HomeMy WebLinkAboutIMPV-01-2023-187443.TIF L Public health Department Subdivision KINGSWAY
" Environmental Health Division PI NI: 269905290976
- PO Box 389.25 Government Drive.Newton,NC 28658 LO'fk 16
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Site Address: 5806 KINGSWAY BLVD, HICKORY NC 28602
Name on Permit: MARIUS BAHNEAN
Property Size: Acres 0.57
Directions: 127 South right on Kingsway Blvd
Owner/Authorized Representative Acknowledgement of Permit Receipt
LIP, 1 certify that 1 am the owner or authorized agent(owner's authorization required)representing the owner of
the described above.
property
11 I t 3 As the property owner or authorized representative, I have received the above referenced
permit(s)as requested in the application for service RBPR-12-2021-39572,by the following method(s):
Received in Person
r Facsimile Transmittal (Return form with signature required)
J Electronic Image Transmittal!E-mail (Return receipt required)
(LAP.) As the property owner or authorized representative I have reviewed and understand the specific conditions
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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.
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Permit Issue Date: 01/11/2023
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Owner/Authorized Representative Signature (/ Ci
Date ___�, C)/.Z .
Documentation of Permit(s)Transmittal
(permit transmitted by electronic or other means)
Permit transmitted by (name of percnn sending permit)
n Signature Date./"fime )P1 U1
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Method: ' Fax Y Email US Mail Other
Owner's request to send by the above indicated method of transmittal in lieu of signature
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�� CATAWBACOUNTY Case IMPV-01-2023-187443
, Public Health Department Subdivision KINGSWAY
\k.)Q�.�(:\ 3 Environmental Health Division PIN# 269905290976
\\ _ PO Box 389,25 Government Drive,Newton,NC 28658 LOT# 16
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Site Address: 5806 KINGSWAY BLVD, HICKORY NC 28602
Name on Permit: MARIUS BAHNEAN
Property Size: Acres 0.57
Directions: 127 South right on Kingsway Blvd
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: Public Water Maximum Occupants: 6
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: IIIB-SYSTEM W/SINGLE EFFLUENT PUMP
Pump Required
Permit Conditions:
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 arc 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'(l5A 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 he used for an accepted system without Environmental I lealth authorization or permit
modification.Please notify Environmental Health of this change prior to system installation.
4iiietkePeek;el) 01/11/2023
Authorized State Agent Pemtit Issuance Date
1/11/2028
Permit Expiration Date
No grading or construction activity is allowed in areas designated for system and repair without approval of the Health Department.
cLprtnu� 01/20/2023 13.12
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Catawba County Environmental Health
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Parcel: 269905290976, 5806 KINGSWAY BLVD lin=50ft
HICKORY, 28602
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 dela 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(hereof by any person or entity.
Copyright 2021 Catawba County NC
12/29/2022
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES Sheet L of'
DIVISION OF ENVIRONMENTAL HEALTH PROPERTY ID W:2499 vs1R()gib
.ON-SITE WASTEWATER SECTION COUNTY: G A t6 A,1,01
SOIL/SITE EVALUATION
for ON-SITE WASTEWATER SYSTEM
OWNER: a r►S-1-U 0/1 /If t elm I.% APPLICATION DATE 3//4,22, •
ADDRESS: I fi 3A- (II e n Stn olt R lvol Krinxv;lit -La/3►Ra.2-b 7,2-6 DATE EVALUATED: I�.f 2O/J2
PROPOSED FACILITY:Ne v hmA�t PROPOSED DESIGN FLOW(.1949): 3 CO 5(61 • PROPERTY SIZE: Dl S 7 ace c
LOCATION OF SITE: S R'oh�k'j,i sv c 1 Mir) [fir, -v►may, NC 7-$h 0- PROPERTY RECORDED: 4/2/I`i'1 1
WATER SUPPLY: 0 Private WI Public 0W,e}i (] Spring LiOther
EVALUATION METHOD: 0 Li uger Boring Pit U Cut
TYPE OF WASTEWATER: VSewage 0 Industrial Process 0 Mixed
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DESCRIPTION NTITAL SYSTEM REPAIR SYSTEM OTHER FACTORS(.1946):
Available Space(.1945) S -
SITE CLASSIFICATION(.194S):
System Types) SO o �v°lo EVALUATED BY: Airke P�rk►rJ5
y OTHER(S)PRESENT:
• . Site LTAR (� , 3 b. z 5
COMMENTS: