HomeMy WebLinkAboutIMPV-10-2022-182185.TIF + f,1'I'AR'N,1(Qt' 'r\'�+,sr floc n Ib1I'V-Iti•2u22•I$2IX5
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'• .,w • i En iroruncntat Itcalth Division t'INir 269905190133
�' W 1't)Itos tlt9.23 Government Misc.Neswon.NC' 2Xhtih Hirer 85&86
Site Address: 1244 SHIREBOURN, HICKORY NC 28602
Nam on Permit: KURT&JILL BENFIELD
Property 31ze: Acres 2.430
Directions: 1244 Shireboum, Hickory
Owner/Authorized Representative Acknowledgement of Permit Receipt
x:. ertitr that I am the owner or authorized agent(owner's aulhorii:uion required)representing the ossner of
•property described abuse.
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As the property owner or aulhori/ed representative. I have rcceis ed the above referenced
ermit(s)as requested in the application for service RRPR-08-2022-42 )02. by the Ibllowing niethnd{st:
Received in Person
Facsimile Transmittal (Return firm with signature requited)
IElectronic Image"Transmittal/ -mail (Return receipt required)
15s
,4 Lh4the property owner or autharited represent;uiec l have revleased amid understand tine specific conditionshe permit issued, and further understand that all applicable regulatory' requirements specified under the
North Carolina Laws and Rules fur Sewage Treatment and Disposal Systems (1 SA 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 vxastew ater system and or water supply well permitted.
Permit Issue Date: 10112/2022
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OtsncrAuthoricrd Representative Sigma e
" Date I'v— /'z—2 L- ;',/ �/6v--•r' �,;/y,.---- '"
Documentation of Permit(s)Transmittal
(permit transmitted by electronic or other means)
Permit transmitted by brume(4 per•.srrrr.ir'rOtrr;permit/
Signature Date. time
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Method: Fax __ Email _US Mail __.—. ___."_��Other
Owner's request to send by the above indicated method of transmittal in lieu of signature
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http://www.surveymo n key.com/s/EHCusttomerServlce
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CATAWBACOUNTY Case# IMPV-102022-182185
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cPublic Health Department Subdivision DEERFIELD SUBD
Environmental Health Division PIN# 269905190133
PO Box 389,25 Government Drive,Newton,NC 28658 LOTH 85&86
Site Address: 1244 SHIREBOURN, HICKORY NC 28602
Name on Permit: KURT&JILL BENFIELD
Property Size: Acres 2.430
Directions: 1244 Shirebourn, Hickory
Improvement Permit
AN AUTHORIZATION TO CONSTRUCT MUST BE ISSUED PRIOR TO BUILDING PERMITS
THIS PERMIT IS NOT FOR SEPTIC INSTALLATION
Permit Category: Relocation Wastewater Flow 480 d
9•P•
Type of Facility: Primary Residence
Basement? No Basement Plumbing? No Bedrooms: 4
Water Supply: Maximum Occupants: 8
INITIAL SYSTEM SPECIFICATIONS
Existing Wastewater System: 25% REDUCTION
System Classification: IIIG-OTHER NON-CONY TRENCH SYSTEMS
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: *Relocation of repair area for proposed future pool area.
`Proposed new pool location MUST remain 15 feet from existing system area.
*DO NOT DISTURB EXISTING SEPTIC SYSTEM.
*Proposed office to contain bathroom which may be hooked into existing septic tank.
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 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.
°176f 1/117€4
10/12/2022
Authorized State Agent Permit Issuance Date
10/12/2027
Permit Expiration Date
No grading or construction activity is allowed in areas designated for system and repair without approval of the Health Department.
chpcnuit 10/13/2022 09:32
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Catawba County Environmental Health Ti„ -10_toit_ l$7)85
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Parcel: 269905190133, 1244 SHIREBOURN 1 in=80ft
HICKORY, 28602
This map/report product was prepared from the Catawba County,NC Geospallal Information Services, Catawba County has made substantial efforts
to ensure the accuracy of location and labeling Information contained on this map or dale on this report.Catawba County promotes and recommends
the Independent verification of any data contained on this mop/report product by the user,The County of Catawba,Its employees,agents.and
personnel,disclaim,and shall not bo held Ilabto for any and oil domagos,loss or liability,whether direct.Indirect or consequential which arises or may
arise from this map/report product or the use theroof by any person or entity.
Copyright 2021 Catawba County NC
10/12/2022
I)I I'ARIMLNT OF I IPA1.Tl1 AND I IIIMAN SERVICES Slue I of
OF
DIVISION PUBLIC'I ILAI A II.ENVIRONMENTAL.I I1iALT1I SECTION PROPERTY II)a j C j f 90/33
UN-SITE WATER PROTECTION BRANCH COUNTY Pr AwbA
SOIL/SITE EVALUATION
for ON-SITE WASTEWATER SYSTEM
(Complete all fields in lull)OWNER: / ta- 5i11 _B[ 11) _ APPLICATION DATE�(D/G
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ADDRESS:( DATE EVALUATED: 4 [�f72
PROPOSED FACILITY: f7 o�.)4- 1 PROPOSED DESIGN FLOW(.1949): (G�D PROPERTY SIZE: 2•t/3creS
LOCATION OF SITE: 12 al/+ 5 to bo LIU) HiTKarl IW zg-koz PROPERTY RECORDED:
WATER SUPPLY: F4rivate LI Public Ef WcII ❑Spring ❑Other
EVALUATION METHOD: C)Au cr Boring C Pit Cl Cut TYPE OF WASTEWATER: 1:3 ewage O Industrial Process [I Mixed
a I I
1'
11
0 SOIL MORPHOLOGY OTHER
I, (.1941) PROFILE FACTORS
I .1940
F. LANDSCAPE HORIZON
POSITION/ DEPTH
.1942 PROFILE
a SLOPE.% (IN.) .1941 .1941 SOIL .1943 .1956 .1944 CLASS
STRUCTURE/ CONSISTENCE/ WETNESS/ SOIL SAPRO RESTR <AR
TEXTURE r MINERALOGY COLOR DEPTH CLASS IIORIZ
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3
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1 0 33�-50 C �5K ss P 5L 50/ Ay ri
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s o_y L 6 Fri 5 6.5( 1 II ?..5
L/ Z� $6K Fr55 0PSNt
2 z(o -53 k ASS S 53
73% O.
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DE.SCRII'T(ON INITIAL SYSTEM REPAIR SYSrL'.M OTI 1ER FACTORS(.1946):
Av! ' sm.,:CLASSIFICATION(.I948): 3 —
Available Space(.1945) 1 fit ps
AI /1 5 O . 1 EVALUATED BY: M_44.4.akir
system"rype(s) lV /�1 �Q fed( , OTI IER(S)PRliS1iNT:
sit,LEAK MI4 0.3
COMMENTS:
Updaied February 2014
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Catawba County Environmental Health ^'Qf-Ip-2o11-I8Z185
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Parcel: 269905190133, 1244 SHIREBOURN 1in=80ft
HICKORY, 28602
This map/repon product was prepared from the Catawba Courtly.NC Geoapabal Infonrration Services. Catawba County has made substantial efforts
tp ensure the accuracy of location and labeling Information contained on this map or data on this report,Catawba County promotes and recommends
the independent venfoabon of any data contained on this rna 'report product by the user.The County of Catawba.Its employees,agents,and
personnel,drsclarn,and shall not be held liable for any and all damages,Iasi or liability,whether direct,Indirect or oortseguertital which arenas or may
arse from this map/report product or tho use thereof by any person or entity,
Copyright 2021 Catawba County NC
10112/2022