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CONSTRUCTION For Office Use only
AUTHORIZATION 'CDP Fite Number 3 9 6 9 1
Catawba County Public Health Department County ID Number.364810471485-Hi?I2_a-t
Environmental Health Division
Evaluated For: NEW 3175
` P.O Box 389, 100-A Southwest Blvd Township:
Newton NC 28658 PERMIT VAL D UNTIL:
Phone: (828)-465-8270 Fax: (828) 465-8276 0 3/ 0 3/ a 0 1 5
Applicant: Cassie Nantz Property Owner: Cassie Nantz
Address: 3063 Hodges St 7 Address: 3063 Hodges St
City: Connelly Springs Rd City: Connelly Springs Rd
State/Zip: NC 28612 State2ip: NC 28612
Phone
Phone 4:
)
Property Location & Site Information
Address/Road Subdivision: Phase: Lot:
1400 Prison Camp Rd
Newton NC 00000 Directions
Structure: SINGLE FAMILY
of Bedrooms: 3
rt of People:
`Water Supply: PUBLIC
System Specifications
Minimum Trench Depth: a 0
Site Classification: PS Inches
Minimum Soil Cover.
Saprolite System? (j)Yes QNo 8 Inches
Design Flow: 3 6 0 Maximum Trench Depth: 3 0 Inches
Soil Application Rate: 0 3 Maximum Soil Cover: 1 8 Inches
'"System Classification/Description: 'Distribution Type: GRAVITY- SERIAL
TYPE III G. OTHER NON-COW. TRENCH SYSTEMS Septic Tank:
1 0 0 0 Gallons
`Proposed System: 25% REDUCTION 1-Piece: QYes ()No
Pump Required: QYes *No QMay Be Required
Nitrification Field 9 0 0
Sq. ft. Pump Tank: Gallons
No. Drain Lines 5 1-Piece: QYes ()No
Total Trench Length: 3 0 0 f1 GPM-vs ft. TDH
.
Trench Spacing, _ 9 Qlnches O.C. Dosing Volume: _ Gallons
Feet O.C.
Trench Width; 3 Inches
Feet Grease Trap: Gallons
Aggregate Depth:
inches Pre-Treatment: ONSF OTS-1 OTS-11
Septic Tank Installer Grade Level Required: QI II 0111 01V
Page 1 of 3
CDP File Number , 39691. County ID Number. 364810471485
❑ Open Pump System Sheet
Repair System Required:Yes ONo ON o, but has Available Space
Trench Spacing: 8 Inches O.C.
(Desig pair System
Classification: ps - 9 Feet O.C.
Trench Width: Inches
n Flow: 36 0 _ 3 Feet
Soil Application Rate: 0 3 Aggregate Depth: inches
u Minimum Trench Depth:
"`System Classification/Description: Inches
TYPE III G. OTHER NON-CONY. TRENCH SYSTEMS Minimum Soil Cover.
Inches
Maximum Trench Depth: 3 ~
"Proposed System: 25`,6 REDUCTION Inches
Maximum Soil Cover:
Nitrification Field 9 0 0 Inches
Sq. ft.
No. Drain Lines 'Distribution Type: PRESSURE MANIFOLD
Total Trench Length: 3 0 0 ft Pump Required: (J)Yes ()No 0May Be Required
Pre-Treatment: ONSF OTS-I 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 pennit 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.
This Authorization for Wastewater System Construction shall be valid for a person equal to the period of validity of the Improvement Permit, not
to exceed five years, and may be issued at the same time the Improvement Permit Issued (NCGS 13OA-336(b)). If the installation has not been
completed during the period of validity of the construction Permit, the information submitted in the application for a permit or Construction
Authorization is found to have been incorrect, falsified or changed, or the site is altered, the permit or construction Authorization shall became
invalid, and may be suspended or revoked (.1937(g)). 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
(1939(b)).
Applicant/Legal Reps. Signature Required? 0Yes /ONO
Applicant/Legal Reps. Signature Date:
'Issued By: 1952 - Phelps. Robert Date of Issue: 0 3/ 0 3/ a 0 1 0
.
Authorized State Agent '?40- Malfunction Log ()Yes
OHand Drawing @Import Drawing Total Time :(HH 1[A)
**Site Plan/Drawing attached.**
Hours Minutes
Page 2 of 3
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CONSTRUCTION AUTHORIZATION
Catawba County Public Health Department
Environmental Health Division GDP File Number: 39691
P.O Box 389, 100-A Southwest Blvd 364810471485
County File Number:
Newton NC 28658
Date: _0.3./ 0 3 / a 0 1 0
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