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HomeMy WebLinkAboutIMPV-08-2022-178883.TIF r CATAWBA COUNTY • f.lik Public Health Department Subdivision ' - Si Environmental Health Division � PIN# 365803427373 ' PO Box 389,25 Government Drive,Newton,NC 28658 LOT# 1 o, SlteAddress: 2367 HENDRIX RD, MAIDEN NC 28650 Name on Permit JESSE FREEMAN Property Size: Acres 29.73 Directions: NC 16,Right onto Providence Mill RD,Left onto Hendrix RD / Owner/Authorized Representative Acknowledgement of Permit Receipt ,! I cut that I am the owner or authorized agent(owner's authorization required)representing the owner of the sr. -rt described above. I,, . X. / As the property owner or authorized representative,I have received the above referenced r rmit(s)as requested in the application for service RBPR-06-2022-41297,by the following method(s): Received in Person �7 Facsimile Transmittal (Return form with signature required) �/ Electronic Image Transmittal/E-mail (Return receipt required) As the property owner or authorized representative l have reviewed and understand the specific conditions he 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:08/29/2022 Owner/Authorizedj Representative Signature . �, (Date +2'P Documentation of Permit(s)Transmittal (permit transmitted by electronic or other means) Permit transmitted by (name of person sending permit) Signature 31. 0 Date/Time J hi)) 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 yotPiease ttake a few momentts tto complette our custtomer service survey att http://wwwsurveymonkey.com/s/ERCusttomerService f_CO5) 3ter IAA J FP rt,t-ma, 08130,2022 12:t t .A134 CATAWBA COUNTY Case# IMPV-08-2022-I 78883 [5 till ,, Public Health Department Subdivision d\„ H Environmental Health Division PIN# 365803427373 PO Box 389,25 Government Drive,Newton,NC 28658 LOT# 1 !g Site Address: 2367 HENDRIX RD, MAIDEN NC 28650 Name on Permit: JESSE FREEMAN Property Size: Acres 29.73 Directions: NC 16, Right onto Providence Mill RD, Left onto Hendrix 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 g.p.d Type of Facility: Primary Residence-New House Basement? No Basement Plumbing? No Bedrooms: 3 Water Supply: Private Well Maximum Occupants: 6 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: 50%REDUCTION HORIZONTAL System Classification: IIIE-PPBPS GRAVITY DOSED SYSTEM Pump *May Be* Required Permit Conditions: -See AC 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' (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. 1/47( 08/29/2022 Authorized State Agent Permit 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. n;: 08/30/2022 12:11 Ieget D(/ - 7,7 z- (4/7 C.1- X / u e Li ell 08 Z 1-i9ggeti 0 t r14 ,4, \`� a `� .\ a ; 1 •r• °do � 9 sI d � ti -`e . y 4 `-v a u 3° is w1,, attA N vg . . , /G ci ,� 3 \ I • ea '''j err'. ri t id, s t g go ii IV 5461, DEPARTMENT OF I lI ALIII AND I IUMAN SERVICES Sheer 1 of 1 DIVISION OI:PUBLIC I-IIAL.:f1l,ENVIRONMENTAL FIE?AI:ITI SECTION PROPERTY ID#: ON-SI'll?WATER PROTECTION 13RANC11 COUNTY: & Tmih6_ SOIL/SITE EVALUATION for ON-SITE WASTEWATER SYSTEM (Complete all fields in full) / OWNER: J 5e pe�B� _ APPLICATION DATE CAigr ZZ ADDRESS: 36 adj/1/lt:' MI(1 /Ld Mp'dam ,4/ 2eci.U-? DATE EVALUATED: PROPOSED FACILITY: PROPOSED DESIGN FLOW(.1949 : yio GPP PROPERTY SIZE: 77- 7 3 &.rgS LOCATION OF SITE: �3L - 4 /'i*" r4 1I/lai�n A" 2g/$D PROPERTY RECORDED: iPrivate SUPPLY: Private ❑Public Well ❑Spring 0 Other EVALUATION METHOD: ❑Au cr Boring R Pit 0 Cut TYPE OF WASTEWATER: Aewage ❑Industrial Process ❑Mixed P R SOIL MORPHOLOGY OTHER F (.1941) PROFILE FACTORS 1 .1940 • L Is LANDSCAPE HORIZON . POSITION! DEPTH .1942 PROFILE a SLOPE% (IN.) .1941 .1941 SOIL .1943 .1956 .1944 CLASS 1 STRUCTURE/ CONSISTENCE/ WETNESS! SOIL SAPRO RESTR &LTAR TEXTURE MINERALOGY COLOR DEPTH CLASS HORIZ �S o-y 6 ,s�(5p,5X PS 1 ze- YU �cC i561� if,s5Isp,5tx�P tb -9 L G ,;35 St1 S LS 9- Zq Sc -s6,� k , 5s ,s- PS 2 2`l-4a CL w561� rIfcS 0. -z5 0.f . 2S tC II 0.- v 5( 58/( .&i s,s(1.c r F'S Z'!- yo ,SCL W56)C . ,Ss s�l s o!� 3 Cody az�s Z...1' o-z'-1 5c Salk Fr 5 c(st ko '73 z'- (O S(t�5jK Fi ps- 0 4 r � o DESCRIPTION INITIAL SYSTEM REPAIR SYSTEM OTHER FACTORS(.1946): Q P SITE CLASSIFICATION(.1948): c'5 Available Space(.1945) ^� o/ p EVALUATED BY: CV.i.4 C.f1/1Q. 1'LQ{-5(��l System Type(s) Z5 10 red 50 l0 rel( OTHER(S)PRESENT: �J Site LTAR . Z-s 0 . Z > COMMENTS: IUpdated February 2014 — F ,A r� N ti .) Lyv—o&—zoZ? -13-38g3 ). 4 ‘a / 1;1 ii. .k..". . 1 -? • r'' •'` .•ia 0's —:, re ,, • ..k . „..s .. • 4', . 0 r r 30 © \° S5 AA ‘,,' i 30. i O Ns aN zvm i 1 1S' _ n~i 0 Ar �� 10,E all ...464201 1- 1 • �. telj al 1 JD -1°7 A It ., ` ,, � . ,►�•4 � voll .''L ; N c,*\L' it. 'C i., Saer 5