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HomeMy WebLinkAboutIMPV-09-2022-180859.TIF ©+f�, CAT AN't3A COI'N11 �+ Pubht Health Dcpaitmcnt Sulxiivic,on .� a Emlrnnmenlal health I)i ision PING 367603420091 �; PO Hot 389,:S Goxemmcnt rime,Nc s1t n,N(' 2iir 5hl LU 24 r Sit.Addr►eer 4988 ANDERSON MOUNTAIN RD, MAIDEN NC 28850 Name on Permit: JOSHUA GRAY Name on Permit: STEVEN HARRISON Property Size: Acres 30.67 Directions: NC 150, R East Maiden Rd, L Anderson Mt Rd, L 4986 Anderson Mt Rd Owner/Authorized Representative Acknowledgement of Permit Receipt t____/ I certify that I ant the owner or authorircd agent(owner's authorization required)representing the owner of he property described above. i( As the property owner or authorized representative,I have received the above referenced permits)as requested in the application for service RBPR-08-2022-42128,by the following method(s): Received in Person _ Facsimile Transmittal (Return form with signature required) V 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(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:09/21/2022 Owner/Authorized Representative Signature_ Date ei/M/ZOZ Z. Documentation of Permit(s)Transmittal (permit transmitted by electronic or other means) Permit transmitted by (name of person sending permit) Signature el( Date/Time I3o ,) Method: Fax v/ 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 att http://www.surveymonkey.com/s/EHCusttomerService ply smaI Jgt-A� ' rti`A Mr"- or‘ SQ(eke ei- pLtd,p,. uit 09[:1(1021 II 42 _kQS: b.• CATAWBACOUNTY Case# 1MPV-09-2022-180859 Public Health Department Subdivision d Environmental Health Division PIN# 367603420091 PO Box 389,25 Government Drive,Newton,NC 28658 LOT# :ji, SY Site Address: 4986 ANDERSON MOUNTAIN RD, MAIDEN NC 28650 Name on Permit: JOSHUA GRAY Name on Permit: STEVEN HARRISON Property Size: Acres 30.67 Directions: NC 150, R East Maiden Rd, L Anderson Mt Rd, L 4986 Anderson Mt 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 480 g.p.d 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: 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 Polestar Sewage Treatment and Disposal Systems' (I5A 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. Z.-- ,et:seei__, • 09/21/2022 • Authorized State Agent Pem»t Issuance Date 9/21/2027 Permit Expiration Date No grading or construction activity is allowed in areas designated for system and repair without approval of the Health Department. ehpennit 09/22/2022 1I:42 POc2Oc2t2 L-' )-(7R)=6 rr, pv-o1 X?L- i10$5? Catawba County Environmental Health 466 y t6.� 4e� � �u� 9 /150 to R r W ELL-61 02 /VS43 .Y 46 . I. At'. % la..tp 4. ' i 1 1 lim . \) vimT�' .r- `CP \k ` `etib/C 0 lei . , :`'A ' F{'hkA rII otor t ,Ap tr e_,.\-- Ret.1/e e) , , ,A- 1)0CJ \ 1" :) 1 11 I} t 5gtr Parcel: 367603420091, 4986 ANDERSON 1 in=200ft MOUNTAIN RD MAIDEN, 28650 • This map/report product was prepared 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 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 user.The County of Catawba,its employees,agents,and personnel,disclaim,and shall not be held liable for any and all damages,loss 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 09/21/2022 • • DEPARTMENT OF HEALTH AND HUMAN SERVICES Sheet of DIVISION OF PUBLIC HEALTH,ENVIRONMENTAL HEALTH SECTION PROPERTY II)#: ON-SITE WATER PROTECTION BRANCH COUNTY: Catawba` SOIL/SITE EVALUATION for ON-SITE WASTEWATER SYSTEM �" (Complete all fie1�s in full) OWNER: cJ I U e.,n H I ct,4c.-) y\ APPLICATION DATE ADDRESS: _DATE EVALUATED:9pp—.22 PROPOSED FACILITY: PROPOSED ESIGN FLOW(.1 4 ): 1715-0 PROPERTY SIZE: LOCATION OF SITE: PROPERTY RECORDED: WATER SUPPLY: 0 Private U Public well ❑Spring Cl Other EVALUATION METHOD: 0 Auger Boring CYPit 0 Cut TYPE OP WASTEWATER: wage 0 Industrial Process ❑Mixed ` $n l < 'r r �j1+'r'z � ;Y'4 i-. r t,r f i �, a ,j,�N}s "'x a x,r S I % ,fr' ,4. ♦ ..r} i .i •. 3 ; ,qs 1 1t'� ��I� 2� �, rA3 r " d,, t' i " ...'- el .' J Yr}�•r tb �t +r'Yw a * ti }f x r`w .P :. `a,' : • Y t ! az;�� ,�. � r r ci tt. i y+ . fy i • .' 'i, 1., r ., r '2i �{ . L r 44 2r,,_` ,; L , a .N t 4r z y ,, ✓ t I', r i, yi x: r s 2.1.• Af ,� J 1 ,� , s -.tr ! • 1 A ! X i a r ; „y� �y''- "V,`V 71 �.of ''j Y 7 "� .. E d ',' t.:N v..q 2 -a rtc+y'm.. .14 1 k , . ., t V14 f e J 46' '.:1.1 t.? x a t �y r s8;. y � W '�`"`. R s a 1ya3 a v x 7 ' '..? r r = r j+ t < l.� 3 a e r, 1 �3 . 'fit - a ++i+'�'errs � ><xn.'�:� di.tt-xe+� t It �:.,.�•,p. `; ►llu��! u '".! 0 },� ref f Yf*j i , � � rsr` IL ,i O v Lc-- (L 4 Fr _5L 1Z-LiU J3j/CL w4A c /' i 3_5' --12 6r f 7 ,,-- • 1 CLl� � {{ �( PAS 2 L.CL.t y/. 4r ✓ 15- / C i.3c't Ait kx, k O -i' L G( Cr , St g-d ' r(_L. $ (( r 36 _ ,r;/, 3 52 -it-lib4(Loig¢f .i , ,,..3.5. -a L_- G i7 Sz 4 / 0 -;-1 C:fr ki5lif, fr. -,2f-: iiek I ,.5' • 3?% DESCRIPTION INITIAL.SYSTEM REPAIR SYSTEM OTHER FACIURS(.1946): ,�j� Available Space(.1945) ii5 ✓ SITE CLASSIFICATION(.1948): _1� 'T/T— EVALUATED BY: '" ,'� System Type(s) L1f OTHI'R(S)PRESENT: �MI'A-,�c'„/` Site LTAR .-3 __. / r COMMENTS: Updated Febr uary 2014 • • • • Catawba County Environmental Health - of . -10 C2 i \a 4 • 94T x 1 68,* r., s 46.24 ,.\ \ \ d•'' \ .... 11,,, \ r „t>` ';:;* \ \\ (\i,45. ,..,.-- .1- ,. tiT.44 \ , '‘4 \ \ \ \ tr \ \ \ \ \ \ / • TA/ / ,,,, G '�to 6 ,Atik ti- " ,_ ,, 0- 0-1)"' 1317_,,(„C- 3voi- 7 ,1 0 4 fr L.:11-... 2_6,11/s)Di,- ,pir--- J 1) --,,y) . _ •6135 \ ` I 1 C /' \ 11 3 r fr/ CL 1-(i5Ifi r12 \ .i K4c k tti Parcel: } 5 _ ce 367603420091, 4986 ANDERSON l t� 1 in=300ft MOUNTAIN RD MAIDEN, 28650 ) �I)- /---1 •fA ()41_ (.., di- 7- 5// �x.�/ /6w��'' gills p/report product was prepared from the Catawba County,NC Geospatial Information Services. Catawba County has made substantial efforts e to ensure the accuracy of location and labeling Information contained on this map or data on this report.Catawba County promotes and recommends IySP,, 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,loss or liability,whether direct,indirect or consequential vt ich arises or may arise from this map/report product or the u e thereof by any person or entity. / ) LA I-i F t_ ,,11 � Copyright 2021 Catawba County NC , .J J 08131/2022 J).