HomeMy WebLinkAboutIMPV-04-2018-098598.TIF 4k8A • • CATH BA COUNTY Case ft Ih11'V-04-2018-098598
.- rr.1 � ,, Public Health Department Subdivision FAIRWAY ACRES
<�1rL'll'.S Y Environmental Health Division PINK 372018302767
�"0 1/ PO Box 389, 100-A Southwest Blvd,Newton,NC 28658 LOT# 7
184.1
NAME ON PERMIT: !CAN GHEORGHE LEAHU, 1655 20TH AVE DR NE 115, HICKORY NC 28601
Site Address: 1273 FAIRWAY DR, NEWTON NC 28658
Property Size: Square Feet:28,749.60 Acres:0.66
Directions: Startown Rd, left Sandy Ford, left Fairway, property on right before curve
p Owner/Authorized Representative Acknowledgement of Permit Receipt
6-61 certify that I am the owner or authorized agent(owner's authorization required)representing the owner of
the property described above.
1 �vAs the property owner or authorized representative, I have received the above referenced
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permit(s)as requested in the application for service EHPR-04-2018-28829, by the following method(s):
_Received in Person
Facsimile Transmittal (Return form with signature required)
qq���� Electronic Image Transmittal/ E-mail (Return receipt required)
�WC,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 (ISA 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: 04/23/2018 C //
\ Owner/Authorized Representative Signature \� '1 (
Date4 -2,-/e
Documentation of 1'ermit(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
We wantt tto hear from youPlease ttake a few momentts tto complette our custtomer service survey att
http://www.surveymonkey.com/s/ERCusttomerService
el,penni, 04/232018 12:32
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t\;A CATAWB.A COUNTY ❑� #` l ■ Case k ID•I I'V-04-z01R-098598
sGEy I y Public Health Department ' `'yy� Subdivision FAIRWAY ACRES
< - p•1 - Environmental Ile;dth Division r T • `'l '3 l PINtf 372018302767
" ��j PO Box 389, I00-r\Southwest Blvd,Newton,NC 28658 k _, ti r • a{r LOTk 7
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NAME ON PERMIT: IOAN GHEORGHE LEAHU, 1655 20TH AVE DR NE 115, HICKORY NC 28601
Site Address: 1273 FAIRWAY DR, NEWTON NC 28658
Property Size: Square Feet:28,749.60 Acres:0,66
Directions: Startown Rd, left Sandy Ford, left Fairway, property on right before curve
Improvement Permit
tgX4W130. p; r THIS`'PERMIT1S'HOT FOR SEPTIC INSTALLATION ._ tato,^o ,..
Facility: Primary Residence
Permit Category: New Septic Bedrooms 3
WATER SUPPLY: Private Well
Basement? Yes Basement Plumbing? No
INITIAL SYSTEM SPECIFICATIONS
Projected Daily Flow 360 g.p.d
Proposed Wastewater System: 25% REDUCTION
Type: 1110-OTHER NON-CONV TRENCH SYSTEMS
Permit Conditions:
REPAIR SYSTEM SPECIFICATIONS
Repair System Required? Required
Proposed Wastewater System: 25%REDUCTION
Type: IIIG-OTHER NON-CONY'TRENCH SYSTEMS
Landscaping or other site alterations that potentially divert groundwater or surface water toward the septic system, or prevent proper
drainage away from the septic system, including the direction of gutter flows or foundation drains,is not approved,and may result in failure to
approve the initial system installation,or the suspension/revocation of existing permits.
The issuance of this permit by the Health Department does not guarantee the issuance of other permits. It is the responsibility of the applicant
/properly 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'Lars and Rules for Serenee Treatment mut Disposal Systems' (I5A NCAC INA.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.
04/23/2018
AUTHORIZED STATE AGENT APPROVAL DAVE
Permit Expiration Date: 04/23/2023
No grading or construction activity is allotted in areas designated for system and repair without approval of the Health Department.
cl,pcnnii 04/23/2018 12:32
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Parcel: 372018302767, 1273 FAIRWAY DR lin=40ft
NEWTON, 28658
This map/report product was prepared from the Catawba County,NC Geospatial Information Services. Catawba County has made substantial efforts
to ensure the accuracy of location and labeling information contained on this map or data on this report.Catawba County promotes and recommends
the Independent verification of any data contained on this map/report product by the user.The County of Catawba,its employees,agents,and
personnel,disclaim,and shall not be held liable for any and al damages,toss or liability,whether direct,indirect or consequential which arises or may
arise from this map/report product or the use thereof by any person or entity.
Copyright 2014 Catawba County NC
04/23/2018
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Catawba County Environmental Health
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Parcel: 372018302767, 1273 FAIRWAY DR lin=601t
NEWTON, 28658
This map/report product was prepared from the Catawba County,NC Geospatial Information Services. Catawba County has made substantial efforts
to ensure the accuracy of location and labeling information contained on this map or data on this report.Catawba County promotes and recommends
the independent verification of any data contained on this map/ropart 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 horn This map/report product or the use thereof by any person or entity. . . •
Copyright 2014 Catawba County NC
04/06/2018
DEPARTMENT OF HEALTH AND HUMAN SERVICES
DIVISION OF PUBLIC HEALTH,ENVIRONMENTAL HEALTH SECTION Sleet of
ON-SITE WATER PROTECTION BRANCH PROPERTY ID R:
SOIIJSITE EVALUATION COI1NfY.-Catawba
for ON-SITE WASTEWATER SYSTEM
(Complete all fields in full)
OWNER__ZO n
� r APPLICATION DATE
_
ADDRESS: l - - -- _
PROPOSED FACILITY:-C(7S'.(I PROPOSp DESIGN FLOW 1949 : 4 ` C, DATE IZELUA7ED:�/y
LOCATION OF SITE: 5 � .(�,�, 4' L(' ) 7 PROPERTY SIZE:
��� /rpt-� PROPERTY RECORDED:
WATER SUPPLY: 0 Private ❑Public 11 0 Spring 0 Other
EVALUATION METHOD: 0 Auger Boring IjJ)tt ❑Cut
''„ aR5TYPE OF WASTEWATER: l�wage 0 IndustrialProcess Mixed
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DESCRIPTION INIIAL
/�SYSTEM REPAIR SYSTEM) OTHER FACTORS(.1946):
Available Space(.1945)
4-1-) P5 ,Y-I SITE CLASSIFICATION(.1948): e5
System Types) EVALUATED BY: ff
OTHER(S)PRESENT: ��/7��Ly� u/;.'K//''r"
Site LTAR !. ! 3
COMMENTS:
Upt4ail February 2014