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Site Address 3974 CEDAR WOOD TR.TERRELL NC 28682
Name on Permit: 'ELITE BUILDERS OF SURRY INC
Property Sue: Acres 0 49
Directions: 16 South left on 150 east Right on Kiser island left on cedar wood trail last wooded lot on lee
Owner/Authorized Representative Acknowledgement of I'crmit Receipt
g1 certify that I am the.»sncr or authoriicd agent((Miler's authuri/atlurt required representInl.. III,:us%nor nl
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the pmpert) dcxrihcd abuse.
X .ktl)' As the property owner or aulhoriied representative. I have received the above referenced
permits)as requested in the application fur service RBPR-02-2022-3999I.by the following method(s):
Received in Person
Facsimile Transmittal(Return form with signature required)
41 Electronic Image Transmittal'E-mail (Return receipt required)
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'� " As the property owner or authorised 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(ISA NCAC I8A.1900),
and/or Well Construction Standards(ISA NCA('2C.0100), shall apply to the issuance of this permit and
the construction(tithe wastewater system and or water supply well permitted.
Permit Issue Date:04/27/2023
OssneriAuthuri/cd Representative Signature
//ei/Dateatc Z)
Documentation of I'erniil(s) transmittal
(hermit transmitted by electronic or other means)
Pet tilt tranvnittril hs fnume of 7rrrsrin semhng 7terMlii
4 .,signature
Date Iime 5�1 ll�
'Method: Fax .1 Email t S Mail Oilier
Owner's request In send by the above indicated method of transmittal in lieu of signature
We wantt tto hear from yoiPlease ttake a few momentts no complette our custtomer service survey all
http://www.surveymonkey.com/s/ENCusttomerScrvice
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,44 a CATAWBA COUNTY Case# IMPV-04-2023-I94541
14t ii-tPublic Health Department Subdivision
Environmental Health Division PIN# 461704734177
8 PO Box 389,25 Government Drive,Newton,NC 28658 LOT# 4
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Site Address: 3974 CEDAR WOOD TR, TERRELL NC 28682
Name on Permit: "ELITE BUILDERS OF SURRY INC
Property Size: Acres 0.49
Directions: 16 South left on 150 east Right on Kiser island left on cedar wood trail last wooded lot on left
Improvement Permit
AN AUTHORIZATION TO CONSTRUCT MUST BE ISSUED PRIOR TO BUILDING PERMIT'S
TI[IS PERMIT IS NOT FOR SEPTIC INST'ALLA'I'ION
Permit Category: New Septic Wastewater Flow 360 g.p.d
Type of Facility: Primary Residence
Basement? Yes Basement Plumbing? Yes Bedrooms: 3
Water Supply: Private Well Maximum Occupants:
INITIAL SYSTEM SPECIFICATIONS
Proposed Wastewater System: 50%REDUCTION HORIZONTAL—Alternating Dual Field Nitrification System
System Classification: IVA-ANY SYSTEM WITH LPP DISTRIBUTION
Pump Required ***** Operator Required
REPAIR SYSTEM SPECIFICATIONS
Repair System Required? install with Initial System
Proposed Wastewater System: 50%REDUCTION HORIZONTAL
System Classification: IVA-ANY SYSTEM WITH LPP DISTRIBUTION
Pump Required ***** Operator Required
Permit Conditions: 'INSTALL DUAL ALTERNATING DRAINFIELDS.
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 suspensionfrevocation 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' (I SA NCAC I 8A.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.
#4 -zo---
04/27/2023
Authorized State Agent Permit Issuance Date
04/27/2028
Permit Expiration Date
No grading or construction activity is allowed in areas designated for system and repair without approval of the Health Department.
elyxruit 05/02/2023 15:33
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DEPARTMENT OF HEALTH AND HUMAN SERVICES Shur 'of
DIVISION OF PUBLIC HEALTH,ENVIRONMENTAL HEALTH SECTION PROPERTY ID IP:
ON411/I WATFA PROTECTION BRANCH
SOIL/SITE EVALUATION COUNTY:` taw
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for ON-SITE WASTEWATER SYSTEM
y- 1 A1,�l� (Complete a oil fields is full}
UWNER: �-1• Ili �
ADDRESS: �] f r /� n,_ APPLICATION DATE_
PROPOSED FACILITY:�� DATE EVALUATED:`c 1T 1',�
PROPOSED D 1 7 0W(1949) PROPERTY SIZE:
LOCATION OF SITE: 1�ti!! /rr' is--ttc. PROPERTY RECORDED:
WATER SUPPLY: 0 Private 0 Public ell U Spring Other
EVALUATION METHOD: 0 Au cr Boring i 0 Cut
'y` TYPE OF WASTE WATER: l�Srwege ❑Ind Process Mixed
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OFSCRIP1IOt. INITIAL SYSTIJA REPAIR SYSTEM
OTHER FACTORS(,t 94b);
Available Spew(.IS743) 4 .`f�J {� rviygr ITE,CLASSIFICATION(.I948):- —11
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System Typo)
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OTHER(S)PRESENT:
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