HomeMy WebLinkAboutIMPV-3-10-5448.TIF
g CATAWBA COUNTY Case # IMPV-3-10-5448
Public Health Department Subdivision
4 Environmental Health Division
PO Box 389, 100-A Southwest Blvd, Newton, NC 28658 Lot #
~g 2 w PIN# 374310353430
Applicant/Owner RONALD BRAIM
Site Address: 4249 LEE CLINE RD, Conover, NC
Property Size: SF 1.21 ACRES
Directions: CORNER OF RIFLE RANGE & LEE CLINE RD
Improvement Permit
Permit Valid: Expires In Five Years: _X_ No Expiration:
Facility: House
Permit Category: Expansion Bedrooms 3
Projected Daily Flow 360 g.p.d
WATER SUPPLY: Public Water Type:
Basement? No Basement Plumbing? No
Proposed Wastewater System: 25% REDUCTION
Type: IIIG - OTHER NON-CONY TRENCH SYSTEMS
Proposed Repair: 50% REDUCTION PPBPS
Permit Conditions:
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 03/15/2010
AUTHORIZED STATE AGENT APPROVAL DATE
Permit Expiration Date: 03/15/2015
No grading or construction activity is allowed in areas designated for system and repair without approval of the Health Department.
03/16/10 14:00
~MPR-2-ID-q032
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AUTH-3-10-5450
IMPV-3-10-5448
WELL-3-10-5451
RONALD BRAIM
1842 sM 4249 LEE CLINE RD, CONOVER
Owner/Authorized Representative Acknowledgement of Permit Receipt
1I certify that I am the owner or authorized agent (owner's authorization required) representing the owner of
the 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 EHPR-2-10-4032 , by the following method(s):
Received in Person
Facsimile Transmittal (Return form with signature required)
Electronic Image Transmittal/ E-mail (Return receipt required)
d I 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 3 (15 i o
Owner/Authorized Representative Signature Jam--
Date I- A-/r
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 Sbaet _ of
DIVISION OF ENVIRONMENTAL HEALTH PROPERTY ID
ON-SITE WASTEWATER SECTION COUNTY:
SOIL/STTE EVALUATION
A lita~rl : for ON-SITE WASTEWATER SYS
Ronald ea,i n APPLICATION DATE 24110
ADDRESS: DATE EVAL ATED; b t !o!,
PROPOSED FACILITY: o u P 0 SED DESIGN FLOW (.1949): 3-160 PROPERTY SIZE; • 2.
LOCATION OF m. 4 2-`19 LC e C t i n¢. PROPERTY RECORDED:
WATER SUPPLY; 0 Private Public 0 Well 0 S,~' g 0 Other
EVALUATION ivmmoD; 0 Auger Boring Pit IJ Cut
TYPE OF WASTEWATER: Sewage Industrial Pmass 0 Mixed
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DESCRIPTION N= SYSTEM REPAIR sYsTEM OTHER FACTORS (.1946):
SITE CLASSIFICATION (.1948)•
Available Space (.1945) P,S AD
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LEGEND
use the rollowing standard abbreviations
SOIL coNVENTIONAL LPP MVERALOGY/
r A nSCAPE POSITION CRO TErnmE .1955 LTAR* . 957 L AR• [ [)NSISTENCE ST'RUCff1R6
CC (cmWave slope) I S (Send) 12 - 0.8 0.6-OA mm (Non- gansrve) G (Smsie Grain)
(oaY Sand) Sm (S1igwy Expansive) M Odussie)
CV ProvoWay) stop)) EXP (bPnifve) CR (Cnrmb)
D e
SL (Sandy Loma) 0 8 - 0 6 OA-0-3 GR (Caux1m)
DS (Debsic Stomp) IT (F1oodP9eia) L(I.aam) ABK(Aampbctoeb )
FS
FS (Fo d Slope) SCI. (Sandy Clay Loam) 0.6 - 03 03 - 0.15 PL (platy)
L(b Slope) III SiL Lonm) PR (Pas:natic)
L (Ir ) CL (Gay Loam)
N (Nose Slope) SiCL (Silty MY I'-) MOTST
Route) S (drs Slope) Si (a) VFR Nay Frfalle) NS (Nm i*A
T (fens=) rv SC (Study Clay) 0.4-0.1 0.2-0.0s FR fie) SS (Mj* Sticky)
FT (Firm) S (Stlty)
sic (Silty Clay) VF1 Nay Sam v. Very Sticky) VS Nay Wdm
0 C ( (t]Or¢amrpe) Now EFI (E:ma)ely Few) NP Ob"bc fir)
SP (SLghfly pbsic)
*Ad) ust LTAR dam to dept, mnstcteacq structure, 09 wetnar, iandseape, podtio4 wagewater flow nerd goallty. P (Ptmic)
VP (Very FW&)
I,►A=W DEPTH In inches below nmusl soil surface
DEPTH OFFILL In inches form land so¢am
ItFST&I=MHOB Wff Tbi Imm and depth from land sutftum
SAPBOL TB S(sabble) at U(umsahble)
SOIL WLTJ SS Inches firm land solace to fine warn or inches fr= land tmfam to snit colors with cbm®a 2 or lea - r=oad Mmsell velar chip desipation
CL,(STffTf mom S (Suitabl j PS (Provisionally Suitable). )c U Mnatitable)
E of oprolite shaU be by pits.
Lo *4= Aaesp>an~ Race (LTARr Owe
Show roMe locations and other site features dimensions, reference or heoehmark and North).
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