HomeMy WebLinkAboutIMPV-05-2022-170545.TIF 4 � (..CATA►►en COt/N1 i'
14 t ! Public Ilcalth t')epanmcnt Subdis uu+n THAD AND HAROLD GABRIE
it"A I linvnonmcntal Ikaith Division i'lNa 461703128063
Po 13o%389,25(iovcnunrnt I>tivc.Ne,.ttm.NC 2$65$ I(mi 4
Site Address: 4232 CASCADE ST. TERRELL NC 28682
Name on Permit: MICHAEL THOMAS
Property Size: Acres 0.48
Directions: Right off of Sherrills Ford Rd onto Hob Ln. Left onto Cascade St 4th lot on left
/ Owner/Authorized Representative Acknowledgement of Permit Receipt
I certify that I am the ossner or authorized agent Iossner's authnrizatinn required representing the ussncr of
the property described atxne.
As the property owner or authorized representaiive. I hose t CO:
isell the above referenced
111`` perntit(s)as requested in the application fir service RIWR-03-2022-40369. hs the following method(s):
Received in Person
Facsimile Transmittal(Return limn with signature required)
JElectronic Image Transmittal I:-mail (Return receipt required)
41
NtAs the property owner or authorized represent:Hive I have reviewed and understand the specific conditions
of the permit issued, and further understand that all applicable regulator; requirements specified under the
North Carolina laws and Rules for Sewage Treatment and Disposal Systems(I5A NCAC 18A.1900),
and/or Well Construction Standards(I 5A NCAC 2C.0100). shall apph to the issuance of this permit and
the construction of the wastewater system and or water supply well permitted.
Permit Issue Date:05/02/2022 � �� ��
Owner/Authorized RepresentativeSignature ... ., I
'Date s/18ia0)2_
Documentation of Permit(s)Transmittal
(permit transmitted by electronic or other means)
Permit transmitted by (name a/per.vut>.ending permit/
Signature CfcI)ate Time 5 kill
Method: Fat -J Email US Mail Other
Owner's request to send by the above indicated method of transmittal in lieu of signature
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http://www.survlymonkey.com/s/EHCusttomerService
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4yy)' CATAWBA COUNTY Case# IMPV-05-2022-170545
f~ j.I Public Health Department Subdivision THAD AND HAROLD GABRIEI
lot •
Environmental Health Division PIN# 461703128063
PO Box 389,25 Government Drive,Newton,NC 28658 LOT# 4
Site Address: 4232 CASCADE ST,TERRELL NC 28682
Name on Permit: MICHAEL THOMAS
Property Size: Acres 0.48
Directions: Right off of Sherrills Ford Rd onto Hob Ln. Left onto Cascade St.4th lot on left.
Improvement Permit
AN AUTHORIZATION TO CONSTRUCT MUST BE ISSUED PRIOR TO BUILDING PERMITS
THIS PERMIT IS NOT FOR SEPTIC INSTALLATION
Permit Category: New Septic
Wastewater Flow 360 g.p.d
Type of Facility: Primary Residence
Basement? No Basement Plumbing? No Bedrooms: 3
Water Supply: Private Well Maximum Occupants: 6
INITIAL SYSTEM SPECIFICATIONS
Proposed Wastewater System: 50%REDUCTION VERTICAL
System Classification: IIIE-PPBPS GRAVITY DOSED SYSTEM
REPAIR SYSTEM SPECIFICATIONS
... .-......
Repair System Required? Required
Proposed Wastewater System: 50%REDUCTION VERTICAL
System Classification: IIIE-PPBPS GRAVITY DOSED SYSTEM
Permit Conditions:
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 acoroved,and may result in failure to
approve the initial system installation,or the susoension/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 I 8A.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.
Any permit issued for a conventional system may be used for an accepted system without Environmental Health authorization or permit
modification.Please notify Environmental Health of this change prior to system installation.
05/16/2022
Authorized State Agent Permit Issuance Dale
5/16/2027
Permit Expiration Date
No grading or construction activity is allowed in areas designated for system and repair without approval of the Health Department.
05/17/2022 10:25