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,y' �-�1 Public Health Department Subdivision BLACKBURN RIDGE PH 2
It ,��ef Environmental Health Division PIN# 361702577095
�\ 11, PO Box 389,25 Government Drive,Newton,NC 28658 I.()'I'# 26
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Site Address: 3394 SWEETGUM LN, LINCOLNTON NC 28092
Name on Permit: KEVIN&MARK COX
Property Size: Acres 0.53
Directions: Left off of Blackburn Bridge Rd onto Woodgreen Dr. Right onto Sweetgum Ln. 6th lot on left,end of cul-de-sac.
Owner/Authorized Representative Acknowledgement of Permit Receipt
I certify that I am the owner or authorized agent(owner's authorization required)representing the owner of kC__
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the property described above.
C-_ As the property owner or authorized representative, I have received the above referenced
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permit(s)as requested in the application for service RBPR-08-2022-41945, by the following method(s):
Received in Person
Facsimile Transmittal (Return form with signature required)
4 Electronic Image Transmittal/E-mail (Return receipt required)
<C As the property owner or authorized representative I have reviewed and understand the specific conditions
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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(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: 10/12/2022
Owner/Authorized Representative Signature /-<:0\1 \-, e& 51
Date 10/25/2022
Documentation of Permit(s)Transmittal
(permit transmitted by electronic or other means)
Permit transmitted by (name of person sending permit)
SignatureC4E- Date/Time /0/26:h___) _
Method: Fax J Email US Mail Other
Owner's request to send by the above indicated method of transmittal in lieu of signature
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$• • CATAWBA COUNTY Case it AUI'H-I0-2022-182165
H f ?- Public Ilealth Department Subdivision BLACKBURN RIDGE PH 2
Environmental Health Division PINfi 361702577095
PO Box 389,25 Government Drive.Newton,NC 28658 10•!•1; 26
18 w
Site Address: 3394 SWEETGUM LN, LINCOLNTON NC 28092
Name on Permit: KEVIN&MARK COX
Property Size: Acres 0.53
Directions: Left off of Blackburn Bridge Rd onto Woodgreen Dr. Right onto Sweetgum Ln.6th lot on left,end of cul-de-sac.
Authorization to Construct Permit
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
Soil LTAR: 0.3 g.p.d./ft2
WASTEWATER SYSTEM REQUIREMENTS
Proposed Wastewater System: 25% REDUCTION
System Classification: IIIG -OTHER NON-CONY TRENCH SYSTEMS
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
Drainfield: Total Area: 900 sq ft Total Trench Length: 300 ft
Aggregate Depth: in Maximum Trench Depth on Downhill Sidewall: 30 in
Minimum Soil Cover: 6 in Minimum Trench Separation: 9 ft on center
Number of Drain Lines: 6 Trench Width: 3 ft
Distribution: Serial
Pre Treatment: NONE
Additional Specifications:
"Do not drive,grade, cut or fill over any part of the initial or repair septic areas.
"Install new 1000 gal septic tank and 300 feet of 25%reduction product according to manufacturer
specifications.
*All parts of the septic system area(including repair) MUST remain 10 feet from property lines, 50 feet from
existing wells/well area,and 5 feet from building structure(including decks/porches).
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? Required Soil LTAR: 0.275 d.lft2
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Proposed System: 50%REDUCTION HORIZONTAL
System Classification: IIIB-SYSTEM W/SINGLE EFFLUENT PUMP
Pump Required
i 0n20/2022 I 2:07
A� CATAWBA COUNTY Case AUTII-10-2022-182165
4Q - Public Health Department Subdivision BLACKBURN RIDGE PH 2
< '1 Environmental Health Division PIN# 361702577095
PO Box 389,25 Government Drive,Newton,NC 28658 LOT# 26
1• .2 w
Site Address: 3394 SWEETGUM LN,LINCOLNTON NC 28092
Name on Permit: KEVIN&MARK COX
Property Size: Acres 0.53
Directions: Left off of Blackburn Bridge Rd onto Woodgreen Dr.Right onto Sweetgum Ln.6th lot on left,end of cul-de-sac.
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 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' (I 5A 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.
3/),49 — (1°W176
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.
c imerm i i 10/20/2022 12:07