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HomeMy WebLinkAboutAUTH-06-2022-174181.TIF 4,9i • c,cl;►WBA(�r)hNrry case. , ,... I. Public Health Ddpartntent Sulxlivisiun CRESCEN r LAND AND TIMBI /), Environmental Ilenhh Division I INIl 460715638007 �l. Y/� PO nos.tt39,25 Ikacnnurnl Drive,Newton,N(' 28G5 1 Lt)'I'N 104 site Address: 4053 CHEVLOT HILLS RD,SHERRILLS FORD NC 28673 Name on Permit: GAYNELL FOSTER Property Size: Acres 0.78 Directions: Hwy 150 to Cheviot Hills Dr,property on left,see sign a mailbox Owner/Authorized Representative Acknowledgement of Permit Receipt ��1 certify that I ant the owner or authorized agent(owner's authorization required)representing the owner of /4. the property described above. XJAs the properly owner or authorized representative, I have received the above referenced permit(s)as requested in the application for service El-WIZ-03-202I-36956, by the following method(s): Received in Person Facsimile Transmittal (Return forth with signature required) VElectronic Image Transmittal/E-mail (Return receipt required) p�J As 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(1 SA NCAC 18A.1900), and/or Well Construction Standards(I SA 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:06/21/2022 Owner/Authorized Representative Sign,ttur� - -�, g - Date (e l r 2l 22— Documentation of 1'errnit(s)Transmittal (permit transmitted by electronic or other means) Permit transmitted by (name gfperson sending perms) Signature cif Date/"time (111/171 Method: Fax V Entail US Mail Other Owner's request to send by the above indicated method of transmittal in lieu ofsignature We wantt tto hear from yomPlease ttake a few momentts tto complette our custtomer service survey att http://www.surveymonkey.com/s/EHCusttomerService Shan- &be la,nofnct,1.fed,1j, t't ) 0bey' A ��fr4('''sega0 n`'� P-r elq+rwul ((6/2112022 15:39 y1�46p.. CATAW BA COUNTY Case# AUTH-06-2022-174 181 rt7 Public Health Department Subdivision CRESCENT LAND AND TIMBE .� Environmental Health Division PIN# 460715638007 PO Box 389,25 Government Drive,Newton,NC 28658 LOT# 104 NPir IY Site Address: 4053 CHEVLOT HILLS RD, SHERRILLS FORD NC 28673 Name on Permit: GAYNELL FOSTER Property Size: Acres 0.78 Directions: Hwy 150 to Cheviot Hills Dr, property on left, see sign a mailbox Authorization to Construct Permit Permit Category: Relocation 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 Soil LIAR: .4 g.p.dlft2 WASTEWATER SYSTEM REQUIREMENTS Proposed Wastewater System: 50%REDUCTION VERTICAL System Classification: IVA-ANY SYSTEM WITH LPP DISTRIBUTION Septic Tank: New Tank: 1,000 gal Pump Tank 1.000 gal Grease Trap_gal Dosing Volume 126 gal Pump Specs: 14.35 GPM @ 18.07 TDH Pressure Head 2 ft Draw Down 6 in Drainfleld: Total Area: 450 sq ft Total Trench Length: 150 ft Aggregate Depth: in Maximum Trench Depth on Downhill Sidewall: 40 in Minimum Soil Cover: 15 in Minimum Trench Separation: 8 ft on center Number of Drain Lines: 3 Trench Width: 2 ft Distribution: LPP Pre Treatment: NONE Pump Required ***** Operator Required Additional Specifications: This permit issued pursuant to Section 11.(c)of SL 2018-114 using the signed and sealed LSS Evaluation attached here. Catawba County Environmental Health has not evaluated soils or site conditions for this property. Furthermore, CCEH has not field-verified soil descriptions submitted by the Licensed Soil Scientist. CCEH exclusively used the LSS evaluation and system design proposal to permit the septic system and future septic repair area. Catawba County Environmental Health is not responsible or liable for accuracy of soil descriptions or septic system design for this permit(s). Prior to CCEH's inspection of the system installation, all property corners must be surveyed,all property lines must be marked, and the 50 ft. lake setback, as applicable, must be surveyed. No deviation from the permit is permissible. If the system cannot be installed exactly as proposed by the LSS, maintaining all applicable setbacks under 15A NCAC 18A.1900, the property owner is responsible for a LSS resubmittal under SL 2018-1 14 Section 11.(c); new permit fees applicable. Do not drive, grade, cut, or fill over the septic system area/septic repair area. Damage to the septic areas will result in permit revocation. **PLEASE NOTIFY Catawba County EHS of the scheduled septic installation date, at least one week in advance, so a pre-installation site visit can be made. Call 828-320-3077. *The septic drain lines must be flagged in by the system designer(LSS), before the septic installation can begin *The water line must be at least 10 feet from any part of the septic system. hp' n i 06/21/2022 16:43 c 07iliri CATAWBA COUNTY Case ii AUTH-06-2022-174181 Public Health Department Subdivision CRESCENT LAND AND TIMBI R ^we , i i Environmental Health Division PIN4 460715638007 Po Box 389,25 Government Drive.Newton,NC 28658 I.oT4 104 w Site Address: 4053 CHEVLOT HILLS RD, SHERRILLS FORD NC 28673 Name on Permit: GAYNELL FOSTER Property Size: Acres 0.78 Directions: Hwy 150 to Cheviot Hills Dr,property on left, see sign a mailbox See also attached site plan. 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. >>>>> Do not install system under wet conditions ««< PROPOSED REPAIR Repair System Required? Required Soil LIAR: .35 g,p.ddit2 Proposed System: 50%REDUCTION VERTICAL System Classification: IVA-ANY SYSTEM WITH LPP DISTRIBUTION Pump Required 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 Authorization to Construct Permit is subject to revocation if the site plan,plat or the intended use changes,or if site conditions are altered. The Authorization to Construct 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'Lars and Rules for Sewaee 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. 06/21/2022 Authonzed State Agent Permit Issuance Date 6/21/2027 Permit Expiration Date No grading or construction activity is allowed in areas designated for system and repair without approval of the Health Department. clipernrit 06/21/2022 15:58 1(C )) cat wba coflnty ublic health The North Carolina Department of Health and Human Services, Division of Public Health,issued a position statement on July 24,2018 pursu nt to Session Law 2018-114(H13374)Sections 9 through 12 regarding the Implementation of Session Lbw Provisions. The completion of this form is necessary to conform with the requirements. I The NC Licensed Soil Sdendg(i5S"Wittthrough his/her signature below makes the following statements: 1. The LSS Evaluation attached to this application Is to be used to produce design and construction features for permitting in accordance with SL 2018-114 Section 11.(c). 2. The L55 Evaluation is being submitted pursuant to and meets the requirements of SL 2018-114 Section 11.(c). 3. The LSS maintains an errors and o issions liability Insu'ance policy issued by an Insurer,as required by North Carolina State Law,in an amount commensurate with the risk of performing the work referenced herein. Property Address: 153 ctt 1(0 t{k(sQJ. 5hi r,I `- L Fo ed,NC. aaGi3 `"N Signed this '. day of 11; ,20 z/ • . /. c‹, "Ne Eir. jai:t." _. ‘7151-(24-sl, SOIL Printed Name: 5;r"ue furl* 4.0 jJS' i r North Carolina Licensed Sall Scien st Cam" Mailing Address: ' s :� I '• • / f , e 29h • Office Number: 7v v • ,6 Cell Number: ; . i Email address: as la 4 ri� f,• Alto toii,c,„„-� - Acknowledged by Owner/Owner's Legal Representative(Circle correct one.) If signed by""wners legal representative he appropriate legal documentation must be attached hereto. By: `'.i-t1-A,I -& � L Printed Name: e'1t.i,•, L1 •0S4 J Mailing Address: 51 W.f. LZ 4n► N❑c,4 -S3k-ec,1-1 -C11 - (i 6j-ef Office Number: Cell Number: 1`7t."- - Ss'11#. 7 l it Email address: F k f e C- - -4er, rle S1•,c n.t,,,e 4 ca Lr it& - no-DJ-+m I( �( catawbacountync.gov / Environmental Health F;)1a oaf Colas+a Coanir Gorcinn col Ctniti r s43+4..• 25 Gormle nl Unve I PO Box 389 I Newton N( 2865E 18Z8.465.821U MAKING. LIVING. BETTER. vir, Rill gt FORESTRY SERVICES OF THE CAROLINAS, PA www.s.ilandforestryservlces.com Project#:21-0038 July 9th, 2021 Gaynell Foster Attn:Shantae Brown Email:shantaeb@lakenormanrealtv.com RE: Soil&Site Evaluation for a 3 Bedroo Residence on CL&T Lot 104,0.78 ac Parcel, PIN# 460715638007,4053 Cheviot Hills Ro.d, Sherrills Ford,NC 28673. . Ms. Foster: At your request Soil&Forestry Services of he Carolinas(S&FS)has performed soil/site evaluations on parcel noted above. The Lot size is noted on the attached survey map&soil evaluation form.The purpose of our work was to identify soil ar las with potential to support subsurface wastewater disposal systems and provide design details for Sess on Law submittal to Catawba County Health Department. Site Conditions At the time of our evaluation land cover on the property was partially wooded/open and had an existing house,septic,drive and well.The existing 1/0 stem is located partially under the existing house and is to be abandoned.The well is also proposed tbe abandoned.Topography within the evaluated area was gently slope near the house site and propoed drainfield area. Property lines and corners were marked at the time of the evaluation by Phillip Hars. The client provi ed an Autocad File of a survey as a basemap. The proposed septic layout wassated via survey and used to produce the attached Site Plan.The house foundation/existing housewell and proposed well was located via Survey by Phillip Harris. i .Methodoloav We had previously evaluated soil areas thr ugh the use of backhoe pits. Soil morphological conditions including color,texture,structure, etc.wer reviewed in the field with six backhoe pits on the property flagged and located via survey.Three of th six backhoe pits are located in the proposed septic layout. Soil suitability was determined by referencing 1SA NCAC 18A.1900"Laws and Rules for Sewage Treatment and Disposal Systems". Soil&Sie Evaluation Forml were utilized to record the soil morphological data for each pit.An on-grotind layout of systenj and repair was performed using a laser level. Pin flag locations of the layout were also located by survey. Detailed system&repair information is summarized in the following paragraph f 1r this Lot. i 4053 Cheviot Hills Road(See Attached DesfF nl The septic layout for this lot (8'centers)yidlded a total of 347 linear feet of line.The primary system Is proposed as 166 linear feet of PPBPS(50% eduction)drainfield with low pressure distribution.Trench depth is specified at 36 Inches.The repair stem is proposed as 181 linear feet of PPBPS (50% Reduction)drainfield with low pressure distribution.Trench depth is specified at 36 Inches. Both systems are Saprolite controlled and require a 100'setback to any well.The existing well and septic must both be abandoned. Session Law Reauirements An LSS Evaluation may be submitted In conilunction with a complete application to the LHD.The application shall include all information described in 15A NCAC 18A.1937(d)and be accompanied by a signed and dated statement from the appli�•:nt(owner or owner's legal representative)that reads as follows: "The LSS Evaluation attached to this applic•tion is to be used to produce design and construction features for permitting in acc• dance with SL 2018-114 Section 11.(c).". Owner Date 'Pk.Print Name , 4rf `k Signature iI. ,o -/,�ag !llY . 7- o2 J -a The LSS Evaluation shall include a statement bearing the LSS seat and signature that reads as follows: 'The LSS Evaluation is being submitted pursuant to and meets the requirements of Si 2018-114 Section 11.(c)." Disclaimer This report reflects the findings of S&FS,PA. This LSS Evaluation is being submitted pursuant to and meets the requirements of Si 2018-114 Section 11.(c).Any site modifications that Impact the proposed septic areas on 4053 Cheviot Hills Road,Sherrills Ford may nullify this design.System design requirements and site requirements shall be adhered to for installation and Operations Permits to be issued by the local Health Department.Jf vc u have Questions regarding these requirements a Pre- Construction meeting should be scheduled to discuss,Please contact S&FS if you have any questions regarding this report or the attached information. S&FS also offers septic system inspection,wetland delineation and forest services. Sincerely, SOX �' / 4 fl -.1.-`-',. , / ;I/ •: ■ t .r r- Iv 40.10) _ `A • S.Ashley Rollans,L S Attachment: Septic Design ( SEHL & FORESTRY SERVICES OF THE CAROLINAS, PA www.soilan'i orestryservices.com Attached is a proposed design fora PPBPS Septic System w/Low Pressure distribution for a 3 bedroom single family residence on 4053 Cheviot Hills Rd Lot# 104,(PIN#460715638007 ),Sherrills Ford NC,28673. Contents: Page Information for the Installer---------------- ----------_------- ---------------------- 1 Design Information Design Specifications 2-3 Layout Specifications 4 System Tapsheet 5 Site Plan/System Plan 6 Calculations 7 Profile Descriptions B-9 Original Plat 10 -jsity , � ojA A. R n 1/41011/A, � r March 23,2022 • Project#:21-0038 Design By: Soil& Forestry Services of the Carolinas, PA 1 INFORMATION FOR THE INSTALLER: The permit should be read very carefully prior to bidding. The following are details that must be considered along with all csther considerations. - Tanks shall be approved by NC DHHS, and certification supplied by the manufacturer. - Tanks shall be water tested prior to ins llation. - The installer shall be responsible to the wner for placement of the tanks and to insure that final grades are returned to the on 'nal natural grade,with exception of added structural features. - The supply trench shall be compacted t eliminate cavities left during initial fill placement. - Installation of the system shall be during dry conditions in order to protect the soil structure. - All fittings shall be pressure rated fittings. - All joints shall be cleaned with PVC pipe cleaner and a heavy bodied glue applied to weld all joints. - Where required by the county health department,post installation inspections by the designer must be scheduled 5 week days in advance. - Trenches shall be carefully excavated so the bottom is within 2" from the highest to . the lowest points of elevation within the trench. If the bottom elevation needs adjusting after it has been trenched, it will be done by removing high points rather than filling low points. It is extremely important to insure that trenches are not over excavated during initial trenching. All fine grading within the trench will be hand done with a shovel. No loose material will be left in the trench - All pipe openings in the tanks shall be properly grouted. This also applies to the joints around the riser. - All tanks shall be properly back filled and compacted to prevent slump at a later date. - Earth dams,constructed of relatively impervious material, shall be installed at the beginning and end of each lateral. - No heavy equipment shall be used on the field during or after installation. The use of a small loader(i.e. Bobcat)or a trencher(i.e. Ditch Witch 2300/2310) may be used for installation. - Elevations at pinflag locations should be checked by the installer prior to installation - Pumptank riser should be 6"above grade, control panel should be 12"above grade. - Septic tank riser shall be a minimum of 6" above finished grade. - System is specified as a PPBPS installation with low pressure distribution. - Repair is specified as a PPBPS installation with low pressure distribution. - Backfill 4 -6" of material (County Approved) over panels,rake trench walls, lime side- walls, install trenches 24" wide and have no more than 1/4" fall in 10 feet. - Existing Well to be abandoned and all system components must be 100' from wells. - Ex. Tank must be properly abandoned. New tanks must be 15' from Powerline - Owner obtained an Encroachment agreement for septic lines under powerline 2 LP PPBPS SYSTEM FOR WASTEWATER TREATMENT Owner/Applicant: Gaynell Foster Current Address: 4053 Cheviot Hills Road Sherriils Ford,NC 28673 Phone: 704.880.4664 County: Catawba Location: 4053 Cheviot Hills Rd Sherrills Ford, NC 28673 Source of Wastewater Flow: 3 Bedroom Single Family Residence Estimated Gallons Per Day Flow: 360 gpd System Flow: 14.35 gpm Design Specifications Drainfield Size: 150 Loading Rate (gpolft.2): 0.4 Depth of Gravel in Trench: NA (PPBPS ) Gravel Size: NA (PPBPS ) Trench Depth: 40 in., Repair 40 in. Trench Depth Trench Width: 24 in, Septic Tank Size: 1000 Pump Tank Size: 1000 Estimated Supply Line Length: 56 Supply Line Diameter: 1.5 in. SCH 40 PVC Supply Line Volume: 9.74 Dosing Volume: 126.00 Supply Manifold: N/A Supply Manifold Length: N/A Supply Manifold Volume: N/A Recommended Float Controls: SJE Sensor Float Control Switches as Required for Control Panel or County Approved Equivalents Recommended Control Panel: SJE-Rhombus Model 112 (NEMA 4x)Control Panel or County Approved Control Panel. Pressure Head: 2 ft. Friction Head: 0.71 Elevation Head: 13.00 Total Dynamic Head: 18.07 Threaded Union: In Tank Gate Valves: 1 in Tank 1 per lateral Check Valves: In Tank Anti-Siphon Hole: NA Additional Comments: Soil suitability was performed by Soil & Forestry Services of the Carolinas, PA 3 4053 Cheviot Hills Rd LP PPBPS DESIGN FLOW(gpd): 360 SOIL APPLICATION RATE (gpolft.2): 0,4 TOTAL AREA TRENCH BOTTOM: 300 TOTAL LATERAL LENGTH: 150 NUMBER OF FIELDS: 1 LATERAL LENGTH REQUIRED PER FIELD: 150 SUPPLY LINE LENGTH: 56 TOTAL DYNAMIC HEAD: 18.07 MANIFOLD SIZE: NIA DOSING VOLUME: 126.00 PUMP TANK DRAW DOWN*: 6.0 SEPTIC TANK SIZE: 1000 PUMP TANK SIZE: 1000 'Pump tank draw down based on a volume basis of 21 gallons per inch. Draw down may vary among pump tank manufacturers. 4 4053 Cheviot Hills Rd. (LOT 104) Project#:21-0038 LAYOUT FOR 3 BEDROOM HOME March 23,2022 FLAG FLAGGED DESIGN LINE# COLOR BS I� FS ELEVATION LINE LENGTH LINE LENGTH TBM 1NSTR. HOUSE CNR (LEFT FRONT) 769.00 P.TANK 766.60 1 RED 775.00 35 22 2 ORANGE 774.30 42 42 3 YELLOW I 773.00 55 55 4 BLUE 771.50 69 53 5 PINK 770.00 76 76 6 RED 768.90 70 70 Total 347 318 SOIL LINE ',TAR SYSTEM LTAR TRENCH J.FNGTI( GPD/FT3 TYPE GPD/FT= SYSTEM pISTRIBlrr1ON *System 150 0.400 MOD, 0.400 PPBPS LOW PRESSURE Repair 184 0.350 MOD. 0.350 PPBPS LOW (Line 4- 16' PRESSURE Included) Notes: **AII septic lines located via Licensed Surveyor **All measures in feet **Nitrification lines are demonstrate. on contour via colored pin flags 5 LP PPBPS TAPSHEET -4053 Cheviot Hills Rd-Lot 104 SYSTEM 1AIC1 Cdor ElCNatinn Length 1 I F1ow/holt Trench Are& Number of Panels 2 ORANGE 77430 42 0.156 0.41 84 10 3 YELLOW 779.00 55 0.156 0.41 110 13 4 BLUE 771.50 53 0.156 0.41 106 12 total feet - 150 gal/min— 14.35 35 Des.Fl 360 Pump Flu 8.78 soil LTA 0.4 LTAR+5 0.42 LTAR with a 0.8 LTAR with mod..+3% 0.84 .156 equals 5/32 Inch hole C.lir LAKE NORMAN J fiv CE NORMAN .- / 47 APPROX. L T1ONS OF AX. um< ,./ 4 37 \n �IV iP 1 __ I_ 1 60/ 61 62 Ar y I' t�\ &lFF—ER .D5fD 4511 GOat,R4t‘ \ <ti ` PP pi. DPDSED WF1c ilia e t k II.I £ BED YSTEM LOT 104 3 s j .4 D. 78 ACRES ± Oh `fy sR, c EX. * LL W P..;P..;1 sa�4+�ti� •0; lit _ - •6"-- .." tir "p N . iv .'.147,63 0. ........ :WV 0....•R. 11 mliffr CC Z 1/ t10' UTILITY EASEMENTrfir DB: 1807-1296 CP2) ` �` ���_ I', 43 I 1, CALE 44 4e 1 ,X# I 7 CALCULATIONS Location 4053 Cheviot Hills Rd Sherrills Ford, NC 28673 Project Number 21-0038 Lot No: 104 No. of Bedrooms 3 Design Flow 360 9a'/day LTAR 0.4 9al/ft2day PPBPS? (YES OR NO) YES Supply Line Length 56 ft. Supply Line Volume 9.744 gal. FRICTION FACTOR INTERPOLATER Required Feet of Line 150 ft. 2"SCH 40 PVC Amount of Line from Layout 150 ft. GPM f 20 0.84 Gallons per Minute 14.35 °a -0_88 25 1.27 Required Septic Tank Capacity 1000 gal. -1.28 Pump Tank Capacity 1000 gal. 30 1.78 -1.76 Panel Volume 3.6 gal. 35 2.37 #of Panels 35 -2.25 Dosing Volume 126.00 gal. 40 3.03 Note: Dosing Volume based on 100%of#of 43.07 3.48 panels times 3.6 gal/panel 45 3.77 48.14 4.28 50 4.58 57.11 5.89 60 6.42 Tank Draw Down 6.0 Generic Draw Down of 21 gat per in. Pump Run Time 8.78 minutes Elevation Head 13 ft. Pressure Head 2 ft. Friction Factor 1.27 ft1100 ft.(From the interpolator.) Friction Head 0.71 ft. Total Dynamic Head (+15%) 18.07 ft., Sheet l of1. PROPERTY ID#:�s f COUNTY. SOIL/SITE EVALUATION for ON-SITE WASTEWATER SYSTEM Complete all fields in full) OWNER: ( ,cz n.P If Ftzr5-4, C✓ A _ APPLICATION DATE ADDRESS: GTj ( _r/ �} \i ll c �� Ski'P ; lI r x N C. ? (n73 DATE EVALUATED:S - PROPOSED FACILITY: 80:Z. PR9POSFp DESIGN LOW .1949):,3� PROPERTY SIZE: . 7$ LOCATION OF SITE: �}G 5 , r t,�,..i /�;',. S t 4 S 1,Q,f,t"4'.1,c -o t C,1 13 PROPERTY RECORDED: kii-05 WATER SUPPLY: rivate ❑Public B�Well E Spring 0 Other EVALUATION METHOD: 0 Auier Boring J Pit 0 Cut TYPE OF WASTEWATER: wage 0 Industrial Process 0 Mixed s s • • P p SOIL MORPHOLOGY OTHER F (.1941) PROFILE FACTORS I .1940 E LANDSCAPE HORIZON POSITION/ DEPTH PROFILE ei# SLOPE (IN.) 1942 .1941 .1941 SOIL .1943 .1956 .1944 CLASS STRUCTURE/ CONSISTENCE/ WETNESS/ SOIL SAPRO RESTR &LTAR TEXTURE MINERALOGY COLOR DEPTH CLASS HORIZ o- -,t r—,l1 19-CS ►tea( vcsbtc r",55 5 �S _33 1 to 1-4,-2_9 Wt..w t..s5c._ - ^ - �o Vim! } aq-SU �Q ( 1 h .. ;� rpr S� 1"IT`/��Lr:. �rSie c d,.h 2g 5- et g Lc,, r- r-e-15S RSEXP 2 1:!1 o% q- to REj> ;_ w h , 7 _ _ o . 7-S' ' '4-18 'il1 .,,51,Yi4 vt p. - . - (1Y1..:3 j `,i R C-. k ,F. •, k '.. p �tf 14Z,, — CL.r� c!_ I 3 1 l0'--: F,z-'z 13R,e..,...,,ytg. Y, ,, ., N '-cS 1 L(6 Ps o,3s_.... o7.Li amp J,,_LI,;a RBc1/ J,Abc ., '^ ..- c s°yd CI Ca-` c-, ,...1,- " ✓1.1.' - a.. O - /p ac.( .. %1,L r;sS5PSz P /o- 2 �3�e1.» lw �s� a PS 4 (-j0..r Z•< �, - S(ass " ~ '� -- O ,'1-4 .4?-41 CC:tt Sti DESCRIPTION INITIAL SYSTEM REPAIR SYSTEM OTHER FACTORS(.1946): q `.. Available Space(.1945) SITE CLASSIFICATION(.1948):ps e , o) y�j? ,Ir System Types) P P S ppp,(J s — EVALUATD BY: S, asG-e. P91.a.1 ¶' ' •ESTcits '. .44 4.• Site LTAR C C . - 0:35 t `A ,� 'v. 'ei _ 12$1 ' `•"• COMMENTS: a c ..uk-**Itrper.__ ' Updated February 2014 g SOILISITE EVALUATION Sheet of_- (Continuatton Sheet-Complete all field in full) PROPERTY ID#:q o7is63:'7 DATE OF EVALUATION: 5i253(2-/ COUNTY: Cc tom.✓2 • • • • • P R SOIL MORPHOLOGY OTHER O F (.1941) PROFILE FACTORS ' .1940 L LANDSCAPE HORIZ .1942 E POSITION/ ON .1941 .1941 SOIL .1943 .1956 .1944 PROFILE k SLOPE% DEPTH STRUCTURE/ CONSISTENCE/ WETNESS/ son, SAPRO RESTR CLASS AFT TEXTURE MINERALOGY COLOR DEPTH CLASS HORIZ &LTAR c— Lie'-'....',. --. _.-, g ' Ira r s r .....,1201. s '' ''' , 1 IL pP.a`�e 4, --3 ►3Sc1 ...rsy14 r,- 553'a5xf -��-p L Cam` _Saif 17 • COMM ENTS: Updated February 2014 wr ao,„aru{1 /J I. J CI „ y !r t ` ^ID emu• h a I �'� / oNr i y Lp< ��7'E . ., J-ON., l`' . z \\ < J 1C 'i�4 �i U �_p s_�j t u O_ #tto ,.0,y �, �• 44'G t,�.. �� a/fit.2 ' S " $p ,S .0 ,i. s . rr 4y1y) r 1 o e 1-4. 4'# •'t r . i \ �. v. Q2 ' z •r,�,'°ya _fig maw ti ik \ 70.1k, ' :�i 0 / ;--(7. 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's#`:iii i �i1!§ix ;iE I13i1� ��:i� il �i #i�� S: :00 \fy �t \ vaasµ�'.�o7T \ f t 1* iti ti U lli 104 ) 41 . ilk% 1 1 ; : ,1141-, .-ilast ‘i i .4 I 4 I - 4 j 4 .41 , 1 ; . iii21` lth tl - i ..'s I)i 1 fa ,...„ 114;3 4‘1,AU 3739-1217 FILED ELECTRONICALLY CATAWBA COUNTY NC DONNA HICKS SPENCER FILED Apr 21, 2022 AT 09:45:00 AM BOOK 03739 START PAGE 1217 END PAGE 1223 INSTRUMENT # 09099 EXCISE TAX $0.00 Prepared by: Duke Energy Carolinas,LLC Site Address:4053 Cheviot Hills Road Return to: Duke Energy Carolinas,LLC Sherrills Ford,NC 28673 Attn: Susan Cannella Parcel#:460715638007 Address: 6325 Wilkinson Blvd. Charlotte,NC 28214 North Carolina Distribution Encroachment Agreement for Nitrification Field Encroachments State of North Carolina County of Catawba THIS NORTH CAROLINA DISTRIBUTION ENCROACHMENT AGREEMENT FOR NITRIFICATION FIELD ENCROACHMENTS ("Agreement"), made this 18 day of April , 2022, by and between DUKE ENERGY CAROLINAS, LLC, a North Carolina limited liability company ("Duke Energy"), and Gaynell Y. Foster("Grantee"). • Grantee is the owner of a .78-acre parcel of land situated in Catawba County, North Carolina, and being the land described in a deed from Crescent Resources, Inc. to John Wayne Foster (deceased) and wife, Gaynell Y. Foster in Deed Book 1807, Page 1295, dated November 30, 1992, Catawba County Register of Deeds (the "Property"); • Duke Energy has previously acquired a thirty (30) foot wide easement area over the Property on which easement area Duke Energy maintains and operates electrical facilities (the"Easement Area"); and • Grantee desires to use a portion of the Easement Area for the construction, installation, operation, and maintenance of a nitrification field (the "Encroachment"). NOW, THEREFORE, in consideration of the premises and of the mutual covenants herein contained, Duke Energy, insofar as Duke Energy's rights are concerned, hereby authorizes Grantee, her successors and assigns, ingress and egress to construct, install, operate, monitor, repair, and maintain the Encroachment within the Easement Area upon the following terms and conditions: For Grantee's Internal Use: Work Order#,43100063 1 of 6 Submitted electronically by "Duke Energy" in compliance with North Carolina statutes governing recordable documents and the terms of the submitter agreement with the Catawba County Register of Deeds. 3739-1218 1. Grantee shall construct, install, operate and maintain the Encroachment as shown on a map, dated 3/24/2022, and entitled "4053 Cheviot Hills Road," which is attached hereto as Exhibit A and incorporated herein by reference (the "Map"). Other than removing the Encroachment, Grantee shall not alter or add to the Encroachment in any way without receiving prior written consent from Duke Energy. Should Grantee perform any work in the Easement Area without the prior written consent of Duke Energy, should it fail to perform the work in a manner consistent with the specifications approved by Duke Energy, or should the Encroachment threaten any Duke Energy facility,then Grantee shall be liable to Duke Energy for any costs Duke Energy incurs while remedying actual or potential threats to Duke Energy's facilities arising from such work. 2. This Agreement shall automatically terminate upon complete removal of the Encroachment by Grantee. Should the encroachment no longer be required for the facility it is designed to serve, this Agreement shall be terminable by Duke Energy upon ninety(90)days written notice of Duke Energy's desire to terminate. 3. Duke Energy shall have the right to install at any time additional structures for the support of its present or future electric lines within the Easement Area. Duke Energy agrees to locate these additional structures, if reasonably possible, so as not to obstruct use of the Encroachment and in compliance with I5A NCAC 18A.1950. 4. Grantee may plant low-growing shrubbery on and around the Encroachment provided that Duke Energy shall have necessary access to its structures for maintenance purposes. Any trees or shrubs in the Easement Area shall not be permitted to reach a height of more than twelve(12)feet. If any such trees or shrubs do reach a height of more than twelve(12)feet, then Duke Energy shall have the right to remove them without removing the stumps if removal could damage system. 5. Grantee shall not place, or cause to be placed, a septic tank or any related device, constructed of any material type, in Duke Energy's Easement Area other than inert piping for septic draining purposes. 6. Grantee shall, upon request of Duke Energy and at no cost to Duke Energy, erect barriers around the Encroachment area or existing facilities owned or operated by Duke Energy. Barriers shall be of an acceptable size and construction to Duke Energy. Once installed to Duke Energy's specifications, Grantee shall not be liable for the costs of relocating or replacing any barrier that is later determined by Duke Energy to hinder its access to the facilities or Easement Area. 7. Grantee shall not utilize any equipment within Duke Energy's Easement Area in such a manner that any portion of said equipment would come any closer than fifteen (15) feet from any conductors of its electric lines. Grantee's operation of equipment and use of materials within Duke Energy's Easement Area shall adhere to applicable federal, state, and local laws, rules and regulations, including the guidelines set forth by the National Electrical Safety Code(NESC),the OSHA Standard for equipment minimum safe working distances, and the North Carolina Overhead High-Voltage Line Safety Act (OHVSA). For Grantee's Internal Use: Work Order#:43100063 2 of 6 3739-1219 8. Grantee shall be liable for, and shall indemnify, protect, and save harmless Duke Energy from any taxes or assessments which may be levied for or as a result of the Encroachment. 9. Duke Energy shall not be liable for any damage to the Encroachment resulting from Duke Energy or its contractors in the construction, reconstruction, replacement, maintenance, or removal of Duke Energy's present or future facilities. 10. Grantee shall not do any digging, grading, or filling nearer than five feet (5) feet to any of Duke Energy structures or anchors and any slopes within the Easement Area shall be no greater than a one to four ratio. 11. Grantee shall not do any filling or piling of earth on Duke Energy's Easement Area unless shown on the Map and approved by Duke Energy. The surface of the Easement Area shall be properly graded, raked,and seeded after construction of the Encroachments is complete. 12. Duke Energy may have facilities (e.g. counterpoise wires) buried in the vicinity of the Encroachment. Grantee shall exercise diligence to avoid damaging any underground facilities, will notify Duke Energy immediately if any damage does occur, and reimburse Duke Energy for the costs of any repairs made necessary by such damage. 13. The Encroachment is subject to the paramount right of Duke Energy at all times to make use of Duke Energy's entire Easement Area for the construction, maintenance, reconstruction, and operation of electric lines. In the future, Duke Energy may require, within the N.C.G.S. 130A statute and the 15A NCAC .1900 rules, the relocation or modification of the Encroachment, and Grantee shall comply with the demand at no cost to Duke Energy within ninety (90) days after receipt of the written demand. 14. This Agreement is effective only insofar as the easement rights of Duke Energy in the Easement Area are concerned; and Grantee shall obtain from others such permission and permits as may be necessary from third parties. 15. Grantee assumes all risks incident to the Encroachment and does hereby release and shall indemnify, defend, and save harmless Duke Energy, its officers, directors, employees, contractors, and agents from and against claims,damages, demands, legal or administrative actions (formal or informal), expenses (including reasonable attorney's fees and court costs), and liability (whether or not such liability has been judicially determined) for loss of or damage to property of Grantee, Duke Energy or others, (including environmental damages and hazardous or toxic waste cleanup) and injuries to or death of all persons, howsoever resulting, by reason of Grantee's use of the Encroachment. 16. The recitals set forth at the opening of this Agreement are incorporated herein as if fully restated in this Section 16. For Grantee's Internal Use: Work Order#:43100063 3 of 6 3739-1220 17. Should Grantee desire or be required to contact Duke Energy for any reason related to this Agreement it shall contact Duke Energy's customer service center and request to speak to the land services group. 18. This Agreement shall be governed by the laws of the state of North Carolina without regard to the conflicts of law provisions therein. The parties agree that the proper venue for any dispute related to this agreement are the courts located in county in which the Property is located, and the parties hereby submit to the jurisdiction thereof. 19. This Agreement contains the complete understanding of the parties and shall supersede any prior and contemporaneous communications, agreements, and assurances related to the subject matter of this Agreement. Any modification of this Agreement must be agreed to in writing and signed by the parties. The parties agree that the Easement shall remain in full force and effect. The only modifications to the terms thereof,caused by the Agreement, shall be those which are expressly stated in this Agreement. 20. The failure of Duke Energy in any one or more instances to insist upon compliance with any provision or covenant herein or to exercise any right or privilege herein shall not constitute or be construed as a waiver of such or any similar provision or covenant. 21. This Agreement shall be recorded at Grantee's sole expense. /Remainder of Page Left Intentionally Blank] For Grantee's Internal Use: Work Order II:43100063 4 of 6 3739-1221 IN WITNESS WHEREOF, Duke Energy and Grantee have caused this Agreement to be signed under seal in their names,as of the date first above written. DUKE ENERGY CAROLINAS,LLC (SEAL) a North Carolina limited liability company By: (SEAL) Name; P1lci Goip )e � y Title: a r1 c S °Mr e s Mettler" STATE OF NORTH CAROLINA , COUNTY OF WretkC- nd The foregoing document was acknowledged before me this . day of Fetirtjrtr' 2022, by ?akulAA Gour•le'/ ,as L,Grid cer V;C€ S/larlafer of DUKE ENERGY CAROLINAS, LLC, a North Carolina limited liability company, who is personally known to me or who has produced as identification. Dennis F. Daniels Official signature of Notary ublic Notary Public Drir ; c Dot el)C 1 S Wake County Notary Public printed or signed name North Carolina August )2 2i02 S My Commission expires: For Grantee's Internal Use: Work Order I:43100063 5 C t 6 3739-1222 IN WITNESS WHEREOF, Duke Energy and Grantee have caused this Agreement to he signed under seal in their names, as of the date first above written_ GRANTEE: i (SEAL) GAYN a L Y. FOSR STATE OF NORTH CAROLINA COUNTY OF L pt.64 4j le The foregoing document was acknowledged before me this ) day of fir( r ) 2022, by C-"k, e,./ "/� r o s 't-pf,who is personally known to me or who has produced Yv T as identification. JULIE B. LITTLE u' - ,' "` >" NOTARY PL BLIC Of ial signature of Notary Public Catawba County North Carolina � My Commission Expires Sept 28,2023 Notary Public Writ:tt d ;e signed name _ - P v 23 My Colti±t'.i 'iiori expires: For Grantee's Internal Use: 6 of 6 Work Order#:43100063 3739-1223 •S. -tk!r EXHIBIT A /14:, 4053 Cheviot Hills Road \ • Sherrills Ford, NC 28673 (Op, 49 \\I" I.AI K li,' NO1-?114A AT \ \ Owner: Gaynel I Foster r .., Parcel ID# 460715638007 3/24/2022 , \ . fiti,,•, • . . 5r./.. - 4 7 - APT ' • , -—41.1-11,0" • .4F,P4OX 4,44CA Van 17.,,,a, TAN /.K 11771.E.,C MUM rif NINA41-1 .. ._ , . 1 1‘, : \ ,/) \ -.. .. I I , 4. .1 eit 4 "OW \ Srif,Xt /if. st e411 .Pj. V z ,) 9. 1 Ati, . \ \ le I \ 1: I /5 . . 0£1 1 y ,). f4 0.78 ACRES 1 \\\\\ 14f, - 11-\- - —11;4 4\it \ ii:1).:13•\\,4\II: ,-...."4..1'.,:.; ./:.., ...':. . i.....4.,.; 1$9° 1 \ IV ft 1 - 'E 43../ .4- :,..P.F11+, ,,,,• , ,KALE ' 4 4 - 411__ I I' 40 —,,T ) )It' , ! \ Line to septic tank I i . %., THIS MAP MAY NOT BE A CERTIFIED SURVEY AND HAS NOT BEEN REVIEWED BY A LOCAL GOVERNMENT AGENCY FOR COMPLIANCE WITH ANY APPLICABLE LAND DEVELOPMENT REGULATIONS AND HAS NOT BEEN REVIEWED FOR COMPLIANCE WITH RECORDING REQUIREMENTS FOR PLATS. . :_... ., ,_. .... ..,...._.,_.:.....,:.,.. _ _..:.:,,, :::::,,,,,,::,::::::......:...:1....1..:.,..:....:;.............:...,....i;,...,.:....,..,...i,",..,,,.,:.....,..,,.....i...„.i,,........::".....:.. .:,...:,........i,:....:;....',,,,„„,..l......:.,...'. Gontraet.on..sewer _InsP 'on: ;: LC . L C1art eatty 3530 Dockside:l ane= •• •......,. 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This_sum is:for: :..ire >•a: inspection.onijT and does noi.includet3t±e-ci�ta€system:m�ust-l>�'brt uP'tio:specatiaaa or;repa�::AnY 1lo?r - < . ::,deviation.:from:above: cations mvo. :.ex..:: st rill be ec ted only.upon: and:itwill ite©nine; a 6Ea=cost' ;an a love ...2'.. ..............- ... lying . ro An : or _... ....._. .._...cant . `owner"at:.: co_ ::however'it.must i t ,, «..::..;::::.: al <''` ;: h :P P..�-. Y ppgrade r�to,sYstemt.�an,�i3�`etiY._ :::_ *._. + 4_ Y!.. f � . . ... ...... Requirements:and_:deadline.for.completion.Respectfully inbmi -by Cha Beatty Gradin LLC This may �e withdra ; ; ''- ` a ent.. v x. • yin � - . / .:.••. • Z L: Si of SubsarFare S Date-•......Signature ystems Opetetor. The above rice;:s ifications:and:conditions ar•e satin ctio' and:: Yoii are author ized to-do..itie�work a.:' : P PeC. . ry heretiy_aoced. -.Pa ent.will�be o ve: yin SI -Date: it l 8�� -