HomeMy WebLinkAboutIMPV-3-10-5220.TIF
SBA CATAWBA COUNTY Case # IMPV-3-10-5220
G Public Health Department
Environmental Health Division Subdivision MORRIS SHARPE ESTATE
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s PO Box 389, 100-A Southwest Blvd, Newton, NC 28658 Lot # PT 4
1842 w PIN#
279014343212
Applicant/Owner ROY CARSWELL
Site Address: 932 VILLAGE CIR, Hickory, NC
Property Size: SF 1.039 ACRES
Directions: HWY 127 S TO VILLAGE CIR/ LT ON VILLAGE CIR/ 100 FT ON RT
Improvement Permit
Permit Valid: Expires In Five Years: _X_ No Expiration:
Facility: House
Permit Category: Other Bedrooms I
Projected Daily Flow 240 g.p.d
WATER SUPPLY: Public Water Type: County/City/Township Water
Basement? No Basement Plumbing? No
Proposed Wastewater System:
Type: IIIG -OTHER NON-CONV TRENCH SYSTEMS
Proposed Repair: 25% REDUCTION
For repair installation, install new septic tank.
Permit Conditions: -This permit is not for septic installtion.
The issuance of this permit by the Health Department does not guarantee the issuance of other permits. It is the responsibility of the
applicant/property owner to insure that all Catawba County Planning/Zoning and Building Inspections requirements are met. This
Improvement Permit is subject to revocation if the site plan, plat or the intended use changes, or if site conditions are altered. The
Improvement Permit is not affected by a change in ownership of the property. This permit was issued in compliance with the
provisions of the North Carolina 'Laws and Rules for Sewage Treatment and Disposal Systems' (15A NCAC 18A.1900). Neither
Catawba County nor the Environmental Health Specialist warrants that the septic tank system will continue to function satisfactorily
Megen McBride 03/09/2010
AUTHORIZED STATE AGENT APPROVAL DATE
Permit Expiration Date: 03/09/2015
No grading or construction activity is allowed in areas designated for system and repair without approval of the Health Department.
03/10/10 08:12
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IMPV-3-10-5220
ROY CARSWELL
V 932 VILLAGE CIR, HICKORY
84 Sm
Owner/Authorized Representative Acknowledgement of Permit Receipt
pc I certify that I am the owner or authorized agent (owner's authorization required) representing the owner of
the property described above.
9~1_ As the property owner or authorized representative, I have received the above referenced permit(s)
as requested in the application for service EHPR-2-10-3891, by the following method(s):
V v Received in Person
Facsimile Transmittal (Return form with signature required)
Electronic Image Transmittal/ E-mail (Return receipt required)
_ As the property owner or authorized representative I have reviewed and understand the specific
conditions of the permit issued, and further understand that all applicable regulatory requirements
specified under the North Carolina Laws and Rules for Sewage Treatment and Disposal Systems
(15A NCAC 18A.1900), and/or Well Construction Standards (15A NCAC 2C.0100), shall apply to
the issuance of this permit and the construction of the wastewater system and/or water supply well
permitted.
Permit Issue Date
Owner/Authorized Representative Signature ~exfl
i
Date 3 -.A - a 0 ! D
Documentation of Permit(s) Transmittal
(permit transmitted by electronic or other means)
Permit transmitted by (name of person sending permit)
Signature Date/Time
Method: Fax Email US Mail Other
Owner's request to send by the above indicated method of transmittal in lieu of signature
acknowledges the conditions and statements above.
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF ENVIRONMENTAL HEALTH ,Sheet of
ON-SITE WASTEWATEBSECTION PROPERTY rD t{;
SOIL/SITE EVALUATION COUNT Ty: ~
for ON-SITE WASTEWATER SYSTFjq
OWNER o r _APPLICATION DATE 2-1/h
to
ADDRESS:
PROPOSED FACILITY; R PROPOS~D DESIGN FLOW 1949: 2 p DATE EVA>:jJAD' o
LOCATION OF SITE: 2 a e i rc j C KO PROPERTY SIZE: I. D
WATER SUPPLY: Q Private Public Well Spring Other a a I PRQPERTY/RECORD
EVALUATION METHOD; Auger Boring 0 Pit 0 Cut I,
TYPE OF WASTEWATER: Sewage 0 Industrial P=m 0 WLv,d
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DESCEamoN SYSTEM PMAm SYSTEU OTHER FACTORS (.1946):
SITE CLASSIFICATION (.1948):
Available Space (.1945)
G EVALUATED BY: L M
~ Type(a) OTHER(S) PRESENT: AM=r
Site LTAR C),3
COMMENTS:
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LEGEND
use the following standard abbreviations:
SOIL CONVENTIONAL LPP NIINERALOGY/
LANDSCAPE POSMON GROUP TEXTURE ,1955 LTAR• ,1957 LTAR• CONSISTENCE STRUCTURE
CC (Comoave Slope) I S (Send) 11-0.9 0.6 - 0.4 NEXP (Nam ePansive) G (Single Gnlm)
CV (Convex Slope) LS (Loamy Send) SIM (Slightly D*A-i-) M (Massive)
D (Drainage Way) F-7CP (Espan&z) CR (Cam b)
DS (Debris Shtmp) II SL (Sandy .Lam) 0.9-0.6 GA - 03 GR (Gmmlar)
EP (Flood Plain) L (Loam) SEX (Subaugder Bbdcy )
FS Ton Sk") ABK (Angu>ar Blocky)
H (Hand Slope) III SCL (Sandy Clay Loam) 0.6-0.3 03-0.1s PL (Platy)
L (Linear SI%-) SM (Silt Loam) PR (Pdmndc)
N (Nose Slope) CL (Clay Loam)
R (Ridge) SiCL (Silty Clay Loam) MOIST R f
S (Shoulder Slope) Si (Silt) .
T (Tee) VPR Nay Friable) NS (Y. y
N SC (Sandy Clay) 0.4-0.1 0.2-0-05 FtL (Pdwe) SS (Sri* NOW
Sic (Silty Clay) PI (Fam) S (Sdrky)
C (Clay) VF! Nay Fan, V. Very Sticky) VS (Vry 9dk)
0 (Organic) Name EFl (Eimemdy Fam) NP 04-PiNde)
SP (SEA* ?Wtic)
*Adjxu LTAR doe to depth, consistence, structure, loll w•ebms, landseape, Position, wastewater flow and geality. P (Pb a)
H DEPTH In inches below natu al soB att = V? (Very P>azaie)
DEPTH OFFICE In inches from land smfam
RESTBICTNE HOIU7ON Thie}ast and depth from land surface
SAPROLIIS S(suitable) orU(rmsuh&Wc;)
SOIL WM?= Inches fmm land mrfeze to fine water or inches ft= land rmfaco to sosl col= with clsz®a 2 or lea - rxord Monseg color chip designation
CLASMFICA770N S (Snitablej, PS (Paovisioaelly Suimble), -U (Uacuitable)
Bm mdmm of sspmlite shall be by pits
Lot*4= Aaeptm= Ram (LTARr gaUday e
Show roMe locations and other site features (dimensions, refereaee or henchmsrk and North).
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