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Home My WebLink AboutIMPV-04-2018-098667.TIF ,g' CATAWBA COUNTY Case v • M1� [.t.T �, Public Heohh Depnrt�nent Subdivision < •�® '� Environmental Health Division PIN 365602553940 ' PO Box 389, 100-A Southwest Blvd,Newton,NC 28658 LO't'd it ,. NAME ON PERMIT: MICHELLE SHOOK, PO BOX 493, MAIDEN NC 28650 Site Address: 4692 RAINEY LN, MAIDEN NC 28650 Property Size: Square Feet289,674.00 Acres:6.65 Directions: East Maiden, Right on Rainey Ln, Property on the Left Owner/Authorized Representative Acknowledgement of Permit Receipt t• I certify that I am the owner or authorized agent(owner's authorization required)representing the owner of the property described above. j L As the property owner or authorized representative, I have received the above referenced permit(s)as requested in the application for service R13PR-03-2018-28645, by the following method(s): Received in Person Facsimile Transmittal (Return form with signature required) Electronic Image Transmittal/ E-mail (Return receipt required) ../'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(ISA 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: 04/24/2018 Owner/Authorized Representative Signature Date 4/— 2t.— /8' 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 We wantt tto hear from yoWlease ttake a few momentts tto complette our custtomer service survey att http://www.surveymonkey.com/s/EHCusttomerService 011001919 04/26/2018 09:25 �'= ti \3 \ CATAw'IS,\COUNTI' E�a R+l±�� ■ case IMPV-Od-2018-098667 ['f'�-7\ Public hcalth Department } -'+-7'e d_t Subdivision < 1 Environmental Health Division r' t+s, ' '+ � PINH 365602553940 a- PO Box 389, 100-A Southwest Blvd,Newton,NC 28658 r LOT# • ydy{�j��i4 NAME ON PERMIT: MICHELLE SHOOK, PO BOX 493, MAIDEN NC 28650 Site Address: 4692 RAINEY LN, MAIDEN NC 28650 Property Size: Square Feet,289,674.00 Acres:6.65 Directions: East Maiden, Right on Rainey Ln, Property on the Left Improvement Permit >;,q rrfk '$�,.�U�f{a;:5,,.. - to- HIS P' J --4 'TERMIT IS NOT.{FOR SEPTIC'INSTALLATION 7 V.,A. Facility: Primary Residence - House Permit Category: New Septic Bedrooms 4 WATER SUPPLY: Private Well Basement? No Basement Plumbing? INITIAL SYSTEM SPECIFICATIONS Projected Daily Flow 480 g.p.d Proposed Wastewater System: 25% REDUCTION Type: III0-OTHER NON-CONN TRENCH SYSTEMS Permit Conditions: 'See AC permit _ REPAIR SYSTEM SPECIFICATIONS Repair System Required? Required Proposed Wastewater System: 25% REDUCTION Type: IIIH-SYSTEM A1'/SINGLE EFFLUENT PUMP PUMP REQUIRED Landscaping or other site alterations that potentially dived 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 aporove 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 Improvement Permit is subject to revocation if the site plan,plat or the intended mise changes.or if site conditions are altered. 'rhe 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 Science Treatment and Disposal Seteems' (ISA NCAC ISA.190(. Neither Catawba County nor I he Environmental Health Specialist warrants that the septic tank system will continue to function satisfactorily for any given period of time. z 891,),(„ Y 04/24/2018 AUTHORIZED STATE AGENT APPROVAL DATE 4/24/2023 Permit Expiration Date: No grading or construction activity is allowed in areas designated for system and repair without approval of the Health Department. chpamtit 04/26/2018 09:24 A1,i-h- o4 -2olg_ oil 678 Catawba County Environmental Health kits - cw- soil- 09309 b11 v. (353) R1 \sc \ N P-414"r 47-Ln ., N< 4 V atM.<1 vM "yr �aS .. 3r_ iy,nth d# .` �O� I lir rlrM4i 111iJ1 lir' to 8 des° of m v . ,....,.? 4 N I>\ OrgiMu /" w� J Parcel: 365602553940, 4692 RAINEY LN lin=80ft MAIDEN, 28650 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 04/24/2018 DFYAEMFNTOFENVIRONMENT AND NATURAL RESOLflS Sheet_of — DIVLSION OF ENVIRONMENTAL HEALTH PROPERTY IDM: .0N-SITE WASTEWATER SECTION COUNTY: SOIL/SITE EVALUATION " for ON-SITE WASTEWATER SYSTEM OWNER (lltte. ,olli S�tooti PLICATION DATE ' ADDRESS: tf IT 'h 4-41 DATE EVALUATED: 4-10-Id PROPOSED FACILITY: it 15 PROPOSED DESIGN FLOW(.1949): if alp PROPERTY SIDE: LOCATION OF SITE: PROPERTY RECORDED: WATER SUPPLY: 0 Private 0 Public fWen 0 SWI g 0 Other EVALUATION METHOD: rAuger Boxing �yS. ng p Pii Cut TYPE OF WASTEWATER Sewage 0 Industrial Process 0 Meed ii-ir __..._..._.._..._.... .....___..._._..................� ..._......_.lira._._-_..._.,:::::::__...._. ,..._........_.._..::_:::__ ..........__.........._.._.-ilii . ._.__.._......_.._ __._.__...................._..._.....- ---- ___.......--'--..._.. ...._...._._._......_.__._..._.........._..___—_.rail-._. -_rail .Ellin .,.:�-_,:_::�,::::�::_:::-:: ,:::�-:-::._::-_:.._.._..._...__,.__� • _.__.._.:.:.._..._ - ger, _ - ._..: .._.-. .. .__............ .....::..........__...._._.....,.........._.._.__._;....._._._._........ .._ ii,.:.: : ........-^=.',;::� ilii ... -:�_...._._........ 051 Rrt:R!o-t:::: :::-: _-;__: !,!:::,: :: O .. , . .,:-_.._._.,_....::::,,,:!:,o ...-__,.:.�.__:: ::_.€;.. t::;:::::: _,lira $L3I�€14Yt�ff12TOP[SGY'"==�:_::;''_=-i`t !t:' _ .. _...__._.........._ . -... rail.. - .,_....._ - . lira. . �.. ._. .._._._.... ilii' .lira_. �-- - - _Q _ ._..._.__ _rail._ _......................__..___......_._.__.._._._...__..._.. .......,,.-_.._.....�:! :_::�..._.._......_ - -- - -- - � ::_-:= t:t[_-ilii._.::-:::::: :�,., -; _m _ _ : _ani -`'i€ :__!; ._.._........ 3141 ::.:-.7P :___.__'. 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KA.: !;:;:a1,14;::::: _-:iau€_ €,-,.:::,•:-:: =_:: 1 ;- €s ....._,....... — :::Ya = _ :PDSL R/I1C:. : .: ..L.._::-b" :S ;=:!-851;4:8...J:-:::_'STS;-::5(lI!'. h5y$ e _BES: a[:!: . .: .. _ , CLAS•::: -, --._._......-.._._•--: . -!: €€::::## 1i4Rl ii__::: ::-::: :::-:i:::: ah?3 °_nEertr _ unSs;_ €-; 4)t ':::- :: ii _:: =sY:urf€�_, =:_��::....rail_.. :...._.... .............ilii-;.�-:r_.._, .. - 4LT b-6 L 6- 1?3 L chi re-rrm 1 °i3-t{1/ C-r.rns'/A .«Gk rr r, ^i' • Iia ( 27s at-7. .It ...GY I'w11- • �y-foro 7-2) C— 16� f—^ )t y 5-2 2 ° 2� 75 C 1c rE. ft .1 Cirn. Iry73; ( ZS VCC M T. rdyi LS`/ i2 ,r,.,cbl,t. P-6 r L C.- . VF.• S )1 L rS(1 Fr F...? 3 7°t0 31-47 12.-,GA- . ' t / 3 N 0-6 Z Vrr -(0112 b- 3y C nit Fr sin 4 '11_57 C 1/2:4, 51SIr, Fr r, , Si- 122,r- . • DESCRIPTION ATTIAL SYSTEM REPAIR renal OTHER FACTORS(.1946k Available Space(.1945) - f SITE CLASSIFICATION(.1948):. f '' fi yS,�T s) (2..1 °(. 2 c - EVALUATED BY: f4�LM ) r OTHER(S)PRESENT: • Site LIAR ; 'Z.'S ,2-71- COMMENTS: �. nn . .S i e5. z tk�. ,11„-.4444.2197..4'^.. .an,YJ:..faMJiT�.ni �.>.k ,. n,.9a5.�Ybk�.chili,.:44;4rt2mX"s i3 ..n_§:iii Nk ,, + .a a .,,_ ,ilii rail Catawba County Environmental Health V. a +� o 4444 e a to\� ® sir 140 ` rJ o ns_ fa ei Is \\1/4(81N------ \L. nc+ .I, . .---"---Th / Parcel: 365602553940, 4692 RAINEY LN 1in=80ft MAIDEN, 28650 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 04/24/2018