HomeMy WebLinkAboutAUTH-10-2022-181685.TIF t
s41 _ CATAWBA COUNT' Case N AUTII-10.2022.I81685
y/�. Public Health Department Subthvision
r ' Environmental Health Division PINtt 279215546549
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f� I1r PO Box 359,25 Government Drive.Newon,NC 28658 I.OTM TR 1
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Sits Address: 1811 12TH AVE SW, HICKORY NC 28602
Nam on Permit: CHOUA THAO
Property Size: Acres 0.6
Directions: US 70,left onto 19th St SW, left onto 19th St SW, last home on the dirt road
Owner/Authorized Representative Acknowledgement of Permit Receipt
certify that I am the owner or authorized agent(owner's authorization required)representing the owner of
the property described above.
Xijr As the property owner or authorized representative,l have received the above referenced
permit(s)as requested in the application for service EHPR-09-2022-42287,by the following method(s):
Received in Person
Facsimile Transmittal(Return form with signature required)
IElectronic Image Transmittals E-mail (Return receipt required)
or-As the properly 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(1 SA NCAC 18A.1900),
and/or Well Construction Standards(ISA 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: 10/04/2022
Owner/Authorized Representative Signature_--_.-. `" _.- _.
Date r iig '2Z
Documentation of Permit(s)Transmittal
(permit transmitted by electronic or other means)
Permit transmitted by _.-_-_.___ (name of person sending permit)
..
Signature___. �.... ........._..._-._....__.._...__. Date/Time 10/1162,__
Method: Fax Ni Email US Mail Other
Owner's request to send by the above indicated method of transmittal in lieu of signature
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�i \ CATAW BA COUNTY Case# AUTH-10-2022-181685
i� 1 Public Health Department Subdivision
d .,. "j� Environmental Health Division PIN# 279215546549
PO Box 389,25 Government Drive,Newton,NC 28658 LOT# TR 1
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Site Address: 1811 12TH AVE SW, HICKORY NC 28602
Name on Permit: CHOUA THAO
Property Size: Acres 0.6
Directions: US 70, left onto 19th St SW, left onto 19th St SW, last home on the dirt road
Authorization to Construct Permit
Permit Category: Repairs Wastewater Flow: 360 g.p.d.
Type of Facility: Primary Residence-SFD
Basement? Yes Basement Plumbing? Yes Bedrooms: 3
Water Supply: Private Well Maximum Occupants: 6
Soil LIAR: g.p.d.Ift2
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: 1,000 gal
Pump Tank _gal Grease Trap_gal
Dosing Volume gal Pump Specs: GPM @ TDH
Pressure Head ft Draw Down in
Drainfieid: 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 EXISTING SEPTIC TANK
*NEW 1000GAL SEPTIC TANK
*NEW DISTRIBUTION BOX AND SUPPLY LINE
*RISERS REQUIRED
*50FT FROM WELL
*15FT FROM BASEMENT
*ALL GUTTERS SHOULD BE PIPED AWAY FROM DRAINFIELD
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.Ift2
Proposed System:
System Classification:
10/17/2022 10:07
44 r CATAWBACOUNTY Case# AUTH-I0-2022-181685
g(.......t. Public Health Department Subdivision
.eCQ � ,' Environmental Health Division PIN# 279215546549
�J PO Box 389,25 Government Drive,Newton,NC 28658 LOT# TR 1
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Site Address: 1811 12TH AVE SW, HICKORY NC 28602
Name on Permit: CHOUA THAO
Property Size: Acres 0.6
Directions: US 70, left onto 19th St SW, left onto 19th St SW, last home on the dirt road
The issuance of this permit by the I lealth 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' (15A NCAC I8A.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)94n [u4n3.
10/04/2022
Authorized State Agent Permit Issuance Date
10/4/2027
Permit Expiration Date
No grading or construction activity is allowed in areas designated for system and repair without approval of the Health Department.
chpennit 10/05/2022 14:38