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HomeMy WebLinkAboutIMPV-11-2022-184292.tif CATAWBA COUNTY Case# IMPV-11-2022-184292 r1116.1‘ PublicHealthDepartmentSubdivision ROCKINGHORSE RIDGE � w Environmental Health Division PINK 367704607282 �( � PO Box 389,25 Government Drive,Newton,NC 28658 LOTtt 9 Site Address: 4286 ANDERSON MOUNTAIN RD, MAIDEN NC 28650 Name on Permit: JAMES KMOSKO Property Size: Acres 0.64 Directions: NC 16 S, bear right onto Anderon Mountain Rd, property on the left Owner/Authorized Representative Acknowledgement of Permit Receipt y `t1 certify that I am the owner or authorized agent(owner's authorization required)representing the owner of the property described above. `1c-{ As the property owner or authorized representative, I have received the above referenced permit(s)as requested in the application for service EHPR-09-2022-42299,by the following method(s): Received in Person _ Facsimile Transmittal (Return form with signature required) .,J Electronic Image Transmittal/E-mail (Return receipt required) 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: 11/11/2022 Owner/Authorized Representative Signature -- Date 12/9/2022 Documentation of Permit(s)Transmittal (permit transmitted by electronic or other means) Permit transmitted by (name ofperson sending permit) r " j Signature Date/Time )1 tin. Method: Fax ,/ 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 yoiPlease ttake a few momentts tto complette our custtomer service survey att http://www.surveymonkey.com/s/EHCusttomerService i Om e$ )1,m-)0S1/o 0 g -- . tivA ,•hprunn 11/11/2022 15.20 f r ,111i3: e CATAWBA COUNTY Case tl IMPV-11-2022-184292 ti(........r rive,Newton,NC 28658, Public Health Department Subdivision ROCKING HORSE RIDGE d Y EnvPOBoxironment389a ,25l HealthGovernment DivisionDri PINt! 9367704607282 LOTH 8. . w Site Address: 4286 ANDERSON MOUNTAIN RD, MAIDEN NC 28650 Name on Permit: JAMES KMOSKO Property Size: Acres 0.64 Directions: NC 16 S, bear right onto Anderon Mountain Rd, property on the left 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 360 d 9.P. 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: 50%REDUCTION HORIZONTAL System Classification: IIIB-SYSTEM W/SINGLE EFFLUENT PUMP Pump Required Permit Conditions: *IP only for property purpose. *Do not drive,grade,cut or fill over any part of the initial or repair septic areas. *All septic system areas MUST remain 10 feet from property lines, 50 feet from neighboring wells,and 5 feet from building structure. 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 I Icalth 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. °I164Vt ()1gr‘ 11/11/2022 Authorized State Agent Permit Issuance Dale 11/11/2027 Permit Expiration Date No grading or construction activity is allowed in areas designated for system and repair without approval of the Health Department. dLpc,,iui 11/11/2022 15:28 Catawba County Environmental Health �/ 4 11 Di" ,'124Z- „ye II '[,11to U' .4278 1\ t 2�.1a 5a 1 lo '�$ uo Il .D4"ev/ay ' ,r`�`°\ SLQ c cia� ` YSe�kr' Pica �o4 y ' '. a •..1, Alto, 5 (t611a.0o � i_ go �`°�S� 25 * "E o�� o z3 Zt �yl '�- rIli 10 —A Itk 0 zDV° g so S 110.00429B Parcel: 367704607282, 4286 ANDERSON 1 in=40ft MOUNTAIN RD MAIDEN, 28650 This map/report product was prepared from tho Catawba County,NC Geospoctal Information Services. Catawba County has made substanbat efforts to ensure the accuracy of location and labeling Information conlolnod on this map or data on this report.Catawba County promotos and recommends the Independent verification of any data conlolnod on this map/roport product by the user.The County of Catawba,its employees,agents,and personnel,disclaim,and shall not be held liable for any and all damages,loss or'lability,whether direct,Indirect or consequential which anses or may arise from this map/report product or the use thereof by any person or entity. Copynght 2021 Catawba County NC 11/11/2022 DI.PARTMEN1 OF IIFALTII AND HUMAN SERVICES Sheet r�__��°I"�1 1.1ll�tt-1 DIVISION OF PI;RI IC I ILALTH.ENVIRONMENTAL HEALTH SECTION PROPERTY ID N. 6-47181 ON-SITI:WATER PROTECTION BRANCH COUNTY: C• F SOIL/SITE EVALUATION for ON-SITE WASTEWATER SYSTEM (Complete all fields in full) OWNER: �a e5 140)044 _ APPLICATION DATE ADDRESS:AQZ anLkte f Norse b f 1 Al 44•4 /Vt 216S0 DATE EVALUATED: PROPOSED FACILITY:ty ___ it PROPOSED DESIGN FLOW(.1949): 3Go GPO PROPERTY SIZE: O.eW ACIe LOCATION OF SITE: UZCa AY1,�$Ori Matsu+74t4 4 M4rdeil Art n(50 PROPERTY RECORDED: WATER SUPPLY: Ylrivate ❑Public i'—Well ❑Spring ❑Other EVALUATION METHOD: ❑Au r Boring i Yit ❑Cut TYPE OF WASTEWATER: L7Sewage 0 Industrial Process r Mixed P R U SOIL MORPHOLOGY OTHER I' (.1941) PROFILE FACTORS t .1940 L LANDSCAPE HORIZON POSITION/ DEPTH .1942 PROFILE q SLOPE% (IN-) .1941 .1941 SOIL .1943 .1956 .1944 CLASS STRUCTURFJ CONSISTENCE/ WETNESS/ SOIL SAPRO RESTR &LTAR TEXTURE MINERALOGY COLOR DEPTH CLASS HORIZ L 0--y ,5C $(J& f SS,4 SAC) 5 y- 3y C Salk S� Q 1 3 y-so C Mk a x 5s� 7 , 55 ° 50-53 CL 6C ,K( _sits?,` J74, . 2-5 C s 0-6 .. c 5ev f(55,fispf �S51( rr(0- Lio C i S/S5b�o Lig 2 go-y$ a tC o�L 55tS�.fQrY �°n• 0- 2 5 L. 5 0-9 se sale r;i s,s ,Sr f S Li-3b C 36f rI sis ,Spry 5 tl 3 0 3b -50 CL 1,.Mg rrf ss f sQ,SW o It. 0• 2975 C 5 °—� sy ss ,,,- + S 310 C. .kI� Jixp y3 4 3b-y3 et It46k rri rSiti sef 51. p. 7- 5 DFSCRIVI1ON INITIAI.SYSII:M Itl•PAIIt SYSTIiM Oil IER FACTORS(.1946): q_7�7 ° � f$ SITE CLASSIFICATION (.1948): [L Available Space(.1945) I 1�, ZS�f red 50�� yid EVALUATED BY: C��Af�(1L_1'l �''1 System Typc(s) 0 • an IER(S)PRESENT: Site I:TAR 0. l 5 O, 21-5 COMMENTS: _ Updated February 2014 Catawba County Environmental Health il- or1 �,Zt-N11C VP I co litIllicl g •4278 ID V. ® �t 2 �4 © w 3$ c 0 0 Q , IC C �•4286 t�` tri 110.00 O �out © o z ao� , o 3 222.32 l� �� Z 1 1H' 1a r �s J\? 0 1O1 13° 73 kJfl 60 $ 110.00 •4298 Parcel: 367704607282, 4286 ANDERSON 1in=40ft MOUNTAIN RD MAIDEN, 28650 This map/report product was prepared from the Catawba County,NC Geos alta1 Information Services. Catawba County has made substantial efforts to ensure the accuracy of location and labeling Information contalnod on this map or date on this report,Catawba County promotes and recommends the Independent verification of any dole conlalnod on this meplroporl product by the user.Thu County 01 Catawba.Its employees,agents.and personnel,disclaim,and shall not be hold labia for any and all damages,loss or liability,whether direct,Indirect or consequential which enses or may arise from this map/report product or the use thereof by any purson or wilily. Copyright 2021 Catawba County NC 11111/2022