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Home My WebLink AboutIMPV-3-10-5105.TIF IMPROVEMENT PERMIT For Office Use OnIV r- r,cCDP File Number 3 9 6 9 8 Catawba County Public Health Department +►:1 County ID Number: EHPR-2-10-3985 ( Environmental Health Division t~ P.O Box 389, 100-A Southwest Blvd LEV atedForNEW Newton NC 28658 ship: Phone: (828)-465-8270 Fax: (828) 465-8276 PERMIT VALID UNTIL' 3J3/2015 'NOTE TO INSPECTIONS DIVISION: Building Permits cannot be issued with this Improvement Permit. osyd SL Applicant: Jason Cox Property Owner: Clyde Joyner Address: 5344 Lisa Ln Address: 7632 Berrywood Circle City: Hickory City: Humtersville -7 State2ip: NC 28602 State/Zip: NC 28078 Phone (828) 443-5857 Phone Property & Site Information Address/Road Subdivision: Phase. Lot: 5711 Grove Park Hickory NC 28602 Directions Structure: SINGLE FAMILY Hwy 127 S, pass Deerpark, L Grove Park, property # of Bedrooms: 5 on right, access at end of rock columns # of People: 'Water Supply: NEW WELL S stem Specifications Initial System 'SiteZ`iassl rca Ion: PS Minimum Trench Depth: 1 8 Inches Saprolite System? QYes (Q No Maximum Trench Depth: 0 4 Inches Design Flow: 6 0 0 Septic Tank: 1 0 0 0 Gallons Soil Application Rate: 3 1-Piece: QYes No Pump Required: QYes No (D May Be Required 'System Class ification/Description: TYPE III G. OTHER NON•CONV. TRENCH SYSTEMS Pump Tank: Gallons Proposed System: 25% REDUCTION 1-Piece: QYes ONo Repair System Required: QYes ONO ONo, but has Available Space Repair System 'Site Classification: PS Minimum Trench Depth: 1 8 Inches Soil Application Rate: 3 Maximum Trench Depth: a 4 Inches `System Class iflcationJDescription: Pump Required: QYes No O May be Required TYPE III G. OTHER NON-CONY, TRENCH SYSTEMS Pump Tank: Gallons 'Proposed System: 25% REDUCTION Pagel of 3 CDP File, Number 39698 County ID Number: EHPR-2.10-3985 "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. Site Plan The Improvement Permit shall be valid for 5 years from date of issue with a site plan (means a drawing not necessarily drawn to ® 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 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 morethan 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 130A335(q). 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)). Applicant/Legal Reps. Signature R I I i ( equired? eYes ONO V 2A, I ' P I 'I k Applicant/Legal Reps. Signature: L' U Date: 'Issued By: 1919 - Susan Miller Date of Issue: 3 / 3 / a 0 1 0 Authorized State Agent: OValid without Expiration? 0 C re ate CA? OHand Drawing @Import Drawing **Site Plan/Drawing attached.** Total Time:(HH:MM) 0 0 Hours 0 0 Minutes Page 2 of 3 IMPROVEMENT PERMIT Catawba County Public Health Department Environmental Health Division CDP File Number: 39698 P.O Box 389. 100-A Southwest Blvd EHPR-2-10-3985 Newton NC 28658 County Fife Number: Date: 03 / 03 /2010 Click below to import an image from an external location: Drawing Type: Improvement Pormit pfl O + < ~a J a~' L S4 n` uJ Page 3 of 3 Pi P2 NCDENR Division of Environmental Health On-Site Wastewater Section Date: e 3 e 3 1 a e 1 0 Soil/Site Evaluation File 3 9 6 9 8 For On-Site Wastewater System PIN EHPR-2-10-3985 *Owner Clyde Joyner Proposed Facility SINGLE FAMILY Proposed Design Flow (.1949) 6 0 0 Location of Site 5711 Grove Park Property Size Water Supply NEW WELL Evaluation Method Pit 1940 Horizon SOIL MORPHOLOGY Profiled Landscape Depth .1941 Other Profile POS Slope % (IN) Mineralogy Matrix Mottle Factors Texture Structure Consistence Color Color 1 L 0-12 SL 1-Wea sbk fr .1942 Wet. 15 oro 12-48 C 2-Mode sbk fr 1943 Depth q 8 s GPS Saprolite: (in) .1944 Rest. n/a Horizon EHS .1947 Class ps Susan Miller Profile 3 LTAR - L 0-12 SL 1-Wea sbk fr .1942 Wet. 15 % 12-48 C 2-Mods sbk fr .1943 Depth 4 8 s GPS Saprolde (in) 1944 Rest n/a Horizon EHS 1947 Class ps Copy rattle Susan Miller Profile 3 3 L 0-12 SL 1-Wea' sbk fr .1942 Wet 15 % 12-48 C 2-Mode sbk fr 1943 Depth 4 8 s GPS Saprofite.(in) .1944 Rest, n/a Horizon EHS .1947 Class Ps Copy Profile Susan Miller Profile 3 LTAR _ .1942 Wet. % .1943 Depth GPS Saprofite:(in) •1944 Rest. Horizon EHS 1947 Class Copy Profile Profile LTAR .1942 Wet. % 1943 Depth CPS Saprolite:(in) .1944 Rest. Horizon EHS 1947 Class Copy rofifo Profile LTAR Available Space (.1945) S OtherFactors(,1946) PS Site Classification (.1948)Ps Initial LTAR: . 3 Repair LTAR:. 3 Others Present: Megen McBride Comments: Evaluated By: Susan Miller NCDENR Division of Environmental Health On-Site Wastewater Section Date: 0 3/ 0 3/ a 0 1 0 Soil/Site Evaluation File 3 9 6 9 8 For On-Site Wastewater System PIN E H P R - ; 1 0 - 1940 Horizon SOIL MORPHOLOGY Profile# Landscape Depth .1941 Other Profile POS Slope % (IN) Mineralogy Matrix Mottle Factors Texture Structure Consistence Color Color .1942 Wet. % .1943 Depth GPS Saprolile:(in) .1944 Rest. Horizon EWS 1947 Class Copy,PProftt Profile LTAR .1942 Wet. olo .1943 Depth GPS Saprolitejin) .1944 Rest. Horizon EHS 1947 Class CopyPlrofil Profile LTAR 1942 Wet. % .1943 Depth GPS Saprolite (in) 1944 Rest. Horizon EHS .1947 Class Copy rotil Profile L TAR .1942 Wet. % .1943 Depth GPS Saprolite.(in) .1944 Rest. Horizon 1947 Class EHS Copy~rofil Profile LTA R 1942 Wet. % .1943 Depth GPS Saproltte (in) 1944 Rest. Horizon 1917 Class EHS Copy-Prohl Profile LTAR Comments'. Attach Image The "Open Drawing Form" button, opens the the drawing form. The "Import" button, attaches the drawing, or other image into the space below. Open Drawing Farm J- V n~ Profile: 1 X Y Z Profile: 2 X Y Z Profile: 3 X Y Z Profile: X Y Z Profile: x y Z Profile: X Y Z Profile: X Y Z Profile- x Y Z Profile: X Y Z Profile: X Y Z