HomeMy WebLinkAboutOP-02-2023-189076.TIF CATAWBA COUNTY Case# OP-02-2023-189076
,Q' .I Public Health Department Subdivision
J "C Environmental Health Division PINt 371212874023
PO Box 389,25 Government Drive,Newton,NC 28658 LOT#
I2
Site Address: 359 21ST ST SE, HICKORY NC 28602
Name on Permit: LESLIE KENWORTHY
Property Size: Acres 0.35
Directions: I 40W Exit 126 and turn right, left at light on 21st St SE, house on the right
Operation Permit
Permit Category: Repairs Wastewater Flow: 360 g.p.d•
Type of Facility: Primary Residence-SFD
Basement? No Basement Plumbing? No Bedrooms: 3
Water Supply: Private Well Maximum Occupants: 6
System Type: IIA-CONV SYSTEM(SINGLE-FAMILY OR 480 GPD OR LESS)
Description: REPLACEMENT OF SEPTIC TANK ONLY
System Code: System Code Description:
Types V and VI systems expire in 5 years.
Owner must contact Environmental Health 6 months prior to expiration for permit renewal.
System Installation Comments: *NEW 1000GAL SEPTIC TANK
TP-STB-1000-1012
10-15-22
PERMIT CONDITIONS:
1.All maintenance,monitoring,&performance requirements shall be in accordance with 15 A NCAC 18.1900, Rule.1961
2.Operation&Maintenance Specifics: *PUMP SEPTIC TANK AND CLEAN FILTER EVERY 3
YEARS
Subsurface system operator required? Yes No_X_
This system has been installed in compliance with applicable NC General Statutes,Rules for Sewage Treatment and Disposal.
KELLY ISEHOUR#1099 01/24/2023
System Installer Installation Date
Doge, 54.s
02/13/2023
Authorized State Agent Permit Issuance Date
Form F
chpennit 02/20/2023 09:22
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Parcel:371212874023, 359 21ST ST SE 1 in=40ft
HICKORY, 28602
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02/13/2023