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HomeMy WebLinkAboutRBPR-05-2018-29117.TIFCATAWBA CO~JN~'~ TrIEALTH DEPARTMENT l~s`~'~ Telephone (828) 465-8270 TDD (828) 465-8200 WLS ~# (,~u - O(/~l~f Impr~uvement Permit AC epair Permi .~ Operation Permit. System Typp2~ Well Permit. Replacement Well Owner/Agent ~ ~.~~~~~ ~~.~ ~~ Phone Address ~~ 3~ ~,,~ ~Y Subdivision ~~ur~~ ~.- /1- c~f~iv..~ ~S ~~^,~~~ ~ ^~-~ Section/Block/Phase Lot# Lot Size a ~/ ~( Directions // _s /1_~3 .° S/~' S ~v~ '- ,s!5'r /~e~ ~~ L~ ~r- Property Address ,S (..aloe Facility: House Mobile Home Business Multi-family Other: Pin Number y Q~ - ,~ ^ ,~'- ~yfy Other Zoning Approval # # Bedrooms_~ # Seats # Employees Application Rate ~ ,~ GPD Flow ~/ $'~ Hot Tub or Spa yes/no Special Fixtures Basement yes/no 100% Repair Area~no Basement Plumbing yes/no Water Supply Private Well~_ Public Semi-Public ************************************************************************************************************************ Type of System.: Trench Bed ~ Pump Pump/Panel Panel LPP Other Septic Tank Size G ~~51'~ Pump Tank Size Nitrification Field: Total Square Feet ~ Q ~ Depth of Stone ~,z ° Bed Size (tp ~( 5C~ Trench Width Total Length of All Trenches Number of Trenches Trench Length / / / / / Feet on Center Maximum Trench Depth~Q-3 ~ Distance of Nearest Well. S ~ *DO NOT INSTALL SEPTIC WHEN WET* *WELL RECORD REQUIRED AT COMPLETION* *************************************************************************************************************************** Topo ~'" - / L % Slope ~ 1 ructu e C ,fE Clay Min. / y ~ Soil Wetness ~ Soil Depth ~ a ~~ ~ s©•~' Restric Hoz. at -'' Available space o ~ \\~ 1 Overall Class S ~ ~' ~ ~C! VC/ _, _ ^ - Comments ~ ~ .~ ~ ;~~'~ ~°' ~ ~~ C ~~,5~ ~~ Filter Required ~ ~ ` L I 4Riser required when. ~ I ~ S tank is more than 6 ~ L~ { ~/ inches deep. ~ **NO GUARANTEE OR WARRANTY IS IMPLIED'OR GIVEN AS TO THE PERFORMANCE OR LENGTH OF TIME THIS SYSTEM WILL FUNCTION** ************************************************************************************************************************ ~`~ *Improvement Permit has no expiration date and is transferable, but may be revoked if site .plans or intended use changes for the proposed facility An Authorization to Construct is valid for (5) five years from date issued and is not transferable. Well Permit valid for 5 years provided site conditions do not change. Well location, installation, and protection must meet state and local regulations, and must be inspected and approved by a representative of the Catawba County Health Department before any portion of the installation is put into use. The siting of the well by the Health Department staff is to provide protection from known p sib a sources of contamination. No volume of water is guaranteed at any site by the Health Department. ,~ p Permit Date EHS Owner/ ent Septic qT"a Installe By ,~ Date -~/~° EHS Well Installed By ]Wlp( ~z,~,}~~ Well Grout Approval DateJ(~-/ - LL Well Head Ap oval to - -~- Date Sample Collected Date of Results Results ~~ : EHS White -Office Yellow -Owner/Agent Pink -Building Inspection Auihorizati to Construct