HomeMy WebLinkAboutIMPV-02-2023-190131.TIF •
CATAWBA COUNTY
• ii Public Health Department Subdivision
\� Environmental H Div PIN#
PO Box 389,25 Governmentealth ision Drive 366803120121,Newton,NC 28658 LOT#
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Site Address: 3081 N OLIVERS CROSS RD, NEWTON NC 28658
Name on Permit: *MICHAEL BROWN
Property Size: Acres 7.61
Directions: US 321 S Bus, left onto Prison Camp Rd, right onto Jack Whitener Rd, right onto saint James Ch Rd, left onto
Fred Beard Rd, right onto Providence Mill Rd, left onto Water Plant Rd, left onto N Olivers Crossroad, property
on the left
Owner/Authorized Representative Acknowledgement of Permit Receipt
_I certify that I am the owner or authorized agent(owner's authorization required)representing the owner of
1 the property described above.
XAs the property owner or authorized representative, I have received the above referenced
permit(s)as requested in the application for service EHPR-01-2023-43138, by the following method(s):
Received in Person
Facsimile Transmittal (Return form with signature required)
V- Electronic Image Transmittal/E-mail (Return receipt required)
•
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(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.
Permit Issue Date: 02/27/2023
Owner/Authorized Representative Signature
Date
Documentation of Permit(s)Transmittal
(permit transmitted by electronic or other means)
Permit transmitted by (name of person sending permit)
1/4 7
Signature l.r Date/Time 314 s /J
Method: Fax 'Email US Mail Other
Owner's request to send by the above indicated method of transmittal in lieu of signature
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chpennit 02/27/2023 09:40
�`e CATAWBA COUNTY Case# IMPV-02-2023-190131
"I" ,� Public Health Department Subdivision
d "I Environmental Health Division PIN# 366803120121
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PO Box 389,25 Government Drive,Newton,NC 28658 LOT#
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Site Address: 3081 N OLIVERS CROSS RD, NEWTON NC 28658
Name on Permit: *MICHAEL BROWN
Property Size: Acres 7.61
Directions: US 321 S Bus, left onto Prison Camp Rd, right onto Jack Whitener Rd, right onto saint James Ch Rd, left onto
Fred Beard Rd, right onto Providence Mill Rd, left onto Water Plant Rd, left onto N Olivers Crossroad, property
on the left
Improvement Permit
AN AUTHORIZATION TO CONSTRUCT MUST BE ISSUED PRIOR TO BUILDING PERMITS
THIS PERMIT IS NOT FOR SEPTIC INSTALLATION
Permit Category: Repair/Expansion Wastewater Flow 480 g.p.d
Type of Facility: Primary Residence-SFD
Basement? Yes Basement Plumbing? Yes Bedrooms: 4
Water Supply: Public Water Maximum Occupants: 8
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: IIIG-SYSTEM W/SINGLE EFFLUENT PUMP
Pump Required
Permit Conditions: *DO NOT FILL OVER SEPTIC SYSTEM AREA
*ALL FUTURE GRADING MUST NOT DIRECT DRAINAGE OVER ANY PART OF SEPTIC
INITIAL OR REPAIR AREAS
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 18A.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.
efl....„........,--- „ 5,4.4s
02/27/2023
Authorized State Agent Permit Issuance Date
2/27/2028
Permit Expiration Date
No grading or construction activity is allowed in areas designated for system and repair without approval of the Health Department.
chprrmit 02/28/2023 13:18