HomeMy WebLinkAboutIMPV-2-10-4419.TIF
t~Y IMPROVEMENT PERMIT For Office Use Only
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Catawba County Public Health Department =CDP File Number 3 $ 4 $ 3
Environmental Health Division County ID Number: EHPR-1-10-3404
P.O Box 389, 100-A Southwest Blvd Evaluated For: NEW
Newton NC 28658 Township.. 1P'~_a-®,11i~~Cj
Phone: (828)-465-8270 Fax: (828) 465-8276 PERMIT VALID UNTIL: 1/29/2015
*NOTE TO INSPECTIONS DIVISION: Building Permits cannot be issued with this Improvement Permit.
Applicant: Constantin Boureanu Property Owner: Constantin Boureanu S~
Address: 5155 Orchard Park Dr Address: 5155 Orchard Park Dr
CRY: Hickory C$Y Hickory
State/Zip: NC 28602 State/Zip: NC 28602
~,_Phone ~(828) 320-4225 Phone
Property & Site Information
Address/Road Subdivision: Abernethy Park Phase: 7 Lot: 59
5155 Orchard Park Dr
Hickory NC 28602 Directions
Structure: SINGLE FAMILY Hwy 127, L Bethel Ch Rd, R Orchard Park Dr, lot in
# of Bedrooms: 3 cul-de-sac
# of People:
*Water Supply: PUBLIC
System Specifications
Initial System
Site Classification: PS Minimum Trench Depth: 1 8 Inches
Design Flow: 3 6 0 Maximum Trench Depth: a 4 Inches
Soil Application Rate: 3 Septic Tank. 1 0 0 0 Gallons
1-Piece: 0Yes #No
*System Classification/Description: Pump Required: (*Yes ONo C) May Be Required
TYPE III B. SYSTEM W/SINGLE EFFLUENT PUMP
Pump Tank: 1 0 0 0 Gallons
*Proposed System: 25% REDUCTION
1-Piece: OYes *No
Repair System Required: 0 Yes ONo ONo, but has Available Space
Repair System
*Site Classification: PS Minimum Trench Depth: 1 8 Inches
Soil Application Rate: Maximum Trench Depth: a 4 Inches
3
*System Classification/Description: Pump Required: (@)Yes C )No O May be Required
TYPE III B. SYSTEM W/SINGLE EFFLUENT PUMP Pump Tank: 1 0 0 0 Gallons
*Proposed System : 25% REDUCTION
Pagel of 3
CDP File Number 38483 County ID Number: EHPR-1-10-3404
*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 ofthis permit bythe 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.
See attached soil notes by Jason Boyd, EHS on 5112107.
The Improvement Permit shag be valid for 5 years from date of issue with a site plan (means a drawing not necessarily drawn to
Site Plan scale that shows the existing and proposed property lines with dimensions, the location of the facility and appurtenances, the
® site forthe proposed Wastewater system, and the location of water supplies and surface waters).
Plat The Improvement Permit shag be valid without expiration with plat (means a property surveyed prepared by a registered land
surveyor, drawn to a state of one inch equals no morethan so feet that includes: the specific location of the proposed facility
O 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 13oA335(f)). The person owning or controlling the system shall be responsible for assuring compliance
with the laws, rules, and permit conditions regarding system location, instailation, operation, maintenance, monitoring,
reporting, and repair (.1938(b)),
Applicant/Legal Reps. Signature Required? jYes ONo
Applicant/Legal Reps. Signature ~~1~ t~~:~=2 Date: / l G D
*Issued By, 1919 - Susan Miller Date of Issue: 1 / a 9 / a 0 1 0
Authorized State Agent: .00,A/1OValid without Expiration?
01-land Drawing *Import Drawing
**Site Plan/Drawing attached.** TotalTime:(HH:MM)
0 0 Hours 0 0 M inutes
Page 2 of 3
CDP File Number: 38483 County File Number: EHPR-1-10-3404
Drawing Type: Improvement Permit Date: 0 1/ a 9/ 1 0 1 0
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Page 3 of 3
t:r` TANV11A COIIN"I'Y
Case # WLS2007-00298
4 ; I'uhlic Heal~t Departwcnt
Envirmuuenutl Iluiltli Division Subdivision ABERNETHY PARK PH 7
\ \ vdr / - PCJ Box 389. IlTO A Saitltwcst Blvd. Newton, NC 28658 Sect/BUPh/Lot # 1'H 7 Jy
(,S28)465-8270 FAX (828) 465-8276 TDD (823) 405-8200 1'IN#
9l t279008974976-59
Applicant/Owner ABERNETHY PARK Pope Site Address: ORCHARD PARK DR LOT 59 G
Property Size: 20,827 SF ACRES Directions: BETHEL CHURCH RD TO PITTSTOWN RD/ LFT ON PITTS TOWN/ LFT ON ABERNETHY PARK DR/ RT ON
ORCHARD PARK DR/ LOT 459 _
6
improvement Permit 0)
Permit Valid For: Five years No Expiration oq
Facility (Residential): House Q:7
House X Mohile Home Multi-Family Bedrocros _ 4 New? Addition?
Projected Daily Flow g.p.d Water Supply Private Well? Public?~ Semi-Public?
Basement: , N Basement Plumbing: Hoffu /Sp c N Special Fixtures (explain):
_ vb --5 r~ y ~ v
Proposed Wastewater System: Type:
Proposed Repair:
Permit Conditions:
1` r
Owner or Legal Representative ignature: Date:
Authorized State Agent: Date: The issuance of this permit by the Health Department cloes not Luarantee the issuance of other permits. It is the responsibility of the applicant/property
owner to insure that all Catawba County PlannhaVZoning and Building Inspections requirements are met. This Improvement Permit is subject to
revocation if the site plan, plat or the intended use changes, or il'site conclitions arc altered. The Improvement Permit is not affected by a
change in ownership of the property. This permit was issued in compliance with the provisions or the North Carolina 7,aws and Rules for
Sewage Treatment and Disposal Systems' (I 5A 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.
Authorization to Construct Wastewater System (Required for Building Permit)
See site plan and additional auachinems ( )
Proposed Wastewater System: Type: Wastewater Flow g.p.d
New Repair Expansion Soil LTAR: g.p.d./ft2
Type of Facility: -
Basement: N Basement Plumbing: N HotTub/Spa: N Special Fixtures (explain):
Wastewater System Requirements
Tank Size: Septic Tank gal Pump Tank gal Grease Trap gal
Drainfield: Total Area: sq ft Total Length: ft Maximum Trench Depth in
Trench Width ft Minimum Soil Cover - Minimum Trench Seperation ft
Distribution: Distribution Box Ser6rDistribution Pressure Manifold LPP Other
Additional Specifications:
Authorized State Agent: Date:
Permit Expiration Date:
I have read and accept the specifications and all conditions of this permit as indicated.
Owner or Legal Representative Signature: Date:
Form B
r: \TiAnnn rkV'onnsVit2~num ryi
CATA W BA COUNTY
R bloc i le;ilth Dep.ntment Case It WLS2007-00298
t > >
- I Lnvironmeutal Flcalth Division Subdivision f\13ERNETHY 1ARK I FI 7
110 Box 359; 100-A Southwest E3h,d, Newton, NC 28658 Sect/131JI'h/Lot It
PH 7 59
a (522'8) 465-8270 FAX (828) 465-8276 TDD (82S) 465-8200 131N# 91 1279008974976-59
Applicant/Owner ABERNETHY PARK
Site Address: ORCHARD PARK DR LOT 59
Property S 20,827 SF ACRES
Directions: BETHEL CHURCH RD TO PITTSTOWN RD/ LFT ON PITTS TOWN/ LFT ON ABERNETHY PARK DR/ RT
ON ORCHARD PARK DR/ LOT #59
Improvement Permit Authorization "Co Construct Well Permit
SITE PLAN
Ho Q10 w
G ,ys-fern,
ArP
S'
y Br• ,
Neos~ I
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0
Scale
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.
eAuthorized State Agent Date
Form C
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UEFAF',rME~;-, OF ENVIRONMENT, HEACTH..~.,D NATORAL RESOURCES
DIVISION OF ENVIRONMENtAL HEALTH PROPERTY II .
ON-SITE WASTc"WATERSECTION COUN'T'Y:
S OILVS`TTE,E VALUATION
L,a~ for ON S, MASTE~NA-TER SYSTEM
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01 ARTUA,~'~k7,
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Appg APPi ICATiOt' DATi BATE EVALUATED/1x,167
'.in-ts-( `y,t(S'r t~ . ...-i >c:{ f w: 'td",f adze kr
fPROOSED F, ACILrITY ~w `P~ROPOSED:DESIGN FLOW,( 1949), . PROPERTY SIZE ~ a
LOCATION OF SCI~;a r~. ~r=G6 ~lflt' PROPERTY RECORDEDA_
;{jta t t f ~r~
y':GVATER SUPPLY. '0 Priva{e`Pu61tc I~ Welly Spring C1k01hd W` r 1.• IA
.EVti¢LU°A?TON IviETHOD: ~7 Auger Boling .'Rit C7'Cut j
• r' n I.
TYPEkOF' WAS1~WAsTER: DlSeivagc t ~ ~ ~'Indusmal~`Process O Mixed~~ sL ii~t ~ ur~f• ~ -
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~'DESCPrmoN ,INITIALSYSTFI+7" 1lEPrlIRSYSiEM 07 F RFACLIORS(:1946):
s Ariilablc'7Spice{:1945) S1TE.(MASSMCATION_( I949):
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407
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SOIL CONVEI\TION:A;L_ UP MINERALOGY/
U'1DSCA".P.F, POSiTiON GROIT ~ R 19~5t-TAR' r195~+LTAR COtrSiSTEVLE ~aSTRIICTIIRE
I.2' '0 8 0 6 = 0.4' NECP (Non ezpanslvc)_ G (Single Gizin)
X (C666 c Ssope) > 1 S aC I.' t4 ti :;S at ; t z t a
V (Convex~5lopc) _ .,_~,Y Ste)' $EYP (Sllghd~rF~cpanstv:c) iM~(Maulrc}'
(Drainage Way)' -1 )"15 _ _ E?CP (Expansive) ac x CR7(Crote)
JS (Dchru Slump} YII St (Sandy Loam) 0:8 - 0`6 ) w O.a, :0 3 ; I Fr tr Y GR (Granular)
~u SB1C'(Subu►Salu E
'-"'r (FloodPlaln)' L(Loam);xt tr4t;'1 I', l d y '.a. it1, i s Y*
'S (Foot-slope)K (Ahgular Blo
i (Hcd'Slop~)' Ill 51 (Silf)r; ~f rS <„a 0 6±s0 3r t': .:'03 - 0 I5 v r k 6, t- PL (Platy)
. (Li" SIppi 51CL (Si1ry,Clay,Loarn) PR (Pnimitic)
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{ORlZC)N DEPTH Gi¢'siches, below naturallsoll siiiface~•,~.,~. _ fi c _x....s r ~.r 1~~ :z €
5EPTN QF FILL In i lehes,from land surfsce 4 a 7.! d
m7m., C77VE HOPJZON Thickness and depth-from:land
.APR011TE ; S(suilable) tir U(tms6itable) ' f ~ I
0'L !;'ET7NE: S i Irie ha from land surface to hiewueror inches from land sunitc to:soil•eolors-with ehroma 2:.or fes:t chordlunsell eolbrehip daig:
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USSIFIC.tI7QN S (Suitable); PS (Prorisiona)iy.5wtable), or U (Unsuitable) A. I
vaJusuon o[saprolitc shall be by pia
ti rm ~.ect?tu+cc Rate (LTARp~6al/davlft' i 3 t ) ;
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i Show prole locations ind.bthec ide features (dimensions, re[ecence~o,c benehmarl.,~agnd Nocch). i
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CF ENVIRONMENT, HE:\LTH. AND NAI'U AL RESOURCES Sneer ~oJ
DIVISION Of` ENVIRONMENTAL HEALTH PROPERTY IU-,
ON-5ITE WASTcWATEr SECTION COUNT`r:
SOIL/SITE EVALUATION
for ON-SITE WASTEWATER SYSTEM
0~•,+ER: {~o~-~, 1 APPLICANT:
ADDRESS: T APPLICATION DATE: DATE EVALUATED:
PROPOSED FACILITY: PROPOSED DESIGN FLOW (.1949): PROPERTY SIZE:
LOCATION OF SITE: PROPERTY RECORDED:
WATER SUPPLY: ❑ Private ❑ Public ❑ Well ❑ Spring ❑ Othc:
EVALUATION METHOD: ❑ Auger Boring J9 Pit ❑ Cut
TYPE OF WASTEWATER- ❑ Sewage ❑ Industrial Process ❑ Mixed
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DESCRJMGN INTTL1LSYSTEM WAJR SYSTEM '
OTHF_R FACTORS (.1946):
Avail3ble'Space (.1945) SITE CLASSIFICATION (.1948):
I
1LUATFD BY
SyStC:11 Typc!s) G~() 7:
LEGEND
use the following standard abbreviations
SOIL CONVENTIONAL LPP MINERALOGY/
IANDSCAFF. POSITION GROUP TEXTURE .1955 IJAR .1957 LTAR CQNSISTENCE STRIICTI;RE
X (Coneavc Slope) 1 S (Sand) 12 • 0.8 0.6-0.4 NE,YP (Non-expansive) G (Single Grain)
--V (Convex Slope) LS (Loamy Sand) SE.YP (Slightly Expansive) M (Massive)
D (Drainage Way) EXP (Expansive) CR (Crumb)
DS (Debris Slump) Il SL (Sandy Loam) 0.8 -0.6 0.4 - 03 GR (Granular)
-''r (Flood Plain) L (Loam) SBK (Subangular E
:S (Foot Slope) ABK (Angular Blo
i (head Slope) Ill SI (Silt) 0.6 - 03 02 -0.15 PL Mary)
_ (Linear Slope) SICL (Silty Clay Loam) PR (Prismatic)
J (Nose Slope) CL (Clay Loam)
Z (Ridge) SCL (Sandy Clay Loam) MOST WFT
i (Shoulder Slope) SLC (Si)t Loam Clay)
(Terrace) VFR (Very Friab}c) NS (Noe-eddy)
IV SC (Sandy Gay) 0.4-0.1 0.2 - 0.05 FR (Friab}c) SS (Suthdy Ski
SIC (Silty Clay) FT (rum) s (Sticky)
VFI (Very Firm v. Very Sticky) VS (Very sticky:
0 (Organic) None EFI (Ext. ely Firm) NP (Non•pl dcI
SP (Slit" Peas
P (Plastic)
YO rEs VP (Very Ptutic
iORIZOH DEPTH In inches below narural soil surface
-
)EPTH OF FILL In inches from land surface
Lr_7RIC77VE HORIZON Thickness and depth fivm land surface
:APROLJTE S(suitable) or U(unsuitable)
:O!L WE7WEES Inches from land surface to free water or inches from land surface to soil colors with chroma 2 or less - record Munsell color chip dcsig-
:L45S/F/C.fT10,V S (Suitable), PS (Provisionally Suiubic), or U (Unsuitable)
:valuation of saprolitc shall be by pits.
-term Acceptance Rate (LTAR): gaUday/ft' )
Show profile locations and other site features (dimensions, reference or benchmark, and North).
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