HomeMy WebLinkAboutAUTH-08-2022-178798.TIF ('A'I'AwitA('O11\I1 case N Al:'I I I-OS-2022-I71091t
(0...4. Public I Icallh I)partment Subdivision
�, � hnvaunmcntal IIiahh Ihrlsu'r' PI Nil 278103306276
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Site Address: 2972, 2974, 2976, 2978 OLD SHELBY RD, HICKORY NC 28602
Name on Permit: CHARLES RADCLIFFE REVOCABLE TRUST
Property Size: Acres 2.28
Directions: 1-40 exit 121 Take Old Shelby Rd South, Building 2nd from the corner of Old Shelby and Mountain Lake Rd
Owner/Authorized Representative Acknowledgement of Permit Receipt
1 certify that I am the owner or authorized auent(owners authorization required)representing the owner of
the property described abo%e.
___ As the property owner or authorized representative, I have received the above referenced
permit(s)as requested in the application for service EHPR-06-2020-3.790,by the Ibllowing method(s):
Received in Person
Facsimile Transmittal (Return form with signature required)
J Electronic Image Transmittal/E-mail (Return receipt required)
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(I5A NCAC I8A.1900),
and/or Well Construction Standards(I5A 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: 08/29/2022
Owner/Authorized Representative Signature P. 3'&47-ittAZZIC4642-
Date 9/2/22
Documentation of Perm it(s)Transmittal
(permit transmitted by electronic or other means)
Permit transmitted by (name of person sending permit)
n r
Signature �, Date/lime U t 3e'ZL
Method: Fax J Email US Mail Other
Owner's request to send by the above indicated method of transmittal in lieu of signature
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�134,`• CATAWI3A COUNT\ Case I AUf11-08-2022-178798
ti .t.li ,y Public Ilcalth Department Subdivision
"3 Ilrvironmental Ilcalth Division I'INN 278103306276
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PO Box 389.25 Government Drive,Newton,NC 28658 1,OIY1
5.
Site Address: 2972, 2974, 2976, 2978 OLD SHELBY RD, HICKORY NC 28602
Name on Permit: CHARLES RADCLIFFE REVOCABLE TRUST
Property Size: Acres 2.28
Directions: 1-40 exit 121. Take Old Shelby Rd South, Building 2nd from the corner of Old Shelby and Mountain Lake Rd
Authorization to Construct Permit
Permit Category: Repairs Wastewater Flow: 480 g.p.d.
Type of Facility: Multi-Family-one half of an eight bedroom Quadplex
Basement? Yes Basement Plumbing? Yes Bedrooms: 4
Water Supply: Public Water Maximum Occupants: 8
Soil LTAR: g.p.dJft2
WASTEWATER SYSTEM REQUIREMENTS
Proposed Wastewater System: REPLACEMENT OF SEPTIC TANK ONLY
System Classification: IIA-CONV SYSTEM (SINGLE-FAMILY OR 480 GPD OR LESS)
Septic Tank: New Tank: 1,500 gal
Pump Tank _gal Grease Trap_gal
Dosing Volume gal Pump Specs: GPM @ TDH
Pressure Head ft Draw Down in
Drainfield: Total Area: sq ft Total Trench Length: ft
Aggregate Depth: in Maximum Trench Depth on Downhill Sidewall: in
Minimum Soil Cover: in Minimum Trench Separation: ft on center
Number of Drain Lines: Trench Width: ft
Distribution: Distribution Box
Pre Treatment: NONE
Additional Specifications:
*Pump, crush, and fill with dirt the existing tank being replaced.
*Plumb the new tank into the drainfield flagged with red flags. This bed is dry when probed. See Catawba
County repair permit number 4115 issued 7/15/82.
*Bring a new distribution box and corrugated pipe in case the existing is deteriorated or damaged.
*Risers are required for the new tank. If the top of the tank depth is over 3ft, a re-enforced tank will be required.
*Do not install the new tank in the REMC 40ft distribution right of way.
*Call 828-320-3077 at least one day before installing the new tank to discuss options for connecting to the
original bed then serial feeding to the bed flagged with red flags.
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? Soil LTAR: _ g.p.d.ft2
Proposed System:
System Classification:
chpcnni( 0829,2022 15.22
4.`. CATAWBA COUNTY Case# AUTH-08-2022 178798
Public 1{ealth Department Subdivision
(11111
„. i Environmental Health Division PIN# 278103306276
444,21t.' lilt PO Box 389,25 Government Drive,Newton,NC 28658 LOT#
Site Address: 2972, 2974,2976,2978 OLD SHELBY RD, HICKORY NC 28602
Name on Permit: CHARLES RADCLIFFE REVOCABLE TRUST
Property Size: Acres 2.28
Directions: 1-40 exit 121. Take Old Shelby Rd South, Building 2nd from the corner of Old Shelby and Mountain Lake Rd
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'Laws and Rules for Sewage Treatment and Disposal Systems' (I 5A 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.
-/P14f- fillii
08/29/2022
Authorized State Agent Pennit Issuance Date
8/29/2027
Permit Expiration Date
No grading or construction activity is allowed in areas designated for system and repair without approval of the Health Department.
ehpennit 08/29/2022 15:22
Catawba County Environm ntal Health 40R022 ! 7g7Q3
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Parcel: 278103306276, 2964 OLD SHELBY RD 1 in=60ft
HICKORY, 28602
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08/16/2022