HomeMy WebLinkAboutIMPV-05-2022-170677.TIF �_� CATAWBA COUNTY Case# IMPV-05-2022-170677
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,25l HealthGovernment DivisionDrive, PIN# 3699025633071B Newton,NC 28658 LOTfi
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Site Address: 6546 SHERRILLS FORD RD, CATAWBA NC 28609
Name on Permit: "C J HOMES, INC
Property Size: Acres.99
Directions: S NC 16 Hwy, Buffalo Shoals Rd, Sherrills Ford Rd, property on left past Barefoot Ave
Owner/Authorized Representative Acknowledgement of Permit Receipt
iktII-I certify that I am the owner or authorized agent(owner's authorization required)representing the owner of
the property described above.
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/OV As the property owner or authorized representative, I have received the above referenced
permit(s)as requested in the application for service EHPR-03-2022-40305,by the following method(s):
r/ 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 1 have reviewed and understand the specific conditions
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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: 05/04/2022
Owner/Authorized Representative Signature t�vi4 (' k/ er,i,rt
Date `) * D -22
Documentation of Permit(s)Transmittal
(permit transmitted by electronic or other means)
Permit transmitted by (name ofperson 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 yoiPlease ttake a few momentts tto complette our custtomer service survey att
http://www.surveymonkey.com/s/EHCusttomerService
clipein l 05/17/2022 08:50
CATAWBA COUNTY Case# [MPV-05-2022-170677
C.(1
11111) Public Health Department Subdivision
Environmental Health Division PIN# 369902563307
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PO Box 389,25 Government Drive,Newton,NC 28658 LOT# 1 B
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Site Address: 6546 SHERRILLS FORD RD, CATAWBA NC 28609
Name on Permit: *C J HOMES, INC
Property Size: Acres.99
Directions: S NC 16 Hwy, Buffalo Shoals Rd, Sherrills Ford Rd, property on left past Barefoot Ave
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 d
9.P.
Type of Facility: Primary Residence
Basement? No Basement Plumbing? No Bedrooms: 3
Water Supply: Public Water Maximum Occupants: 6
_ INITIAL SYSTEM SPECIFICATIONS
Proposed Wastewater System: 25% REDUCTION
System Classification: IIIG-OTHER NON-CONY TRENCH SYSTEMS
_ REPAIR SYSTEM SPECIFICATIONS
Repair System Required? Required
Proposed Wastewater System: 50%REDUCTION VERTICAL
System Classification: IIIE-PPBPS GRAVITY DOSED SYSTEM
Permit Conditions: Keep all parts of septic system and any future repair system minimum: 50'from any well, 10'
from property lines, 10'from water and utility lines, 10'from building foundation with drain, 5'
from any deck or porch. Lines to be installed on contour. Do not grade drive or fill over system
or repair area.
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' (I5A 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.
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05/04/2022
Authorized State Agent Permit Issuance Date
5/4/2027
Permit Expiration Date
No grading or construction activity is allowed in areas designated for system and repair without approval of the health Department.
chp.',n,ii 05/17/2022 08:50