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HomeMy WebLinkAboutAUTH-3-10-5500.TIF g CATAWBA COUNTY Case # AUTH-3-10-5500 G Public Health Department Subdivision -3, Environmental Health Division DEERFIELD 4 PO Box 389, 100-A Southwest Blvd, Newton, NC 28658 Lot # 49 2 s~ PIN# 268902798192 Applicant/Owner CALIN SERAZ Site Address: 1347 SHADOWFAX WYND, Hickory, NC Property Size: SF 1.07 ACRES Directions: HWY 127 S - TURN RIGHT INTO DEERFIELD - TURN RIGHT ONTO SHADOWFAX WYND - PROPERTY ON LEFT Authorization to Construct Permit Authorization to Construct Wastewater System (Required for Building Permit) * See site plan and number of additional attachments Proposed Wastewater System: 25% REDUCTION Wastewater Flow 360 g.p.d Type: 111G - OTHER NON-CONV TRENCH SYSTEMS Soil LTAR: 0.3 g.p.d.M2 Permit Category: New Septic Type of Facility: House Basement? No Basement Plumbing? No Bedrooms: 3 Wastewater System Reguirements Tank Size: New Tank 1,000 gal Pump Tank gal Grease Trap gal Dosing Volume gal Pump Specs: GPM @ TDH Pressure Head ft Draw Down in Drainfield: Total Area: 900 sq ft Total Length: 300 ft Maximum Trench Depth 30 in Aggregate Depth in Trench Width 3 ft Minimum Soil Cover 6 in Minimum Trench Separation 9 ft on center Number of Drain Lines 5 Distribution: Serial Additional Specifications: Proposed Repair System Class: IIIB Proposed System: 25% REDUCTION Distribution Type:: Pressure Manifold Soil LTAR: 0.3 g.p.d.M2 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 Authorization to Construct Permit is subject to revocation if the site plan, plat or the intended use changes, or if site conditions are altered. The Authorization to Construct 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 for any given period of time. Megen McBride 03/17/2010 AUTHORIZED STATE AGENT APPROVAL DATE Permit Expiration Date: 03/17/2015 No grading or construction activity is allowed in areas designated for system and repair without approval of the Health Department. 03/17/10 10:56 ~NPK~3-iv -~llo l 1387 SWo4ax vVjrJ, Plue.,b►r1 muy ewe o~I;~ a-~ such a d ~ct4 loo-l(on as Tu ensure. raq 141 iiWt -eke, sTk 4ofl~- aKd ~YGLR~'~iCtA~ v~"'~ 15 too d. y Q\ ~r~ OY ov loo 10VA q Cpy1~t7~ C". t;M 7 r I$°'oU '~`~Y1S~~(~~tl( M1~~S~ ;Clnt~u~e a, £ ~,~5 pYE ~DYl.c rU~'C~b~ NtCe h~ wdLi pOof AL) s1~ ens , V-11 ta4 s~q~ali 3bo~~ ~I a57 -Gov ;1d 6Y cu~~ 7 hovSL ` 5r x 5i 4h IaAour. D~ Nod dr~Jt , vjt , ca, GV r F e All, Ore vJ , p~rcq ~ ~1e.1~ 'Mu`st ~je,• ~,,L 9 re VckVe(A ~vw~x _ ~yhd, Calin Seraz V 1347 Shadowfax Wynd, Hickory I84 sM Owner/Authorized Representative Acknowledgement of Permit Receipt 63 I 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-3-10-4101, by the following method(s): CS 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 .34-711D ~--Owner/Authorized Representative Signature CffG~~Ci SERA6 i (-/Date3 17 a o t'o 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.