HomeMy WebLinkAboutAUTH-11-2022-183605.TIF 4101114144 CATAWBA COUNTY r
fs r Public Health Department ♦ Subdivision AARON H LAIL
i 1 s Environmental Health Division PINff 460703144409
Illoirdif PO Box 389.25 Government Drive.Newton.NC 28658 LOTt 7
Site Address: 3868 LANDMARK DR.SHERRILLS FORD NC 28673
Name on Permit JONATHAN HART
Property Size: Acres 0.49
Directions: Hwy 150 to Little Mt Rd,Little Mt Rd,to Landmark Dr,Property on Lakeside
Owner/Authorized Representative Acknowledgement of Permit Receipt
rMl certify that I am the owner or authorized agent(owner's authorization required)representing the owner of
f` the properly described above.
-)C- L3 As the property owner or authorized representative, I have received the above referenced
permit(s)as requested in the application for service RBPR-03-2021-37020,by the following method(s):
_ Received in Person
Facsimile Transmittal (Return form with signature required)
iElectronic. Image Transmittal/E-mail (Return receipt required)
kzeml 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 Laws and Rules for Sewage Treatment and Disposal Systems(15A 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: 11104l2022
�f Owner/Authorized Representative Signature
C Date /i'!)— a,.a,
Documentation of Permit(s)Transmittal
(permit transmitted by electronic or other means)
Permit transmitted by,. (name of person sending permit)
LK Signature Date/Time i 1(j 71))
Method: Fax 1 Email US Mail Other
Owner's request to send by the above indicated method of transmittal in lieu of signature
We wantt tto hear from yoi.rPlease ttake a few momentts tto complette our custtomer service survey att
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CATAWBA COUNTY Case# AUTH-11-2022-183605
Ailobo
1,.., AR ./,( Public Health Department Subdivision AARON H LAIL
d H Environmental Health Division PIN# 460703144409
PO Box 389,25 Government Drive,Newton,NC 28658 Lon 7
Ig sw
Site Address: 3868 LANDMARK DR, SHERRILLS FORD NC 28673
Name on Permit: JONATHAN HART
Property Size: Acres 0.49
Directions: Hwy 150 to Little Mt Rd, Little Mt Rd,to Landmark Dr, Property on Lakeside
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 LIAR: .35
g.p.d.lft2
Proposed System: 50%REDUCTION HORIZONTAL
System Classification: VA-SAND FILTER PRETREATMENT
Pump Required ***** Operator Required
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' (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.
1
11/04/2022
Authorized State Agent Permit Issuance Date
11/4/2026
Permit Expiration Date
No grading or construction activity is allowed in areas designated for system and repair without approval of the Health Department.
c'11,�'""i 11/152022 10:45