HomeMy WebLinkAboutIMPV-11-2022-185206.TIF r .
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t. Public Health Department Subdivision HUNTERS CHASE PH 2
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ti Environmental Health Division I'INIl 372308775673
Po Box 389,25 Government Drive.Newton.NC 28658 1.0TO 30
Site Address: 4468 STEEPLE CHASE DR, HICKORY NC 28601
Name on Permit: SCOTT MILLER
Property Size: Acres 0.69
Directions: Section House RD, Left Hunters Chase, Right Steeplechase DR,3rd house on right
Owner/Authorized Representative Acknowledgement of Permit Receipt
XI certify that I am the owner or authorized agent(owner's authorization required)representing the owner of
the property described above.
As the property owner or authorized representative, I have received the above referenced
permit(s)as requested in the application lOr service RBI'R-07-2022-41623,by the following method(s):
Received in Person
/Facsimile Transmittal (Return form with signature required)
V Electronic Image Transmittal/E-mail (Return receipt required)
SAs 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 (I5A NCAC I8A.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.
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Permit Issue i)ate: 11/29/2022
Owner/Authorized Representative Signature
Date _..1 Z ' V - 2 0 ZZ
Documentation of Permit(s)Transmittal
(permit transmitted by electronic or other means)
Permit transmitted by s (name a/person scrrclinf;permit)
Signature . CI V Date/'Time ji)( of C Z-
Method: Fax V Email US Mail Other
Owner's request to send by the above indicated method of transmittal in lieu ot'signature
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:. ('ATAWBA COU NTY Case# IMPV-1 I-2022-185206
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1~(.1.,ii 2 Public Health Department Subdivision HUNTERS CHASE PH 2
'-'I Environmental Health Division PIN# 372308775673
PO Box 389,25 Government Drive,Newton,NC 28658 LOP/ 30
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Site Address: 4468 STEEPLE CHASE DR, HICKORY NC 28601
Name on Permit: SCOTT MILLER
Property Size: Acres 0.69
Directions: Section House RD, Left Hunters Chase, Right Steeplechase DR, 3rd house on right
Improvement Permit
AN AUTHORIZATION TO CONSTRUCT MUST BE ISSUED PRIOR TO BUILDING PERMITS
THIS PERMIT IS NOT FOR SEPTIC INS'I'ALLAI'ION
Permit Category: Relocation Wastewater Flow 480 d
9•P.
Type of Facility: Primary Residence- SFD
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: IIIE- PPBPS GRAVITY DOSED SYSTEM
REPAIR SYSTEM SPECIFICATIONS
Repair System Required? Required
Proposed Wastewater System: 50%REDUCTION VERTICAL
System Classification: VA-SAND FILTER PRETREATMENT
Pump Required ***** Operator Required
Permit Conditions: *DO NOT CUT OR FILL OVER SYSTEM 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 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' (I5A 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!With authorization or permit
modification.Please notify Environmental Health of this change prior to system installation.
/ 17/71...............,-- ,t 5,4HS
11/29/2022
Authorized State Agent Pennit Issuance Date
11/29/2027
Permit Fspiration Date
No grading or construction activity is allowed in areas designated for system and repair without approval of the Health Department.
ehpennit 12/06/2022 16:37