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Home My WebLink AboutIMPV-12-2022-186283.TIF • s` + cATAwBA Cot'N'r • case d IMPV-12-2022.18b2t(3 ii(..... t�1� Public Ilealth Ikpanment Subdivision 3. RJli Emironmenlal health Ihvlsinn f'INu 3169904733197 PO I3oa 3AY,25(iovernmcnt Unvc.Newton,Nt' 2865t 11 I a 1 Site Address: 1996 HOPEWELL CHURCH RD, SHERRILLS FORD NC 28673 Name on Permit: KELLY FORD Property Size: Acres 3.493 Directions: E NC 150, left Sherrills Ford Rd,right Hopwell Church Rd approx 1/4 mile on left Owner/Authorized Representative Acknowledgement of Permit Receipt IL I certify that I am the owner or authorized agent(owner's authorization required)representing the owner of 11( the property described abuse. h.As the property owner or authorised representative. I have received the above referenced permit(s)as requested in the application for service EIIPR-10-2022-42479, by the following method(s): Received in Person / Facsimile Transmittal (Return firm with signature required) Electronic Image'I'ransmittal/ 1.-mail (Return receipt required) 1.A As the property owner or authorized representative I ha%e reviewed and understand the specific conditions issued, applicablerequirements specified the permit and further understand that all regulatory .pecttted under the North Carolina Laws and Rules for Sewage Treatment and Disposal Systems(I 5A NCAC 18A.1900), and/or Well Construction Standards (ISA 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: 12/16/2022 ` �� Owner/Authorized Representative Signature Lill Date I / o )a Da 3 Documentation of Permit(s) Transmittal (permit transmitted by electronic or other means) Permit transmitted by (mime(?I'person s 'puling permit) Signature I)ate,'I'ime i i)/)3 Method: Fax Email (IS Mail Other Owner's request to send by the above indicated method of transmittal in lieu of signature We wantt tto hear from yatirlease ttake a few momentts tto complette our custtomer service survey att http://www.surveymonkey.com/s/ HCusttomerService 1.4 .\_0,ie 0 I c �titfi .Ei� �� t2-Ih!u22 111$ CATAWBACOUNTY Case# Public Health Department Subdivision IMPV-12-2022-I86283 Environmental Health Division PIN# 369904733197 PO Box 389,25 Government Drive,Newton,NC 28658 LOT# 1 w Site Address: 1996 HOPEWELL CHURCH RD, SHERRILLS FORD NC 28673 Name on Permit: KELLY FORD Property Size: Acres 3.493 Directions: E NC 150, left Sherrills Ford Rd, right Hopwell Church Rd approx 1/4 mile on 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 g.p.d Type of Facility: Primary Residence 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 VERTICAL System Classification: IVA-ANY SYSTEM WITH LPP DISTRIBUTION Pump Required ***** Operator Required Permit Conditions: *Do not cut, drive, fill, or grade over septic or repair areas. *This is an improvement permit only and is not intended for septic installation purposes. 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 I8A.1900). Neither Catawba County nor the Environmental I lealth 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. .. ,-- 7%......... 12/16/2022 Authorized State Agent Permit Issuance Date 12/16/2027 Permit Expiration Date No grading or construction activity is allowed in areas designated for system and repair without approval of the Ilealth Department. chiw,wit 12/16/2022 14:48 ItP E 4/Q /o-20z2- ti2Y17 Catawba County Environmental Health iiitev ii.7ozz- 1nz83 I20,) t h 1 py 0 U. a * 8 ti ti r- (206) ,i 01• 760 CJ a U (211 i / 4. o^. l21 .1996 t•-i° 5,0 r C3 .3 cv (1g51 _ _ fgs' �o 3 J ' °t (1?9) " �/ La 5s, 1.4 4 it 19 .3- • rs'Ariy id, d Ir. w Parcel: 369904733197, 1996 HOPEWELL 1 in=100ft CHURCH RD SHERRILLS FORD, 28673 This map/report product was prepared from the Catawba County,NC Geospatial Information Services. Catawba County has made substantial efforts to ensure the accuracy of location and labeling information contained on this map or data on this report. Catawba County promotes and recommends the independent verification of any data contained on this map/report 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 liability,whether direct,indirect or consequential which arises or may arise from this map/report product or the use thereof by any person nr entity. Copyright 2021 Catawba County NC 12/16/2022 DEPARTMENT OF HEALTH AND HUMAN SERVICES Sheet ( of l DIVISION OF PUBLIC HEALTH,ENVIRONMENTAL HEALTH SECTION 4 PROPERTY ID#: ON-SITE WATER PROTECTION BRANCH -I Z y ( COUNTY:_Catawba_ SOIL/SITE EVALUATION for ON-SITE WASTEWATER SYSTEM +/ , (Complete all fields in full) OWNER: /4a1ki Ia/- _ APPLICATION DATE ADDRESS: DATE EVALUATED: ((/2c /ZZ PROPOSED FACILITY: tube j$r PROPOSED DESIGN FLOW(.1949): 360 PROPERTY SIZE: LOCATION OF SITE: /QQ6 fb t. J( Cku1"41 tom. PROPERTY RECORDED: WATER SUPPLY: 0 Private 0 Public B/Vell 0 Spring ❑Other EVALUATION METHOD: ❑Auger Boring RiPit 0 Cut TYPE OF WASTEWATER: ❑Sewage 0 Industrial Process 0 Mixed • • • • P R SOIL MORPHOLOGY OTHER 0 i F (.1941) PROFILE FACTORS 1 .1940 L LANDSCAPE HORIZON E POSITION/ DEPTH 1942 PROFILE # SLOPE% ON.) .1941 .1941 SOH.. .1943 .1956 .1944 CLASS STRUCTURE/ CONSISTENCE! WETNESS/ SOIL SAPRO RESTR &LTAR TEXTURE ��-�MINERALOGY COLOR DEPTH CLASS HORIZ 0—00 51k- G / ,.St I N rv4- r✓4 prf 1 LS, /-IS' USdk s2CL /-2 - "/ /� f rayt 4 c k O. '� �f ": L5 —? sic 1- r✓L 5c= Q•� c .. � 1 ;� 7-23 set_ rL. cc- R NI '1c:t '''4'.:.*, k:; --3 kAL C /-t S c—. Q ° Fi7 .ti s S .3/-5 I kSSk. et_ (`ie Se '(6, lorzTft -/ S&L L Fe - �,7 3 LS l S-..3 3 (/f-XP G f=7 SF 0 10y4 7/4 1). ?S- 4 /Ox 3.3—zt5 w.t6' ccrA; fe. <-(--- le/4 y 5-.S-y 41S6rc .e L ;! , ) se- K�i� • ,;. o_r; '' - S c vt=d2 .Sc-- 6 y 5 stiff ;-r// ✓'S` L 5 S"- ILI ,Sz l' C ne SN R c., !s/c scc '. z- 7-3-417 DESCRIPTION INITIAL SYSTEM REPAIR SYSTEM OTHER FACTORS(.1946)- Available Space(.1945) PS 6 SITE CLASSIFICATION(.1948): ('S s ' EVALUATED BY: �'�.., (L System Type(s) 2 SS' 4J- - j OTHER(S)PRESENT: Site LTAR 0, Z5"-- Zr COMMENTS: Updated February 2014 A- _. - 4 . y247q Catawba County Environmental Health ,... i (c),j .\\-\\ ,,,., , -,. ....„ 9 i ' \ \ 41 i '..,,.•s',. • • ` / `/ s ti • • tri ,1 r i 11 r .1960 t r J l i • ' f 1 t r J i t Si r __,r II 1 �i r 1r �' I '- ,_irit r r i i (206 ' y II � „� I \ , . i7 p t1 a • 4 �+ a 1976,�� ' �� << 11 , \ p 1 �! t` 1 r 'II ;k I il ,1 1.4 1 —r I 1 l ! �'s. . ....,..F/I, i •1992 .r �• I 2 �' ' r r ' 0 IN. 4," \-"" p0 \ 1 1 I ilf 1/1 ;, '1 —_ a 1 _ (21 ---- > a 1996 `',� -�`�,.i s) r oy, to \\:\\ t. (res ...-- " ".,- t4 \\\49 I.2r15,4. !}• / 1 7 c? ...,. (;;9) --- s5o it, f. . tr, \ NtSitt \ / __.---_ _ aff-----.„. 1:3:// Jo, VP, Parcel: 369904733197, 1996 HOPEWELL 1 in=100ft CHURCH RD SHERRILLS FORD, 28673 This map/report product was prepared from the Catawba County,NC Geospatial Information Services. Catawba County has made substantial efforts to ensure the accuracy of location and labeling information contained on this map or data on this report.Catawba County promotes and recommends the independent verification of any data contained on this map/report 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 liability,whether direct,indirect or consequential which arises or may arise from this map/report product or the use thereof by any person or entity. Copyright 2021 Catawba County NC 12/16/2022