HomeMy WebLinkAboutIMPV-04-2023-193786.tif ,..17fi► CATAWBA COUNTY
+J i li Public Health Department Subdivision
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,pt ss Environmental health Division I'INN 365606386118
�\/flitOP PO Box 119,25 Government Drive,Newton.NC 2*651 LOT#
Site Address: 2357 E MAIDEN RD. MAIDEN NC 28850
Name on Permit LANEY BEARD
Property Stec: Acres 0.99
Dtnctloas: Right off of Jim Beard Rd onto E Maiden Rd. Empty lot on right.
Owner/Authorrced Representative Acknowledgement of Permit Receipt
l certify that I am the owner or authorized agent(owner's authorisation required)representing the owner of
the property described above.
xIs_ As the property owner or authorized representative, I have received the above referenced
permit(s)as requested in the application for service RBPR-11-2022-42740, by the following method(s):
Received in Person
/ Facsimile Transmittal (Return form with signature required)
_I Electronic Image Transmittal/ E-mail (Return receipt required)
JLk 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(I5A NCAC 18A.1900),
and/or Well Construction Standards(I SA 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:04/18/2023
Owner/Authorized Representative Signature E'- -
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Documentation of Permit(s)Transmittal
(permit transmitted by electronic or other means)
Permit transmitted by (name of person sending permit)
Signature Date/Time Iti�5I)5
Method: Fax �Finail US Mail Other
Owner's request to send by the above indicated method of transmittal in lieu of signature
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, a • CATAWBA COUNTY Case# IMPV-04-2023-193786
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.i.it Public Health Department Subdivision
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d '-1 Environmental Health Division PIN#114 365606386118
PO Box 389,25 Government Drive,Newton,NC 28658 LOTH
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Site Address: 2357 E MAIDEN RD, MAIDEN NC 28650
Name on Permit: LANEY BEARD
Property Size: Acres 0.99
Directions: Right off of Jim Beard Rd onto E Maiden Rd. Empty lot on right.
Improvement Permit
AN AUTHORIZATION TO CONSTRUCT MUST BE ISSUED PRIOR TO BUILDING PERMITS
TIIIS PERMIT IS NOT FOR SEPTIC INSTALLATION
Permit Category: New Septic Wastewater Flow 360 d
9P•
Type of Facility: Primary Residence
Basement? No Basement Plumbing? No Bedrooms: 3
Water Supply: Public Water Maximum Occupants: 6
INITIAL SYSTEM SPECIFICATIONS
Proposed Wastewater System: 25% REDUCTION
System Classification: IIIB-SYSTEM W/SINGLE EFFLUENT PUMP
Pump Required
_ _ _ _ _ REPAIR SYSTEM SPECIFICATIONS _ _
_-_.. _____ -__.. ____ .___. ___.. _aRepair System Required? Required
Proposed Wastewater System: DRIP IRRIGATION
System Classification: IVA-ANY SYSTEM WITH LPP DISTRIBUTION
Pump Required ***** Operator Required
Permit Conditions:
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' (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 l lealth authorization or permit
modification.Please notify Environmental Health of this change prior to system installation.
04/17/2023
Authorized State Agent Permit Issuance Date
4/17/2028
Pennit Expiration Date
No grading or construction activity is allowed in areas designated Jar system and repair without approval of the Ilealth Department.
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Parcel: 365606386118, 2357 E MAIDEN RD 11n=50ft MAIDEN, 28650
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arise horn Ihla mspJreport product or the use thereof by any person or entity. which orient or may
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01/23/2023