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CONSTRUCTION For Office Use Only
AUTHORIZATION *CDP File Number 39a6644
Catawba County Public Health Department
County ID Numbe. EHPR-2-10-3889
r
Environmental Health Division Evaluated For: REPAIR *7gnk ats
* a' P.0 Box 389, 100-A Southwest Blvd
Township: °0'[D g)S
Newton NC 28658 PERMIT VALID UN IL:
Phone: (828)-465-8270 Fax: (828) 465-8276 0 a/ 1 9/ a 0 1 5
Applicant: Walter R. Leach Property Owner: Walter R. Leach
Address: 3040 NW 5Th St. PI. Address: 3040 NW 5th St. PI.
City: Hickory City: Hickory
State/Zip: NC 28601 State/Z ip: NC 28601
:
Phone Phone#
Property Location & Site Information
Address/Road Subdivision: Phase: Lot: 17
3040 NW 5Th St. Place
Hickory NC 28601 Directions
Structure: SINGLE FAMILY
# of Bedrooms:
# of People:
*Water Supply: PUBLIC
System Specifications
Minimum Trench Depth:
Inches
(Design Classification: Minimum Soil Cover.
Inches
Flow: Maximum Trench Depth:
Inches
Soil Application Rate.- Maximum Soil Cover:
Inches
*System Classification/Description: 'Distribution Type:
Septic Tank:
1 0 0 0 _ Gallons
*Proposed System: 1-Piece: ()Yes ONo
Nitrification Field Pump Required: ()Yes ONo ()May Be Required
Sq. ft'
No. Drain Lines Pump Tank: Gallons
1-Piece:OYes ONo
Total Trench Length:
ft. GPM-vs- ft. TOH
Trench Spacing: _ 8Inches O.C.
Feet O.C. Dosing Volume: _ Gallons
Trench Width: Inches
_ Feet
Aggregate Depth: Grease Trap: Gallons
inches Pre-Treatment: O NSF OTS-1 O TS-II
Septic Tank Installer G rade Level Required: (S)l Oil 0111 ON
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COP File Number 39264 County ID Number: e>+Pa-2•to•ses9
❑ Open Pump.System Sheet
Repair System Required:OYes ()No ONo, but has Available Space
Repair System T8Fe91 s 0.
Trench Spacing:
'Site Classification: - O,C.
T rench Width: Inches
Design Flow: - Feet
Aggregate Depth:
Soil Application Rate inches
Minimum Trench Depth:
'System Classification/Description: Inches
Minimum Solt Cover,
Inches
Maximum Trench Depth: Inches
'Proposed System:
Maximum Soil Cover:
Nitrification Field Inches
Sq. ft.
'Distribution Type:
No, Drain Lines
Total Trench Length. h Pump Required: OYe5 ONo OMay Be Required
- Pre-Treatment: ONSF OTS-1 OTS-II
'Site Modifications
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 Checkinq with appropriate governing bodies in meetinq their requirements.
This permit is to replace a collapsed septic lank. Install ft new 1000 gal, lank, S It. from house, 100 It, from any well, 10 H. from property lines. Connect
now tank to existing drainfin1d.
Pump out and cnrsh existing (ank.
This Autnorttatlon for Wastewater System Conrvucaon shall bevaild for a pemon equal to the period of validity of the Improvemom Permit not
to exoeed five years, and may be Issued atthe sametlme tho Improvement Permit Issued (NCOS 190A-3361b)). If the Installation hat; not been
Completed during the period of validity ofthe Construction Permit the Information gubmleed In the appilcMion for a permit or Construction
Authorization Is found to have been Incorrect falsified or changed, or the site Is altPmd, the permit or ConSUIXtIon AuthortzAlon shall become
invalid, and may be suspended or revolted (.1911(g)). The person awning or corttr°iling the system shall be responsiblefor assuring compliance
with the laws, rules, and pertnlt conditions regarding system locaaon, installation, operation, maintenance, monltodng, reporting and repair
(1938(b)i.
Applicant/Legal Reps. Signature Requui 7 OYes 4 ONO
Applicant/Legal Reps. Signaturle~~ Lt1~ Dale: ` I I ~v v
'Issued By: 2246 • Megen McBride Dole of Issue: 0 a 0 1 0
Authorized Slate Agent: Malfunction Log Oyes
(51-land Drawing Olrnport Drawing Total rlme:(HH:MtA)
*Site Plan/Drawing attached.**
Page 2 of 3 0 0 Hours 0 0 111n,ite
CDP File Number: 39264 County ID Number: E"PR-2-10.3889
Drawing Type: Construction Authorization Date: 0 a/ 1 9 / a 0 1 0
Qinch
Scale: Qaiock = ft.
Drawing QN/A
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