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Home My WebLink AboutAUTH-04-2023-193074.tif 1 �c��-7; CATAW[BA COI INTY Case ti At1TH-04-2023-193a74 --U Public Health Department Subdivision 41 -. s Environmental Health Division PIN# 373417113323 PO Box 3$9,25 Government Drive,Newton,NC. 2$65$ LO"[# w Site Address: 4830 RALEIGH ST,CONOVER NC 28613 Name on Permit: SANDRA SHOOK Property Size: Acres 0.41 Directions: Springs Rd,turn right Raleigh St before County Home Rd,on left Owner/Authorized Representative Acknowledgement of Permit Receipt )(55,.. I certify that I am the owner or authorized agent(owner's authorization required)representing the owner of the property described above. X SS As the property owner or authorized representative, I have received the above referenced as re requested in the application for service EHPR-03-2023-43896, bythe followingmethod(s): permit(s)' q Pp � ('): Received in Person Facsimile Transmittal(Return form with signature required) Electronic Image Transmittal/E-mail (Return receipt required) SS. 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:04/05/2023 Owner/Authorized Representative Signature Qwi.Ott 4-, (4-6.-- ----" "� Date y /0 2.3 Documentation of Permit(s)Transmittal (permit transmitted by electronic or other means) Permit transmitted by .. ........ ..._...........----....__....._...................._......_(name of person sending permit) [ Signature ,.. _..........__._..Date/Time.._ 51/3....__... 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.sunreymonkey.com/s/EHCusttomerService sancvAo„vico-71 4 qvitltd • 6411 frt trot(0)64110'4i-6A Apo mit 04l05(2023 0,):13 �tS: , CATAWBA COUNTY Case# AUTH-04-2023-193074 F. .I. ,4 Public Health Departmentimil Subdivision .1 '� Environmental Health Division PIN# 373417113323 (...... PO Box 389,25 Government Drive,Newton,NC 28658 LOT# Site Address: 4830 RALEIGH ST, CONOVER NC 28613 Name on Permit: SANDRA SHOOK Property Size: Acres 0.41 Directions: Springs Rd,turn right Raleigh St before County Home Rd,on left Authorization to Construct Permit Permit Category: Repairs Wastewater Flow: 240 g.p.d. Type of Facility: Primary Residence-SFD Basement? Yes Basement Plumbing? Yes Bedrooms: 2 Water Supply: Private Well Maximum Occupants: 4 Soil LTAR: g.p.d.!ft2 WASTEWATER SYSTEM REQUIREMENTS Proposed Wastewater System: REPLACEMENT OF SEPTIC TANK ONLY System Classification: IIA-CONY SYSTEM(SINGLE-FAMILY OR 480 GPD OR LESS) 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: sq ft Total Trench Length: ft Aggregate Depth: in Maximum Trench Depth on Downhill Sidewall: in Minimum Soil Cover: in Minimum Trench Separation: ft on center Number of Drain Lines: Trench Width: ft Distribution: Distribution Box Pre Treatment: NONE Additional Specifications: *PUMP CRUSH AND FILL EXITING SEPTIC TANK *NEW 1000GAL SEPTIC TANK *ENSURE 50FT SETBACK TO WELL 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? Soil LTAR: g.p.d.ift2 Proposed System: System Classification: 04/05/2023 15:09 41$ * CATAWBA COUNTY Case# AUTH-04-2023-193074 tin ,_ Public Health Department Subdivision LJ "I Environmental Health Division P[N# 373417113323 PO Box 389,25 Government Drive,Newton,NC 28658 LOT# Site Address: 4830 RALEIGH ST, CONOVER NC 28613 Name on Permit: SANDRA SHOOK Property Size: Acres 0.41 Directions: Springs Rd,turn right Raleigh St before County Home Rd, on left 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 Rules for Selvage 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 Health of this change prior to system installation. iq„ E,4.+s 04/05/2023 Authorized State Agent Permit Issuance Date 4/5/2028 Permit Expiration Date No grading or construction activity is allowed in areas designated for system and repair without approval of the Health Department. elipennit 04/10/2023 10:20 Catawba County Environmental Health O E Pg- 03 - R03 - q3896, A fl4roq . ao3 /qg7q (140) M.$ Lcl .4so 11-1 Sc i .. 1-0cc i 0 l I Dr-1\)2. (140) (113) 8 •4818E.] • g oa w. t0 � Parcel:373417113323, 4830 RALEIGH ST 1in=40ft CONOVER, 28613 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 ell damages,loss or liability,whether direct,Indirect or consequential which arises or may arise from this map/report product or the use thereof by any person or entity. Copyright 2023 Catawba County NC 04/05/2023