HomeMy WebLinkAboutIMPV-03-2023-190971.tif I
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1'.TAlrir . CATAWBACOUNTY
yi fl Public Holt Department Subdivision
lss Eniimomkntal Ftea1ti Division PINT 278116856078
t�/40 PO Bost 3E9,'25 Government Drive,Newtan.NC 216S$ LATH A
Uri'Mos Addsys$: 2570 OLD SHELBY RD,HICKORY NC 28602
Nuns on Paneit SCOTT HART
Properly Man Acres 5.01
Dtnctlons: t40 W to Exit Old Shelby Rd.Turn L go Approx 1 mile past Hildebran Shelby Rd on R,then turn Left to
Pndperty
Owner/Authorized Representative Acknowledgement ofPerrstit Receipt
xI certify that I am the owner or authorized agent(owner's authorization required)representing the owner of
the property described above.
KAs the property owner or authorized representative,I have received the above referenced
permit(s)as requested in the application.for seryicc.RBPR-II-2021-39391,by the following method(s):
Received in Person.
_ FacsiitiileT ansmittal(Return form with signature required)
V Electronic Image Transmittal/E-mail (Return reccipt.required)
I? 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 76A.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:03/1012023
Owner/Authorized Representative Signature &/ rC7 `.tt' /tE
Date 3f a I Jaoa3
Documentation of Permit(s)Transmittal
(permit transmitted by electronic or other means)
Permit transmitted by (name of person sendin permit)
Signature plc Date/Time 3 j)i J3
Method: Fits 4 Email US Mail Other
i
Owner's request to send by the above indicated method of transmittal In lieu of signature
We wantt tto hear from yoiPkase ttake a few momentts tto complette our custtorner service survey art
http://www.surveymonkey.com/s/EHCiattomerServlui
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_e CATAWBA COUNTY Case# IMPV-03-2023-190971
ti li( ,y Public Health Department Subdivision
Q "I Environmental Health Division PIN# 278116856070
1
PO Box 389,25 Government Drive,Newton,NC 28658 LOT# A
8, vm
Site Address: 2570 OLD SHELBY RD, HICKORY NC 28602
Name on Permit: SCOTT HART
Property Size: Acres 5.01
Directions: 140 W to Exit Old Shelby Rd, Turn L go Approx 1 mile past Hildebran Shelby Rd on R,then turn Left to
Property
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-SFD
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: 25%REDUCTION
System Classification: IIIB-SYSTEM W/SINGLE EFFLUENT PUMP
Pump Required ***** Operator Required
Permit Conditions: *DO NOT CUT OR FILL OVER SYSTEM AREA
*REPAIR WILL REQUIRE AN ENGINEER
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 ot'the property. This permit was issued in compliance with the provisions of the North Carolina'Laws and
Rules for Sewage Treatment and Disposal Systems' (15A 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 I lealth of this change prior to system installation.
/ ice„ 5,40 S
03/10/2023
Authorized State Agent Permit Issuance Date
3/10/2028
Permit Expiration Date
No grading or construction activity is allowed in areas designated for system and repair without approval of the Health Department.
chprimit 03/10/2023 12:12
Catawba County Environmental Health I '61'g- 1(- 0)1 -3139
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Parcel: 278116856070, 2570 OLD SHELBY RD 1in=60ft
HICKORY, 28602
This map/report product was prepared from the Catawba County,NC Geospatal Information Services. Catawba County has made substantial efforts
to ensure the accuracy of location end labeling information contained on this map or data on this report Catawba County promotes and recommends
the independent verification of any data 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 end all damages,loss or liability,whether direct,Indirect or consequential which anses or may
arise from this map/report product or the use thereof by any person or entity.
Copyright 2023 Catawba County NC
03109/2023
DITARTMI NT OF I1IAL111 AND I IUMAN SERVICES Sheet_1 of Z
DIVISION OF PUBLIC IIEAL111 I:NVIRONMIiNTAI.I IEAL111 SECTION PROPERTY 11)M:
ON-SITE WATIR PROTTC11ON RRANCI I COUNTY:
SOIL/SITE:EVALUATION
for ON-SITE WASTEWATER SYSTEM
(Compkle all IkW%In MI)
OWNER: _ APPLICATION DATE
ADDRESS: DATE EVALUATED:
PROPOSED FACILITY: ROPOSED DESIGN FLOW(.1949): PROPERTY SIZE:
LOCATION OF SITE: PROPERTY RECORDED:
WATER SUPPLY: 0 Private D Public 0 Well ❑Spring 0 Other
EVALUATION METHOD: 0 Au er Boring 0 Pit 0 Cut TYPE OF WASTEWATER: 0 Sewage 0 Industrial Process 0 Mixed
r
R SOIL MORPHOLOGY OTHER
o
F (.1941) PROFILE FACTORS
1 .1I<40
E LANDSCAPE HORIZON
POSITION/ DEPTH 1942 PROFILE
• SLOPE% (IN.) .1941 .1941 SOIL •1941 .1956 .1944 CLASS
STRUCTURE/ CONSISTENCE/ WETNESS/ SOIL SAPRO RESTR <AR
TEXTURE MINERALOGY COLOR DEPTH CLASS IIORIZ
r o 4'3 riff �s
/ �3-S rL ID y 4,2 r- S
1 / g" I r SL- 10 34 6- e
I 9 r �
�p 19 J.5- Ws4� SG rr
3S`fd asbice SLR Fr- Per—
irl.-----•
.6-id Syr 1 �� �S
2 la-,3-� c�sb,�_SCL Fr ,z
5 3 -qg 491/4fbk- sGe_ Fr ivAv;rr .tr
y
O - l( gr ,SL 0 y'i%/ �S
j/-3- sd/- sat- i r- 10y 616
3 3s q8 rasU.scL Fr oefJer- Io Q'q
n.
O -IV 9r L lDy•i/z
14.3s' s 6 k. c F; heav 2,s qt.( is
4 3s-LI8 ,1t6-C. �► !� zs 7/, 8 _ Z
'II
DFSCRIPT1ON INmALSYSTF REPAIR SYST 1 OTHER FACTORS(.1946):
SITE CLASSIFICATION(.1948): P S
Available Space(.1945)
EVALUATED BY: D + ../S 4•S
System Type(s) S Z S` OTHER(s)PRESENT:
Site LTAR .3 c3
COMMENTS:
Updated February 2014
SOIL/SITE EVALUATION .shah o
(►'�wnnnwnion Ahnl('umlrlkN ell field InJW1)
UI rAR11`IfNTor III.A1.111 ANI)IRIMAN SERVICES PROPERTY I!)if:
1)IVISION or runic I11iM,111 I)ATI:OF EVALUATION:
I Nv1RONMENTAI.11EA1.11I SLCIION COUNTY:
ON-SITE WA1LR rRO11:CflON 11RAN('I I
• • •
SOIL MORPIIOLOCY OTIIEIt
r (.1941) PROFILE FACTORS
ar4o
▪ LANllccArl: How
roma-MN .1911 .1911 SOIL ,I94J .1956 .1944 PROFILE
• SLOPC St
ON STR(cl IIRFI CONSISTENCE! WETNESS/ SOIL SA PRO RLSTR CLASS
omit TEXTURE ININERALOGY COLOR iEIr1I1 CLASS 110RIZ <AR
(IN,)
1:4„ 0'3 grSI- /0' 3// fiS
13-Zg sr- .may e- u� a
Es/0 �561 G �';- z,f 7,
COMMENTS:
lJpducd February 2011