HomeMy WebLinkAboutIMPV-08-2022-178325.TIF ..1.i � CATAWBA COUNTY Case# IMPV-08-2022-178325
.t.� ,y\ Public Health Department Subdivision
d „ 'aC Environmental Health Division PIN# 376301098838
PO Box 389,25 Government Drive,Newton,NC 28658 LOT# 2
8 9,
Site Address: 5374 RIVERBEND RD, CLAREMONT NC 28610
Name on Permit: KRISTA HINSON
Property Size: Acres 1.9
Directions: NC-16, right onto River Bend Rd, property on the right
• Owner/Authorized Representative Acknowledgement of Permit Receipt
I certify that I am the owner or authorized agent(owner's authorization required)representing the owner of
the property described above.
As the property owner or authorized representative, I have received the above referenced
permit(s)as requested in the application for service EHPR-07-2022-41776, by the following method(s):
Received in Person
Facsimile Transmittal (Return form with signature required)
V Electronic Image Transmittal/E-mail (Return receipt required)
S" 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 (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: 08/22/2022
Owner/Authorized Representative Signature
Date
Documentation of Permit(s)Transmittal
(permit transmitted by electronic or other means)
Permit transmitted by (name of person sending permit)
Signature Off Date/Time '/2&I))
Method: Fax .J 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 yor<Please ttake a few momentts tto complette our custtomer service survey att
http://www.surveymonkey.com/s/EHCusttomerService
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+ CATAWBA COUNTY Case# IMPV-08-2022.178325
r' t lit Public Health Department Subdivision
d vs Environmental Health Division PINK 376301098838
PO Box 389,25 Government Drive,Newton,NC 28658 LOT 2
1a
Site Address: 5374 RIVERBEND RD,CLAREMONT NC 28610
Name on Permit: KRISTA HINSON
Property Size: Acres 1.9
Directions: NC-16, right onto River Bend 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 480 g.p.d
Type of Facility: Primary Residence-SFD
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: IIIB- SYSTEM W/SINGLE EFFLUENT PUMP
Pump 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 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 I SA.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.
Dety4 roeNg
08/22/2022
Authorized State Agent Permit Issuance Date
8/22/2027
Permit Expiration Date
No grading or construction activity is allowed in areas designated for system and repair without approval of the Health Department.
chocino! 08/23/2022 15:56
•" Catawba County Environmental Health
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Mil mop/roped product wee propared from the Catawba County,NC Geospatlal information Services. Catawba County has made substantial efforts
to ensure the accuracy of location and labeling information contained on Pile map or date on this report,Catawba County promotes end recommends
the independent verification of any data contained on this map/roport product by the user,The County of Catawba,Its employees,agents,and
personnel,disclaim,and shell not bo held fable for any and all damages,loss or liability,whether direct,Indirect Or consequential which arises or may
anae from this map/report product or the use thereof by any poraon or entity.
Copynght 2021 Catawba County NC
08/22/2022
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES '. Sheet I of
DIVLS1ON OF ENVIR.ONMENTAL HEALTH PROPERTY ID N:
.ON-SITE WASTEWATER SECTION COUNTY:
SOIL/SITE EVALUATION
1 .
ifqr ON- II-E WASTEWATER SYSTEM PZ IV-37P°9828
OWNER: te.,) (rik R.,ii ado-Inal4, APPLICATION DATE
ADDRESS: DATE EVALUATED:
PROPOSED FACILITY: PROPOSED DESIGN FLOW(.1949): PROPERTY SIZE:
LOCATION OF SITE: PROPERTY RECORDED:
WATER SUPPLY: D Private 0 Public 0 Well 0 Spring li Othcr
EVALUATION METHOD: 0 Auger Boring 0 Pit 0 Cut
TYPEOF W.ASTEWATER: 0 scwage 0 Industrial Process 0 Ktx ed • ,
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COMMENTS:
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SOIL/SITE EVALUATION Sheer c2o
(Cocum.ollon Sheer-Comp/tie cUfuld in full)
PROPERTY ID I<:
DATE OF EVALUATION:
COUNTY:
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n SOIL MORPHOLOGY OTHER
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LANDSCAPE .1942
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COMMENTS:,
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Upd.ud Fcbru.ry 2014
Catawba County Environmental Health
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Parcel:376301098838, CLAREMONT, 28610 1 in=100ft
This map/report product was prepared from the Catawba County,NC Geoapafiat In*pmyUon Seroces. 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 UAW.The County of Catawba,rts employees,agents,and
personnel,disclaim,and shall not be held liable for any and all damages,loss or liaba4y,whether direct,Indirect or consequential which anses or may
anse from this map/report product or the use thereof by any person or entity.
Copyright 2021 Catawba County NC
08/22/2022
Catawba County Environmental Health
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Parcel: 376301098838, CLAREMONT, 28610 1 in=100ft
n+Is map/report product wee prepared from the Catawba County,NC Geoa9atlal Information Services. Catawba County has made substantial coons
to ensure the accuracy of location and labeling Information contained on this mop or data on this report Catawba County promotes and recommends
the independent verification of any data contained on INS moplrepon product by the user.The County of Catawba,its employees,agents,and
personnel,disclaim,end shall not be held liable for any and all damages,loss or liability,whether diroct,Indirect or consequential which arises or may
arise from this map/report product or the use thereat by any person or entity.
Copyright 2021 Catawba County NC
08/22/2022