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~eil CATAWBA COUNTY Case # IMPV-3-10-5275
Public Health Department
Q 2 Subdivision
a Environmental Health Division
g PO Box 389, 100-A Southwest Blvd, Newton, NC 28658 Lot #
I Su PIN# 365717104745
Applicant/Owner NORMAN HUGHES
Site Address: 2140 WITHERS RD, Maiden, NC
Property Size: SF 0.439 ACRES
Directions: EAST MAIDEN (MAIDEN SIDE) WITHERS RD/.7 ON LEFT
Improvement Permit
Permit Valid: Expires In Five Years: _X_ No Expiration:
P00 ~
Facility: House
i
Permit Category: New Septic Bedrooms 2
Projected Daily Flow 240 g.p.d I
WATER SUPPLY: Well Type: Individual Well O
Basement? No Basement Plumbing? No b
Proposed Wastewater System: 25% REDUCTION
Type: IIIG - OTHER NON-CONV TRENCH SYSTEMS
Proposed Repair:
WHEN NEW SYSTEM IS INSTALLED OLD WELL WILL HAVE TO BE ABANDONED AND NEW WELL
Permit Conditions: -DRILLED WHERE SHOWN ON SITE PLAN
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 Svstems, (15A NCAC 18A .1900). Neither
Catawba County nor the Environmental Health Specialist warrants that the septic tank system will continue to function satisfactorily
Robbie Phelps 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.
03/09/10 15:35
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CATAWBA COUNTY Case
G _
Public Health Department Subdivision
Section/BUPh/Lot#
v ~d Environmental Health Division
PO Box 389, I OOA Southwest Blvd, Newton NC 28658 RIN#
j $ 4 2 sm (828) 465-8270 Fax (828) 465-8276 TDD (828) 465-8200
A licant/Owner of
Site Address: b] -4
Pro e Size:
Directions:
Owner/Authorized Representative Acknowledgement of Permit Receipt
+I certify that I am the owner or authorized agent (owner's authorization required) representing the owner of
/tie property described above.
As the property owner or authorized representative, I have received the above referenced permit(s)
as requested in the application for service, by the following method(s):
Received in Person
- Facsimile Transmittal (Return form with signature required)
Electronic Image Transmittal/ E-mail (Return. receipt required)
J_tAs 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 ,319'1 b
Received Date
Catawba County Public Health
Environmental Health Section
Owner/Authorized Representative Signature
Date
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, Health, and Natural Resources Sheet:
Division of Environmental Health Property ID:
On-site Wastewater Section Lot
SOIL/SITE EVALUATION File
for ON-SITE WASTEWATER SYSTEM AppID:
Owner: Applicant: Norman Hughes
2140 Withers Rd. Date Evaluated: 3/5/2010
Proposed Facility: Design Flow (.1949) Property Size:
Location of Site: Property Recorded:
Water Supply: [ ] Public [ ] Individual [ x ] Well [ ] Spring [ ] Other
Evaluation Method: [ x ] Auger Boring [ ] Pit [ ] Cut
Type of Wastewater: [ x ] Sewage [ ] Industrial Process [ ] Mixed
R
q' SOIL-MORPHOLOGY b
F, °1941 PROFILE FACTORS
I1.940 .1942
L La'ndscape' Horizon 1941 .1941 Soil 1943 :1956 1944 Profile
E Position/ Depth Structure/ "Consistence:" Wetness/, . Soil Sapio Restr- Class
Slope°!o (IN.) " Texture, Mineralogy Color Depth (IN.) Class ;l ;Horir & LIAR
1 0-40 CL, sbk fr,ss,sp,sexp
42-48 CL, sbk fr,ss,sp,sexp chroma4 48 .275
2 0-48 sc,sbk fi,ss,sp,sexp 48 .275
Description Initial System Repair System Other Factors (.1946):
Available Space (.1945) ps Soil Evaluation By: Robbie Phelps
System Type(s) 25% Others Present: Jason Boyd
Site LTAR 0.275 Site Classification (.1948): PS
Site Evaluation By:
Others Present:
Catawba County, North Carolina
N This map product was prepared from the Catawba County, NC, Geographic lrrjormation System.
Catawba Countv has made substantial efforts to ensure the accuracy of location and labeling information
contained on this map. Catawba County promotes and recommends the independent verification of any
data contained on this map product by the user. The County of Catawba, its employees, agents and
personnel disclaim, and shall not be held liable for any and all damages, loss or liability, whether direct, indirect
or consequential which arises or may arise from this map product or the use thereof by any person or entity. Legend
Selected Parcel Number: 3657-17-10-4745
I inch= 40 feet Prepared for:
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THIS IS NOT A LEGAL DOCUMENT Tuesday, March 09, 2010 09:28 AM