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Home My WebLink AboutIMPV-08-2022-177707.TIF I I2 44 a CATAWBA COUNTY 1'uhlic health Department tiubdtviaion t.^ Environmental health DIVISIOn I'INM 470001098048 �\� - PO Box 3R9,25 Government Drive,Newton,NC 2R658 ,�� LOIN Site Address: 1601 BROWN CHAPEL RD,CATAWBA NC 28609 Name on Permit: JARROD 8 SHANON ADAMS Property Size: Acres 12.716 Directions: Hwy 150 to Shernls Ford Hwy Right on Joe Johnson Rd right on long island left on brown chapel property on left Owner/Authorized Representative Acknowledgement of Permit Receipt certify that I am the owner or authorized agent(owner's authorization required)representing the owner of the property described above. OkAs the property owner or authorized representative,I have received the above referenced permit(s)as requested in the application for service RBPR-01-2022-39831,by the following method(s): Received in Person Facsimile Transmittal(Return form with signature required) JElectronic Image Transmittal/E-mail (Return receipt required) "/' /s the property owner or authorized representative I have reviewed and understand the specific conditions i. of the permit issued, and further understand that all applicable regulatory requirements specified under the North Carolina Laws and Rules for Sewage Treatment and Disposal Systems(15A NCAC 18A.1900), and/or Well Construction Standards(15A NCAC 2C.0100), shall apply to the issuance of this permit and the construction of the wastewater system and/or water supply well permitted. Permit Issue Date:08/15/2022 Owner/Authorized Representative Signature trk Date 41 (6I 2- Documentation of Permit(s)Transmittal (permit transmitted by electronic or other means) Permit transmitted by _ (name of person sending permit) Signature Datc/Time VI D ill Method: Fax .( Email _US Mail Other Owner's request to send by the above indicated method of transmittal in lieu of signature we wantt tto hear from yoiPlease ttake a few momentts tto complette our custtomer service survey aft http://www.surveymonkey.com/s/EHCusttomerServIce OH/16)7022 17:01 itiL 3��• No CATAWBA COUNTY Case# IMPV-08-2022-177707 ,• t ,? Public Health Department Subdivision Q .� 0' Environmental Health Division PIN# 470001098048 PO Box 389,25 Government Drive,Newton,NC 28658 LOT# /8.2 Site Address: 1601 BROWN CHAPEL RD, CATAWBA NC 28609 Name on Permit: JARROD&SHANON ADAMS Property Size: Acres 12.716 Directions: Hwy 150 to Sherrils Ford Hwy Right on Joe Johnson Rd right on long island left on brown chapel property on left Improvement Permit AN AUTT IORIZAI'ION TO CONSTRUCT MUST BE ISSUED PRIOR TO BUILDING PERMITS THIS PERMIT IS NOT FOR SEPTIC INSTALLATION Permit Category: New Septic Wastewater Flow 480 d 9.P. Type of Facility: Primary Residence Basement? No Basement Plumbing? No Bedrooms: 4 Water Supply: Private Well Maximum Occupants: 8 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: SEE AC FOR PERMIT CONDITIONS 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 I Iealth 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?remittent and Disposal Systems' (I 5A 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. d--------, il (-73 08/15/2022 Authorized State Agent Pennit Issuance Date 8/15/2027 Permit Expiration Date No grading or construction activity is allowed in areas designated for system and repair without approval of the Health Department. 08/16/2022 17:05 ki `J4 4 I3L' P lt, 14 to \Ph. 164 t...�" " 1,if' �: . . t•. 4°• I __..� v.4 I I . < < • _ • 93a 4,,,.. ' f: FEi. 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