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HomeMy WebLinkAboutIMPV-3-10-5779.tif va A CATAWBA COUNTY Case # IMPV-3-10-5779 Q Public Health Department Subdivision Q a Environmental Health Division TO Box 389, 100-A Southwest Blvd, Newton, NC 28658 Lot # .1 42 . , PIN# 375208986246 Applicant/Owner BRIAN WATERS Site Address: 3514 N OXFORD ST, Claremont, NC Property Size: SF 1.85 ACRES Directions: 1-40E/ EXIT 135 CLAREMONT/ RT ACROSS BRIDGE / PROPERTY ON RIGHT BEFORE CHURCH Improvement Permit Permit Valid: Expires In Five Years: _X_ No Expiration: Facility: House Permit Category: Other Bedrooms 3 W Projected Daily Flow 360 g.p.d WATER SUPPLY: Well Type: Individual Well Basement? Yes Basement Plumbing? Yes 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: IP for as built of existing system for accessory building. 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 03/25/2010 AUTHORIZED STATE AGENT APPROVAL DATE Permit Expiration Date: 03/25/2015 No grading or construction activity is allowed in areas designated for system and repair without approval of the Health Department. 03/26/10 10:20 G BRAIN WATERS 3514 N OXFORD ST, CLAREMONT, NC 28610 -1842 sM Owner/Authorized Representative Acknowledgement of Permit Receipt 6~~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-3-10-4395, by the following method(s): ~~Received in Person Facsimile Transmittal (Return form with signature required) Electronic Image Transmittal/ E-mail (Return receipt required) 4as 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 3/25/2010 Owner/Authorized Representative Signature Date 3 a ?//Z0 Documentation of Permit(s) Transmittal (permit transmitted by electronic or other means) Permit transmitted by (name (?fperson 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.