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HomeMy WebLinkAboutIMPV-09-2022-181160.TIF 4tZ ,4� CATAWBACOUNTY' .._... _. ____ y •/.l;y Public Health Department Subdivision ABERNETHY PARK PH 12 [m , ,s •Environmental Health Division PIN# 279012878298 /f PO Box 384,25 Government Drive,Newton,NC 28658 I.OT# 92 JO w Stu,Addreea: 5140 MEADOW PARK LN, HICKORY NC 28602 Name on Permit CONSTANTIN BOUREANU Property Skis: Acres 0.45 Directions: 5140 Meadow Park Ln Owner/Authorized Representative Acknowledgement of Permit Receipt XI certify that I am the owner or authorized agent(owner's authorization required)representing the owner of the property described above. i( As the property owner or authorized representative,I have received the above referenced permit(s)as requested in the application for service RBPR-03-2020-34153,by the following method(s): Received in Person Facsimile Transmittal(Return form with signature required) 7 Electronic Image Transmittal!E-mail (Return receipt required) (l'.?).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(I SA NCAC 18A.1900), and/or Well Construction Standards(1SA 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:09/27/2022 Owner/Authorized Representative Signature pv-,S-\O,sic \v1 .A.r_c;_`n ,3 Date lc I 1`DI 24322. Documentation of Permit(s)Transmittal (permit transmitted by electronic or other means) Permit transmitted by (name ofperson se ding permit) et Signature Date/Time )0 Ilia) 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 youPlease ttake a few momentts tto complette our custtomer service survey att http://www.surveymonkey.com/s/EHCusttomerService (os1eU adj /ec. , netJ P e i.,.. ,„ 09/27/2022 11:41 CATAWBACOlifnay Case# 1MPV-09-2022-181160 Q' y Public Health Department Subdivision ABERNETHY PARK PH 12 Environmental Health Division PIN# 279012878298 PO Box 389,25 Government Drive,Newton,NC 28658 LOT# 92 18 L w Site Address: 5140 MEADOW PARK LN, HICKORY NC 28602 Name on Permit: CONSTANTIN BOUREANU Property Size: Acres 0.45 Directions: 5140 Meadow Park Ln 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? Yes Basement Plumbing? Yes Bedrooms: 3 Water Supply: Public Water Maximum Occupants: 6 INITIAL SYSTEM SPECIFICATIONS Proposed Wastewater System: 25%REDUCTION System Classification: IIIG-OTHER NON-CONY TRENCH SYSTEMS Pump*May Be* Required REPAIR SYSTEM SPECIFICATIONS Repair System Required? Required Proposed Wastewater System: 50%REDUCTION VERTICAL System Classification: IVA-ANY SYSTEM WITH LPP DISTRIBUTION Pump Required ***** Operator 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 7Featment and Disposal Systems' (15A 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. °V)1/61 . 11117 \ 09/27/2022 Authorized State Agent Permit Issuance Date 9/27/2027 Permit Expiration Date No grading or construction activity is allowed in areas designated for system and repair without approval of the Health Department. 10/12/2022 08:24 iOP ~ : �om yy v: i irill: by ! - r r PPP74hS' ral li # .1 li i il 1 I li IP I I I TE :;14 --3; t hi 1 I rli Iri Id 1 I 4)4 1` • as i • 11 il 1 ; i 111401 1. i VV-613 -C, 11/4 14 I ti :10; 1 ‘Z,."'. ) 11 1 1111 11 4 1 4 I il 111 lull ii opn; !litzlisP a i 4 1 3 !4 i ;I dill . ifil dj 1 't— p iii --`\1=:, a 1-- a 1 I 1 . a -,i; tqfill 0 00 1 R o a I! 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