1I \`; V 60'. SB '°.\ 7856 856.77 20 OAK :CT �� i• \.; v _� C v 86239 \ I . \ r , \ V S 7�, ''+85602 '� \a ±861 42 • +853.8 855 83 \ II��1,� �i `` - aT' e •' +BSSI59 849.64 N i 861 + 2 C \ 4"LT\\1 \ \\ \S. !)� �>j L.-- 86 66 643 1'+ 60 6 0• +860.42 \ _� s 1\ 00 848.67 1 \ 'CS r V° gy- 1�•"� �� p f Tv )j 'F 27V re 1 , 849. - * 11` . ° 62 42 V i i 861.27 858.59 o 'II '\ �<".�':. ! \ " +85881 • 0! can \ +�` 8 6v' F@4�� 'J x+867 93 +84676 o i fF1 'c 7 Ov \� f 865.33 +65652: 6 98 44/414-r�WALL• 6b.''/+c`85747 . - 1 \ - 8421 �., q Se 222 J). OAK \\ 4, Y 862.84 ) i /Coe i - . . �.. . +852.10 \ \ ' 1 i / , >• ,_L 1} 847.11 18 OAK 4 \� +85 BO :,', RET WALL1/ 551 #1 ' : \ iii , .7,13- . '! ••• .`"` +839.02• \ ` , ' j85407�WELL ♦` .V e +847.88 \\ \.\ +/ `�.i.,.-1-5-i..77—...: iF may. n�(] +851.97. v - \\ t!50.71."'" r .843.11 \`. ri/ j+84346: +836.90 +852.87 4,\ 18" CMP r +842.67 1 i \ v • i'il-�° 1\�j v' y \ +843.77 el 18" CMP . .:.,�_, 2.015 AC +/- -I1 6's` +837.68 ri,1,�9� / (\ 62-160 <j� / 4 / ■ / • .SCI ti o #4 REaAR / ' / O 4 1 / / / 7 V / / / DATE: 10-21 -2015 DB: 3103 DEDMON SURVEYS crni c. 1 " — An' DB: Parcel Report Page 1 of 1 Parcel Report - Catawba County NC Parcel Information: Owner Information: Parcel ID: 471003310511 Owner: SANCHEZ NORBERTO Parcel Address: 8304 AEROMARINE BLVD Owner2: SANCHEZ IRASEMA City: CATAWBA, 28609 Address: 1830 SUGARLOAF CLUB DR LRK(REID): 301112 Address2: Deed Book/Page: 3103/1095 City: DULUTH Subdivision: LONG ISLAND AIRPORT PH 4 State/Zip: GA 30097-7451 Lots/Block: 1/ Last Sale: School Information: Plat Book/Page: 50/160 School District: COUNTY Elementary School: CATAWBA Legal: Calculated Acreage: 2.010 Middle School: MILL CREEK Tax Map: High School: BANDYS Township: CATAWBA School Map State Road #: Tax/Value Information: Tax Rates(pdt) Zoning Information: City Tax District: All in County Zoning District: COUNTY County Fire District: SHERRILLS FORD Zoningl: R-30 Building(s) Value: $652,900 Zoning2: Land Value: $79,700 Zoning3: Assessed Total Value: $732,600 Zoning Overlay: WP-O Year Built/Remodeled: 2007/ Small Area: SHERRILLS FORD Current Tax Bill Split Zoning Districts: / Zoning Agency Phone Numbers Miscellaneous: Firm Panel Date: 2008-03-18 Building Permits for this parcel. Firm Panel #: 3710471000K Building Details 2010 Census Block: 1019 WaterShed: WS-IV Critical Area 2010 Census Tract: 011503 Voter Precinct: P21 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. ©2015, Catawba County Government, North Carolina. All rights reserved. %O YDAtOi\S per coin Rced ?cc roc> c Cloonc\. http://gis.catawbacountync.gov/nomap/parcel_report.php?key=471003310511&typ=P 2/25/2016 -1\, CATAWBA COUNTY 51 '`t' \ Public Health Department Case8 W152007-00845 1., 1 Environmental Health Division Subdivision LONG ISLAND AIRPROT PH'. ' \-tC qWIl PO Box 389, 100-A Southwest Blvd,Newton,NC 28658 Sect/BUPh/Lot# 1 i (828)465-8270 FAXO(828)465-8276 TDD(828)465-8200 PIN# 471003310511 Applicant/Owner: SCOTT A BROWN Site Address: 8304 AEROMARINE BLVD CATAWBA NC Property Size: SF 2.01 ACRES Directions: HWY 150/LT ON SHERRILLS FORD RD/RT ON MOLLYS BACKBONE/RT ON MONBO/RT ON SAUNDERS/ CORNER OF SAUNDERS AND AEROMARINE Catawba County Health Department Operation Permit 20' STe.-821 U du, 14,, g,///et cI2qIo4 ,- �- 5 r' �U e' P muu ie00961. for sero, 45 N152 •N He r- ti o pause ea s r o CL 9 dk 3 o .. Nd Sec Pi P "---_____________, System Code voSce�ey / SaunatC5 Dr.� • p / rqo I _ EL F10vi9 Pre-$sutz �1tutji=b111 System Type: Description: [UI'n��-U /7 d. Types V and VI systems expire in 5 years. (In accordance with Table a) Owner must cont ct health department 6 months prior to exiration for permit renewal. PERMIT CONDITIONS: I 1. Performance: System shall perform in accordance with Rule .1961. )012 beg II. Monitoring: As required by Rule. 1961. GIBI .�II—Cd1-5, 1VtCsr III. Maintenance: As required by Rule . 1961. Other: SST 2�1. �1c-'-"'' p`'�SS�'C� Subsurface system operator required? Yes No I If yes, see attached sheet for additional operation conditions, maintenance and reporting. 11 1tf og IV. Operation: ` G f'P Q P fIL CA. 0.(av(tt This system has been installed in compliance with applicable North Carolina General Statutes, Rules for Sewage Treatment and _ Disposal,and All conditions of the improvement Permit and Construction Authorization. 211h15 WiI�IS �o�Z�OM System Installer Install do Date /� t.�. 11 ((3�0t •u4'ze. a e •g-n Date of Ope{{atio Permit Issurance Form F r,'\TLprmuNFnnnNWLSavn.rnf ' CATAWBA COUNTY p r^ - ,��;— p /'- p.\ Public Health Department It P v Case# WLS2007-00845 .cIt'I '`:j Environmental Health Division &,456 VI Subdivision LONG ISLAND AIRPROT PH: \2\ d. I; PO'Box 389. 100-A Southwest Blvd.Newton,NC 28658 art n r ,SecUBUPh/Lot# . :-...•v,_1- (828)465-8270 FAX1(828)41655-82(7766 TDD Kt-((828)46/5'-8200 �,4 .t4 )'j' f 10 7 PIN# 471003310511 •Applicant/Owner SCOTT A BROWN 7" r) �`u7y� �� �o5 �c Site Address: 8304 AEROMARINE BLVD CATAWBA NC Property Size: SF 2.01 ACRES Directions: HWY 150/LT'ON SHERRILLS FORD RD/ RT ON MOLLYS BACKBONE/ RT ON MONBO/RT ON SAUNDERS/ CORNER OF SAUNDERS AND AEROMARINE Improvement Permit Permit Valid For: Five years rt No Expiration Facility(Residential): House / House X Mobile Home Multi-Family • Bedrooms '1 New? "s! Addition? Projected Daily Flow '5 E 0 g.p.d Water Supply Private Well? —1L Public? Semi-Public? Basement: Y Basement Plumbing: Y l-lotTub/Spa: N Special Fixtures(explain): Proposed Wastewater System: Z)7(° .,V-'y7 Type: TI7, Proposed Repair: 2T '4 Permit Conditions: - - Owner or Legal Representative Signatur- =�\' Date: '�' a7 Authorized State Agent: 1 ff L I Date: . - L2- b'7 The issuance of this permit by the I•lealth 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 arc 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' (I5A NCAC I8A .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( ). I / Proposed Wastewater System: r1.1?. , , Type: lg. dj Wastewater Flow 3 D 0 g.p.d New ✓ Repair Expansion Soil LTAR: '3 g.p.d./k2 Type of Facility: 3 6-94 ietizah-lx Basement: Y Basement Plumbing: y HotTub/Spa: N Special Fixtures(explain): Wastewater System Requirements Tank Size: Septic Tank 1 b o 0 gal Pump Tank (vo ' gal Grease Trap gal Drainfield: Total Area: /d J sq ft Total Length: -v ft Maximum Trench Depth J 6 in Trench Width 3 ft Minimum Soil Cover It in Minimum Trench Separation I It Distribution: Distribution Box Serial Distribution Pressure Manifold t— LPP _ Other Additional Specifications: -- Authorized State Agent: IA' )9 Date: 6—ZY-o7 Permit Expiration Date: l- zg- (ti 1 have read and accept the specifications and all conditions of this permit as indicated. Owner or Legal Representative Signature: \�\-E .. Date: b � ' )--b7 1\ Form B r:Tieinnry kVnm,MV(y'ann.mr // • CATAWBA COUNTY %'�'Ri Case# WLS2007-00845 .( (<,(,�• Po,ac Health Depanmem I= j Environmental Health Division Subdivision LONG ISLAND AIRPROT PH au r' \�` /�i PO Box 389, 100-A Southwest Blvd,Newton,NC 28658 Sent/BL/Ph/Lot t# y, (828)465-8270 FAX B328)465-8276 TDD(828)465-8200 PIN# 471003310511 Applicant/Owner SCOTT A BROWN Site Address: 8304 AEROMARINE BLVD CATAWBA NC Property Si SF 2.01 ACRES Directions: HWY 150/LT ON SHERRILLS FORD RD/RT ON MOLLYS BACKBONE/RT ON MONBO/RT ON SAUNDERS/ CORNER OF SAUNDERS AND AEROMARINE ® Improvement Permit e7 Authorization To Construct El Well Permit SITE PLAN . gL10 I . , ' , — N 7 Wun9-Rt Y f� / 2 ' / u 44 / / / 9 o / 1 (�A ni /. "�?y. Z) / ,C. /�7 r / h/ / acm io 15 ,7 —_._� • F� "\ ! rim,„;�cµ 4' —ZJ -fir” �j. ✓rbZ-2 "Irin.!l v,,pf,.t 1n;^: 2;K 41,1 `(or I�N'1 nityc bun 9 2 /f'' Y)1 o of R TYO Tcs � o no- p{ �_ /1 P'-t / / JN • fati•n Ciaar Yri '1 i fa( / / 1 t 0 \ f` - x` nc n a f r or /-, I(Q Scale 0V>r an7 nirkz, 4rfaa. 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 plan or site conditions are altered. Authorized State gent Date Form C r:Tidonad\fnrrnN V Spin no C/+TAWBA COUNTY Case t! W LS2007-00845 Public Health Department Environmental Health Division Subdivision LONG ISLAND AIRPROT PH: .‘VA114vIlWy FO Box 389, 100-A Southwest Blvd,Newton,NC 28658 SecUBIJPh/Lot k . c : (828)465-8270 FAX'(828)465-8276 TDD(828)465-8200 PIN# 471003310511 Applicant/Owner: SCOTT A BROWN Site Address: 8304 AEROMARINE BLVD CATAWBA NC Property size: SF 2.01 ACRES Directions: HWY 150/LT ON SHERRILLS FORD RD/RT ON MOLLYS BACKBONE/RT ON MONBO/ RT ON SAUNDERS/ CORNER OF SAUNDERS AND AEROMARINE WELL PERMIT Proposed Use: Private Public_ Semi-Public _ Other GROUTING DEPTH: MINIMUM 20 FEET SETBACKS: I. BUILDNG FOUNDATIONS 25 FT. 5. UNDERGROUND STORAGE TANKS 100 FT. 2. EXISTING&PROPOSED SEPTIC SYSTEMS-MIN. 50 FT. 6. STREAMS/BROOKS/CREEKS 50 FT. 3. EXISTING&PROPOSED SEPTIC REPAIR AREA-MIN. 50 PT.' 7. LAKES/PONDS RESERVOIRS 50 FF. 4. SEWAGE PUMP SUPPLY LINE 50 Ff. ALL OTHER POSSIBLE SOURCES OF GROUND WATER CONTAMINATION 100 FT. The well driller must verify all sepearations are adhered to before drilling the well. If the well driller is unable to maintain any of the above separations,contact the Health Department at(328)465-8270 before drilling the well. SEE SITE PLAN FOR PERMITTED WELL LOCATION /-rb L4, Issued By: Permit Issuance Date: flsiure: WELL INSPECTION: p� � � � GROUTED DEPTH: 20' DATE: "T 7'O'/ INITIALS: APPROVED CASING: PVC ✓ STEEL DATE: INITIALS: CASING HEIGHT 12" ABOVE LAND SURFACE /✓ DATE: INITIALS: WELL COMPLETION REPORT RE-C V IVED _ DATE: 0 Mt: INITIALS: Pe WELL HEAD APPROVED l DATE: Mai INITIALS: Mitt\ Well Driller Date Drilled Well permits are valid for 5 years from the date of issuance and are subject to suspension andUor revocation fro non-compliance with appropriate state and local rules and regulations, or if false information was given in order to obtain a permit. Wells shall be constructed in accordance with all state and local regulations and rules. The Well Completion Report must be submitted to the Health Department within 30 ays upon comp) ion of a well. • Authoriz d State Agent Final A pr�al Date - Form D c ndomfa'Ymm Muss“ ,.mr DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES DIVISION OF ENVIRONMENTAL HEALTH Sheet of .ON-SITE WASTEWATER SECTION PROPERTY ID#: SOIL/SITE EVALUATION COUNTY: /' J _1}. for ON-SITE WASTEWATER SYSTEM 7 '° [2-7— (� b V� OWNER: r ��^^'"l. APPLICATIONDATE ADDRESS: PROPOSED FACILITY:_ (PROPOSED DESIGN FLOW(.1949): DATE EVALUATED: b-- � LOCATION OF SITE: PROPERTY SIZE: WATER SUPPLY: Private PROPERTY RECORDED: Public Well 0 Spring 0 Other EVALUATION METHOD: 0rn Auger Boring E'Pit 0 Cut . TYPE OF WASTEWATER: LT Sewage 0 Industrial Process 0 Mixed "13:" :::: . :0 .. SOIL MORPEOTAGY -OTHER i : (1941X I'ROT;ILEFACTOR5 :G ....1910. .- . . :. . : : : .E LAND. '&:ORS .. 1942 .. : d .: : .. $Ct6PE "ZON ... 1441 " H :::4941 SOIli E943 ... 1956 4941A; ' POSITION! DEPTH STRUCI'utio CONSISTENCE! WETNESS/ SOIL,_,,, ..SAPRb... .:RESTR ._PROFILE :: :!;SLOPE.%:: (TN.) TEXTURE::::: . :::S41INERALOG.Y .... C(ILOR.. -:::DEPT$' .::CLASS °:!HORI2 CLASS.:a! '9--10 L ssh ry rag.., 4L TAR 1°--9S ut t ssh T, f� 1 "le • n-( L CL r4' . Yr J 11-Lt R .Lc [- • x 4 k l'r I-5, L18 • (2--Lfk L 4-0 F; f.., . 3 ((of 3 -- 7v3Z C 46 1 f 4 3 • DESCRIPTION INITIAL SYSTEM REPAIR SYSTEM OTHER FACTORS(.1946): Available Space(.1945) f . SITE CLASSIFICATION(.1948): PP System Type(s) rt. N. 2:1°4 EVALUATED BY: 4-4-/! OTHER(S)PRESENT: Site LTAR rip COMMENTS: ' • • LEGEND • • • use the following standard abbreviations SOIL CONVENTIONAL LPL' MINERALOGY/ t 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)(Convex Slope) LS(Loamy Sand) SEXP(Slightly y Expaysi G(Single Grain)D(Drainage Way) Expansive) M(Massive) DS(Debris Slump) II SL(Sandy Loam) 0.8-0.6 0.4-03 EXP(Expansive) CR(Crumb) FP(Flood Plain) L(Loam) OR(Granular) FS(Foot Slope) SBK(Subangolm Blocky) H(Head Slope) III _ SCL(Sandy Clay Loam) 0.6-03 03-0.15 PL (Angular L(Linear Shape) SiL(Silt Loam) PL(Platy) N(Nose Slope) CL(Clay Loam) PR(Prismatic) R(Ridge) SiCL(Silty Clay Loam) MOIST S(Shoulder Slope) Si(Silt) T • T(Tenace) VFR(Very Friable) NS (Nmspry N SC(Sandy Clay) 0.4-0.1 0.2-0.05 FR(Friable) 5.6(Slightly Sticky) SiC(Silty Clay) FI(Finn) S(Sticky) C(Clay) VFI(Very Firm v.Very Sticky) VS(Very Sticky) 0(Organic) None EFI(Extremely rum) NP(Namplatic) SP(Slightly Plastic) *Adjust LTAR due to depth,consistence,structure,soil wetness,landscape,position,wastewater flow and quality. P(PIIyC) NOTES HORIZON DEPTH In inches below natural soil surface VP(Very Plastic) DEPTH OF FILL In inches from land surface RESTRICTIVE HORIZON Thickness and depth from land surface • SAPROLITE S(suitable)or U(unsuitable) • • SOIL WETNESS Inches from land surface to free warm or inches from land surface to soil colors with chrome 2 or less-record Mansell color chip designation CLASS/F•ICATTON S(Suitable),PS(Provisionally Suitable),crU(Unsuitable) Evaluation of sepiolite 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). • • • • • • • DENR(######) Review(####I7) • • \ CATAWBA COUNTY Q� \� 100A SOUTHWEST BLVD RECEIPT l~ NEWTON,NORTH CAROLINA 28658 U� ®i PHONE: 828.465.8399 � i't.1 r Thursday, February 25, 2016 $t}Z sM www.catawbacounync.gov PAYOR: Sanchez, Norberto& Irasema PAYMENTS TRANSACTION NUMBER: TRC-627182-25-02-2016 PAYMENT DATE : 02/25/2016 PAYMENT TYPE: Check 005320 INVOICE NUMBER FEE NAME FEE AMOUNT 02-16-325613 Improvement Permit Fee $150.00 TOTAL PAYMENTS : $150.00 EHPR-02-2016-23279 CASE TYPE: Environmental Health Plan Review WORK CLASS: OSWP SITE ADDRESS: 8304 AEROMARINE BLVD, CATAWBA NC 28609 Applicant DG HOME SERVICES LLC, 1125 PHILLIPS LN,STATESVILLE NC 28625 H:704201718 IC:704201718I Owner NORBERTO& IRASEMA SANCHEZ, 1830 SUGARLOAF CLUB DR, DULUTH GA 30097 C:7048777138 ** NO PEOPLESOFT ACCOUNT ASSIGNED ** receipt 02/25/2016 14:56 Page 1 all