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Public health Department � t • a.rlSubdivision
G ;, -1 Environmental I lealth Division r ?-j I r r PINk 372014427819
4"01/11Y PO Box 389, 100-A Southwest Blvd,Newton,NC 28658 7 + LOT/
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NAME ON PERMIT: RICHARD CROTTS, 4130 CARRIAGE LN, HICKORY NC 28602
Site Address: 2515 SANDY FORD RD, NEWTON NC 28658
Property Size: Square Feet:81,892.80 Acres:1.88
Directions: Startown Rd, left Sandy Ford Rd, property on left
Improvement Permit
•r4 C `` r'0 "` m.`THISSPERMITSIS'NOTOFOR SEPTIC INSTAL`Li4TIONtz' e. '`vim..
Facility: Primary Residence
Permit Category: New Septic Bedrooms 3
WATER SUPPLY: Public Water
Basement? No Basement Plumbing?No
INITIAL SYSTEM SPECIFICATIONS
Projected Daily Flow 360 g.p.d
Proposed Wastewater System: 25% REDUCTION
Type: IIIG-OTHER NON-CONN TRENCH SYSTEMS
Permit Conditions:
_ REPAIR SYSTEM SPECIFICATIONS
Repair System Required? Required
Proposed Wastewater System: 25%REDUCTION
Type: IIIG-OTHER NON-CONN'FRENCH 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
/property owner to insure that all Catawba County Planning/Zoning and Building Inspections requirements are met. This Int pnn'emenI
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 Thr Sewn;e Treatment and Disposal Sestenrs' (ISA 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.
L
04/23/2018
AUTHORIZED STATE AGENT APPROVAL DATE
Permit Expiration Date: 04/23/2023
A'o grading or construction activity is allowed in areas designated for system and repair without apprnt'al of the Health Department.
ehpennit 04/24/2018 09:37
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Parcel: 372014427819, 2515 SANDY FORD RD lin=60ft
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 all damages,loss 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
Catawba County Environmental Health
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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
Op independent verification al any data contained on this map/report product by the user,The County of Catawba,its employees,agents,and
,,,pirsonnel,disclaim,and shall not be held liable for any and all damages,loss or liability,whether direct,indirect or consequential which arises or may
:tese from this trap/report product or the use thereof by any person or entey.
•-:[' ' Copyright 2014 Catawba County NC '
04/06/2018
DEPARTMENT OF HEALTH AND HUMAN SERVICES Sheet_of_
DIVISION OF PUBLIC HEALTH,ENVIRONMENTAL HEALTH SECTION PROPERTY ID it:
ON-SITE WATER PROTECTION BRANCH COUNTY:_Catawba
SOH/SITE EVALUATION
for ON-SITE WASTEWATER SYSTEM
(Complete all fields m Cue)
OWNER: k;--c_ i (Fait _ APPLICATION DATE
ADDRESS: // DATE EVALUATED:
PROPOSED FACILITY: <��'j ),L(� PRO OSED D t FLOWA.1 9): (-1 IOII PROPERTY SIZE:
LOCATION OF SITE: CT` r / /!j(�.np O ,ta PROPERTY RECORDED:
WATER SUPPLY: l7 Private NMiblic ❑]Well/ 0 Spring 0 Other
EVALUATION METHOD: B-Au:. Boring LUCE'Cut TYPE OF WASTEWATER: L45ewage 0 Industrial Process 0 Mixed
: 2 tbc .- .:
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DESCRIPTION INITIAL SYSTEM REPAIR SYSTEM OTHER FACTORS(.1946):
P5 13517E CLASSIFICATION(.1948):
Available Spew(.1945)
r11-72-12-
Sysa®Type(s) -� EVALUATED BY:
OTFIER(S)PRESENT: .--/ -Q
Site LTAR , ! 15.}t
COMMENTS:
Updated February 2014 -