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HomeMy WebLinkAboutRBPR-06-2022-41429.TIF �� THIS IS NOT A PERMIT Case# RBPR-06-2022-41429 dst. l y CATAWBA COUNTY I IEALTI I DEPARTMENT '! PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES f: SY Residential Building Plan Review- BuildingNew LICENSED SOIL SCIENTIST Applicant FOUR CORNERS OF CHARLOTTE LLC, 1612 SEATTLE SLEW CT,WAXIIAW NC 28173 C:704-713-2602 ROMELLE03gYA110O.COM Paid By FOUR CORNERS OF CHARLOTTE INC (ROMIL CAHUDGAR), 1612 SEATTLE SLEW CT,WAXIIAW NC 28173 NAME TO APPEAR ON PERMIT Four Corners of Charlotte LLC SITE ADDRESS: 2658 CI IARLESTON CT,CLAREMONT NC 28610 PIN# 375207684535 NAME of SUBDIVISION: OLDE SAVANNAH Lot# 43 Section/Block PROPERTY SIZE: Square Feet Acres 0.6 DIRECTIONS: Rock Barn Rd,right on Savannah Ln right Charleston Ct at end on right before cul-de-sac PRIMARY CONTACT: Applicant SEWER TYPE: Septic Tank GALLONS PER DAY: 480 WATER SUPPLY: Public Water DESCRIBE WORK: COVID 19 Submittal New 4 bedroom SFR 45 x 47 with 10x10 rear deck SITE INFORMATION Do any of the following apply to the property for which this application is applied? If the answer to any of the questions below is"YES",then supporting documentation is required: Does this site contain any jurisdictional wetlands? No Does this site contain any existing wastewater systems? No Is any of the wastewater going to be generated on the site other than domestic sewage? No Is the site subject to approval by any other public agency? Yes Are there any easements or right-of-ways on this property? No APPLICATION FOR: New Structure STRUCTURE TYPE: PRIMARY RESIDENCE FACILITY TYPE: Single Family Residence OTHER DESCRIPTION: DESCRIPTION OF EXISTING STRUCTURES ON SITE(IF ANY) DIM EXISTING STRUCTURE: NUMBER OF EXISTING BEDROOMS: 0 OF OCCUPANTS: 8 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 45x 47 with 10x10 deck 0 OF NEW BEDROOMS:: 4 BASEMENT? No BASEMENT FIXTURES? No PLUMBING REQUIRED? Desired system types(Improvement Permit or Authorization to Construct): ACCEPTED: ALTERNATIVE: CONVENTIONAL: OTHER: YES INNOVATIVE: ANY: Other described: PPBPS Bed eL:ppliu,t,:•„ 06/21/2022 14:19 Page 1 of3 API. re CATAWBA COUNTY Case# R[3PR-06-2022-41429 (....r.IlLs"�iyiell Public Health Department Subdivision OLDE SAVANNAH lioC4Environmental Health Division PIN# 3752078134535 or PO Box 389, 100-A Southwest Blvd,Newton,NC 28658 W NAME ON PERMIT: FOUR CORNERS OF CHARLOTTE LLC ( ), 1612 SEATTLE SLEW CT,WAXIIAW NC 28173 Four Corners of Charlotte LLC Site Address: 2658 CHARLESTON CT,CLAREMONT NC 28610 Property Size: Square Feet Acres 0.6 Directions: Rock Barn Rd,right on Savannah Ln right Charleston Ct at end on right before cul-de-sac Completed applications are valid for a period of 2 years.Improvement Permits are valid:with complete site plan=60 months(5 years);with complete plat =without expiration. An Authorization to Construct will remain valid as long as the Improvement Permit is valid.An Authorization to Construct issued for septic repair is valid for 60 months(5 years).Permits may be revoked if the information on this application/site plan changes or if the Intended use for the proposed facility changes. Permits may be revoked if site conditions are altered such that they effect permit conditions or installation requirements I have reed this application and certify that the information provided herein is true,complete and correct Authorized county and state officials are granted right of entry to conduct necessary inspections to determine compliance with applicable laws and rules. I understand that I am solely responsible for the proper identification and labeling of all property lines and corners and making the site accessible so that a complete site evaluation can be performed. The undersigned is the owner of the property or legal agent of the owner. Date: Signature of Applicant or Agent If you need further information or assistance please call 828-465-8270 AREA2 FEENAME DATE FEE AMOUNT LSSP 06/20/2022 S 135.00 TOTAL FEES S135.00 FEES ARE NON-REFUNDABLE ONCE A SITE VISIT IS MADE OR WORK ON A PLAN REVIEW HAS COMMENCED SYSTEM REDESIGN AND/OR RETRIP WILL INCUR AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) ehappiicauon 06/21/2022 14:19 Page 2 of 3 (;41 RECEIVED J U N 1 7 2022 catawba county public health Environmental Health LSS NewseeApplicationTSforEnvISNironmentalOTAPE7Health Services ((poi' tisAppation is for: J ]X New Construction ❑ Existing Facility Improvement Permit Authorization to Construct ❑ New Septic ❑Septic Repair/Malfunction 0 Septic Relocation 0 Septic Expansion ❑ Existing System Inspection or Reconnection ❑New Well ❑ Replacement Well ❑Well Abandonment 0 Well Repair Property Address 2658 Charleson Court, Claremont, NC 28610 Acres 0.593 Subdivision Olde Savannah Place Lot# 43 Driving Directions to Property From Newton, take NC-16 N. to Rock Barn Road, NE. Turn right onto Rock Barn Road, NE. right onto Savannah Lane, and right onto Charleston Court. Lot is located on the right. Describe work Constructing new 4-bedroom single family residence C Ll U Si,b A01211 Applicant Name Four Corners of Charlotte, Inc. Applicant Address 1612 Seattle Slew Court. Waxhaw, NC 28173 Phone Cell Phone 704-713-2602 Owner Name Same as above Owner Address Phone Cell Phonc Contractor Name License# Contractor Address Phone Cell Phone Name to Appear on Permit? ®Owner ❑Applicant ❑Contractor Who will be the Primary Contact? to Owner ❑Applicant 0 Contractor Proposed New Construction-Residential Primary Residence ® New Residence ❑ Addition to Residence #of New Bedrooms*t 4 #of Occupants 8 Project Description Constructing new single family residence. Structure Dimensions,also specify dimensions of decks&porches 45-ft x 47-ft with 10-ft x 10-ft rear deck Basement ❑Yes El No Basement Plumbing ❑Yes No Accessory Dwelling #of New Bedrooms It #of Occupants Structure Dimensions Basement ❑Yes ❑No Basement Plumbing ❑Yes ❑ No Accessory Structure(s)Describe Structure(s)Dimensions Plumbing ❑Yes ❑No Describe Plumbing Needed Multi-Family Residence #of Apartments #Bedrooms per Apartment*? Total#Bedrooms in Structure st #of Occupants Structure Dimensions Basement ❑Yes ❑ No Basement Plumbing ❑Yes ❑ No Well Construction/Abandonment/Repair Proposed Well Type ❑ Individual Well ❑Semi-Public Well ❑Community Well Abandonment Type ❑ Drilled 0 Bored ❑ Dug ❑ Unknown Well Repair Requested ❑ Yes ❑No Describe Will Certified Well Contractor Install Water Line or Electrical Line from Well Head to Pressure Tank?❑Yes ❑ No catawbacountync.gov Environmental Health Catawba County Government Centel 25 Government Drive I PO Box 389 I Newton NC 28658 1828.465.8270 MAKING. LIVING. BETTER. Existing Structures on Site Describe Structure Dimensions #of Bedrooms * #of Occupants Basement ❑ Yes ❑ No Basement Plumbing ❑ Yes ❑ No Existing Water Supply ❑Individual Well f1 Shared Well-Number of Connections ❑Community Well EN County/City/Township Water Line Is a public water supply available'? '* ® Yes ❑ No Commercial ❑ Proposed New Construction ❑ Existing/Change of Use ❑ Repair Food Service Specify Type #Seats Dining Area(Sq. Ft.) #Employees per Shift #of Shifts Church #of Seats Daycare❑Yes ❑ No #of Children #of Employees per Shin #of Shifts Commercial Kitchen ❑Yes ❑ No Residential Kitchen ❑Yes 0 No Daycare#of Children #of Employees per Shift #of Shills Business/Other Specify Type Structure Dimensions Retail Floor Space #of Employees per Shift #of Shifts Other Information Calculated Design Flow,Commercial t (This value will be determined by EH staff) The Applicant shall notify the local health department upon submittal of this application if any of the following apply to the property in question. If the answer to any question is"yes",applicant must attach supporting documentation. ❑Yes CA No Does the site contain any jurisdictional wetlands? ❑Ycs CI No Does the site contain any existing wastewater systems? ❑Yes El No Is any wastewater going to be generated on the site other than domestic sewage? Yes No Is the site subject to approval by any other public agency? ❑Yes ren No Are there any easements or right of ways on this property? Describe If applying for an Improvement Permit or Authorization to Construct,Please Indicate Desired System Type(%): (systems can be ranked in order of your preference) ❑Accepted 0 Alternative 0 Conventional ❑Innovative al Other PPBPS Bed 0 Any *Any room that will be intended for sleeping at the time of construction or for future consideration should be noted as a bedroom and counted on all applications.The number of bedrooms will be confirmed by rooms identified on floor plans as a bedroom at the time of building permit issuance. This may prevent the need for septic system expansion in the future. t If structure is plumbed but has no bedrooms,calculated design flow will be determined by EH Staff. ** If No,a well permit must be issued with the Authorization to Construct. RETRIP TO THE PROPERTY AND/OR SYSTEM REDESIGN WILL INCUR AN ADDITIONAL CHARGE(SEE FEE SCHEDULE) Completed applications are valid for a period of 2 years. Improvement Permits are valid:with complete site plan=60 months(5 years); with complete plat=without expiration. An Authorization to Construct will remain valid as long as the Improvement Permit is valid.An Authorization to Construct,issued for septic repair is valid for 60 months(5 years).Permits may be revoked if the information on this application/site plan changes or if the intended use for the proposed facility changes. Permits may be revoked if site conditions are altered such that they effect permit conditions or installation requirements. I have read this application and certify that the information provided herein is true,complete and correct. Authorized county and state officials are granted right of entry to conduct necessary inspections to determine compliance with applicable laws and riles. I understand that I am solely responsible for the proper identification and labeling of all property lines and corners and making the site accessible so that a complete site evaluation can be performed. The undersigned is the owner of the pro or 1 gal agent of the owner. Signature of Owner or Legal Agent ramon gonzalez(Jun 16,2022 12:46 EDT) Date Jun 16, 2022 Printed Name of Owner or Legal Agent ramon gonzalez �.- SW/ °pro* ROY COOPER•Governor NC DEPARTMENT OF " HEALTH AND KODY H. KINSLEY•Secretary HUMAN SERVICES HELEN WOLSTENHOLME• Interim Deputy Secretary for Health .,� MARK T. BENTON•Assistant Secretary for Public Health Division of Public Health COMMON FORM FOR LICENSED SOIL SCIENTIST COVID-19 PERMIT OPTION FOR NON-ENGINEERED SYSTEMS See instructions for Use in Appendix A Except for"Date received",this Section to be completed by the!SS in accordance with S.L.2020-97,Section 3.19 and G.S. 130A-336.2 LHD USE ONLY: Initial submittal of this NOI received: by Dote lnitiofs PART 1: Notice of Intent to Construct(NOI)-Please check all that apply ❑■ Single System or ❑ Multiple Systems AND ❑■ New ❑ Expansion ❑ Relocation of all or part of the Existing System ❑ Relocation of Repair Area ❑ Repair—LHD Permit Number ❑ Repair—EOP/LSS COVID 19/AOWE Permit Number 1. Facility Owner's name:(Owner,Company Name, Utility, Partnership, Individual,etc.): Four Corners of Charlotte, LLC Mailing address: 1612 Seattle Slew Court City: Waxhaw State: NC Zip: 28173 Telephone number: 704-713-2602 E-mail Address: romelle03@yahoo.com 2. Licensed Soil Scientist(LSS)name: Larry Thompson, LSS LSS License number: 1287 Mailing address:PO Box 541 City: Midland State: NC Zip: 28107 Telephone number: 704-301-4881 E-mail Address: larry@thompsonenv.com 3. Licensed Geologist(LG)(if applicable)name: NIA _License Number: Mailing address: City: State: Zip: Telephone number: E-mail Address: 4. Proof of Errors and Omissions or other appropriate liability insurance for the following persons is attached that includes the name of the insurer,name of the insured and the effective dates of coverage: ❑� LSS ❑ LG 5. Property location(physical address,tax parcel identification number or subdivision lot, block number of the property to be permitted): 2658 Charleston Court, Claremont, NC 28610 (Lot 43-Old Savannah Pl.) County Name: Catawba 6. Type of facility: ❑■ Place of residence No. Bedrooms: 4 No.Occupants:8 ❑ Place of business Basis for flow calculation: ❑ Place of public assembly Basis for flow calculation: NC DEPARTMENT OF HEALTH AND HUMAN SERVICES • DIVISION OF PUBLIC HEALTH LOCATION:5605 Six Forks Road, Raleigh, NC 27609 MAILING ADDRESS:1642 Mail Service Center, Raleigh, NC 27699-1642 www.ncdhhs.gov • TEL: 919-707-5874 • FAx 919-845-3972 AN EQUAL OPPORTUNITY/AFFIRMATIVE ACTION EMPLOYER COVID-19 Permit Option Common Form LHD Reference: 7. Factors that would affect the wastewater load: Design is for domestic strength wastewater only, 8. Type and located of proposed wastewater system: Gravity flow PPBPS bed located to the left of the proposed house site. System type Ille. 9. Design wastewater flow: 480 gpd Design wastewater strength: ❑■ domestic ❑ high strength ❑industrial process(For industrial process wastewater,a Professional Engineer licensed in accordance with G.S.89C shall design the on-site wastewater system.) 10. A plat as defined in G.S. 130A-334(7a)is attached: ❑■ Yes ❑ No A site plan as defined in G.S. 130A-334(13a)is attached: ❑■ Yes ❑ No 11. Location of proposed or existing wells(drinking water, irrigation,geothermal,groundwater monitoring, sampling,etc.)and any potable and non-potable water conveyance lines is indicated on attached plans and complies with 15A NCAC 18A.1950: D Yes ❑ No This is a saprolite system. ❑■ Yes ❑ No 12. Evaluation(s)of soil conditions and site features in accordance with G.5. 130A-335(al)signed and sealed by a LSS is attached: ❑Yes ❑ No 13. Evaluation of geologic and hydrogeologic conditions signed and sealed by a LG is attached ❑Yes ❑■ NA 14. Proposed landscape,site,drainage,or soil modifications are attached: ❑Yes ❑U NA Attestation by LSS pursuant to S.L.2020-97,Section 3.19 and G.S. 130A-336.2 l Larry Thompson, LSS hereby attest that the information required to be included with Licensed Soil Scientist(Print Name) this Notice of Intent to Construct is accurate and complete to the best of my knowledge and that the proposed system shall meet applicable federal,State,and local laws, regulations,rules and ordinances,and that the proposed system does not require a Professional Engineer, licensed in accordance with G.S.89C, and in accordance with 15A NCAC 18A.19, i ities determined to be engineering as determined by the North Carolina Board of Examiners for n an eyors. • 06-20-22 Signature of Lic oil Scieentist Dote Oef self-submittal of NOI: I, hereby submit this NOI prepared by Print Name of Owner Print Name of Licensed PE pursuant to G.S. 130A-336.1. Signature of Owner Date DHHS/EHS/OSWP-LSS C-19 COMMON FORM Updated April2022 Page 2 of 6 COVID-19 Permit Option Common Form LHD Reference: NOTES: LIABILITY: The Department, the Department's authorized agents, or local health departments shall have no liability for wastewater systems designed,constructed, and installed pursuant to an LSS COVID-19 Permit Option[S.L.2020- 97,Section 3.19(d)and G.S. 130A-336.2(f)J RIGHT OF ENTRY: The submittal of this Notice of Intent to Construct grants right of entry to the Local Health Department and the State to the referenced property. ISSUANCE OF BUILDING PERMIT: Once the LHD deems that the Notice of Intent to Construct is complete via signature in the section below, the owner may apply to the local permitting agency for a permit for electrical, plumbing, heating,air conditioning or other construction, location, or relocation activity under any provision of general or special law pursuant to G.S. 130A-338. DHHS/EI-IS/OSWP—LSS G 19 COMMON FORM Updated April 2022 Page 3 of 6 COVID-19 Permit Option Common Form LHD Reference: This section for Local Health Department use only. PART 2: LHD Completeness Review of the Notice of Intent to Construct "(c) Completeness Review for Notice of Intent to Construct.—The local health department shall determine whether the notice of intent to construct required pursuant to subsection(b)of this section is complete within five business days after receiving the notice of intent to construct.A determination of completeness means that the notice of intent to construct includes all of the required components.If the local health deportment determines that the notice of intent to construct is incomplete,the local health deportment shall notify the owner and list the information needed to complete the notice. The owner may then submit additional information to the local health department to cure the deficiencies in the initial notice.The local health deportment shall make a final determination os to whether the notice of intent to construct is complete within five business days after the department receives the additional information. If the local health department fails to act within any time period set out in this subsection,the owner may treat the failure to act os a determination of completeness. The owner shall be able to apply for the building permit for the project upon the decision of completeness of the notice of intent by the local health department or if the local health department foils to act within the five business day time period." The review for completeness of this Notice of Intent was conducted in accordance with G.S. 130A-336.2(c). This NOI is determined to be: ❑ INCOMPLETE(If box is checked, Information in this section is required.) Based upon review of information submitted in Part 1, the following items are missing: Copies of this form listing missing items were sent to the LS5 and the Owner on Date via with directions to re-submit missing items using Page 5 of this form. Email,FAX,USPS,hand-delivered Print Name of Authorized Agent of the LHD Signature of Authorized Agent of the LHD Date ❑ COMPLETE(If box is checked, information in this section is required.) Based upon review of information submitted in Part 1 of this form,this NOI is deemed COMPLETE. Copies of this signed form were sent to the LSS and the Owner on via . Dote Email,FAX,USPS,hand-delivered A copy of this NOI and tracking information was sent to the State on via Date Email,FAX,LISPS,hand-delivered Print Name of Authorized Agent of the LHD Signature of Authorized Agent of the LHD Date DHHS/EHS/OSWP—LSS C-19 COMMON FORM Updated April 2022 Page 4 of 6 COVID-19 Permit Option Common Form LHD Reference: Re-submittal of NOI with missing items included This Section is for use by owner to submit items noted as missing during LHO Completeness Review above. Resubmittals must be accompanied by a cover letter from the LSS. LHD USE ONLY: This NOI resubmittal received: by Date Initials Item#from initial NOI Resubmittal description Attestation by LSS pursuant to S.L.2020-97,Section 3.19 I, hereby attest that the information required to be included with Licensed Soil Scientist(Print Name) this Notice of Intent to Construct is accurate and complete to the best of my knowledge and that the proposed system shall meet applicable federal, State,and local laws,regulations, rules, and ordinances. Signature of Licensed Soil Scientist Date The section below is for Local Health Deportment use after submittal of items noted as missing above. LHD Follow-up Completeness Review of Notice of Intent to Construct This follow-up review for completeness of this Notice and Intent was conducted in accordance with G.S. 130A- 336.2(c). This NOI is determined to be: ❑ INCOMPLETE Based upon review of information submitted in the RESUBMITTAL above,this Notice of Intent remains INCOMPETE because the following items from Part 1 of this form remain missing: Copies of this signed form were sent to the LSS and the Owner on _ via _ Date Email,FAX,USPS,Hand delivered Print name of authorized Agent of the LHD Signature of authorized Agent of the CND Date ❑ COMPLETE Based upon review of information submitted in the RESUBMITTAL above in addition to information provided in Part 1 of this form,this NOI is deemed complete. Copies of this signed form were sent to the L55 and the Owner on via Date Email,FAX,LISPS,Hand-delivered A complete copy of this form with tracking information was sent to the State: via Dote Email,FAX,LISPS,hand-delivered Print name of authorized Agent of the LHD Signature of authorized Agent of the LHO Date DHHS/EHS/OSWP-LSS C-19 COMMON FORM Updated April 2022 Page 5 of 6 COVID-19 Permit Option Common Form LHD Reference: PART 3: Authorization to Operate(ATO) Except for dote received,the Section below is to be completed by the Owner. LHD USE ONLY: Initial submittal of request for ATO received: by Date Initials Date of Post-construction Conference: The following items are included in this submittal for an Authorization to Operate under an LSS COVID-19 permit: 1. Signed and sealed copy of the LSS's report that includes the information in G.S. 130A-336.2(k) ❑Yes ❑ No 2. Operation and management program ❑ Yes ❑ No 3. Fee (as applicable) ❑Yes ❑ No 4. Notarized letter documenting Owner's acceptance of the system from the LSS ❑Yes ❑ No 5. On-site Wastewater Contractor name: License number: Mailing address: City: State: Zip: Telephone number: E-mail Address: 6. Proof of Errors and Omissions or other appropriate liability insurance for the On-site Wastewater Contractor is attached and includes the name of the insurer, name of the insured,and the effective dates of coverage. ❑Yes ❑ No Attestation by the Owner far Authorization to Operate hereby attest that all items indicated above have been provided to the Print name of Owner County LHD and the system shall meet applicable federal,State,and local laws, regulations, rules,and ordinances. Signature of Owner Date This section for LHD Use Only. LHD Review of required information for the ATO ❑ INCOMPLETE Based upon review of information submitted in the Section above,the following items are missing from the information required for an Authorization to Operate for an LSS COVID-19 permit: Copies of this signed form were sent to the LSS and the Owner on via Date Email,FAX,USPS,Hand-delivered Print name of authorized Agent of the LHD Signature of authorized Agent of the LHD Dote ❑ COMPLETE Based upon review of information submitted in the Section above,this Authorization to Operate is hereby issued in accordance with G.S. 130A-336.2(m). A copy of this complete NOI/ATO with tracking information was sent to the State on via Dote Email,FAX,USPS,Hand-delivered Print name of authorized Agent of the LHD Signature of authorized Agent of the LHD Date ISSUANCE OF CERTIFICATE OF OCCUPANCY: Once the LHD determines completeness based upon the ATO submission,the owner may apply to the local permitting agency for permanent electrical service to a residence,place of business or place of public assembly pursuant to G.S.130A-339. DHHS/EHS/OSWP—LSS C-19 COMMON FORM Updated April 2022 Page 6 of 6 THOMP-0 OP ID:D2, �CC�RDa CERTIFICATE OF LIABILITY INSURANCE DATE{0912 8/2021 M8/2021 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(les) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in Ileu of such endorsement(s). PRODUCER 918-779-7880 CONTACT David Vaughan Vaughan Insurance Group, LLC PHONE 918-779-7880 1 FAX 918-779-7885 PO Box 52534 INC,No,Ext) (NC,No): Tulsa, OK 74152-0534 ad"1( ss.dIvJr@hlgginbotham_net David Vaughan INSURERIS)AFFORDING COVERAGE NAIC i INSURERA:Mid Continent Casualty Company 23418 INSURED Thompson Environmental INSURER B Hartford Underwriters Ins Co 30104 Consulting, Inc. INSURER C: PO Box 541 Midland, NC 28107-0541 INSURERD INSURER E: INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUER POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSD W 1O IMMIDD,YYVY) (MMDOfY 1 A X COMMERCIAL GENERAL LIABLITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR 04-GL-001067648 09/25/2021 09/25/2022 DAMAGE TO RENTED 100,000 PREMISES(Es nrcirrenceS $ MED EXP(Any one person) $ EXCLUDED A X Professional Llab 04-GL-001067648 09/25/2021 09/25/2022 PERSONAL&AM/IN,JuRY $ 1,000,000 GEML AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 3,000,000 X POLICY [ JECT LOC PRODUCTS-COIo4/OP AGG $ 3,000,000 OTHER _ $ AUTOMOBILE LIABILnY (Ea eo d D SINGLE LIMITenll $ANY AUTO _ BODILY INJURY{Per person) $ OWNED SCHEDULED _ .ALPff�OppS ONLY AUTTOpS �p BODILY INJURY(Per accident)- $ AUTOS ONLY AUT06 yyN ONLV IPorr ec dent)AMAGE UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADr AGGREGATE $ DEO I RETENTION $ $ B OLIRY X PAT IRS AND EMPLOYERS'LIABL ANYPROPRIETORIPARTNERIEXECUTIVE YIN 38WECNW6175 10/17/2021 10/1712022 E L.EACH ACCIDENT $ 1,000,000 pFFILER�EMg�g EXCLUDED? N N!A (alandatory)n NH) 1,000,000 E L DISEASE-EA RAN OYES $ If yes.eescnbe under 1,000,000 DESCRIPTION OF OPERATIONS belcw E L DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS!LOCATIONS f VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more apace is required) CERTIFICATE HOLDER CANCELLATION FORIN-1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN For Informational Purposes ACCORDANCE WITH THE POLICY PROVISIONS. • AUTHORIZED REPRESENTATIVERE� ACORD 25(2016l03) 01988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Residential Subsurface Wastewater Treatment and Disposal System .1948(d) LSS COVID-19 Permit Option for Lot 43 — Olde Savannah Place 2658 Charleston Court Claremont, NC 28610 Catawba County Parcel: 375207684535 June 16, 2022 Prepared for: 0 D s"Se/ M'4s cP Four Corners of Charlotte, LLC ` 1612 Seattle Slew Court y/ Waxhaw NC 28173 � :��u�11� 704-713-2602 S. 1287c, Qt•Ateni Prepared by: Larry Thompson, REHS, LSS %0A,, Qp •.,� Thompson Environmental Consulting, Inc. p : tAISTEgF •.• ti� PO Box 541 : • Midland NC 28107-0541 - i SEAL ' Phone: 704-301-4881 = 3:" 1208y lar ryG�thorn sonenv.com "Itr, . At4,,,. 4t'i' P 2658 Charleston Court Details Four Corners of Charlotte, LLC has contracted with Thompson Environmental Consulting, Inc. (TEC) to prepare a septic proposal for a 4-bedroom single family residence to be located at 2658 Charleston Court, Claremont, North Carolina. Based upon a deep pit saprolite investigation performed by TEC, it was determined that a sufficient amount of "Suitable" Group 11 saprolite is available for the installation of a Gravity-Fed Prefabricated Permeable Block Panel Bed System (PPBPS) for a 4- bedroom residence at a 0.4 Long Term Acceptance Rate (LTAR) based on 15A NCAC 18A .1956 MODIFICATIONS TO SEPTIC TANK SYSTEMS. The enclosed Licensed Soil Scientist Evaluation is being submitted pursuant to and meets the requirements of SL 2020-97 Section 3.19. The basis for the .1948(d) proposal can be found in 15A NCAC 18A .1956 MODIFICATIONS TO SEPTIC TANK SYSTEMS which states, in part: Other saprolite systems may be approved on a site-specific basis in accordance with Rule.1948(d) or.1970 of this Section. The saprolite was evaluated in deep pits and meets the criteria set forth in .1956(a) with a specified LTAR within the approved range found in .1956(b). One benefit of utilizing a PPBPS bed for this project is that the system will utilize 50% more backfill sand than the equivalent PPBPS trench layout, adding even more treatment and storage capacity. Location From Newton, take NC 16 N., turn right onto Rock Barn Road, NE, turn right onto Savannah Lane, and right onto Charleston Court. Lot is located on the right. References Laws and Rules for Sewage Treatment and Disposal Systems, 15A NCAC 18A, Section .1900, Department of Environment and Natural Resources, Division of Environmental Health, On-Site Wastewater Section, April 2017. Onsite Wastewater Treatment and Disposal Systems; EPA 625/R-00/008 Design Manual, February 2002. Design, Installation and Maintenance of the T& .I Panel Wastewater Treatment System; Sixth Edition, published by T& J Panel. Primary Investigator's Credentials NC Registered Sanitarian No. 1208 NC Licensed Soil Scientist No. 1287 Professional Wetland Scientist No. 1346 NC Subsurface Septic System Operator No. 22199 2 2658 Charleston Court NC Grade IV Wastewater System Installer No. 1762 NC Certified Wastewater System Inspector No. 17621 Plans and Specifications A. Septic Tank 1. The septic tank shall be State approved (Section .1953 of I5A NCAC I8A), watertight, structurally sound, and 1,000 gallons in capacity. 2. The septic tank will be fitted with an approved effluent filter and riser for easy access and periodic maintenance. 3. It is the responsibility of the septic contractor to thoroughly inspect the septic tank prior to accepting delivery to assure that the tank has had time to properly cure and is free of cracks or other structural deficiencies. B. Pipes and Fittings I. All discharge piping,connectors and supply lines should be made of SCH 40 PVC. 2. All joints must be properly"welded"utilizing the appropriate PVC cement for each application. C. Distribution Method 1. Drainlines within the bed will be fed by a distribution box. 2. Distribution box shall be water tested for equal flow at the time of the final inspection. D. Backfill 1. Backfill sand shall be clean, washed, medium sand that is naturally occurring and falls within the gradation of ASTM C-33 specification (used in the ready mix industry and is readily available). E. Drainfield Installation 1. The drainfield location has been marked on-site utilizing metal stemmed flags. Once this area has been approved by the county,the property owner/builder should mark this area and isolate it as much as possible from construction traffic. Prior to the system installation, the septic contractor shall contact the LSS for a preconstruction conference at which time the drainfield area will be re-verified. 2. Under no circumstances shall any construction take place within the drainfield area while the soil is in a wet condition. If the installer has doubts as to whether or not the drain field area is dry enough to begin construction,the LSS for this area should be contacted for permission to proceed with the installation. 3. The specified system is a horizontally installed pre-fabricated permeable block panel bed system — specifically the panel system manufactured by T&J Panel Wastewater Treatment System, Patent No. 4013559; telephone: 1-800-222-2577. 3 • 2658 Charleston Court The installer must follow the manufacturer's guidelines for installing the T&J Panel System and should request an installation manual from the manufacturer prior to beginning construction. 4. The initial bed is 24 feet wide x 38 feet long bed with eight(8)35 foot long PPBPS drainlines placed 3 feet on centers (outer PPBPS lines will be 1.5 feet off bed sidewalls). Total trench length is 280 linear feet. 5. It is essential that the bed be constructed on contour with the land, with the trench bottom being excavated level from beginning to end. The use of a tripod mounted engineer's level is essential to assure that each trench is constructed as level as possible. 6. The bed depth for this system shall be 48 inches(high-side). Each PPBPS drainline shall be placed on 3 foot centers and 1.5 feet off each side wall. 7. Once bed has been dug, the side walls shall be raked, and a light dusting of lime applied. 8. Backfill the trench with 6 inches of sand and level to grade. Once leveled, place 1 x 4 or 6 inch boards on top of the sand the entire length of each drainline. Once the grade boards have been set, the panels may be set into the bed. The panels should be placed 6 inches apart (end-to-end). 4. Once the panels have been set, line the top portion of each chamber with the T&J supplied sand alternative product (SAP — geotextile fabric). GE Foam Sealer or tar seal rope should be placed in the bottom of the U outs to form seals around the pipe as shown in earlier drawings. 10. Tar seal rope, or approved foam, should be placed in the "U" outs of each end of the panel to form seals. Once the tar rope is in place, the Schedule 40 PVC connectors can be added, and the seal completed by the addition of more tar rope on the top and sides of the pipe. Now that the connection and seals are complete,a block cap is placed on each end of the panel so that all openings are covered. 11. Once the panels for each trench have been installed and the top of the panels closed, the bed is ready to be backfilled to the top with the same sand material used in the first lift on the bed bottom. At this point, the bed should be left open for the final inspection by the LSS. F. Final Landscaping 1. The bed backfill shall be shaped to shed rainwater and be free from low spots. 2. The entire area of the bed should be planted with grass as soon as possible to prevent erosion. The soil should be properly tilled, limed (if necessary) and fertilized prior to planting. After applying grass seed, the area should be heavily mulched with straw or other suitable material. G. Utility Conflicts 1. The builder and property owner must take special care in planning for utilities (water, power, gas, telephone, cable lines, etc.). All utilities shall be kept clear of the septic system and its proposed repair area. Improper planning for underground utilities can negatively impact the installation and, in some cases,cause irreparable damage and permit revocation. 4 2658 Charleston Court 2. Water lines must be kept at least ten(10)feet from any portion of the septic system. 3. Irrigation systems should not be placed in the drain field area. Maintenance H. Required Maintenance l. The septic should be pumped/cleaned out when the solids within the tank reach an elevation that is equivalent to 25% of the volume of the tank. In some situations, the tanks may need to be pumped more frequently; for example, if you are using a garbage disposal, it is recommended that the septic and pump tanks be cleaned out annually (TEC recommends that a garbage disposal not be used with this system). At a minimum, the septic tank should be cleaned out every 3-5 years. A reputable septic contractor or certified septic inspector can help you establish a pumping frequency after you have been in the home for a few years. 2. The effluent filter should be inspected once per year. When it becomes necessary to clean the effluent filter,the filter should be removed,and the accumulated debris washed back into the septic tank— not onto the lawn. 3. The drain field area should be maintained to prevent overgrowth of vegetation. Any damp areas, leakages or malfunctions should be addressed immediately. 4. Divert surface water runoff away from the septic tank and drainfield area. Design Specifics Daily Design Flow: 480 GPD—4 bedroom house Septic Tank Size: 1,000 Gallons(2 compartments) Effluent Loading Rate: 0.4 GPD per sq. ft. Bed Dimensions: 24' Wide x 38' Long Bed Depth: 48 Inches Deep(high-side) Distribution Method: Distribution Box Number and Size of Drainlines: (8)35 Feet Long Drainline Spacing: 3 Foot on Centers Distance of Closest Drainline to Bed Sidewall: 1.5 Feet Total Length of PPBPS Drainline: 280 Linear Feet Total Number of Panels: 64 5 • 2658 Charleston Court Repair Option System Type: Non-Treated Drip Dispersal System LIAR: 0.125 Required Square Footage: 3,840 Square Feet Available Square Footage: 4,800 Square Feet 6 NOTES: COIF v,44 LEGEND I.APPARENT SOURCE CF TITLE # A4 LOT 43, RECORDED IN PLAT BOOK 37 PACE 205.(CATAWBA COUNTY REGISTER 0 /4 REBAR(FOUND) OF DEEDS)PARCEL I0/3752-0788-4535(2656 CHARLESTON COURT) CONCRETE MON FOUND �'�JGQ 2. AREA CALCULATED BY COORDINATE GEOMETRY ME1H00. 0 UTILITY POLE � T4 RD• TOTAL LOT AREA 25,829 agfl/ M 0.503 acrta E3W WATER METER I RDCK (PF IRON PIN FOUND 3.SUB•ECT TO R-20 ZONING REGULATIONS. -- PROPERTY LINE LINES NOT SURVEYED 4 MINIMUM SETBACK 35' - --- - SETBACKSCA MINIMUM SIDE YARD 12' .—ETA) RIGHT OP WAY LINE MINIMUM REM YARD 25' —OHW OVEANEID EUlER 6.y►7 5. THIS PARCEL MAT BE SUB.ECT TO EASEMENTS AND/OR RAYS ne-Y-Y-r-fTh 7REELINE EITHER RECORDED CR IMPLIED. A COMPLETE AND FULL TITLE SEARCH WAS NOT PERFORMED FOR THIS SURVEY. 4'4 6. NO PORTION OF THIS PARCEL LES WHINA COMMUNITY OR FEMA FLOOD I 410''' FY ZONE PER FIRM 13710375200J DATED SEPTEMBER 5,2007. VICINITY MAP Om m:A.10 CURVE TABLE ••'•SUPERINTENDANT TO VERIFY ALL DIMENSIONS CURVE LENGTH RADIUS DELTA TANGENT CHORD BEARING PRIOR TO CONSTRUCTION•••• Cl 4488 572.8E 8'27,49- 42.39' 84.55' N55'2964'E ' C2 72.52 99335' 4'I019- 38.28' 72.50' N61'41'59E -IRF 1"PIPE C3 50.01' 793.35' 3'9647 25.01' 50.00' 382'0887w ' Cl 24.10 30.00' 48'02'07' 12.T4' 23.46' 563-195OI5/ ' C5 4646' 5000' 55'32'04'• 28.33' 48.58- 878'5711W ON 401 ORNAMENTAL �pPp 1 TREES gAe�G'y� IRS*4 G _ pcfr-,JOhQC1 TREE LINE • e /Ilb / \ a �PG* \ NW I1 '� /SE fOUR CORNERS OF �' 15 CHARLOTTE LLC ...... \ DR.3729 PG.163 � / \ 11 PB.37 PG 205 / J E PID43752-07695671 / O \N C ZONE ROD 40/ N� !a Q(G�;N`�, 28.163 SO.FT. ,/ /CUR CORNERS OF DEG�nOt. S'. 00, 0.647 AC. ciL I�! CHARLOTTE LLC QJ.\'1- / ` D8.3729 PG.-34 \ lJ0 d +\ PB.37 PG 205 O POO 3752-0788-3435 \ \ ZONE.R-20 Al �,r \ 05 25.629 SQ.FT a 11 0.593 AC, `G44 4 ti \ N�� ��: �e" „ \ ,TY'14 '3. ' g AA \ I / 3.30„ii. 4-‘3, .."i \\ S�/pG IRS R4.44 ,? \ U �66 m %'i 4► o IRS C4TP �(" yg. E0 -4v, , G3 ow a qq NA .3 ' CS F 14 I FOURHA CORNERS OF IRF 1"PIPE ��� DB.3729 PG.185 IRS#4 PR 37 PG 3 Q1yR" S PION 3152ao425 „AI. E NIT ZONE y $'1 ENDA CONNOLLY 8 35.993 60.FT. I STEVEN LAN01$ OR 3 \ DB. 584 PG 1616 PB.37 PG205 I1Nr 3752-0766-5386 TONE.R-20\ $ IRFI41(/TT GRAPHIC SCALE � JaM \ M. IIIII /f \ ( IN FEET ) 1 Inch a 50 ft N/F DATE REVISION AIANG CHUN ZHENG 8, , RF#4 TINS LILT 4/28/22 REVISED PLAN TO THE WILLOW DB.3469 PG.1484 P9.37 PG 205 PIIIO3752-0750-1340 PLOT PLAN: ZONE R-20 2658 CHARLESTON COURT ` CLAREMONT TOWNSHIP,CATAWBA COUNTY,NC THIS IS AN EXISTING PARCEL Of LAND WITHIN A MUNICIPALITY DATE: MARCH 28, 2022 THAT REGULATES PARCELS OF LAND. SCALE:1"=50' I CERTIFY THAT THIS MAP DRAWN UNDER MY SUPERVISION FROM AN PROJECT#. 1091-(1OQ2 ACTUAL SURVEY MADE UNDER MY SUPERVISION (DESCRIPTION RECORDED IN DEED BOOK 1395 PAGE 25); TFWT THE BOUNDARIES NOT SURVEYED ARE '---" INDICATED AS DRAWN FROM INFORMATION IN PLAT BOOK 9095, PACE 4180; PROPERTY OWNER: THAT THE RATIO OF PRECISION OR POSITIONAL ACCURACY IS 1:10,000;AND FOUR CORNERS OF CHARLOTTE THAT THIS MAP MEETS THE REQUIREMENTS OF THE STANDARDS OF 1612 SEATTLE SLEW CT. PRACTICE FOR LAND SURVEYING IN NORTH CAROLINA(2I NCAC 56.1600). THIS 28TH DAY OF APRIL, 2022. WAXHAW,NC 28173 PRELIMINARY SURVEY PROVIDED BY, JULIA A. McDONALD REGISTRATION • L-3617 (ri IDENAA ter- . ..... ..I 3556-A CENTRE CIRCLE •• FAIT MILL SC 29715 D44-865-5263 C-4291. ,/ , - I :V.0O 46'0701' 12.74' :-1111 5183'19r40711 _,...,___ ,/ /�_ -56'3704' 26.33' En 878'S2'(i /-, ___...,-.. .. ...... ,.., , . , AOC - , i 4e&N,; -Y7 / _...,— ' ,,,, , . .--. r s,- •. i itife: it__,--5----,-/ �Rp• r,\O 0. �' SB-7 P7 '_ OC' QJO 4�14.1 7,004k;f49 .�.CP?lb y P3 -/ wF - )�°� r .1 FOUR .0. NE•nJj CHARLOTTE SB-8 !% //,' DB.3T �' 4J. + j .e5� t Ai- <�' .SB-/417A . $'y�. ' // V; •Y• 401„„C.••-''''' 4:••-/.4# / ,_Ifp'•- f; a y ///�. r if•-16:i i' E8 SB-9- / / ,4/ --.7.:<_____ . i vegix.c---, ,.� o y f r \ 0.593 MINi �` 4. SB-6 '.► ' SB , j SB-3 r L \ �,� Z�• �.7,1 . ‘.0"1:----1: : (III: 1'6/.i'l .1 7 � , illa '/' . _.- 96t, - el g /-/ / —,, ik (/ iso.. .c ,y .0., SB-2 ,,,, ,i oB. q �' IRS gta G ?' J PB 37 13 1:• / 4rC. �,� r�Q� , �laax 37s 1 ci,goe`o 1 QG eRE a KNOLL�11 \ ZONE , r/ 'j • `25.993 SO 'y-�• r I GiARLES STEVEN LA1101S �, 0126AC. �/�flf i���a ., — rta x�4P(i ,616 .c�� '� - - / �r i LEGEND � � ����//���`/� • f"t� • �� • LIDAR G:1te ift Contour Lines '/l //� 1�nkl r House B Alopri Septic Tank /�" / I/III Rly - ® PPBPS Bed Area I ® Drip Dispersal Repair Area i / , , , /7 ' ; • Soil Boring Locations //it/ _. ( ■ Pit Locations Date: Proposed Septic Layout June 2022 Figure Ihompwn Cam, Prepared For Fnvironmenta Scale: iiiimiminsulting 2bar Charlmoat, NCn 61tt 20 40 ft Four Corners of Claremont, 28610 Charlotte,LLC Catawba County TEC Job#: 22-173 Thompson Environmental Consulting, Inc. Parcels: 375207683425, 375207684535, and 375207685671 hcet 1 of 2_ PO Box 541 PROPERTY ID#:_ Midland,NC 28107 COUNTY: Catawba SOIL/SITE EVALUATION for ON-SITE WASTEWATER SYSTEM OWNER: Four Corners of Charlotte, LLC ADDRESS: 1612 Seattle Slew Court, Waxhaw, NC 28173 DATE EVALUATED: 05-06-22 PROPOSED FACILITY: Res. PROPOSED DESIGN FLOW(.1949): 480 gpd PROPERTY SIZE: varies LOCATION OF SITE: 2650. 2658,and 2670 Charleston Court.Claremont,NC 28610 PROPERTY RECORDED: WATER SUPPLY: 0 Private Ig Public Ll Well ❑Spring 0 Other Lots 42,43, and 44 Olde Savannah Place EVALUATION METHOD: Auger Boring DC Pit 0 Cut TYPE OF WASTEWATER: [XSewagc I : Industrial Process ❑Mixed • • • • • P o SOIL MORPHOLOGY OTHER F (.1941) PROFILE FACTORS .1940 E LANDSCAPE HORIZON POSITION/ DEPTH 1942 PROFILE # SLOPE% (IN.) .1941 .1941 SOIL .1943 .1956 .1944 CLASS STRUCTURE/ CONSISTENCE/ WETNESS/ SOIL SAPRO RESTR &LTAR TEXTURE MINERALOGY COLOR DEPTH CLASS HORIZ 0-8 FILL 8-84 M/SL FR/NS/NP/NEXP LS II I 1% Si PS 0.4 sap 0-12 FILL 12-84 M/SL FR/NS/NPINEXP 7 LS II PS 1°i% SL 0.4 sap 0-84 M/L FR/NS/NPINEXP LS II PS 1% SL 0.4 sap 0-20 SBK/C FI/S/P/SEXP 20-84 M/SL FR/NS/NP/NEXP II PS LS SI 1% 0.4 sap DESCRIPTION INITIAL SYSTEM REPAIR SYSTEM OTIIER FACTORS(.1946): D SOk s , SITE CLASSIFICATION(.1948): Provisionally 4N- .-.• HO40,os Available Space(.1945) PS PS / {i. . EVALUATED BY: Mac Haupt, LSS =_ rit .- 4is t _,r,'' System Type(s) PPBPS Drip OTHERS PRESENT:LThom son, z ' '1 . ?a • t, ;:4 ,. Site LTAR 0.4 0.125 , w -- COMMENTS: — 12RJ -`'� ,. Updated February 2014 -f- • SOIL/SITE EVALUATION Sheet 2 of 2 (Continuation Sheet-Complete all field in fill) PROPERTY ID#: DATE OF EVALUATION: 05-06-22 COUNTY: Catawba P R O SOIL MORPHOLOGY OTHER F (.1941) PROFILE FACTORS 1 .1940 L LANDSCAPE Ii()RIZ .1942 POSITION/ ON .1941 .1941 SOIL .1943 .1956 .1944 PROFILE # SLOPE% DEPTHSTRUCTURE/ CONSISTENCE/ WETNESS/ SOIL SAPRO RISTR CLASS (IN.) TEXTURE MINERALOGY COLOR DEPTH CLASS IIORIZ &LTAR 0-24 SBK/C FI/S/P/SEXP • 24-84 M/SL FR/NS/NP/NEXP LS II PS 5 1% 24 SL 0.4 sap 0-20 SBK/C FI/S/P/SEXP 20-84 M/SL FR/NS/NP/NEXP LS II PS 6 1% 20 0.4 sap 0-8 FILL 8-84 M/SL FR/NS/NP/NEXP LS II PS 1% SL 0,4 sap 0-84 M/SL FR/NS/NP/NEXP II PS LS 8 1% SL 0.4 sap 0-8 FILL 8_84 M/SL FR/NS/NP/NEXP LS II PS 9 1°/o SL 0.4 sap i ,i`„ ,'I , 1` Updated February 2014 I LEGEND use the following standard abbreviations SOIL CONVENTIONAL LPP MINERALOGY/ LANDSCAPE POSITION GROUP TEXTURE .1955 LTA R* .1957 L'lAR* CONSISTENCE STRUCTURE CC(Concave Slope) I S(Sand) 1.2-0.8 0.6-0.4 SEXP(Slightly Expansive) G(Single Grain) CV(Convex Slope) LS(Loamy Sand) EXP(Expansive) M(Massive) D(Drainage Way) CR(Crumb) DS(Debris Slump) II SL(Sandy Loam) 0.8-0.6 0.4-0.3 OR(Granular) FP(Flood Plain) L(Loam) SBK(Subangular Blocky) FS(Foot Slope) ABK(Angular Blocky) H(Head Slope) III Si(Silt) 0.6-0.3 0.3-0.15 PL(Platy) L(Linear Slope) SiCL(Silty Clay Loam) PR(Prismatic) N(Nose Slope) CL(Clay Loam) R(Ridge) SCL(Sandy Clay Loam) r1OISf WET S(Shoulder Slope) SiL(Silt Loam) T(Terrace) V FR(Very Friable) NS(Nun-sticky) IV SC(Sandy Clay) 0.4-0.1 0.2-0,05 FR(Friable) SS(Slightly Sticky) SiC(Silty Clay) Fl(Firm) S(Sticky) C(Clay) VFI(Very Firm v Very Sticky) VS(Very Sticky) 0(Organic) None None EFI(Extremely Finn) NP(Non-plastic) SP(Slightly Plastic) *Adjust LIAR due to depth,consistence,structure,soil wetness,landscape,position,wastewater flow and quality. P(Plastic) /VOTES VP(Very Plastic) HORIZON DEPTH In inches below natural soil surface UEP'1•H OF FILL In inches from land surface RESTRICTIVE HORIZON Thickness and depth from land surface SAPROIJTE S(suitable)or U(unsuitable) SOIL.WETNESS Inches from land surface to free water or inches from land surface to soil colors with chroma 2 or less-record Mansell color chip designation (ZASSIh7CA'I'LON S(Suitable),PS(Provisionally Suitable),or U(Unsuitable) Evaluation of saprolite shall be by pits. Long-term Acceptance Rate(LIAR):gal/day/ftt Show profile locations and other site features(dimensions.reference or benchmark,and North). , [ _ _,.... 1_ 1 - I 1._—__1__t L- SE Fl U E1 _______i- : I T-1 I I l l_ a__ ► — L JIffLi1T 1-_ 1 f I I , I -- 1------ Updated February 2014 Thompson Environmental Co'nsulting, Inc. Parcels: 375207683425, 375207684535, and 375207685671 Sheet 1 of 2 PO Box 541 PROPERTY ID 4: Midland, NC 28107 COUNTY: Catawba SOIL/SITE EVALUATION for ON-SITE WASTEWATER SYSTEM OWNER: Four Corners of Charlotte, LLC ADDRESS: 1612 Seattle Slew Court,Waxhaw, NC 28173 DATE.EVALUA'rl;l): 02-08-22 PROPOSED FACILITY: Res. PROPOSED DESIGN FLOW(.1949): 480 gpd PROPERTY SIZE: varies LOCATION OF SITE: 2650,2658.and 2670 Charleston Court. Claremont. NC 28610 PROPERTY RECORDED: WATER SUPPLY: ❑Private [XPublic ❑ Well ❑Spring ❑Other Lots 42,43, and 44 Olde Savannah Place EVALUATION METHOD: (X Amer Boring ❑ Pit ❑Cut TYPE OF WASTEWATER: IXSewage ❑Industrial Process 0 Mixed • • • R 0 SOIL MORPHOLOGY OTHER F (.194I) PROFILE FACTORS l .1940 E LANDSCAI'I 11ORIZON POSITION/ DEPTH 1942 PROFILE # SLOPE% (IN.) .1941 .1941 SOIL .1943 .1956 .1944 CLASS STRUCTURE/ CONSISTENCE/ WETNESS/ SOIL SAPRO RESTR &LIAR TEXTURE MINERALOGY COLOR DEPTH CLASS IIORIZ 0-20 SBK/C FI/S/PISEXP 20-43 M/SL FR/NS/NP/NEXP II PS LS 1 1% 20„ SL 0.125 drip Need PS Pit 0.4 sap 0-43 M/SL FR/NS/NP/NEXP II 2 LS SL PS 1% Need 0.4 sap Pit 0-23 SBK/C FI/S/P/SEXP LS PS 23% 23" 23" AR 0.15 0-20 SBK/C FI/S/P/SEXP 20-48 M/SL FR/NS/NP/NEXP II PS 4 LS SL 0,125 drip 1% Need 0.4 sap Pit DESCRIPTION INITIAL SYSTEM REPAIR SYSTEM OTHER FACTORS(.1946): Olt S SITE CLASSIFICATION(.1948): Provisional) , r Z Mo44,_ Available Space(.1945) PS PS EVALUATED BY: Mac Haut, LSS t 4,144.0s System Type(s) PPBPS Drip •� ,y OTHER(S)PRESENT:LThom•so s, �/ d F.�.�°;I i,+.I, x li - ! M, .;:}7 •I! Site LTAR 0.4 0.125 �'', �' COMMENTS: — • Updated February 2014 / I ' SOIL/SITE EVALUATION Sheet 2 of 2 (Continuation Sheet-Complete all field in full) PROPERTY ID#: DATE OF EVALUATION: 02-08-22 COUNTY: Catawba P R 0 SOIL MORPHOLOGY OTHER F (.1941) PROFILE FACTORS I .1940 E LANDSCAPE HORIZ .1942 POSITION/ ON .1941 .1941 SOIL .1943 .1956 .1944 PROFILE it SLOPE% DEPTII STRUCTURE/ CONSISTENCE/ WETNESS/ SOIL SAPRO RESTR ( LASS (IN.) 1 TEXTURE MINERALOGY COLOR DEPTH CLASS HORIZ &LIAR l 0-40 SBK/C FI/S/P/SEXP LS PS 5 23% 4U 0.3 0-42 M/SL FR/NS/NP/NEXP II LS SL PS 6 1% Need 0.4 sap Pit 0-30 SBK/CL FI/SS/SP/SEXP II LS SL PS 7 23% 30" Need 0.3 Pit 0-40 M/SL FR/NS/NP/NEXP . II PS LS SL 0.4 8 1% Need Pit 0-40 M/SL FRINS/NPlNEXP II LS PS 1% SL 0.4 Need Pit COMMI.:ti... Updated February 2014 • LEGEND use the following standard abbreviations SOIL CONVENTIONAL. LPP MINERALOGY! LANDSCAPE POSITION GROUP TEXTURE .1955 LTAR* .1957 LTAR* CONSISTENCE STRUCTURE CC(Concave Slope) 1 S(Sand) 1.2-0.8 0.6-0.4 SEXP(Slightly Expansive) G(Single Grain) CV(Convex Slope) LS(Loamy Sand) EXP(Expansive) M(Massive) D(Drainage Way) CR(Crumb) DS(Debris Slump) 11 SL(Sandy Loam) 0.8-0.6 0.4-0.3 GR(Granular) FP(Flood Plain) L(Loam) SBK(Subangular Blocky) FS(Foot Slope) ABK(Angular Blocky) H(Head Slope) Ill Si(Silt) 0.6.0.3 0.3-0.15 PL(Platy) L(Linear Slope) SiCL(Silty Clay Loam) PR(Prismatic) N(Nose Slope) CL(Clay Loam) R(Ridge) SCL(Sandy Clay Loam) MOIST WET S(Shoulder Slope) SiL(Silt Loam) T(Terrace) VFR(Very Friable) NS(Non-sticky) IV SC(Sandy Clay) 0.4.0.1 0.2-0.05 FR(Friable) SS(Slightly Sticky) SiC(Silty Clay) Fl(Firm) S(Sticky) C(Clay) VFI(Very Firm v.Very Sticky) VS(Very Sticky) 0(Organic) None None EF1(Extremely Firm) NP(Non-plastic) SP(Slightly Plastic) *Adjust[.TAR due to depth,consistence,structure,soil wetness,landscape,position,wastewater flow and quality. P(Plastic) NOTES VP(Very Plastic) HORIZON.DEPTH In inches below natural soil surface DEPTH OF. ILL In inches from land surface RESTRI('77VE HORIZON Thickness and depth from land surface SAPROL/TE S(suitable)or U(unsuitable) SOIL WETNESS Inches from land surface to free water or inches from land surface to soil colors with chroma 2 or less-record Munsell color chip designation CLASSIFICATION S(Suitable),PS(Provisionally Suitable),or U(Unsuitable) Evaluation of saprolite shall be by pits. Long-term Acceptance Rate(LTAR):gal/day/ftt Show profile locations and other site featuresidimensioos,reference or benchmark,and North,. I1 . 1 1 I • 1 SEE FIGURE 1 Updated February 2014 AGENT AUTHORIZATION FORM PROPERTY LEGAL DESCRIPTION: 42 43 & 44 375207683425,375207684535,and 375207685671 LOT NO. PHASE PARCEL ID: S I BEET ADDRESS: 2650, 2658, and 2670 Charleston Court (Olde Savannah Place) Claremont, NC 28610 Please print: Property Owner: Four Corners of Charlotte, LLC Property Owner: The undersigned, registered property owners of the above noted property, do hereby authorize Larry Thompson, LSS of Thompson Environmental Consulting, Inc. (Contractor/Agent) (Name of consulting firm) to act on my behalf and take all actions necessary for the processing, issuance and acceptance of this permit or certification and any and all standard and special conditions attached. Property Owner's Address (if different than property above): 1612 Seattle Slew Court, Waxhaw, NC 28173 Telephone: 704-713-2602 We hereby certify the above information submitted in this application is true and accurate to the best of our knowledge. The NC LSS evaluation attached to this application is to be used to produce design and construction features for permitting in accordance with Session Law 2018-114 Section 11. (c). Ow Sin re: Owner Signature: ramon gonzalez(Jun 16,2022 12.46 EDT) Date: Jun 16, 2022 Date: • Catawba County Environmental Health 90,00 84.00 156.67 O4- tz4 42964* 0Q� 75.00 84.63 144 •2670 125.13 155.74 •2658 a% 24.11 G� ' 84.21 •2650 70.7; mob• /\\. Parcel: 375207684535, 2658 CHARLESTON CT 1 in=50ft CLAREMONT, 28610 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 2021 Catawba County NC 06/17/2022 Parcel Report - Catawba County NC Parcel Information: Owner Information: Parcel ID: 375207684535 Owner: FOUR CORNERS OF CHARLOTTE LLC Parcel Address: 2658 CHARLESTON CT Owner2: City: CLAREMONT, 28610 Address: 1612 SEATTLE SLEW CT LRK(REID): 300242 Address2: Deed Book/Page: 3729/0185 City: WAXHAW Subdivision: OLDE SAVANNAH State/Zip: NC 28173-6642 Lots/Block: 43/ School Information: Last Sale: $36,000 on 2003-12-30 School District: COUNTY Plat Book/Page: 37/205 Elementary School: CLAREMONT Legal: LOT 43 43 PL37-205 OLDE SAVANNAH PL 37-205 Middle School: RIVER BEND Calculated Acreage: .600 High School: BUNKER HILL Tax Map: School Map Township: CLINES State Road #: Tax/Value Information: Tax Rates(pdf) Zoning Information: City Tax District: CLAREMONT Zoning District: CLAREMONT County Fire District: All in City Zoning1: R-1 Building(s) Value: SO Zoning2: Land Value: $28,800 Zoning3: Assessed Total Value: $28,800 Zoning Overlay: Year Built/Remodeled: / Small Area: ST STEPHENS/OXFORD Current Tax Bill Split Zoning Districts: / Zoning Agency Phone Numbers Miscellaneous: Firm Panel Date: 2007-09-05 Building Permit Address Search for this parcel. Firm Panel #: 3710375200J If available, Building Permits for this parcel. Septic 2010 Census Block: 3012 links are not permits. 2010 Census Tract: 010102 Septic Final Permits prior to 08/2018, contact Agricultural District: PROXIMITY Environmental Health. Building Details (.5S Ne ) (°, Watershed: WS-IV Protected Area , r �!� ���3� Voter Precinct: P6/ Voting Map I Parcel Report Data Descriptions 13 List all Owners Deed History Report Assessment Report 1 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. ©2022, Catawba County Government, North Carolina. All rights reserved. 4'A • CATAWBA COUNTY it 100A SOUTHWEST BLVD NEWTON,NORTH CAROLINA 28658 RECEIPT Ati PHONE:828.465.8399 IF Tuesday,June 21, 2022 j 8 4 2 sM www.catawbacountync.gov PAYOR: Four Corners of Charlotte Inc Four Corners of Charlotte Inc(Cahudgar,Romil) PAYMENTS TRANSACTION NUMBER: TRC-42059474-21-06-2022 PAYMENT DATE: 06/21/2022 PAYMENT TYPE: Credit Card 291482252 INVOICE NUMBER ACCOUNT FEE NAME FEE AMOUNT 06-22-408194 110-580200-663000 LSSP $135.00 TOTAL PAYMENTS: $135.00 RBPR-06-2022-41429 CASE TYPE: Residential Building Plan Review WORK CLASS: Building New SITE ADDRESS: 2658 CHARLESTON CT,CLAREMONT NC 28610 Applicant FOUR CORNERS OF CHARLOTTE LLC, 1612 SEATTLE SLEW CT,WAXHAW NC 28173 C:704-713-2602 ROMELLE03@YAHOO.COM Paid By FOUR CORNERS OF CHARLOTTE INC, 1612 SEATTLE SLEW CT,WAXHAW NC 28173 **NO PEOPLESOFT ACCOUNT ASSIGNED** receipt 06/21/2022 14:18 Page 1 of 1