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HomeMy WebLinkAboutIMPV-9-10-10979.TIF �gA • CATAWBA COUNTY Case # IMPV -9 -10 -10979 G Public Health Department ti ( 2 Subdivision Environmental Health Division " '� 9 '- ® `' PO Box 389, 100 -A Southwest Blvd, Newton, NC 28658 Lot # /8. sw PIN# 365717116234 Applicant/Owner JOHN R WOLTERS Site Address: 4185 RL MOORE ST, Maiden, NC Property Size: SF t46 ACRES Directions: 321 S/ LT ON E MAIDEN RD/ LT ON WHITERS RD/ GO APPROX 2 MI/ LT ON R L MOORE ST/ GO TOEND OF ST/ HOUSE ON RT Owner /Authorized Representative Acknowledgement of Permit Receipt Xf.-5 I certify that I am the owner or authorized agent (owner's authorization required) representing the owner of the property described above. ,PS As the property owner or authorized representative, I have received the above referenced permit(s) as requested in the application for service EHPR -9 -10 -7184 , by the following method(s): .-4).___c Received in Person Facsimile Transmittal (Return form with signature required) Electronic Image Transmittal/ E -mail (Return receipt required) S4 SAs 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 (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: 09/13/2010 . i , Owner /Authorized Representative Signature ,c i _ ,' verorL Date �5 F / � 1 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 acknowledges the conditions and statements above. 09/13/10 15:33 z qA • CATAWBA COUNTY Case # IMPV -9 -10 -10979 Q Public Health Department ti Environmental Health Division Subdivision '' :� PO Box 389, 100 -A Southwest Blvd, Newton, NC 28658 Lot # /8_42 tw PIN# 365717116234 Applicant/Owner JOHN R WOLTERS Site Address: 4185 RL MOORE ST, Maiden, NC I--09 —1-16- ?I e'i`( Property Size: SF t46 ACRES Directions: 321S/ LT ON E MAIDEN RD/ LT ON WHITERS RD/ GO APPROX 2 MU LT ON R L MOORE ST/ GO TOEND OF ST/ HOUSE ON RT Improvement Permit L STEM: EX ISTING INITIA SY REPAIR SYSTEM ONLY _ . ........ ...... . ...,. � .. �..... I P FOR R Facility: Acessory Structure Permit Category: Other Bedrooms 2 WATER SUPPLY: Well Type: Individual Well Basement? No Basement Plumbing? No INITIAL SYSTEM SPECIFICATIONS Permit Valid: Expires In Five Years: No Expiration: X_ a Projected Daily Flow 240 9•p•d Proposed Wastewater System: Type: * * ** no system class assigned * * ** 0 Pump Required ?: Operator Required ?: NO Permit Conditions: Existing system is a gravel bed REPAIR SYSTEM SPECIFICATIONS Repair System Required? Required Proposed Wastewater System: LOW PRESSURE PIPE Type: IVA - ANY SYSTEM WITH LPP DISTRIBUTION Pump Required ?: Yes Operator Required ?: YES 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 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 'Laws and Rules for Sewage Treatment and Disposal Systems' (15A NCAC 18A .1900). Neither Catawba County nor the Environmental Health Specialist warrants that the septic tank system will continue to function satisfactorily Luke Sears 09/13/2010 AUTHORIZED STATE AGENT APPROVAL DATE Permit Expiration Date: 09/12/2015 No grading or construction activity is allowed in areas designated for system and repair without approval of the Health Department. 09/13/10 15:33 r/ , .C.itoGk 7 ,s • -4t „A c.4 Nkr 7-E)00i - 01- 6- M\r`il Department of Environment, Health, and Natural Resources Sheet: Division of Environmental Health Property ID: On -site Wastewater Section Lot #: SOIUSITE EVALUATION File #: for ON -SITE WASTEWATER SYSTEM AppID: Owner: Smith Applicant: Address: Moore St Date Evaluated: 9/9/2010 Proposed Facility: Design Flow (.1949) 240 Property Size: Location of Site: Property Recorded: Water Supply: [ ] Public [ ] Individual [X] Well [ ] Spring [ ] Other Evaluation Method: [X] Auger Boring [ ] Pit [ ] Cut Type of Wastewater: [X] Sewage [ ] Industrial Process [ ] Mixed P I� j I II`',, #.?: w ? ,3 u.._, ; @ .xd f�� I i:: -,�,�T ,1{ A S1 , - ! a 1 p �': " " .1 I�. 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N: ,..-3,,1941'.: V"°,1 ,, ' i.S.-,,,,,. ,:,,. 9 1 1- ' ,.zit, 14P; '1 ‹.'i .;iji '• Consistence -'. , :'.,- :„1,-, Color . : 0.- :0 tructure/ _ - ,.it ,,,,c,';t16..1..i-ralogy ,orzon Alf,' MI . - .;i053x.ttp:r • to101..., ;,1.:,-,*extUrel-,- , '.: %.,•..iptv,t5V''. ,,:i 'i , -`; .--.'" s'iop.P:D'..- "' 1 1 Sheet: COMMENTS: FILE #: Landscape Position Group Texture .1955 LTAR Structure R -Ridge 1 S -Sand 1.2 - 0.8 SG- Single Grain SS- Shoulder Slope LS -Loamy Sand M- Massive LS- Linear Slope CR -Crumb FS -Food Slope II SL -Sandy Loam 0.8 - 0.6 GR- Granular NS -Nose Slope L -Loam SBK- Subangular Blocky HS -Head Slope ABK- Angular Blocky CC- Concave Slope III SI -Silt 0.6 - 0.3 PL -Platy CV- Convex Slope SICL -Silty Clay Loam PR- Prismatic T- Terrace CL -Clay Loam FP -Flood Plain SCL -Sandy Clay Loam IV SC -Sandy Clay 0.4 - 0.1 SIC -Silty Clay C -Clay Consistence Consistence Moist Wet Mineralogy VFR -Very Friable NS- Non - Sticky SEXP- Slightly Expansive FR- Friable SS- Slightly Sticky EXP- Expansive FI -Firm S- Sticky VFI -Very Firm VS -Very Sticky EFI- Extremely Firm NP- Non - Plastic SP- Slightly Plastic P- Plastic VP -Very Plastic Sketch of Soil Evaluation Locations Test Hole Test Hole Garage 2 bedroom house