HomeMy WebLinkAboutIMPV-10-2022-182757.TIF ('ATA11'IIA('Ol N IN
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Site Address: 3557 MELICA DR.TERRELL NC 28682
Name on Permit: DAVID ROSE
Property Size: Acres 0.99
Directions: 1-77 exit 36, NC-150 W to Greenwood Rd, turn left on Melica Drive, home is on the right
Owner/Authorized Representative Acknowledgement of Permit Receipt
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I ccrtitt that I am the inner or: ++
uithuriied agent toner's authorization required)representing the(miler of
the proper() described ahot c.
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XAs the property owner or authorized representative. I have received the above referenced
permit(s)as requested in the application for service IEIIPR-t 1-21121-39289.by the li)ilowing method(s):
Received in Person
Facsimile Transmittal (Return form with signature required)
JElectronic image Transmittal/F-mail (Return receipt required)
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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 Lases and Rules fur Sewage Treatment and Disposal Systems (15A N('A( 18A.1900),
and/or Well Construction Standards(I5A NCAC 2C .011111), shall apply to the issuance(Willis permit and
the construction of the wastewater system and/or water supply well permitted.
Permit Issue Date: 10/21/2022
Owner•Authorized Representative Signature Lenot i.�o' learz,�.• (r':YN,e-a'
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Date (o-•17'-,2d,,:•� 7
Documentation of Permit(s)Transmittal
(permit transmitted by electronic or other means
Permit transmitted by (name 1,//)er.srn)semlinc'permit)
Signature ti_ Date.'I'itnc 10/JU/))
F Method: __ ax J Email _11S Mail Other
Owner's request to send by the above indicated method of transmittal in lieu of signature
We wantt tto hear from yoiPiease ttake a few momentts tto complette our custtomer service survey att
http://www.surveymonkey.com/s/EHCusttomerService
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A=� CATAWBA COUNTY Cased IMPV-10-2022-182757
FT t Public Health Department Subdivision HIDDEN HARBOR
„y(,, "j Environmental Health Division PIN# 461712874452
PO Box 389,25 Government Drive,Newton,NC 28658 LP
6
IH42 sM
Site Address: 3557 MELICA DR,TERRELL NC 28682
Name on Permit: DAVID ROSE
Property Size: Acres 0.99
Directions: 1-77 exit 36, NC-150 W to Greenwood Rd, turn left on Melica Drive, home is on the right
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 d
9p
Type of Facility: Primary Residence
Basement? Yes Basement Plumbing? Yes Bedrooms: 4
Water Supply: Public Water Maximum Occupants: 8
INITIAL SYSTEM SPECIFICATIONS
Proposed Wastewater System: 50%REDUCTION VERTICAL
System Classification: IVA-ANY SYSTEM WITH LPP DISTRIBUTION
Pump 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: *ALL WATER MUST BE TURN 15 FEET MIN. FROM DRAINFIELDS BEFORE
AUTHORIZATION TO CONSTRUCT IS ISSUED.
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'(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.
Z- Zse ____
10/21/2022
Authorized Slate Agent Permit Issuance Date
10/21/2027
Permit Expiration Date
No grading or construction activity is allowed in areas designated for system and repair without approval of the Health Department.
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DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
Shea—of____
E3 DIVISION OF EN!'IRONMENTAL HEALTH PROPERTY ID#:
r ON-SITE WASTEWATER SECTION COUNTY:
SOIL/SITE EVALUATION
�) for ON-SITE WASTEWATER SYSTEM
OWNER: i 1 t./' -' APPLICATION DATE
.3 ADDRESS: DATE EVALUATED: /c() (Jt,2
LOOPOSED FAOF SITE:
L- P1 ''ti SYDESI{ (e1 QI /t PROPERTY RECORDED:
LOCATIONROPERTY STZE:
OF SITE: i� �� r l
WATER SUPPLY: 0 Private Public 0 Well 0/s '' g 0 Other
EVALUATION litEl'HOD: 0 • _er Boring i !1 Cut •
TYPE OF WASTEWATER: 1 ewage 0 Industrial Process 0 Mixed
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rDESCRIPTION I1.'IFLlL SYSTEM ' REPAIR$YST Fjd i
OTHER FACTORS(.1946):
IAvailable Space(•1945) Pi e5 SITE CLASSIFICATION(,I948): e--�
1 System Typxs) .5— Q'4, d EVALUATED BY: d/ .}q E vet 1S
Site LIAR OTHER(S)PRESENT:
COMMENTS: }
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Catawba County Environmental Health
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Parcel: 461712874452, 3557 MELICA DR 1 in=54ft
TERRELL, 28682
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03/17/2022