HomeMy WebLinkAboutAUTH-03-2023-191745.TIF AIM'e CATAWBA COUNTY
ev(. Public Health Department Subdivision SHAMROCK PARK MAP 1
ft Environmental Health Division PINE! 375119624495
�(iv� PO Box 389,25 Government Drive,Newton,NC 28658 tint 9
Site Address: 2634 TIFFANY ST, CONOVER NC 28613
Name on Permit *LATHAM YORK
Property Size: Acres 0.47
Directions: Hwy 10 E, Left on Bethany Church RD, Left on Keisler RD, Left Shamrock, Right on Tiffany 2nd to the last.
Owner/Authorized Representative Acknowledgement of Permit Receipt
L 7 certify that I am the owner or authorized agent(owner's authorization required)representing the owner of
r` the property described above.
yLYAs the property owner or authorized representative, I have received the above referenced
1` permit(s)as requested in the application for service RBPR-01-2023-43234,by the following mcthod(s):
Received in Person
Facsimile Transmittal (Return form with signature required)
./ Electronic Image"Transmittal/E-mail (Return receipt required)
LYAs 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 I8A.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: 03/20/2023
Owner/Authorized Representative Signature Latham York
Date 3/27/2023
Documentation of Permit(s)Transmittal
(permit transmitted by electronic or other means)
Permit transmitted by _ (name of person sending permit)
qite:Signature Date/Time *7/)3
Method: Fax v 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 yo*Please ttake a few momentts tto complette our custtomer service survey att
http://www.surveymonkey.com/s/EHCusttomerService
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03l20R023 12:00
_el a CATAWBA COUNTY Case# AUTI I-03-2023-191745
d(.t. ,� Public Health Department Subdivision SHAMROCK PARK MAP 1
......._'lul :1 ' Environmental Health Division PIN# 375119624495
PO Box 389,25 Government Drive,Newton,NC 28658 LOT# 9
/ Y SM
Site Address: 2634 TIFFANY ST, CONOVER NC 28613
Name on Permit: *LATHAM YORK
Property Size: Acres 0.47
Directions: Hwy 10 E, Left on Bethany Church RD, Left on Keisler RD, Left Shamrock, Right on Tiffany 2nd to the last.
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: Public Water Maximum Occupants: 6
Soil LTAR: .3 g.p.d.ift2
WASTEWATER SYSTEM REQUIREMENTS
Proposed Wastewater System: 25%REDUCTION
System Classification: IIIG-OTHER NON-CONV 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: 32 in
Minimum Soil Cover: 6 in Minimum Trench Separation: 9 ft on center
Number of Drain Lines: 5 Trench Width: 3 ft
Distribution: Serial
Pre Treatment: NONE
Additional Specifications:
*INSTALL ON CONTOUR
*15FT SETBACK TO BACK PROPERTY LINE DUE TO UNDERGROUND POWER
`15FT SETBACK TO ANY FOUNDATION DRAINS
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? Not Required,has space Soil LTAR: .3 g.p.d.lft2
Proposed System: 50%REDUCTION VERTICAL
System Classification: IVA-ANY SYSTEM WITH LPP DISTRIBUTION
Pump Required ***** Operator Required
clip,,,,ui 03/20/2023 12:00
�_iii� CATAWBA COUNTY Case ifAUTH-03-2023-191745
Public Health Department Subdivision SHAMROCK PARK MAP 1
Q mil '3 Environmental Health Division PIN# 375119624495
ipil'
PO Box 389,25 Government Drive,Newton,NC 28658 LO"I'# 9
8 v,
Site Address: 2634 TIFFANY ST, CONOVER NC 28613
Name on Permit: *LATHAM YORK
Property Size: Acres 0.47
Directions: Hwy 10 E, Left on Bethany Church RD, Left on Keisler RD, Left Shamrock, Right on Tiffany 2nd to the last.
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 Authorization to
Construct Permit is subject to revocation if the site plan,plat or the intended use changes,or if site conditions are 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 Rulesfor 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.
I 03/20/2023
Authorized State Agent Pennit Issuance Date
3/20/2028
Permit Expiration Date
No grading or construction activity is allowed in areas designated for system and repair without approval of the Health Department.
<:iip,rmit 03/20/2023 12:00
Catawba County Environmental Health
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Parcel: 375119624495, 2634 TIFFANY ST 1 in=40ft
CONOVER, 28613
This map/report product was prepared from the Catawba County.NC Geospaual Information Services. Catawba County has made substantial efforts
to ensure the aoausey 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 allNdamages,loss or liability,whether direct,Indirect or consequential which arises or may
arise from this map/report product or the use thereof by arty person or entity.
Copyright 2023 Catawba County NC
03/20/2023
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