HomeMy WebLinkAboutIMPV-11-2022-184472.tif 138y. CATAWBA COUNTY
r/.t-a 0 Public Health Department SuhJivivon
1 s Environmental Health Division PING 374502683949
i\ PO Dot 389,25 Government Dive,Newton.NC 28658 I_0TH 1
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5It.Address: 6584 VALWOOD RD,CONOVER NC 28613
Name on Permit: TEEN CHALLENGE NORTH CAROLINA ADOLESCENT PROGRAM
Prop.rty Slu: Acres 2.50
Directions: Left off of St Peters Church Rd onto Valwood Rd.Large lot at the corner of Valwood Rd and Central Dr.
Owner/Authorized Representative Acknowledgement of Permit Receipt
F `J 11 certify that I am the owner or authorized agent(owner's authorization required)representing the owner of
the mperty described above.
s the property owner or authorized representative,I have received the above referenced
permit(s)as requested in the application for service RBPR-09-2022-42345,by the following method(s):
_ Received in Person
Facsimile Transmittal(Return form with signature required)
VElectronic Image Transmittal/E-mail (Return receipt required)
,i_ 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(1SA NCAC 18A.1900),
and/or Well Construction Standards(1SA NCAC 2C.0100), shall apply to the issuance of this permit and
the construction of the wastewater system and/or water supply well permitted.
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Permit Issue Date: 11/15/2022 .---
Owner/Autthari d Rep sentative Signature
Date O.,'
9-1 e."
Documentation of Permits)Transmittal
(permit transmitted by electronic or other means)
Pesmittransmitted by (name of person sending permit)
Signature i Date/Time
P. /rV
Method: Fax ' /Email US Mail Other
Owner's request to send by the above indicated method of transmittal In lieu of signature
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e CATAWBA COUNTY Case# IMPV-11-2022-184472
Public Health Department Subdivision
., Environmental Health Division PIN# 374502683949
PO Box 389,25 Government Drive,Newton,NC 28658 LOT# 1
Site Address: 6584 VALWOOD RD, CONOVER NC 28613
Name on Permit: TEEN CHALLENGE NORTH CAROLINA ADOLESCENT PROGRAM
Property Size: Acres 2.50
Directions: Left off of St Peters Church Rd onto Valwood Rd. Large lot at the corner of Valwood Rd and Central Dr.
Improvement Permit
AN AUTHORIZATION '1'O CONS'I'RUCI'MUST BE ISSUED PRIOR TO BUILDING PERMITS
THIS PERMIT IS NOT FOR SEPTIC INSTALLATION
Permit Category: New Septic Wastewater Flow 360 g.p.d
Type of Facility: Primary Residence-SFD
Basement? No Basement Plumbing? NO Bedrooms: 3
Water Supply: Public Water 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: IIIB-SYSTEM W/SINGLE EFFLUENT PUMP
Pump Required
Permit Conditions: *DO NOT CUT OR FILL OVER SEPTIC AREA
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 or 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.
/771.............. ...... I „ Ev4Ns
11/15/2022
Authorized State Agent Permit Issuance Date
11/15/2027
Permit Expiration Date
No grading or construction activity is allowed in areas designated for system and repair without approval of the Health Department.
A pe 5 12/07/2022 16:02
Catawba County Environmental Health
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Parcel: 374502683949, CONOVER, 28613 1in=60ft
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Copyright 2021 Catawba County NC
11/15/2022