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HomeMy WebLinkAboutEHPR-06-2016-24206.TIF THIS IS NOT A PERMIT Case # EHPR-0 6-2 0 1 6-2 4206 —T p ' CATAWBA COUNTY HEALTH DEPARTMENT 0 ` 0 Vr4r• PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES �"4e L 1842 sM Environmental Health Plan Review OSWP • • IMPROVEMENT 0 Contractor SHANE LEDFORD,4433 MADECONIA CHURCH RD, VALE NC 28168 C:8286127367 Owner JAMES & CAROL DAVIS, 2721 CHARLESTON CT, CLAREMONT NC 28610 C:828-244-1107 NAME TO APPEAR ON PERMIT Shane Ledford SITE ADDRESS: 2721 CHARLESTON CT, CLAREMONT NC 28610 PIN # 375207782631 NAME of SUBDIVISION: OLDE SAVANNAH Lot 3 Section/Block PROPERTY SIZE: Square Feet 33,541.20 Acres 0.77 DIRECTIONS: 1-40 to Rockbard exit, At Rockbarn trun into Olde Savannah the subdivision opposite to Rock Barn, 1st Street on Left, House at the end of culdesac. PRIMARY CONTACT: Contractor SEWER TYPE: Septic Tank GALLONS PER DAY: 480 WATER SUPPLY: Public Water DESCRIBE WORK: IP to determine possibility of adding 14x14 Walk-in closet off the back of the home. (No plumbing in addition). 4 BdRm house w/septic. Also detached garage with sperate septic on property. 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, Detached Garage EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: House 68x79, Garage 30x40 NUMBER OF EXISTING BEDROOMS: 4 #OF OCCUPANTS: 2 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: Walk-In Closet Addition 14x14 BASEMENT? No BASEMENT FIXTURES? No PLUMBING REQUIRED? Desired system types (Improvement Permit or Authorization to Construct): ACCEPTED: ALTERNATIVE: CONVENTIONAL: OTHER: INNOVATIVE: ANY: YES Other described: 1/9-eliapplication 06/30/2016 1 5.07 Pagc 1 of 4 S5A • CATAWBA COUNTY Case# EHPR-06-2016-24206 a% Public Health Department Subdivision OLDE SAVANNAH 4 "It;�� ,Y Environmental Health Division PINT! 375207782631 *>•- PO Box 389, I 00-A Southwest Blvd,Newton,NC 28658 /842 s. NAME ON PERMIT: ( SHANE LEDFORD),4433 MADECONIA CHURCH RD, VALE NC 28168 ( Shane Ledford) Site Address: 2721 CHARLESTON CT, CLAREMONT NC 28610 Property Size: Square Feet 33,541.20 Acres 0.77 Directions: 1-40 to Rockbard exit, At Rockbarn trun into Olde Savannah the subdivision opposite to Rock Barn, 1st Street on Left, House at the end of culdesac. 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 unde stand that I am solely responsible for the proper identification and labeling of all property lines and corners and making the site accessible so that„- omplete 5i-->- a •• can be performed. Date: 6-30— lG Signature of Applicant or Agent An Environmental Health Specialist will contact you wit lin 5 working • s of application date. If you need further information or assistance please call 828-466-7291 AREA2 (" tfllli ip . uit{I11111II `_ ,-•- - -- n��li"litl ill l�i " nutr— ro thn ,_.---, FEENAME „Its?' r... DATE 'i;'IIyL FEE AMOUNT ' Improvement Permit Fee 06/30/2016 $150.00• .711117J l:11ITIlll!I�a::.TOTAL FE ES tilt �t tl Nl'�: �illl' Jll'�liP.:, 5150.00' 1 IiVI, I I t � II t-- ._- _ .�� t l i,c._ _. _1201E:: FEES ARE NON—REFUNDABLE ONCE A SITE VISIT IS MADE OR WORK ON A PLAN REVIEW HAS COMMENCED SYSTEM REDESIGN ANDIOR RETRIP WILL INCUR AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) E9-ehappli cation 06/30/2016 14:55 Page 2 of 4 CATAWBA THIS IS NOT A PERMIT count�`Y-7 -----\1' CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services Page I Improvement Permit. Authorization to Construct ❑ Septic Repair ❑ Septic Malfunction ❑ Septic Expansion ❑ New Well Permit❑ Replacement Well [ Well Abandonment❑ Well Repair E Existing System Inspection (Pre-Approval Required) _ Applicatio n is for New Construction ❑ Existing Facility Property Address 272/ GAal/eS 71-6n Za it Subdivision / G/ai ema,tf .4./Z. 2t°d Lot# Acres n SectionBlock/�/Phase Driving Directions to Property ft Roc:fr�o /S ocl-/) In £a- 4 , // /r/ /1 a4/c,Aiu'4 'tom in Ye ve 1vi la(✓1 O .0/5ire ft Roc/C /airs , �IJe / S/IeCf to �e r`/ : l2/DVS, enol o7 aLz.,/cle 5uc, NAME TO APPEAR ON PERMIT? ❑ Owner ❑ Applicant Contractor Applicant Contact Information Name Address Phone Cell Phone Owner Contact Information Name R/c k d ‘41'01 Oa vi.5 / �/ Address 2 72/ G174//e3to,7 Gra , f G/alma./? ✓v ' 7. 24"6/e) Phone 45,256- z/5P- /22 ' Cell Phone 12$ ---2.U4/—//07 Contractor Contact Info(rmatio Name 611ane Z.-qedror., jAddresst/z/3J 71 4eedon /o G% , ,Pi, vad' A/L. 295 /o4 Phone Cell Phone 32 g —6/2 - 73 C 7 WHO WILL BE THE PRIMARY CONTACT? I I Owner ❑ Applicant Contractor Description of Existing Structures on Site Crick hodsc 4' l.3✓1c c 6.gta_y e # of Bedrooms *j' 4/ Structure Dimensions �bk 1_ #of Occupants Basement ❑ Yes No Basement Fixtures Q Yes No 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 f<D No Does the site contain any jurisdictional wetlands? SI Yes 0 No Does the site contain any existing wastewater systems? ID Yes 1M No Is any wastewater going to be generated on the site other than domestic sewage? ® Yes P No Is the site subject to approval by any other public agency? O Yes P No Are there any easements or right of ways on this property? Describe Existing water supply in use ❑ Individual Well ❑ Community Well ❑ Semi-Public Well County/City/Township Water Line Is a public water supply available? ** n 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) Accepted ❑ Alternative ❑ Conventional ❑ Innovative ❑ Other ❑ Any "`A " " A THIS IS NOT A PERMIT county; CATAWBA COUNTY HEALTH DEPARTMENT . -- c, Application for Environmental Services Page 2 Proposed Facility Type Primary Residence ❑ New/R/esidence Addition to Residence # of New Bedrooms *t /) Project Description L✓T//C 0 u../ce o3e7L-- Structure Dimensions /q / e # of Occupants Basement n Yes [-2 No Basement Fixtures 0 Yes DI No I Accessory Structure(s) Describe #of New Bedrooms *t if applicable Structure Dimensions # of Occupants Accessory Dwelling ❑ Yes n No Plumbing (1 Yes fl No Describe Plumbing Needed L Multi-Family Residence#Units #Bedrooms per Lin et Total#Bedrooms *t Structure Dimensions n Food Service Specify Type # Seats Floor Space-Entire Food Service Facility (Sq Ft) # Employees per Shift #of Shifts Dining Area(Sq. Ft.) I I Business Specific Type of Business Retail Floor Space #of Employees per Shift #of Shifts I I Other Facility Type Specify If Church# of Seats Kitchen ❑ Yes ❑ No If Daycare Specify Occupancy Application for Well Construction/Abandonment/Repair Proposed Well Type (— Individual Well ❑ Semi-Public Well Ti Community Well Abandonment Type l Drilled ❑ 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. f 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-- � Date 6-30-/K A- Printed Name of Owner or Agent 6/</n2 G. e o/d Catawba County Environmental Health 0 ,r f > V0 «,,1 t h p. / t�l III II ICI III�� U'' ,,f gll1lti;l '"` --970 bilimporp....‹..\\H. //\,) ■fri.I '"2.09 `b 965 GP es�p ° c�AS� Tb; 9.99 ---.._1 4 24.38 �. 39.18 a y I�1 n I g0 it liLI o 9 'I{r,. 9 1�1(�ea tl' �' it% tt 1ttihJtitt V ' .,111ECPa �Uvo �'� '1 mtl11111h16��' �N r�'I itItH571p JAIIL'd� tflitesttttttt,t, / .. rINNu -� 8 % III II - - 4� 11 ti / lit.ru Ii, f uk}I� Itill, Parcel: 375207782631, 2721 CHARLESTON CT tin=50ft CLAREMONT, 28610 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 06/30/2016 Parcel Report Page 1 of 1 Parcel Report - Catawba County NC Parcel Information: Owner Information: Parcel ID: 375207782631 Owner: DAVIS JAMES RICK Parcel Address: 2721 CHARLESTON CT Owner2: DAVIS CAROL S City: CLAREMONT, 28610 Address: 2721 CHARLESTON CT LRK(REID): 300225 Address2: null Deed Book/Page: 2355/0519 City: CLAREMONT Subdivision: OLDE SAVANNAH State/Zip: NC 28610-8658 Lots/Block: 3/ null Last Sale: $345,500 on 2002-04-15 School Information: School District: COUNTY Plat Book/Page: 37/205 Legal: LOT 3 3 PL37-205 OLDE SAVANNAH PL Elementary School: CLAREMONT Middle School: RIVER BEND 37-205 Calculated Acreage: .770 High School: BUNKER HILL Tax Map: null School Map Township: CLINES State Road #: null Tax/Value Information: Tax Rates(pdf) Zoning Information: City Tax District: CLAREMONT Zoning District: CLAREMONT County Fire District: All in City Zoningl: R-1 Building(s) Value: $384,500 Zoning2: null Land Value: $49,700 Zoning3: null Assessed Total Value: $434,200 Zoning Overlay: null Year Built/Remodeled: 2000/null Small Area: ST STEPHENS/OXFORD Current Tax Bill Split Zoning Districts: null/null Zoning Agency Phone Numbers Miscellaneous: Firm Panel Date: 2007-09-05 Building Permits for this parcel. Firm Panel #: 3710375200J Building Details 2010 Census Block: 3012 WaterShed: WS-IV Protected Area 2010 Census Tract: 010102 Voter Precinct: P6 Agricultural District: Proximity 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. AM rights reserved. http://gis.catawbacountync.gov/nomap/parcel_report.php?key=375207782631&typ=P 6/30/2016 CATAWBA COUNTY $EALTH DEPARTMENT ° N_ �r. . _ s d Telephone: (828)46 -8270 D: (828) p o � Imp. Pmt. X Auth. to Const. P t. Opr, Prmt, Sys. Type Well Prmt. Well Rpr. Prnt. Owner/Agent y S-fj(Le f t Phone Address Subdivision Section/Block/Pt. - •t#3 Lot Size Directions: ;MIN.ia,zc- Ml 1 t / / .� v S .., (t f t 4-a�- a 7)1 tr je$ q . , Facility:House X Mobile Home -Business Multi-family . Other: Tax Map or Pin Number 3 7,�2 7 Other . Zoning Approval# 0 6 O 7 Cialemtwr # Bedrooms #Seats #Employees . Application Rate 6).3 i G,PD flow le c Hot Tub or Spa yesIpecial Fixtures Basement yes/e . 100% Repair Areas/no A.5 Vt.; eVic u Basement Plumbing yes/no Water Supply: Private Well Public .K Semi-Public Type of System: Trench X Bed Pump Pump/Panel Panel LPP Other / // Septic Tank Size 100o Pump Tank Size Nitrification Field: Total Square Feet /3 70 Depth of Stone 12/?GGta., Bed Size_ Trench Width 3 ...r-1, Total Length of All Trenches 4-55 7 Number of Trenches 6 Trench Length 91)lq[)19I)/ 77/BOO/,5'l-Feet on Center Maximum Trench Depth 3j ,r Distance of Nearest Well xi/4 *DO NOT INSTALL SEPTIC WHEN WET'` *WELL RECORD REQUIRED AT COMPLETION* Topo / % Slope Texture Structure / 2 7 _ Clay Min. l '. I — �`�: � INK Soil Wetness r / `� Soil Depth 4-g- " I 1 Restric. Hoz. at�" a / / / 5 4efeS Available space yls/..no I Q / l �,�'p/�1� Overall Class S PSU } 0.0 TTT ��� Comments: ,}, {� , /ay ;/�/f 1111 ,.� f 1 POI '` ' rte. . P 4 0 Ali - N 25 ____._.. 1-42.41‘e_ I \ ,,,-'''',0 I. A \ ,$)t� ��V 1,,,s, Filter Required c5 Riser required when \ tank is more than 6 n. Q _A. 3� 1 inches deep. i 31 **NO GUARANTEE OR WARRANTY IS IMPLIED GIVEN AS TO THE ERFORMANCE OR LENGTH OF TIME THIS SYSTEM WILL FUNCTION** *************************************************************** ********************************************************** *Improvement Permit has no expiration date and is transferable, but may be revoked if site plans or intended use changes for the proposed facility. An Authorization to Construct is valid for(5) five years from date issued and is not transferable. Well Permit valid for 5 years provided site conditions do not change. Well location,installation, and protection must meet state and local regulations, and must be inspected and approved by a representative of the Catawba County Health Department before any portion of the installation is put into use. The siting of the well by the Health Department staff is to provide protection from ki., n possible sources of contamination. No volume of water is guaranteed at any site by the Health Department. ' Permit Date 2 . -OO E . Owner/Agent'—� f Septic Tank Installer By A, 4 ,fc Datej"/Z')O EHS _, ,. v Well Installed By V Well Grout Approval Date Well Head: .proval Date Date Sample Collected Date of Results Results EHS . White-Office Blue-Building Inspection Operation Permit Yellow-Owner/Agent Green-Building Inspection Authorization to Construct ,gA CATAWBA COUNTY Case# OP-9-10-10909 • Public Health Department it et Environmental Health Division Subdivision OLDE SAVANNAH 6 e PO Box 389, 100-A Southwest Blvd,Newton,NC 28658 Lot# W PIN# 375207782631 Applicant/Owner JAMES RICK DAVIS Site Address: 2721 CHARLESTON CT,Claremont,NC Property Size: SF ACRES Directions: Catawba County Health Department Operation Permit IIIE-PPBPS GRAVITY DOSED SYSTEM System Type: (In accordance with Table Va) Description: 50%REDUCTION PPBPS ■ 7 -- 1 Types V and VI systems expire in 5 years. a Owner must contact health department 6 months prior to exiration for permit renewal. System Installation Comments: PERMIT CONDITIONS: 1. All maintenance, monitoring, and performance requirements shall be in accordance with 15A NCAC 18.1900, Rule .1961 2. Operation & Maintenance Specifics: Subsurface system operator required? Yes_ No_X_ If yes, see attached sheet for additional operation conditions, maintenance and reporting. 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. Leatherman's 09/07/2010 SYSTEM INSTALLER INSTALLATION DATE Susan Bumgamer 09/09/2010 AUTHORIZED STATE AGENT DATE OF OPERATION PERMIT ISSUANCE Form F 09/09/10 14:38 g aPR LKio A uT I+ -s-lo - co 5LA DP- 9--io - l09o1 \ I c -c "e NIL Uc( \ ews61) .."‘ \ aatinfielci j' � houSc sT6 H gA CATAWBA COUNTY Case# AUTH-5-10-6869 Public Health Department G 'fi' .. Environmental Health Division Subdivision OLDE SAVANNAH .100 " PO Box 389, 100-A Southwest Blvd,Newton,NC 28658 Lot# 3 tzit + PIN# 375207782631 Applicant/Owner JAMES RICK DAVIS Site Address: 2721 CHARLESTON CT, Claremont,NC Property Size: SF 4769 ACRES Directions: ROCK BARN RD TOWARD CLAREMONT/TURN RT ACROSS FROM ROCK BARN COUNTRY CLUB/ 1ST LEFT/ HOUSE AT END OF CUL DE SAC Authorization to Construct Permit Authorization to Construct Wastewater System(Required for Building Permit' * See site plan and number of additional attachments( 9. Proposed Wastewater System: 50%REDUCTION PPBPS Wastewater Flow 240 g.p.d Type: IIIE-PPBPS GRAVITY DOSED SYSTEM Soil LTAR: .35 g.p.d./ft2 Permit Category: New Septic Type of Facility: Other Basement? No Basement Plumbing? No Bedrooms: 0 Wastewater System Requirements Tank Size: New Tank 1,000 gal Pump Tank gal Grease Trap gal Dosing Volume gal Pump Specs: GPM @ TDH Pressure Head ft Draw Down in Drainfield: Total Area: 345 sq ft Total Length: 115 ft Maximum Trench Depth 36 in Aggregate Depth in Trench Width 2 ft Minimum Soil Cover 6 in Minimum Trench Separation 8 ft on center Number of Drain Lines 4 Distribution: Distribution Box Additional Specifications: 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. Proposed Repair System Class: 1118 Proposed System: 50%REDUCTION PPBPS Distribution Type:: Pressure Manifold Soil LTAR: .35 g.p.d.lft2 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 Authorization to Construct Permit is subject to revocation if the site plan,plat or the intended use changes,or if site conditions are altered. The Authorization to Construct 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 Svstems' (15A 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. Susan Bumgarner 05/03/2010 AUTHORIZED STATE AGENT APPROVAL DATE Permit Expiration Date: 05/02/2015 No grading or construction activity is allowed in areas designated for system and repair without approval of the Health Department. 05/03/10 17:06 St+PR- 4-lo- 4glo Tit-TV—s-lo - L tm, 8 POATN- 5-10 - {l {5V� 134.1 ' - C A56. I1a5' rn,n \fft ! •v'0rti\ 90.Y ,/U/' /�f 're / to IN u1- Rit � crndc ,�� fi, 9 r / o Over St,IS+Q ikk tX Yl. co),13. „_' , Ikjp�,q� fur cc() ,c o. �a any o . I SST°,i'1 Gtr�C ilk S�Arc o ; �; 1 \� ; r O)%ct (ti ocat"G taro" • y ta x i, , i..1 44t3A CATAWBA COUNTY Case/t IMPV•5-10.6868 Public Health Department Subdivision t'" Environmental Health Division OLDE SAVANNAH Q ,e ''PO Box 389,100-A Southwest Blvd,Newton,NC 28658 Lot H 3 18. _ w PINK 375207782631 Applicant/Owner JAMES RICK DAVIS Site Address: 2721 CHARLESTON Cr,Claremont,NC Property Size: SF 0.769 ACRES Directions: ROCK BARN RD TOWARD CLAREMONT/TURN RT ACROSS FROM ROCK BARN COUNTRY CLUB/1ST LEFT/ HOUSE AT END OF CUL DE SAC Improvement Permit Permit Valid: Expires In Five Years: _X_ No Expiration: Facility: House Permit Category: New Septic Bedrooms 4 Projected Daily Flow 240 9-p-d WATER SUPPLY: Public Water Type: County/City/Township Water Basement? No Basement Plumbing? No Proposed Wastewater System: 50%REDUCTION PPBPS Type: IIIE- PPBPS GRAVITY DOSED SYSTEM Proposed Repair: 50%REDUCTION PPBPS Pump Required?: No Operator Required?: NO Permit Conditions: 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' (15A NCAC I8A.1900). Neither Catawba County nor the Environmental Health Specialist warrants that the septic tank system will continue to function satisfactorily Susan Bumgamer 05/03/2010 AUTHORIZED STATE AGENT APPROVAL DATE E Permit Expiration Date: 05/03/2015 No grading or construction activity is allowed in areas designated for system and repair without approval of the Health Department. 05/03/10 17:05 • StkPR- Li-ft)- 4glo TtnPV^5-10 - 1,81# 8 A k1H- 5-10 - tbVel a. sa c_ \ff8 !N +`I I;r\t 'S rn i n .� \ /v/ SO°° r r A w Do no4 Ells e�r.dc fi'� /yo„se OV v StAS'l'<- tlr r"PC1/4 .. 4'T Lit 'l •l SlAS4-111A Ctra I CAt1 "I<St y 7 0\ r,>, r` W 00.Y .-SC- 11 ! ' X383 4' , ,t• vw(Y pt c1V ft G ta1' i. C.: Department of Environment,Health, and Natural Resources Sheet: 1 Division of Environmental Health Property ID: On-site Wastewater Section Lot#: SOIL/SITE EVALUATION File#: AUTH-5-10-6869 for ON-SITE WASTEWATER SYSTEM AppID: Owner: Applicant: Address: Date Evaluated: 4/29/2010 Proposed Facility: Design Flow(.1949) 240 Property Size: Location of Site: Property Recorded: Water Supply. [x]Public [ I Individual [ ]Well I I Spring [ ]Other Evaluation Method: [x]Auger Boring [ ]Pit [ ]Cut Type of Wastewater: [ x]Sewage [ ]Industrial Process [ ]Mixed P R D SOIL MORPHOLOGY b F .1941 PROFILE FACTORS I .1940 .1942 L Landscape Horizon .1941 .1941 Soil .1943 .1956 .1944 Profile E Position/ Depth Structure) Consistence Wetness/ Soil Sapro Restr Class # Slope% (IN.) Texture Mineralogy Color Depth(IN.) Class Horiz &LTAR Is 0-51 cl,sbk SE.fr 51 ps 7 .35 1 Is 0-19 cl,sbk SE,tr 50 sl ps 20 19-50 b/c,sbk SE,fr .35 2 Description Initial System Repair System Other Factors(.1946): Q Available Space(.1945) ps ps Soil Evaluation By: S Bumgarner System Type(s) 50% 50& Others Present: Site LTAR .35 .35 Site Classification(.1948): as Site Evaluation By: S Bumgarner Others Present: Sheet: COMMENTS: 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 FI-Firm S-Sticky VFI-Very Firm VS-Very Sticky EFI-Extremely Firm NP-Non-Plastic :KN.,. SP-Slightly Plastic P-Plastic VP-Very Plastic Sketch of Soil Evaluation Locations NCaC 1 �J J Department of Environment,Health,and Natural Resources Sheet: Division of Environmental Health File#: On-site Wastewater Section SOILJSITE EVALUATION for ON-SITE WASTEWATER SYSTEM CONTINUED P R o SOIL MORPHOLOGY OTHER F .1941 PROFILE FACTORS .1940 .1942 L Landscape Horizon .1941 .1941 Soil .1943 .1956 .1944 Profile E Position/ Depth Structure/ Consistence Wetness/ Soil Sapro Restr Class • Slope% (IN.) Texture Mineralogy Color Depth(IN.) Class Horiz & LTAR Sheet: COMMENTS: 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-Food Slope 11 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 Loam PR-Prismatic T-Terrace CL-Clay Loam FP-Flood Plain SCL-Sandy Clay Loam IV SC-Sandy Clay 0.4-0.1 SIC-Silty Clay C-Clay Consistence Consistence Moist Wet Mineralogy VFR-Very Friable NS-Non-Sticky SEXP-Slightly Expansive FR-Friable SS-Slightly Sticky EXP-Expansive FI-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 y4'A 0 CATAWBA COUNTY Li 100A SOUTHWEST BLVD k' .� � NEWTON, NORTH CAROLINA 28658 RECEIPT eu aa�l e, n�,ave�, PHONE: 828.465.8399 V 4 �t i m Thursday, June 30, 2016 1842 SM www.catawbacountync.gov PAYOR: Ledford, Shane PAYMENTS TRANSACTION NUMBER: TRC-712011-30-06-2016 PAYMENT DATE : 06/30/2016 PAYMENT TYPE: Credit Card INVOICE NUMBER FEE NAME FEE AMOUNT 06-16-330013 Improvement Permit Fee 5150.00 TOTAL PAYMENTS : $150.00 EHPR-06-2016-24206 CASE TYPE: Environmental Health Plan Review WORK CLASS: OSWP SITE ADDRESS: 2721 CHARLESTON CT, CLAREMONT NC 28610 Owner JAMES& CAROL DAVIS, 2721 CHARLESTON CT, CLAREMONT NC 28610 C:828-244-1107 Contractor SHANE LEDFORD,4433 MADECONIA CHURCH RD, VALE NC 28168 C:8286127367 ** NO PEOPLESOFT ACCOUNT ASSIGNED ** receipt 06/30/2016 14:54 Page 1 of 1