HomeMy WebLinkAboutIMPV-12-2022-186608.TIF oliVf CATAWBA COUNTY Caseii IMPV-12-2022-186608
1-- Public Health Department Subdivision
� w Environmental Health Division PINH 461902556538
��, PO Box 389,25 Government Drive,Newton,NC 28658 LOTH
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Site Address: 8511 DOG LEG RD,SHERRILLS FORD NC 28673
Name on Permit DAVID&UTIMANN p2
Property Size: Acres 11
Directions: Mollys Backbone Rd,Azalea Rd,left Dog Leg Rd on right
Ohvmen
��certify that I am the ownerwner/Aut or authororizediRepresentatized agent(owner'se authoriAcknowledgezation required)representingtof thePermit Receipt owner of
the property described above.
Cs the property owner or authorized representative, I have received the above referenced
permit(s)as requested in the application for service EHI'R-09-2022-42399, by the following method(s):
Received in Person
__ Facsimile Transmittal (Return form with signature required)
I Electronic Image Transmittal/E-mail (Return receipt required)
s 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(1 SA 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: 12/27/2022
Owner/Authorized Representative Signature 4. ��<� ---- -
Date ///2 Z 3
Documentation of Permit(s)Transmittal
(permit transmitted by electronic or other means)
Permit transmitted by _ (name of person sending permit)
Signature Date/"rime t/t��3_
Method: Fax I 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 yo&Please ttake a few momentts tto complette our custtomer service survey att
http://www.surveymonkey.com/s/EHCusttomerService
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�'e CATAWBA COUNTY Cased IMPV-12-2022-186608
461902556538
.t. Public Health Department Subdivision
Environmental Health Division I'INq
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PO Box 389,25 Government Drive,Newton,NC 28658 I,OTk
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Site Address: 8511 DOG LEG RD, SHERRILLS FORD NC 28673
Name on Permit: DAVID REUTIMANN
Property Size: Acres 11
Directions: Mollys Backbone Rd, Azalea Rd, left Dog Leg Rd on right
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
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: IIIE-PPBPS GRAVITY DOSED SYSTEM
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 Sewace 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 Health authorization or permit
modification.Please notify Environmental Health of this change prior to system installation.
i
12/27/2022
Authorized State Agent Permit Issuance Date
12/27/2027
Permit Expiration Date
No grading or construction activity is allowed in areas designated for system and repair without approval of the Health Department.
chpeinui 01/13/2023 07:58