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HomeMy WebLinkAboutIMPV-01-2023-187937.tif • CATAWBA CottNfl Case It .fi.ii Public Health lkpattment Subdivision M L DEAL 1,.,,mit Environmental Health Division PIM 373517018124 PO Box 389,25 Government Drive.Newton.NC 28658 1.0Tlt 23&24 tail 5. Site Address: 4586 35TH ST PL NE, HICKORY NC 28601 Name on Permit: DW EXPRESS INC Property Size: Acres 0.92 Directions: Right off of Sulphur Springs Rd NE onto Wandering Ln Ne. Right onto 35th St PI NE. 2nd lot on right. Owner/Authorized Representative Acknowledgement of Permit Receipt A-5I certify that I am the owner or authorised agent(owner's authorisation required)representing the owner of ��// the property described above. l� dam' As the property owner or authorized representative, I have received the above referenced permit(s)as requested in the application for service RBPR-I2-2022-42989,by the following method(s): Received in Person Facsimile Transmittal(Return form with signature required) 7 Electronic Image Transmittal/E-mail (Return receipt required) K , 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(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. Permit Issue Date:01/23/2023 Owner/Authorized Representative Signature___ /-¢she _Shs G-_ `� Date 01/23/2023 Documentation of Permit(s)Transmittal (permit transmitted by electronic or other means) Permit transmitted by (Hume of person sending permit) ofSignature E Date/Time J1)3]73 Method: Fax 1 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 yoiPlease ttake a few momentts tto complette our custtomer service survey att http://www.surveymonkey.com/s/EHCusttomerService�(/I , Kathn0E-D jCc0if Ile h Lie .1v ' rp:mui 01 23 2023 15:24 County: l..,a 4 wr)a. IMPROVEMENT PERMIT FOR G.S.130A-335(al)/SL2022-11 PIN/Lot Identifier:�1 /3 f.35 1 '76I8/c 9 >J 3735)?3 J81 Q / Issued To: G-xP«SS T-►IG Property Location: 3J 54- i( C J A K. c (p01 Subdivision: M L. Derr I Lo:#: a3/0P-1 Block: Section: LSS Report Provided: Yes 13 No❑ ff '�j If yes,name and license number of LSS: )Qr1`1 t,�e A V� I�3 tc,k 173 r New Repair 0 Expansion El System Relocation ❑ pPV Proposed Structure: 3 BR 5,Dic. -f'AMi77(j e— �^ J Proposed Wastewater System Type: HPPBPS U./I f 4viS DST i b.. a. _(Initial) G XI � bK� Pf,B//LP Qcar l k. (Repair) Fill System:❑Yes Iii- If yes,specify:❑New ❑Existing (when adding more than 6 inches of fill to system area please provide a fill plan) Proposed Design Daily Flow: 3(oO GPD Proposed LTAR(Initial):O.G. Proposed LTAR(Repair): 43 Design Wastewater Strength:l estic 0 high strength 0 industrial process Number of bedrooms: 3 Num r of Occupants: (o Other: Pump Required: ❑Yes E3'No ❑M -be required based upon final location and elevations of facilities Artificial Drainage Required: ❑Yes o If yes,please speci details: Type of Water Supply:0 Private well 0 Public well M'Municipal Supply ❑Spring 0 Dther: Drainfield location meets requirements of Rule.1945: Yes No❑ Drainfield location me requirements of Rule.1950: Yes L9' No❑ Permit valid for: Five years[site plan submitted pursuant to GS 130A-334 13a)] 0 No expiration plat submitted pursuant to GS 130A-334(7a)] Permit conditions:yn� t / L 1 ItCOrLitc,A K�-COMlkrlgl7 ?/ + ReQt,ir?J r_ ;� Licensed Soil Scientist Print Name: rvt it H Vlt('• ]�c� 1Qb15 Licensed Soil Scientist Signature: l �.t.,• /r, ! - Date: The LSS evaluation is being submitted pursuant to and meets the requirement of G.S.130A-3 5(a2). *See attached s to sketch* County: Catawba This Section for Local Health Department Use Only Initial submittal received: 12/12/22 by RP Date initials Permit Number: IMPV-01-2023-187937 G.S. 130A-335(a4)states the following: 'If a local health department fails to act on an application for an improvement permit submitted pursuant to subsection (a3)of the section within 10 business days of receipt of a complete application, the local health department shall issue the improvement permit.' In accordance with G.S. 130A-335(a3)the improvement permit application is: ❑ Incomplete(If box is checked, information in this section is required.) The following items are missing: Copies of this were sent to the LSS and the Owner on Date State Authorized Agent: Date: ❑ Denied(See attached report.) Copies of this were sent to the LSS and the Owner on Date State Authorized Agent: Date: © Complete State Authorized Agent: n GTE/ Date of Issuance: 1/23/23 This Improvement Permit is issued pursuant to G.S. 130A-335(a2),(a3),and (a4) using the signed and sealed LSS/LG evaluation(s) attached here. The issuance of this permit by the Health Department in no way guarantees the issuance of other permits. The permit holder is responsible for checking with appropriate governing bodies in meeting their requirements. This site is subject to revocation if the site plan,plat,or the intended use changes,or if information submitted in the application was falsified, inaccurate or misleading. The Improvement Permit shall not be affected by a change in ownership of the site. This permit is subject to compliance with the provisions of the Laws and Rules for Sewage Treatment and Disposal and to conditions of this permit. The location and identification of all property lines,easements,water lines,and other appropriate utilities shall be the responsibility of the owner. The Department,the Department's authorized agents,and the local health departments shall be discharged and released from any liabilities,duties,and responsibilities imposed by statute or in common law from any claim arising out of or attributed to evaluations,submittals,or actions from a licensed soil scientist or licensed geologist pursuant to GS 130A-335(a2). Improvement Permit Expiration Date: 1/23/28 *See attached site sketch* n ,-c a� w 3S H S To ,9 �l.(-\ pC'` a 0`v 66, 7 z 3°' Op SF9. i? 33.23'ecq y° �0SF0® e.5z *. 6 ls, /7 '54g 19 6°' )- (-4c °L ' ® cT 3 2060 m Y 6o 141,4 S C7 NORTH a p4 vm0 CN 3 FXTRq 74 P D � 7, L r� * > X = DK frl a oD � 73 w m D 7y D 13 rm - q co K cZ - Z min c D � � O -< • D 7.) z rm z � mz IJ _ -rI K O m7:I z Ln LEGEND GRAPHIC SCALE Areas contain at least 24 inches of usable 1 '=40' \\\\ material and have potential for accepted, \\ modified conventiona and conventional septic systems. B6 & B7 require cover. 40 0 40 80 ,i I i Unsuitable ® Boring Locations. FOR PRIIHRWLY PLANING PURPOSES ONLY. ALL LOTS WEL REQIATE FRY/ APPROVAL BY THE COUNTY HEALTH DEPARTMENT ON A LOT BY LOT BASS. neS IMP SHOULD BY USED AS A GENERAL GUIDE,SOME ADJJSTYENTS WILL BE NECESSARY IN TFE FLEID DUE TEl SOB.VARIABLLRY AND COMPLEX TOPOGRAPHIC FEATURES. TTHS IMP ONLY REFLECTS EXISTING SQL SUITANUTY FOR ON-SITE SEPTFC TANK SYSTEMS. MAP irnz: JOB/: 22-010e SOIL&FORESTRY SERVICES OF THE CAROLINAS,PA. PRELIMINARY SOIL EVALUATION FILL: C -0Ia P0.FEW R17 AV!!I D R011 AAS,NCI I(Th5F7)SOO SCIFNTTGI PROJECT MGR: SAR. M(X)RESVILII.NC D{11i MC)BI1 E.(701)74.-5016 PROJECT M~E' /�h UPu i I. if Ft NE FIELD WORK: SAX PHONE'.(MO 7F6-'11^ EMAIL:ASI ILEYROUANS6ONALCOM FBMIVGo ma/WV R R M OMB 13•30 0A1 CO MTV.IBSeI$ORASR --son ORAWFI BY: SAR tape measure. Detailed system& repair information is summarized in the following paragraph for this Lot. ML Deal Subdivision Lots 23 &24(See Attached Designl The septic layout for this lot (9'centers)yielded a total of 557 linear feet of li e.The primary system is proposed as 240'of Mod. Conventional (HPPBPS)drai field with g-avity distribution (DBOX).Trench depth (LOW SIDE) is specified at 20 inches.The lot is r pair exempt.There is'y74'available for repair of Mod. Cony. (VPPBPS)drainfield with low pressure dist ibution.Trench depth FLOW SIDE) is specified at 30 inches. I Session Law Requirements All information needed to issue the IP must be submitt d with the application. The application shall include all information described in 15A NCAC 18A .19 7(d) and be accompanied by a signed and dated statement from the applicant(owner or owner's legal gepresentative)that reads as follows: "The LSS/LG evaluation(s)attached to this application i to be used to issue ar>I Improvement Permit in accordance with G.S. 130A-335(a2)and(a3).'f Owner I Date Print Name eu, N C.S143r� Signs 'F 1.--__•c------- � 11/AO/4Z The LSS evaluation shall include a statement bearing th LSS seal and signature that reads as follows: "The LSS evaluation is being submitted pursuant to and meets the requirements of G.S. 130A- 335(a2)." Disclaimer j This report reflects the findings of S&FS, PA. This LSS evaluation is being submitted pursuant to and meets the requirements of G.S. 130A-335(a2)."Any site modifications that impact the proposed septic areas on the site may nullify this design for Lots 23 & 2L ML Deal Subdivisior. System design requirements and site requirements shall be adhered to for installation and Operations Permits to be issued by the local Health Department. If you have questions regarding these requirements a Pre- Construction meeting should be scheduled to discuss. Please contact S&FS if you have any questions regarding this report or the attached information. S&FS also offers septic system inspection, wetland delineation and forestry services. Sincerely, Q SOIL S 0- A1. RO <2 S.Ashley Rollans, LSS ,� % �c� Attachment: Septic Design F 1231 O" NC •TH G Sheet_1_of_2 . • • • PROPERTY ID#: 373517017066&373517018124 TO BE COMBINED_ COUNTY:CATAWBA SOIL/SITE EVALUATION for ON-SITE WASTEWATER SYSTEM (Complete all fields in full) OWNER:_TONY POTTS _ APPLICATION DATE ADDRESS:5556 GRACE CHAPEL RD HICKORY NC 28601 DATE EVALUATED:9/29/22 PROPOSED FACILITY:_3BR PROPOSED DESIGN FLOW(.1949): 360GPD PROPERTY SIZE:0.94 AC total 2 lots LOCATION OF SITE:4586 35T"ST PL NE HICKORY NC 28601 PROPERTY RECORDED:TO BE RECORDEL WATER SUPPLY: ❑Private 'Public CI Well ❑Spring ❑Other EVALUATION METHOD: ❑Aupier Boring I Pit I Cut TYPE OF WASTEWATER: 'Sewage ❑Industrial Process ❑Mixed P R SOIL MORPHOLOGY OTHER O (.1941) PROFILE FACTORS F I .1940 L LANDSCAPE HORIZON E POSITION/ DEPTH PROFILE SLOPE% (IN.) .1942 .1941 .1941 SOIL .1943 .1956 .1944 CLASS STRUCTURE/ CONSISTENCE/ WETNESS/ SOIL SAPRO RESTR &LTAR TEXTURE MINERALOGY COLOR DEPTH CLASS HORIZ LEFT LOT 0-I 1 Bslg Frsssp 56" PS 0.25 U8% 11-20 rbsclwfsbk Frss 1 20-56 brcwmsbk Frsssp FEW TO COM FE DEPL 35 CI-IROM2 40 • L/10% 0-12 bslg Frssp 58" PS 0.25-0.275 I' 12-21 rbsclwfsbk Frsssp 21-58 brc/scwfsbk Frsss FEW FE DEPL 33 C H ROM2 41- 48 1./13% 0-II Bsclwfsbk Frsssp 69" PS 0.25 I' II-39 brc/scwfsbk Frsssp Ffedepl 39-69 rbcwmsbk frsssp Cfe depl chr2@40 .. ;•• ''yam,..° 4 • • Right lot 1 �' -+: Of 1/ / I� r� ti `, o 123A 0 t4�.hc1n DESCRIPTION INITIAL SYSTEM REPAIR SYSTEM OTHER FACTORS(.1946): Available Space(.1945) PS PS-EXEMPT SITE CLASSIFICATION(.1948): PS EVALUATED BY: ASHLEY ROLLANS System Type(s) HPPBPS VI'PI3PS- LP OTHER(S)PRESENT:_MASON FREEMAN&CHAD WAGNER Site LTAR 0.25 (1.3 Updated February 2014 • ', SOIL/SITE EVALUATION Sheet 2 of 2 • ' • (Continuation Sheet-Complete all field in full) PROPERTY ID#:373517017066_ DATE OF EVALUATION:9/29/22 COUNTY: CATAWBA . . . . P R SOIL MORPHOLOGY OTHER 0 (.1941) PROFILE FACTORS F I .1940 .1942 L LANDSCAPE HORIZO .1941 .1941 SOIL .1943 .1956 .1944 PROFILE E POSITION! N STRUCTURE/ CONSISTENCE/ WETNESS/ SOIL SAPRO RESTR CLASS SLOPE% DEPTH TEXTURE MINERALOGY COLOR DEPTH CLASS HORIZ &LTAR # (IN.) 1114% 0-9 bslg Frsssp 60" PS 0.3 P 9-28 rcwmsbk/abk Frsss 1 28-60 rbclwfsbk Frsss 60-78 varslmass 1./13% 0-6 bslg Frsssp 71" PS 0.3 P 6-28 rcmmsbk Frsss 2 28-71 rbclwfsbk Frsss FEW TO COM SAP 71-86 varslmass Frsssp L/15% 0-7 rbsclwfsbk Frssp 42" PS 0.325 P 7-20 brcwmsbk Frsss 3 20-42 rbclwfsbk Frsss COM SAP 42-90 varslmass 1,/12% 0-17 bsclwfsbk Frsssp 60" PS P 0.3 4 17-32 brcwmsbk Frsss 32-60 rbclwfsbk Frssp COM SAP 60-90 varslmass Frsssp I./12% 0-5 rbsclwfsbk Frsssp 56" PS P 0.3 5 5-28 brcwmsbk/abk Frsssp 28-56 rbclwfsbk Frsss COM S1i1S"f 33-15-20% 56-91 varlmass frsssp COMMENTS: LOTS ARE REPAIR EXEMPT AND TO BE COMBINED. MUST BE RECORDED BY DEED OR PLAT PRIOR TO ISSUANCE OF AUTHORIZATION TO CONSTRUCT. 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