HomeMy WebLinkAboutAUTH-03-2023-190979.TIF I
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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$: 2570 OLD SHELBY RD,HICKORY NC 28602
Nuns on Paneit SCOTT HART
Properly Man Acres 5.01
Dtnctlons: t40 W to Exit Old Shelby Rd.Turn L go Approx 1 mile past Hildebran Shelby Rd on R,then turn Left to
Pndperty
Owner/Authorized Representative Acknowledgement ofPerrstit Receipt
xI certify that I am the owner or authorized agent(owner's authorization required)representing the owner of
the property described above.
KAs the property owner or authorized representative,I have received the above referenced
permit(s)as requested in the application.for seryicc.RBPR-II-2021-39391,by the following method(s):
Received in Person.
_ FacsiitiileT ansmittal(Return form with signature required)
V Electronic Image Transmittal/E-mail (Return reccipt.required)
I? As the property owner or authorized representative I have reviewed and understand The specific conditions
of the permit-issued, and further understand that all applicable regulatory requirements specified under the
North Carolina Laws and Rules for Sewage Treatment and Disposal Systems(15A NCAC 76A.1900),
and/or Well Construction Standards(15A NCAC 2C.0100), shall apply to the issuance-of this permit and
the construction of the wastewater system and/or water supply well permitted.
Permit Issue Date:03/1012023
Owner/Authorized Representative Signature &/ rC7 `.tt' /tE
Date 3f a I Jaoa3
Documentation of Permit(s)Transmittal
(permit transmitted by electronic or other means)
Permit transmitted by (name of person sendin permit)
Signature plc Date/Time 3 j)i J3
Method: Fits 4 Email US Mail Other
i
Owner's request to send by the above indicated method of transmittal In lieu of signature
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yy$A _', CATAWBA ct)t WT'. Case# Al'l'l 1-03-2023-190979
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278116856070
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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
Authorization to Construct Permit
Permit Category: New Septic 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
Soil LTAR: 0.3 g.p.d.1ft2
WASTEWATER SYSTEM REQUIREMENTS
Proposed Wastewater System: 25%REDUCTION
System Classification: IIIG-OTHER NON-CONY TRENCH SYSTEMS
Septic Tank: New Tank: 1.000 gal
Pump Tank _gal Grease Trap gal
Dosing Volume gal Pump Specs: GPM @ TDH
Pressure Head ft Draw Down in
Drainfield: Total Area: 900 sq ft Total Trench Length: 300 ft
Aggregate Depth: in Maximum Trench Depth on Downhill Sidewall: 18 in
Minimum Soil Cover: 6 in Minimum Trench Separation: 9 ft on center
Number of Drain Lines: 2 Trench Width: 3 ft
Distribution: Serial
Pre Treatment: NONE
Additional Specifications:
*INSTALL ON CONTOUR
*2 LINES TO TOTAL 300FT
*MAXIMUM TRENCH DEPTH 18 INCHES
*SPLASH PAD REQUIRED WHERE SUPPLY LINE ENTERS DRAINLINE
*SPLASH PAD IS A 12"X12"stepping stone with 5 gal of#5 gravel spread around it
*REPAIR AREA WILL REQUIRE AN ENGINEER
See also attached site plan.
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.
>>>>> Do not install system under wet conditions <<<<<
PROPOSED REPAIR
Repair System Required? Required Soil LTAR: .3 g.p.d./ft2
Proposed System: 25%REDUCTION
System Classification: IIIB-SYSTEM W/SINGLE EFFLUENT PUMP
Pump Required ***** Operator Required
ehpe mm it 03/20/2023 15:21
Ci. CATAWBA COUNTY Case# AIJTH-03-2023-190979
1)1 Public Health Department Subdivision
Environmental Health Division PIN# 278116856070
PO Box 389,25 Government Drive,Newton,NC 28658 LOT# A
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
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 Authorization to
Construct Permit is subject to revocation if the site plan,plat or the intended use changes,or if site conditions arc altered. The Authorization to
Construct 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' (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.
ifi........ -i).)4,,, 5.4.+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.
CI,1R',,lit 03/10/2023 12:11
Catawba County Environmental Health '6Pg- ll-a0al -39391
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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 Geospallal 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 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 and 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
03)09/2023