HomeMy WebLinkAboutIMPV-10-2022-182895.tif 4411111 CATAWBA COUNTY
4+ .) Public Health Department Subdivision
r
e, ' Environmental Health Division PINH 267902575231
III
PO Box 389,25 Government Drive,Newton,NC 28658 LOTH 2
SIte Address: 7800 GREEDY HWY,HICKORY NC 28602
Name on Permit: 'JEFFERSON HULL
Property Size: Acres 2.492
Directions: Hwy 127 S, Right onto Greedy Hwy, Last rlveway on the Right at Old Shelby Rd
Owner/Authorized Representative Acknowledgement of Permit Receipt
l certify that I am the owner or authorized agent(owner's authorization required)representing the owner of
the property described above.
4 As the property owner or authorized representative,I have received the above referenced
as re requested in the application for service RBPR-09-2022-42254,bythe followingmethods :
permit(s) q pp ( )
_ Received in Person
Facsimile Transmittal(Return form with signature required)
_
Electronic Image Transmittal/E-mail (Return receipt required)
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(I5A NCAC 18A.1900),
and/or Well Construction Standards(I5A 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: 10/24/2022 /�
Owner/Authorized Representative Signature �/-C ,--
/( y� o
Date f Z ZZ-_
Documentation of Permit(s)Transmittal
(permit transmitted by electronic or other means)
Permit transmitted by (name of person sending permit)
Signature Date/Time I1/Is/ ?L
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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�ie CATAWBA COUNTY Case# IMPV-10-2022-182895
�Q .t. Public Health Department Subdivision
d '� Environmental Health Division PIN# 267902575231
`C
PO Box 389,25 Government Drive,Newton,NC 28658 LO'f# 2
/8. sw
Site Address: 7800 GREEDY HWY, HICKORY NC 28602
Name on Permit: "JEFFERSON HULL
Property Size: Acres 2.492
Directions: Hwy 127 S, Right onto Greedy Hwy, Last riveway on the Right at Old Shelby Rd
Improvement Permit
AN AUTHORIZATION TO CONSTRUCT MUST BE ISSUED PRIOR TO BUILDING PERMITS
THIS PERMIT IS NO"I'FOR SEPTIC INSTALLATION
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
INITIAL SYSTEM SPECIFICATIONS
Proposed Wastewater System: 25%REDUCTION
System Classification: IIIG-OTHER NON-CONY TRENCH SYSTEMS
REPAIR SYSTEM SPECIFICATIONS
Repair System Required? Required
Proposed Wastewater System: 25%REDUCTION
System Classification: IIIG-OTHER NON-CONY TRENCH SYSTEMS
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 Treatment and Disposal Systems' (15A NCAC I 8A.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.
344rt if) r\
10/24/2022
Authorized State Agent Permit Issuance Date
10/24/2027
Permit Expiration Date
No grading or construction activity is allowed in areas designated for system and repair without approval of the Health Department.
*moot 10/25/2022 08:18
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I)I PARTMENT OF HEALTH AND HUMAN SERVICES Sheet-!—of I_
DIVISION OF PUBLIC HEALTH.ENVIRONMENTAL HEALTH SECTION PROPERTY ID#:ON-SITE WATER PROTECTION BRANCH COUNTY: Q IW11a_
SOIL/SITE EVALUATION
for ON-SITE WASTEWATER SYSTEM
(Complete all fields in full)
OWNER: et D _ APPLICATION DATE giAt
ADDRESS (�r{e �./%t i� N[ (/OZ DATE EVALUATED:r
PROPOSED FACILITY: /Vet.,' )k!l ✓ PROPOSED ESIGN FLOW(.1949): 317O 6A6 PROPERTY SIZE: 33. 1 4Lr%f
LOCATION OF SITE: ?f 64 Ay fii e4 A/( Z 8.&°Z PROPERTY RECORDED:
WATER SUPPLY: �3 Private ❑ Pubic Well 0 Sp ' g ❑Other
EVALUATION METHOD: Cl Auer Boring Pit 0 Cut TYPE OF WASTEWATER: Er/Sewage Sewage L Industrial Process :7 Mixed
• • •
P
R
o SOIL MORPHOLOGY OTHER
F (.1941) PROFILE FACTORS
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E LANDSCAPE HORIZON
POSITION/ DEPTH .1942 PROFILE
or SLOPE% (IN.) .1941 .1941 SOIL .1943 .1956 .1944 CLASS
STRUCTURE/ CONSISTENCE! WETNESS! SOIL SAPRO RESTR <AR
TEXTURE MINERALOGY COLOR DEPTH CLASS HORIZ
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COMMENTS:
Updated February 2014
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