HomeMy WebLinkAboutIMPV-08-2022-177853.TIF � i�1��• C,VhtWtt'A('UI'N''fl' Case N IMI'V-08-2022-17785_i
lJ'_� Public I lcalth Department tiulxln faun
t� leg�0 Environmental Ilcalth Division I'INfi 371014327911
PO Box 389,25(lovcrnment Drive.Newton.NC 28658 1.0111
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Site Address: 3492 RIVER RD, HICKORY NC 28602
Name on Permit: INGRID MCCLUER
Property Size: Acres 19.94
Directions: NC-10 toward 321 N Bus, right onto Robinson Rd, left onto Sandy Ford Rd, right on River Rd, property on the
right
Owner/Authorized Representative Acknowledgement of Permit Receipt
f certify that I aril the owner or authorized agent(owner's authorization required)representing the owner()I'
the property described above.
s the property owner or authorized representative. I have received the above referenced
4
permit(s)as requested in the application for service EllPR-05-2022-41144, by the following method(s):
Received in Person
1 Facsimile"Transmittal (Return form with signature required)
Electronic Image Transmittal/ E-mail (Return receipt required)
s the property owner or authorized representative I have reviewed and understand the specific conditions
6
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(I5A NCAC I8A.1900),
and/or Well Construction Standards(15A NCAC 2C .1)100), shall apply to the issuance of this permit and
the construction of the wastewater system and/or water supply well permitted.
Permit Issue Date: 08/16/2022
Owner/Authorized Representative SignatureV�r`�1(`�^�"�J
Date
Documentation of Permit(s)Transmittal
(permit transmitted by electronic or other means)
Pennit transmitted by (name r4Jk'rson.sending permit)
Signature 9---' _ Date/Time b j�,3/Z4
Method: Fax Nf Email LIS Mail Other
Owner's request to send by the above indicated method of Transmittal in lieu of signature
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.4.1$! e CATAWBACOUNTY Case# IMPV-08-2022-177853
_ i- 2 Public Health Department Subdivision
Q G� Environmental Health Division PIN# 371014327911
PO Box 389,25 Government Drive,Newton,NC 28658 LOT#
/841 sm
Site Address: 3492 RIVER RD, HICKORY NC 28602
Name on Permit: INGRID MCCLUER
Property Size: Acres 19.94
Directions: NC-10 toward 321 N Bus, right onto Robinson Rd, left onto Sandy Ford Rd, right on River Rd, property on the
right
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 240 g p.d
Type of Facility: Primary Residence- New House
Basement? No Basement Plumbing? No Bedrooms: 2
Water Supply: Private Well Maximum Occupants: 4
INITIAL SYSTEM SPECIFICATIONS
Proposed Wastewater System: 25%REDUCTION
System Classification: IIIG-OTHER NON-CONY TRENCH SYSTEMS
REPAIR SYSTEM SPECIFICATIONS
Repair System Required? Required
Proposed Wastewater System: 25%REDUCTION
System Classification: IIIG-OTHER NON-CONY TRENCH SYSTEMS
Permit Conditions: -IP only for purchase and combination of property.
-Do not drive, grade, cut or fill over any part of the initial or repair septic areas.
-All septic areas must remain 10 feet from property lines, 5 feet from building structure,and
50 feet well area.
Landscaping or other site alterations that potentially divert groundwater or surface water toward the septic system, or prevent proper
drainage away from the septic system, including the direction of gutter flows or foundation drains,is not approved,and may result in failure to
approve the initial system installation,or the suspension/revocation of existing permits.
The issuance of this permit by the Health Department does not guarantee the issuance of other permits. It is the responsibility of the applicant
/property owner to insure that all Catawba County Planning/Zoning and Building Inspections requirements are met. This Improvement Permit
is subject to revocation if the site plan,plat or the intended use changes,or if site conditions are altered. The Improvement Permit is not
affected by a change in ownership of the property. This permit was issued in compliance with the provisions of the North Carolina'Laws and
Rules for Sewage Treatment and Disposal Systems' (15A NCAC I8A.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.
37fIt. 1)1Wr
08/16/2022
Authorized State Agent Pennit Issuance Date
8/16/2027
Permit Expiration Date
No grading or construction activity is allowed in areas designated for system and repair without approval of the Health Department.
chpermit 08/18/2022 14:08
Catawba County Environmental Health
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This map/report product was prepared from the Catawba County,NC Gooavotini information Services, Catawba County has made substantial efforts
to ensure the accuracy of location and labeling information contained on this atop or data on this report.Catawba County promotes end 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,lose 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
08/1512022
Catawba County Environmental Health
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True map/report prodoci was prepared from the Catawba County,NC Geoapt+Ital!Warrington Services. Catawba County has made substantwl adults
to ensure the accuracy of tocaton and tabeltnb Intomualton contained on the.map or dela on this report.Catawba County promotes and recomrrrends
the rndependeM venflcatlon of any data contained oft this map/report product by the ulUf.The County of Catawba,Its enipluye.rs,eyunts,and
personnel,disclaim,and shall not be hold liable fur any and all dameyns,suss or liability,wheltier direct,indirect or con equenuel which Ines or may
wis.from Uus map/reporl product or the use thereof by any person or entity.
Copyright 1011 Cetawbe County NC
06/1512022