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SaoAddrssa: 3170 SPRING GARDEN RD CLAREMONT NC 28610
Name on Permit: MARIE CHESLEY
Property Stu: Acres 0 54
Directions: US-70E/Conover 8M1 W,keep straight to stay on Robck Barn Rd NE.right onto Spring Garden Ro r
Owner/Authorized Representative Acknowledgement of Permit Receipt
certity that I am the owner or authorized agent(owner's authorii rtiun required)representing the inn ner of
the property described above.
fps the property owner or authorized representative.I have received the above referenced
permit(s)as requested in the application for service F11PR-05-2022-40928,by the following method(s):
Received in Person
/Facsimile Transmittal(Return form with signature required)
`r Electronic Image Transmittal/ii-mail (Return receipt required)
1#1,--Ks the property owner or authorized representative I have reviewed and understand the specific conditions
of the permit issued, and further understand that all applicable
andDisposal terns(15A NCAC Disulatory requirements specified C 18A�1r9D0).
he
North Carolina Laws and Rules for Sewage Treatment
and/or Well Construction Standards(15A NCAC 2C.0100). shall apply to the issuance of this permit and
the construction of the wastewater system and/or water supply well permitted.
Permit Issue Date:07/08/2022 j
Owner/Authorized Representative�n Signatur ' __ ._"_- '
Date__7 CG.f- d,tx,-...
Documentation of Permit(s)Transmittal
(permit transmitted by electronic or other means)
(name of person sending permit)
Permit transmitted by .___._. _. _ - _ --_ /)7_1?
Date/"I'imc_ 3
signature
Method: _^Fax
Email _US Mail Other
Owner's request to send by the above indicated method of transmittal in lieu of signature _ _
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CATAWBA COUNTY Case# IMPV 07-2022-175283
1k1 t Public Health Department Subdivision HOKELAND HEIGHTS SUBDI'
Environmental Health Division PIN# 376301157662
10 PO Box 389,25 Government Drive,Newton,NC 28658 LOT# 1-6
Site Address: 3170 SPRING GARDEN RD, CLAREMONT NC 28610
Name on Permit: MARIE CHESLEY
Property Size: Acres 0.54
Directions: US-70E/Conover Blvd W, keep straight to stay on Robck Barn Rd NE, right onto Spring Garden Rd
Improvement Permit
AN AUTHORIZATION TO CONSTRUCT MUST BE ISSUED PRIOR TO BUILDING PERMITS
THIS PERMIT IS NOT FOR SEPTIC INSTALLATION
Permit Category: New Septic Wastewater Flow 360 d
9-P.
Type of Facility: Primary Residence-SFD
Basement? Yes Basement Plumbing? Yes Bedrooms: 3
Water Supply: Private Well Maximum Occupants: 6
INITIAL SYSTEM SPECIFICATIONS
Proposed Wastewater System: 50%REDUCTION VERTICAL
System Classification: IliE-PPBPS GRAVITY DOSED SYSTEM
REPAIR SYSTEM SPECIFICATIONS
Repair System Required? Required
Proposed Wastewater System: 50%REDUCTION HORIZONTAL
System Classification: IVA-ANY SYSTEM WITH LPP DISTRIBUTION
Pump Required ***** Operator Required
Permit Conditions: 'DO NOT CUT OR FILL OVER SYSTEM AREA
Landscaping or other site alterations that potentially divert groundwater or surface water toward the septic system, or prevent proper
drainage away from the septic system, including the direction of gutter flows or foundation drains,is not approved,and may result in failure to
approve the initial system installation,or the susoension/revocation of existing permits.
The issuance of this permit by the Health Department does not guarantee the issuance of other permits. It is the responsibility of the applicant
/property owner to insure that all Catawba County Planning/Zoning and Building Inspections requirements are met. This Improvement Permit
is subject to revocation if the site plan,plat or the intended use changes,or if site conditions are altered. The Improvement Permit is not
affected by a change in ownership of the property. This permit was issued in compliance with the provisions of the North Carolina'Laws and
Rules for Sewage Treatment and DilFosal Systems' (I5A NCAC 18A.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.
ice„ 5 41s
07/08/2022
Authorized State Agent Permit Issuance Date
7/8/2027
Permit Expiration Date
No grading or construction activity is allowed in areas designated for system and repair without approval of the Health Department.
07/19/2022 11:35
Catawba County Environmental Health
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Parcel: 376301157662, 3170 SPRING GARDEN 1in:50ft
RD CLAREMONT, 28610
Thle map/report product was prepared from the Catawba County,NC Geospatial Information Services, Catawba County has made substantial&forts
to ensure the accuracy of location and labeling Information contained on this map or data on this report.Catawba County promotes and recomrngnde
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,lust 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
07108/2022
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DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES Sheet of_
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DIVISION OF EENVIRONMENTAL HEALTH COUNTPROPERTY 1D ot ih: { ti
,ON-SITE WASTEWATER SECTION
SOIL/SITE EVALUATION
// for ON-SITE WASTEWATER SYSTEM y a2
OWNER: a t s U APPLICATION DATE
ADDRES • D r r L!c c) II 01 DATE EVALUATED:
PROPOSED FACILITY: .5" PROPOSED DESIGN FLAW(.1949): 7( 0 • PROPERTY SIZE: d CY- <
LOCATION OF SITE:, - ' PROPERTY RECORDED: --
WATER SUPPLY1avate 0 Public ''_Wp-e,l,t, 0 Sluing 0 Oma
EVALUATION METHOD: 0 Auger Baring .�'PIt 0Cut
ME OF WASTEWATER: ewage 0 Industrial Process 0 Eyed .
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Parcel: 376301157662,3170 SPRING GARDEN 11n=50ft
RD CLAREMONT, 28610
This map/report product was prepared horn the Catawba County,NC Geospatlal IntormatJon Services. Catawba County has made substantial tenons
to ensure the accuracy of location and'abating Information contained on this map or data on this report Catawba County promotes and reccevraneis
the independent verification of any data contained on this mapfreport product by the user.The County of Catawba.its enViOrt s,aryeras,an
personnel,disclaim,and shall not be held liable for any and al damages.toss or lllabidy.whether direct.hWject or consequential wt►4+arises nr may
arise horn this map/report product or the use thereof by any pefson or a Catawba Caxnty NC
07K012022
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