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HomeMy WebLinkAboutIMPV-2-10-4979.TIF For Office Use Onlv IMPROVEMENT PERMIT -cDp:Flie N,um be r` 3 9 5 3 6 ; Catawba County Public Health Department EHPR 2_1o-3s97 " y County ID Number. Environmental Health Division IT" ~11 EvaluatedFor FLOW P.0 Box 389, 100-A Southwest Blvd W S. p Newton NC 28658 To h hi = j Phone: (828)-465-8270 Fax: (828) 465-8276 PERF=uT vAUO UNTIL: 2/25/2015 'NOTE TO INSPECTIONS DIVISION: Building Permits cannot be issued with this Improvement Pen-nit. Applicant: Kenneth Rosenbalm Property Owner: Kenneth Rosenbalm Address: 5418 Vallyfield Rd Address: 5418 Vallyfield Rd City: Hickory City: Hickory StatefZip: NC 28602 State/Zip: NC 28602 Phone: (828) 330-0131 Phone Property Location & Site Information Address/Road Subdivision: Vally Field Acres Phase: Lot: 2 5418 Vallyfield Rd Hickory NC 28,602 Directions Structure: SINGLE FAMILY Hwy 127s, L Vallyfield Rd, on L of Bedrooms: 4 # of People: 'Water Supply: EXISTING WELL System Specifications Initial System 'Site Classification. PS Minimum Trench Depth: 1 8 Inches Design Flow: 4 8 0 Maximum Trench Depth: -1 4 Inches Soil Application Rate; Septic Tank: 3 Gallons 1-Piece: )Yes @No System Classification/Description: TYPE III G. OTHER NON-CONY. TRENCH SYSTEMS Pump Required: OYes Q No Q May Be Required Pump Tank: Gallons "Proposed System: 25% REDUCTION 1-Piece: OYes ONo Repair System Required: DYes ONO ONO, but has Available Space Repair System `Site Classification: Ps Minimum Trench Depth: 1 8 Inches Soil Application Rate: 3 Maximum Trench Depth: ~ 4 Inches 'System Classification/Description: Pump Required: (Yes Q No O Maybe Required TYPE III G. OTHER NON-CONV. TRENCH SYSTEMS Pump Tank: Gallons "PfOpOSed System: 25°k REDUCTION Page 1 of 3 COP File Number 39536 County ID Number. EHPR-2-10-3897 *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. The improvement Permit shall 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 theexisting and proposed property lines with dimensions, the location of thefacility and appurtenances, the site forthe proposed wastewater system, and the location of water supplies and surfacewaters). 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 more than 60 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, installation, operation, maintenance, monitoring, reporting, and repair (.1938(b)). 1 Applicant/Legal Reps. Signature Requir"? @Yes ONo d Applicant/Legal Reps. Signature: 4~z Date: *Issued By: 1919 - Susan Miller Date of Issue: a / a 5 / a 0 1 0 Authorized State Agent: J..t,.,~y ALL, OValid without Expiration? 01-land Drawing @Import Drawing **Site Plan/Drawing attached.** Total Time:(HH:MtY1) 0 0 Hours 0 0 Minutes Page 2 of 3 CDP File Number: 39536 County File Number: EHPR-2-10-3897 Drawing Type: Improvement Permit Date: 0 a 5/ a 0 1 0 Click below to import an image from an external location: erg S~ ~c~ 4.1 but, i z QQ X (00 Q Cl . Valley ~'t!d Page 3 of 3 NCDENR Division of Environmental Health Date: c la l a 5 l a ©i e On-Site Wastewater Section Soil/Site Evaluation "File. 3 9 5 3 6 For On-Site Wastewater System PIN r: EHPR-2-10-3897 `Owner Kenneth Rosenbalm Proposed Facility SINGLE FAMILY Proposed Design Flow (.1949) Location of site 5418 Vallyfield Rd Property Size Water Supply EXISTING, VVEI_L Evaluation Method Auger C;O Horizon SOIL IvtORPI'IOLOGY Profiler L scape Depth 1941 Other Profile r SIPo0So1o (IhI? klineralogy (statrix Mottle Factors T exture Structure Consistence Color Color 1 L C 0-6 ( SCL 1-VVea! Si,k tr I .19»2Wet. 10 G" 6-33 2-Mod( s b,, tr 1943 Depth 4 PS CF= saprolite: (in) 38-4213C C 2-Mods s?~t: fr .1944 Rest. n/a Horizon EHS .1947 Class PS Susan Hiller Profile 3 LTAR _ .1942 Wet. % .1943 Depth CF , Saprolile~(in) .1944 Rest. Hori_on 1947 Class S Goy;Er f`l - - Profile j~ l.'AR - ( - - .194 2 Wet, 1943 Depth CPS ssprol4e:(in) 1944 Rest. Horizon ENS 1 .1947 Class Profile Copy P ( i 1 ITAR l 1942 Wet. °f .1943 Depth GU.- 53 proiiie:iinj 1944 Rest. Horizon i 19»7 Ctass Cop)' Fro, l, ( Profile LTAR .1942 wet. r, ! .1943 Depth Gi i saprolile:(in) 1944 Rest. Horizon .1947 Class Cop,; I_- Profile r] LTAR Available Space (1945) s Other Factors(.1946) PS Site Classification (.1948)Ps Initial LT!,%Ry 3 {_:epair LTAP 3 C)litr~ts P[es=~itt: IviegenlMlcEride Co1111~1e1)t's EvatlllF.ltc,d By,,- Susan L,iiler i"llCD~_NR Division of `nvironment.l Health Cn-Site !N 3ste%,vater Seciion Date: 0 a/ a 5/ x 0 1 0 Soil/Site Evaluation File 9: 3 9 5 3 6 For On-Site "l cis tevvater System PIN E H P R - a - 1 0 - 1940 Horizon SOIL MOIRPHOLOGY Landscape 9 1 Other Profile Pro(!IcY r Depth Sloe °>o (Ill) I I'Ain:.r lot•;latrix Mottle Factors Texture Structure Consislol, e Color Color i l 1942 Wet. °.0 1 ` 1943 Depth GPS Sa ro llt~_:(in) f .1944 Rest. Horizon .1947 Class ' 1 Cop;. lei - Profile LTAR .1942 :Net. °o _ - I - .1943 Depth G" Saprolii :(in) .1944 Rest. Horizon ,1947 Class Copyl_'Irsrile i- Pro le U- - - - - - LTAR - .1942 Wet. °>o I 1943 Depth CPS Saproli;e.(in) 1944 Rest. Horizon f - - Y 1947 Class cop:. Profile ~i !LTAR - 1942 Wet. C o - 1 ! 1943 Depth GPg 19441, Rest. Horizon r I .1947 Class Cop. '..la I I Profile LTAR . i i 1942 'Net. I °ro 1943 Depth C; S 1944 Rest. i Horizon 1947 Class co, :'irc;il• - i Profile LTAR Corlimell S Attach Image The "Open Drawing Form" button, opens the the draviing form. The "Import" button, attaches the drawing, or other image into the space below. Open Drawing Form r I IC, 11 o. r rc-'I Profile: 1 ~ X Y Z • Profile: f X _ Y _ Z Profile: j X ! Z Profile: Profile: X - - Y Z Profile: X Y Z Profile' Prc; ' e : 'v ( Z Profile: X - Y Z Profile: X Z ; el