HomeMy WebLinkAboutEHPR-04-2018-28973.TIF A
Yq �G THIS IS NOT A PERMIT Case# EHPR-04-2018-28973
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�� CATAWBA COUNTY HEALTH DEPARTMENT ❑■ .A ❑.
.4� PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES
las 2 w Environmental Health Plan Review-Septic Malfunction ,•D tia.
AUTH_CONST- SEPTIC MALFUNCTION 'i r • ; o4,17;
�
Applicant DEANNA SELF,8000 BARKLIiY RD.SHERRILLS FORD NC 28673
C:980-297-4812
NAME TO APPEAR ON PERMIT
Deanna Self
SITE ADDRESS: 8000 RARKLEY RD,SHI'.RRILLS FORD NC 28673 PIN# 461603021812
NAME of SUBDIVISION: ASBURY PARK Lot k 16 Section/Block B
PROPERTY SIZE: Square Feet 20,908.80 Acres 0.48
DIRECTIONS: E NC 150,right Slanting Bridge Rd, left Keistler Store Rd,left Barkley Rd,on left before Mallard Cove
PRIMARY CONTACT: Applicant SEWER TYPE: Septic Tank
GALLONS PER DAY: 360 WATER SUPPLY: Private Well
DESCRIBE WORK: TANK ONLY
SITE INFORMATION
Do any of the following apply to the property for which this application is applied?
If the answer to any of the questions below is"YES",then supporting documentation is required:
Does this site contain any jurisdictional wetlands? No
Does this site contain any existing wastewater systems? Yes
Is any of the wastewater going to be generated on the site other than domestic sewage? No
Is the site subject to approval by any other public agency? No
Are there any easements or right-of-ways on this property? Yes
Property Easements Description: Waterfront Duke Power
APPLICATION FOR: Existing Structure
STRUCTURE TYPE: PRIMARY RESIDENCE
FACILITY TYPE: House OTHER DESCRIPTION:
DESCRIPTION OF residence
EXISTING STRUCTURES
ON SITE(IF ANY)
DIM EXISTING STRUCTURE: 54 x 75
NUMBER OF EXISTING BEDROOMS: 3 It OF OCCUPANTS: 2
PROPOSED CONSTRUCTION
BASEMENT? No BASEMENT FIXTURES? No PLUMBING REQUIRED?
Desired system types(Improvement Permit or Authorization to Construct):
ACCEPTED: ALTERNATIVE: CONVENTIONAL:
OTHER: INNOVATIVE: ANY: YES
Other described:
chapplicanon 04/24/2018 0855 /'aye 1 o17
rw• CATA11 an COUNTY Case d E1-1 PR-04-2018-28973
.7 fl , Public Health Department Subdivision ASBURY PARK
.1 _ Environmental Health Division PIN# 461603021812
PO Box 389,100-A Southwest Blvd,Newton,NC 28658
•42 a
NAME ON PERMIT: (DEANNA SELF).8000 BARKLEY ILD.SI-IERRILLS FORD NC 28673
( Deanna Self)
Site Address: 8000 BARKLEY RD,SHERRILLS FORD NC 28673
Property Size: Square Feet 20,908.80 Acres 0.48
Directions: E NC 150, right Slanting Bridge Rd,left Keistler Store Rd,left Barkley Rd,on left before Mallard Cove
Completed applications are valid for a period of 2 years.Improvement Permits are valid:with complete site plan=60 months(5 years);with complete plat
=without expiration. An Authorization to Construct will remain valid as long as the Improvement Permit is valid.An Authorization to Construct issued for
septic repair is valid for 60 months(5 years).Permits may be revoked if the information on this application/site plan changes or if the intended use for the
proposed facility changes. Permits may be revoked if site conditions are altered such that they effect permit conditions or installation requirements
I have read this application and certify that the information provided herein is true,complete and correct. Authorized county and state officials are
granted right of entry to conduct necessary inspections to determine compliance with applicable laws and rules. I understand that I am solely
responsible for the proper identification and labeling of all property lines and comers and making the site accessible so that a complete site evaluation
can be performed.
The undersigned is the owner of the property or legal agent of the owner.
Date: Signature of Applicant or Agent
II'you need further information or assistance please call 828-466-7291
AREA I
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i 1 1 NAME DATE FEE AMOUNT
Authorization to Construct(Repair) Fee 04/24/2018 S150.00
TOTAL FEES 5150.O0
FEES ARE NON-REFUNDABLE
ONCE A SITE VISIT IS MADE OR
WORK ON A PLAN REVIEW HAS COMMENCED
SYSTEM REDESIGN AND/OR RETRIP WILL INCUR AN ADDITIONAL CHARGE
(SEE FEE SCHEDULE)
ehapplicadon 04,24/2018 08:54 Page 2 of 7
bAw BA THIS IS NOT A PERMIT
CATAWBA COUNTY HEALTH DEPARTMENT
De .� 3
�.-,*- ;�'�,,,,-;.:� Application for Environmental Services
-- ------ - — -- xFact
-_
Application is for. -New Construction ili.Y .__.. . ..._
- ---------
Etspng .-
❑ Improvement Permit ❑ Authorization to Construct
❑New Septic [z Septic Repair/Malfunctionn Septic Relocation CI septic Expansion
1 LI Existing System Inspection or Reconnection
❑New Well El Replacement Well J ❑ Well Abandonment [1] Well Repair —
Property Address $A2k1R Rd. Subdivision 45bu.t2 Roth.
Intrza V\5 tt C1/4 INA CA?&72,_ Lot # l le "teres . ii b
Driving Directions to Property_(,5 0 W • -bOA 5i- te:i-o e -R 09
Drt K's-tdc2 ( o8 -i<L . o' " on
esi
��1# a4tF
Applicant Contact Information ��� ( t 5
t Name ( �tpnc� So i \\
•
Address Stir)o '3he& e 2c1 Ohl sZ tis +=oR.o 14C 02410?3
Phone 9,a -a - , . Cell Phone Igo -0/97- e/b'!dt
Owner Contact Information
Name C-6402-4 Cla.-ct
Address a qce _Rr( Sht esar l is F e ld.C a to73
Phone ,3_3(22 (o(€52) - asci l Cell Phone 33{p-1132-G7J$9/
Contractor Contact Information
Name LEA 7-2 &4.5�Lie? __Pil5MC License#
Address
Phone L4 p- gay . 302•Lf 'Sell Phone
Name to Appear on Permit? 0 Owner ❑ Applicant ❑ Contractor
Who will be the Primary Contact? Wwner Applicant ❑ Contractor
Existing Structures on Site? //
`t^` Yes ❑ No If yes. describe J4v int 51 f 75
#of Bedrooms * '2j ft of Occupants a Structure Dimensions 5t-' y'.2- ` ,3._
Basement ❑ Yes EA No Basement Plumbing ❑ Yes [g No
Existing Water Supply?
ca Individual Well ❑ Community Well ❑ County/City/Township Water Line
1 Is a public water supply available? " ❑ Yes ❑ No
IWell Construction/Abandonment/Repair
Proposed Well Type ❑ Individual Well ❑ Semi-Public Well ❑ Community Well
I Abandonment Type ❑ Drilled ❑ Bored ❑ Dug ❑ Unknown
I Well Repair Requested ❑ Yes ❑ No Describe
Will Certified Well Contractor Instill Water Line or Electrical Line from Well Head to Pressure Tank? ❑Yes ❑ No
CATAWBA THIS IS NOTA PERMIT
o.,, CATAWBA COUNTY HEALTH DEPARTMENT
Application for Environmental Services
Proposed New Construction - Residential __
Primary Residence ❑ New Residence D Addition to Residence It of New Bedrooms *t________
Project Description _
Structure Dimensions _ #of Occupants
Basement ❑ Yes ❑ Nbo Basement Plumbing 0 Yes 0 No
Accessory Structure(s)Describe Structure Dimensions
Plumbing ❑Yes ❑.No Describe Plumbing Needed _
AccessoIry Dwelling ❑Yes 0 No It of New Bedrooms __ _ # of Occupants ____._______
Proposed New Construction - Commercial
1Food Service Specify Type -
#Seats Floor Space-Entire Food Service Facility(Sq: Ft.)
#Employees per Shift #of Shills Dining Area(Sq. Ft.)Business/Other Specify Type Structure Dimensions
Retail Floor Space ft of Employees per Shift ft of Shifts ___
I
If Church #of Seats Commercial Kitchen ❑ Yes ❑
If Daycare,#of Children
If Multi-Family Residence,#of Apartments #Bedrooms per Apartment't—Total # Bedrooms't
Other Information
Calculated Design Flow, Commercial t (This value will be determined by Eli stall)
The Applicant shall notify the local health department upon submittal of this application if any of the following apply to
the property in question. If the answer to any question is"yes",applicant must attach supporting documentation.
❑ Yes f Does the site contain any jurisdictional wetlands?
LI Yes Does the site contain any existing wastewater systems?
❑Yes L�S1�o Is any wastewater going to be generated on the site other than domestic sewage? r
0 Yes LTNo Is the site subject to approval by any other public agency? U2cccrdarce&sx
13-Yes es 0 No Are there any casements or right of ways on this property? Describe D. .t_ Poual.(L-
If applying for.an Improvement Permit or Authorization to Construct,Please Indicate Desired System Type(s):
J (systems can be ranked in order of your preference)
❑Accepted 0 Alternative 0 Conventional 0 Innovative 0 Other 9Any
'Any room that will he intended fur sleeping at the time of construction or for future consideration should be noted as a bedroom and counted
on all applications.The number of bedrooms will be continued by rooms identified on floor plans as a bedroom at the time of building permit
issuance. Thismay prevent the need for septic system expansion in the future.
t If sticture is plumbed but has no bedrooms,calculated design flow will be determined by EH Staff.
•• If No,a well permit must be issued with the Authorization to Construct.
RETRIP TO THE PROPERTY AND/OR SYSTEM REI)ESIGIN WILL INCUR AN ADDITIONAL CHARGE(SEE FEE SCHEDULE)
Completed applications are valid for a period of 2 years. Improvement Permits arc valid:with complete site plan=60 months(5 years);
with complete plat=without expiration. An Authorization to Construct will remain valid as lung as the Improvement Permit is valid.
Permits may be revoked if the information on this application/site plan changes or if the intended use for the proposed facility changes.
Permits may be revoked if site conditions are altered such that they effect permit conditions or installation requirements.
I have read this application and eerily that the information provided herein is true,complete and correct. Authorized county and start
• officials are granted right of entry to conduct necessary inspections to determine compliance with applicable laws and rules. I
understand that lam solely responsible for the proper identification and labeling of all property lines and corners and making the site
accessible so that a complete site evaluation can be perthnned.
The undersigned is the owner of the pgliperty or legal agent of the owner.
Signature of Owner or Legal Agent_1 (, .ut, ,c_. _LEA.
je
Date ( ( ?2.„'
Printed Name of Owner or Legal Agent j?CII.NNto C('7(=
,T..._- ,.....
DRAIN FIELD Y�
(Fatimntad 15'.40'conventional grnvlty'boo',
-000'opuivatenl linear length; Z
-5'from House,-35 from Lake)
Q
I
HOUSE
SEPTIC TANK
(-8•from Fla sr)
WELL
(-175'from Septic Tank,
-215'from Drain Feld)
Nik
O
B tRKLEY ROAD
8000 Berkley Rd
Sherrills Ford , NC 28673
2018 April 18 11
FyfiteVieti afi
(Not to scale)
I
•
/�J ON-SITE WASTEWATER
A , ,ri/���� A9 ' i\kiiRi�. INSPECTION REPORT (Page 1 of 3)
�r , jli Wit,(`r`� 18 Apr 2018
�`pr J GATE Of INSPECTION k�
Street Address 8000 Berkley Rd
DAVID LYNCH Inspector Certification#43121
city Sherrills Ford state NC zip 28673
David Lynch dlynchenviro@gmail.com Tony Rankin
2708 Peachtree Rd (828) 234-9451 CLIENT NAME
Kortney Kappel
Statesville, NC 28625
Tony Rankin (Buyer)
Kortney Kappel (Realtor - Sellstate Select)
Tony, Kortney:
At your request, on 18 April 2018, I inspected the septic system at 8000 Berkley Rd, Sherrills Ford,
NC. The following is an inspection form that is required by the NC Onsite Wastewater Board.
Enclosed is a copy of the permit for this system from the Catawba County Environmental Health
Department and a site drawing I made that shows the location of the septic system. Also included is
a copy of the MLS, some pictures of the site, the signed pre-inspection contract, and the invoice.
I opened the septic tank and found cracks leading outward from all four corners of the outlet lid
opening. Over time, these cracks may worsen to the point the tank becomes a safety hazard.
The tank is currently still intact and may remain so for some time, but there is no way to repair
broken concrete. The concrete sanitary tee had been retrofitted with a PVC tee with no fitter.
The sludge and scum layers were excessive; therefore, the tank should be pumped by a licensed
septic pumper at this time.
The drain field consists of a conventional gravity 'bed', roughly 15' x 60' in size. This matches the
permit's design.area of 900 sq ft. The end of the bed is roughly 30' from the dropoff slope to the lake
inlet. The field probed dry and appeared to be functioning properly on the date of my inspection.
Sincerely,
David Lynch
Subsurface System Operator (Cert. #996383)
NC Onsite Wastewater Inspector (Cert. #43121)
.�, i i�) �I /1j �' �r �, ON-SITE WASTEWATER
���11 alr� ,l� tr�. INSPECTION REPORT (Page 2 of 3)
• :-/H7'"exv ,riF 18 A r 2018
�J1R"!hl 11 /\�,r',?� DATE OF INSPECTION P.�_
DAVID LYNCH Inspector Certl/kation a 43121
streot Address 8000 Berkley Rd
city Sherrills Ford state NC zip 28673
David Lynch dlynchenviro@gmall.com gmall.com
2708 Peachtree Rd (828)234-9451 CUENT NAME Tony Rankin
Statesville, NC 28625 Kortnev Kapt?el
Pre-Inspection Contract, signed by Client(or client's representative)is attached to Inspection
Inspection shall include any part of the system located
3 Advertised number of bedrooms as stated in more than 5 feet from the primary structure that is
attached sworn statement by owner or owner's representative part of the operations permit
Copy of Operations Permit from Catawba
3 Number of bedrooms/Gallons per day for County Environmental Health attached
designed system size or as stated in available local health Operations Permit not available
department information System requires a certified subsurface water pollution
control system operator pursuant to GS.90A-44
Type of water supply: Well Current Operator's Name
Date septic tank was last pumped: Most recent performance, operation and
maintenance reports are
SEPTIC TANK
8 It from house or structure
175 ft from well if applicable
ft from water line if applicable or known
ft from property line if said property lines are known or marked
-12" distance from finished grade to top of tank or access riser
No Access riser(s)present? r..rmem,
Yes Tank lids intact?
No Tank is in good structural condition? ca.,.,,.,., Tank has cracks leading outward from all 4 corners of the outlet lid Opening
Yes Tank has baffle wall? co....m,
Yes Inflow to tank is unobstructed? runm.w
Yes Water level in tank is relative to tank outlet?
Yes Outlet sanitary T is present in good condition? Tank has been retrofitted with a PVC sanitary tee
No Sanitary r has a filter installed? w,.,.M.
Yes Effluent leaves the outlet? cn,.,..0
No Are roots present in tank? Comment,
No Is there evidence of tank leakage? Comments
Yes Connection is present from house to tank
Yes Connection is present from tank to next component
50+% Percentage of solids noted in tank m,,,,,,.,,,. Very dense scum&sludge layers
PUMP TANK Does system have pump tank? n YES(Complete blanks below) n NO
ft from house or structure
ft from well if applicable
ft from water line if applicable or known
ft from property line if said property lines are known or marked
ft from Septic Tank
distancefrom finished grade to top of tank or access riser
Electrical connections are in place and properly grounded? w,..,a
Audible and visible alarms(as applicable)work? comments
Pump turns on and effluent is delivered to next component? Comments
fmuribe condition of tank lids/access riser: caav,.,,.,
Describe location of control panel: 4 rnmeea
ri /1: ;r. G, r' ON-SITE WASTEWATER
��'��� �'�" '���t���''�• INSPECTION REPORT (Page 3 of 3) •
LT 6 Sj int:7•11 :( .J DATE OF INSPECTION 18 Apr 2018
• Street Address 8000 Berkley Rd
DAVID LYNCH inspector Certification p 43121
city Sherrills Ford State NC ZIP 28673
David Lynch dlynchenviro@gmail.com
2708 Peachtree Rd (828) 234-9451 CLIENT NAME Tony Rankin
Statesville, NC 28625 Kortnev Kennel
DRAIN FIELD
Type of System: i]Conventional Innovative 0 Pretreatment; Type of Pretreatment:
Brief Description of System Type: Type II conventional gravity system
Number of lines: Total linear footage of drain field: 300
5 ft from house or structure
215 ft from well if applicable
30 ft from Septic/Pump Tank
ft from property line if said property lines are known or marked
yes Effluent is reaching the drain field? c,nme'n
No Is there evidence of traffic over the drain field?
Catmints
No Is there vegetation,grading,or drainage that may affect the condition of the system or system components?
rm.nmu
No Were there conditions present that prevented or hindered the inspection?
Yes Any adverse conditions present that require repair, subsequent observation, or further evaluation
from the local health department?
If a decision is made to replace the septic tank,a Permit will be needed from the Catawba County Environmental
Health Dept before any repair work can be taken.
Other pertinent facts noted during inspection / general comments:
Solids in the septic tank exceed 1/3 of the liquid depth.According to NC Sewage Rules, the tank should be pumped.
No representation, warranties,or opinions are hereby given, written,or expressed otherwise,as to the future performance of the
onsite wastewater system described herein. This onsite wastewater system inspection is a presentation of system facts in place on
the date of inspection.
ImPcrtor 54wnre ,G_. rr-L David Lynch eat, 18 Apr 2018
I .
LIAC - OIRCCTICN DISTANCE
� T I
II N 28'30'31- V 38.95'
•
L3 N 61.54'00' V 40.59' \ '
L4 S 72'I6'121 V 41.22'
L5 N 03.06.54' C 14.5i• \ •
L6 s 87'00.06• C 3C.27' Lake Norrnart \ 5ite ;a
LT S 74'36.36' C 8.13' duke Power Company \ al
64.
LA S 12.14• IC 31.93'
1.9 S 46.0x3;• C 12.00• (J. P. Asbury) -
110 S 61.54'00• CI 34.31" UMI - 254 \ dpJd
1.11 S 00.20.03' VI 52.27' D.8.196. Pg.144 \ �S
v
PG
Pa
Pored 1 oar: \ . ,_-- --------
Are¢=0.0109 Ac. - a-ga \ vq
LOCATION YAP - NOT TO SCALE
-� 475.8 Sq.Ft. ao8< 1 as
(To Dugan k Davis) RN-4A. \
•
\ `V>. 01 . • - Tins • \
\
l.Pa(F)G + �. C \ .
`,_ z 8 x. 414 \ Lot >9
C , eg
m a: _ Parcel IA
p 0. a Area=0.021O Ac.
• 916.8 Sq.Ft.
rs
(To D.P.Ca.) ,
Lot >6 _
c Melinda Dugan . `.Ph(F) .
Er And
Margaret E. Davis - - •
D.8.1972,.Pg.786
•
I.Pin(F)
ZS'
o2
4 62BZ32, I
•
30 A.w
- aq w 0
'5
I.PIn(F) r"� Lot 17
John W. Foster
Lot 15 . And Wife
Lorry D. Penn m Goynell Y. Foster
0.8.1280. Pg.11 0: m D.9.1525, P9.808
0
0
DJ C
IN
r`QK• Reel% 1-
i,2 6GtsTEq l�iyhsi I z .• ,
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i .
y '. ' o: i, _ I.Pin(F) 1.Pln(F)
Y "s 9\o :URI- w4.e .. ) \N 87'59'08' w '
�ilrie0 `5.'s N 1norY E i 35.05'
4;,,Y Al.85�,..,,° (n.U..) _ soeT
Ix Na(s) Men Vm k PIC NOUS)
a Road (n. Lw) a Rood
Note: • Barkley Road (60' R/iY.) LEOC143
Total Area To D.P.Co. = 0.0210 Ac. --._..—.._..—.._..—.
Total Area To Dugan k Davis = 0.0109 Ac. .Nes NOT SURVEYED
ALL. N SAE A
ALL CALCULATED
ARE AS NOTED 0
DUKE POWER PROJECT BOUNDARY RASED ON A WATER ❑MIay.ATEo raver oaP.
ELEVATION OF 750.9' ON MAY 13. 1996 AT 8:10 o.m.
MOWS: SURVEY MAC(USMC OOS1MC PHYSICAL
CADENCE EQJC AT TOSE OF SURVEY.
Map Prepared by sre,[CT vatl'E121Y DAY 8[31o,ccr TO
GRAS S(rva��nnry�1 and Mapping, Inc, RECOIDEo CR U.OSCCROED EASEMENTS
Su-raying RUNT-Q--WAYS SETBACKS
SET MOND
• RE: WC1VE COVENANTS NOT S0WGerald YSorbs.RLS DCWV.(To613-1660
26D-A RM Din ANNA. R (704 554-9375 HEREON.HEREON.I•on:
we,.,AC 19002 SOURCE OF TITLE: 0.8.198, Pg.144 -
' DUkE POWER COMPANY
STATE OF NORTH CAROUMA COWANS FORD DEVELOPMENT.
CAST°M COUNTY • LAND EXCHANGE'NTH ' '
1 1c:"'1"AatWsnye^e" . "'N
"" , . „'."^ ^ 4 -„
, ^.,,,' MELINDA DUGAN and
7. «)rna ..."_4"=1at"`1' 1°'°D°•t. • MARGARET E. DAVIS
•
�4s1�.nal vw T •PA..M1 •... d�fD{bry..
444444441/1 .e. R4 f.Tt. MT. CREEK TOWNSHIP '
T'...._•r WD Y4•r` 1' -/ CATAWBA COUNTY N.C.
l.Gf UJ/.rtl,r[ 600K N0. OC 25 0 25 50 75 CREW:RDH
w4+.a Lw Lrr.w MAY 13, 1996 DRAWN BY:RAS
ACOUISI i1ON PARCEL NO. 60064 SCALE : 1'=50' SCALE IN FEET EC.=1':1C,000'
1^SPOSALOREREEST T NO. 8915456 PROJECT NO. 7327 PARCEL NO. 49493 REQUEST NO. 89157
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CATAWBA COUNTY HEALTH DEPARTMENT
NEWTON, NORTH CAROLINA •.
COMPLETION PERMIT FOR SEPTIC TANKS
PERMIT N° o 09' 33
DATE : ,e,,, /, /Pj<
'
OWNER ,.,714, � , ADDRESS
BUILDING COI.RAGTOR_ f` SjJBDIaIS'ION, C(¢. �,,
LOCATION % 55�-/GSL(�c „,a, � .:2„, ,.> 71, „,e,
/Y �.... P_, LOT W
LOT SIZE -^B—LOCI([ OR SECT ON J
HOUSE ( �)/ MOBILE HOME ( ) BUSINESS ( ) OTHER ( ) FHA-VA LOAN ( )
SEPTIC TANK: (SIZE /000 GALS) WATER SUPPLY :
NO. BEDROOMS 3 NO FIXTURESINDIVIDUAL PUBLIC
SAL
GARBAGE DISPOUNIT :YES ( N0 ( 4---IF WELL, TYPE : BORED DRILLED DUG c�
AUTO WASHING MACHINE : YES ( L). NO ( ) DISTANCE FROM SEPTIC TANK OR NEUIRESTT
NITRIFICATION FIELD : 906 SQ.FT . POLLUTION : cv if FT.
1) NUMBER OF LINES 3 SEPTIC TANK INSTALLED BY :
2) LENGTH AND WIDTH OF TINES
9O /y /D ' . . EE p
a) BED SYSTEM ( cl/ CERTIFICATE OF CO ILETION BY :
-- - 60TRENCH-SYSTEM ( ) -. - <,-,, mty
3) DEPTH OF STONE IN LINES pie REMARKS :
ADEQUATE FALL (GRADE) ON:
1) BUILDING (HOUSE) SEWER LINE :
YES ( ANO ( ) . \ •
2) NITRIFICATION LI E : ` DATE INST•LLED: �,� _ l/,2 (9,es'
YES ( --)/NO ( ) et.
SEPT "—T NK LAYOUT
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\EALTH DEPA/R/�/T///�]IEN COPY
r
11:4111(;:: HEALTH DEPARTMENTl5 '� (,jOPPIT FOR SEPTIC TANKS / Peit No.l�I.L�CDATE 1 —EySNA ✓� aADDRESS OF OWNER PHONE
NAME OF CONTRACTOR ADDRESS /9 f.
LOCATIONS • I if AtAl_ Aa - . .I 07t... /-'-• . .I i. Mt' l 54-
— A. ..e _ •�C[�fi
lit — Xefd ,te x .�c .d eercc /✓c/ ...a �/e Ste-°
SUBDIVISION `/vU 19�LR, . LOT NO. SECTION OR BLOCK
LOT SIZ FHA, VA LOAN Septic Tank Contractor must follow all
HOUSE MOBILE HOME ( ) BUSINESS ( ) OTHER ( ) Details of this permit (layout)
NO. BEDROOMS (3) NO. FIXTURES (� / SEPTIC TANK L YO0 I
GARBAGE DISPOSAL UNIT: YES ( ) NO ( ) I G h ►
PLUMBING UNDER BASEMENT FLOOR: YES ( ) NO ( ) + ��
SIZE OF TAN! /c{G LIQUID GALLONS
NITRIFICATION FIEL _. ` �- n i I
1. Number of lines J r p
2. Length and width of456: ( 1 i i
a. Bed System ! X �0 ft. 7� ri
b. Trench system _ ft. li r (�� n�.g‘r•5
3. Total Depth of stone /0 inches / I
GROUNDWATER INTERCEPTOR DRAIN: ( / f /
(IF REQUIRED) _ ( ! l
WATER SUPPLY:- PRIVATE- O PUBLIC ( ) - - -
OWNER NOTIFIED TO CHECK ZONING: YES 412_,Si �¢
OWNER AGREES WITH LAYOUT: YES 0 ( I
/
OWNER AGREES WITH SPECIAL INSTRUCTIONS: YES q 1-1.--c0--( ) ®.4e0
OWNER OR CONTRACT SIGNATU .v .... l •
PERMIT FEE $ 4 tever
IG
PERMIT VOID AFTER 36 MONTHS FINAL APPROVAL OF THIS SEPTIC TANK SYSTEM BY
I ROVEMENT ' - Y IT I SUED 67 THE HEALTH DEPARTMENT SHALL INDICATE THAT THE
SANITARIAN % //,n SYSTEM HAS BEEN CONSTRUCTED ACCORDING TO
(//L / C/[- THE STANDARDS SET FORTH IN THE CATAWBA COUNTY
/ HEALTH DEPT. COPY SEWAGE DISPOSAL REGULATIONS, BUT IN NO WAY
SHALL BE TAKEN AS A GUARANTEE THAT THE SYSTEM
WILL FU CTION SATISFACTORILY FOR ANY GIVEN
M
SOIL CLASSIFICATION: SUITABLE ( ) PROVISIONALLY SUITABLE UNSUITABLE ( )
SITE FACTORS:
1. SLOPE (%) S - PS - U 7. SOIL PERMEABILITY S - PS - U
2. SOIL TEXTURE (12-48 IN.) S - PS - U UNDER 60 MIN. - OVER 60 MIN.
SANDY, LOAMY, CLAYEY 8. OTHER S - PS - U
3. SOIL STRUCTURE (12-48 IN.) S - PS - U (SPECIFY)
4. SOIL DEPTH (IN.) S - PS - U 9. SOIL SERIES:
5. RESTRICTIVE HORIZONS (IN.) S - PS - U A. CECIL ( ) B. HIWASSEE ( )
(IMPERVIOUS STRATA, ROCK) C. MADISON ( ) D. APPLING ( )
6. SOIL DRAINAGE - GROUNDWATER S - PS - U E. PACOLET ( ) F. FLOOD PLAIN ( )
(EXTERNAL - INTERNAL) G. 2-1 CLAY SOIL H. OTHER-SPECIFY
CAIAWBA COUNTY
G- IOOA SOUTHWEST BLVD
NEWTON,NORTH CAROLINA 28658 RECEIPT
teMOIrf
!� aP PHONE: 828.465.8399
v vdt♦� Tuesday,April 24,2018
842 su nww.catawbacountync.gov
PAYOR:
Self, Deanna
PAYMENTS
TRANSACTION NUMBER: TRC-3472249-24-04-2018
PAYMENT DATE: 04/24/2018
PAYMENT TYPE: Credit Card
203030553
INVOICE NUMBER FEE NAME FEE AMOUNT
04-18-352122 Authorization to Construct(Repair) $150.00
Fee
TOTAL PAYMENTS: 5150.00
EHPR-04-2018-28973
CASE TYPE: Environmental Health Plan Review WORK CLASS: Septic Malfunction
SITE ADDRESS: 8000 BARKLEY RD.SI-IERRILLS FORD NC 28673
Applicant DEANNA SELF,8000 BARKLEY RD.SI'IERRILLS FORD NC 28673
C:980-297-4812
** NO PE(PLISOF"I'ACCOUNT ASSIGNED**
receipt 0.02412018 08:54 Page I of I