HomeMy WebLinkAboutIMPV-3-10-5660.TIF
~y-?,A ' , CAT.AWBA COUNTY Case # IMPV-3-10-5660
Public Health Department
d y Subdivision ROXBURY FIELDS
Environmental Health Division
PO Box 389, 100-A Southwest Blvd, Newton, NC 28658 Lot # 6
tg w PIN# 375501363351
Applicant/Owner RICKY LEE LAIL
Site Address: 6280 ROCKY RD, Claremont, NC
Property Size: SF 1.289 ACRES
Directions: HWY 16 N/ RT ON RIVER BEND RD/ GO 1/4 MILE/ LFT ON ROCKY RD/ AT END OF CUL-DE-SAC
Improvement Permit
Permit Valid: Expires In Five Years: _X_ No Expiration:
Facility: House
Permit Category: Other Bedrooms 3
Projected Daily Flow 360 g.p.d w
WATER SUPPLY: Well Type: Individual Well
Basement? No Basement Plumbing? No
C7
Proposed Wastewater System: CONVENTIONAL
Type: IIB - CONV SYSTEM WITH <750 LINEAR FEET OF LINE
Proposed Repair: 25% REDUCTION
Pump Required?: No
Operator Required?: NO
Permit Conditions: As built for existing septic system. IP for enclosure of existing front porch.
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
Susan Bumgarner 03/22/2010
AUTHORIZED STATE AGENT APPROVAL DATE
Permit Expiration Date: 03/22/2015
No grading or construction activity is allowed in areas designated for system and repair without approval of the Health Department.
03/23/10 08:09
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Z Ricky Lee Lail
ti
v ^S 6280 Rocky Rd Claremont, NC
1842 sM
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
the property described above.
1 As the property owner or authorized representative, I have received the above referenced permit(s)
as requested in the application for service EHPR-3-10.56fM , by the following method(s):
1-fa Sz-
Received in Person
Facsimile Transmittal (Return form with signature required)
Electronic Image Transmittal/ E-mail (Return receipt required)
J 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
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.
a -5t, Ioo shed -1 of
DEPARTMENT OF ENVIRONmENI' AND NATURAL. RESOURCES PROPERTY ID 55~
DIVLSION OF ENVIRONMM-TrAL 1•LFALTH COUNTY: bk
ON•SITE WASTEWATERSBCnON
SoiusITE EVALUATION
for ON-SITE WASTEWATER SYSTEM
OWNER , PLICATION DATE DATE EVAWATED2"I
ADDRESS P80PERTY SIZE:
PROPOSED FAC LITY: - PROPOSED DESIGN FLAW {.1949) _
PROPERTY RECORDED:
r,OCATION OF STfE:
WATERSUPPLY: 9Private 0 Public 0 0 pit a Spring 0 other
EVALUATION MEMOD- 8 Auger Boring
Sewage D Industosl Process
OF WASZEWATER l.Txe3
TYPE
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DESaJYTiON WlTLAL SYSTEM REPAIR SYSTEM OTHER FACTORS (.1946):
STIE CLASSIFICATION (.1948): 5
Ava~7able Spar (194 S 5 EVALUATED BY: S
~ *s) a5°lo reA OAR(S) PRESENT.
Syc T
ge LTAR ~ 3S
• C~LMENPS:
LEGEND
use the bUminz standard abbreviations
SOIL CONVENTIONAL LPP MiERALOGY/
LAMSCAPEPOSI'IfON GROUP TEXIVRE .1455LTAt* -1957LTAR* CONSISTENCE
CV ( con- 1 9- Y ) 12'- 0.8 0 6 - 0 4 (11 ) ) M (Mawel LS Sam
m)
D awry) ECP ( ) M (Cn=b)
DS Pabib (Flood Plain)-) JI L SL (So* a°mm) imun) .f~) 01-0.6 OA-03 Gk (Gmnda)
EP
FS (Foal Slope) MK (Snbmyo)ar Blocky)
ABK(AaB kBlxky)
L Mead m ' S CL 0.6.03 03 -115 PL MW)
N (Nowt Slope) CL ( PR (Pn®ahc)
(Clay
s (mmuer slope) ( day Lam) MOTST w~T
sat) ,
T (T`m=) VFR (Vwy Priabk) {ZS (Dim y~
TV SC (Sant day) 0.4 - 0.1 02-OAS FR Wawa) SS (~Y S"A
SIC MY CloY) F1(Fam) S (Ss~ .
O (clay) ) N~ VF NQY Film v. Vfay Sddy) vs (Vay&rd~
(~dYFM4 NP (Ym Nav{)e)
RA~nst LTAR doe t• drp$y coadeteaey atructaro, 84 -b-m- P( (bs*)
NOTeS ~P4 po7:Uian, wactevvater flow and 9~tY P (Phalle)
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l1EXOR6QTVDEPTX In indms baba natumi =a amfa:x VP (very Pb
WOFI= hinches fmtmland cut&
RES781C2Ii'Is HOBL= Muclmee and depth hum Ind aafaae
S(PBOlm S(svW&)aru(tM )
SOIL i znW ,1066 fiam bmd mzfaee to fix water or irides f mm lend m:fsa to ad colas with E4-n 2 or lea -=ard ldanse!( cola chip deip d n
C1d5SII~ CAMN S (Suitable), PS (PanidowHy sn;mble), orU ([hstt>k hlo)
Evab Ldm of munlite sball be by pits
T,me-t ® Ac c eptance Race (LTARY S~~Y~
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