HomeMy WebLinkAboutIMPV-05-2023-194874.TIF �1N (• ('A7A%VBA('OI\I V l
/ 'r * Puhhc health Department Subdivision
kr,�.� ,' I:muonmcntul Ilcnithl)ivisionPIN# 460701150086
tS4 PO Box 389.25 Government I/rive.Newton,N(' 2865K L(1't71 1
Site Address: 3720 LANDMARK DR, SHERRILLS FORD NC 28673
Name on Permit: HELMSMAN HOMES LLC
Property Size: Acres 0.57
Directions: Hwy 150 to Little Mt Rd to Landmark Dr on left
� Owner/Authorized Representative Acknowledgement of Permit Receipt
X/6 certily that I am the owner or authorized agent(owner's authorization required)representing the owner of
the property described ahem.
z CFCs the property owner or authorized representative, I have received the above referenced
pertnit(s)as requested in the application for service R131'R-02-2023-43415, by the Iollowing method(s):
Received in Person
Facsimile Transmittal (Return limn with signature required)
f Electronic Image Transmittal/E-mail (Return receipt required)
'3As 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(1SA 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: 05/03/2023
Owner/Authorized Representative Signature /z.MIL
Date 6-2-23
Documentation of Permit(s)Transmittal
(permit transmitted by electronic or other means)
Permit transmitted by. (name c1I person sending permit)
Signature Date/Time U ,'.3
Method: Fax 1 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 yoiPlease ttake a few momentts tto complette our custtomer service survey att
http://www.surveymonkey.com/s/EHCusttomerService
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4.1 CATAWBA COUNTY Case# IMPV-05-2023-194874
.i, Public Health Department Subdivision
< , � " Environmental Health Division PIN# 460701150086
PO Box 389,25 Government Drive,Newton,NC 2R658 LOT# 1
! w
Site Address: 3720 LANDMARK DR, SHERRILLS FORD NC 28673
Name on Permit: HELMSMAN HOMES LLC
Property Size: Acres 0.57
Directions: Hwy 150 to Little Mt Rd to Landmark Dr on left
Improvement Permit
AN AUTHORIZATION TO CONSTRUCT MUST BE ISSUED PRIOR TO BUILDING PERMITS
THIS PERMIT IS NOT FOR SEPTIC INSTALLATION
Permit Category: New Septic
Wastewater Flow 240 g p d
Type of Facility: Primary Residence
Basement? No Basement Plumbing? No Bedrooms: 2
Water Supply: Private Well Maximum Occupants: 4
INITIAL SYSTEM SPECIFICATIONS
Proposed Wastewater System: 50%REDUCTION HORIZONTAL
System Classification: IIIB-SYSTEM W/SINGLE EFFLUENT PUMP
Pump Required
REPAIR SYSTEM SPECIFICATIONS
Repair System Required? Required
Proposed Wastewater System: 50%REDUCTION HORIZONTAL
System Classification: IVA-ANY SYSTEM WITH LPP DISTRIBUTION
Pump Required ***** Operator Required
Permit Conditions: *Do not cut, drive, fill, or grade over septic or repair areas.
*This is an improvement permit only and is not intended for septic installation purposes.
*When needed, the lower repair lines may require fill for cover with a slope stabilization 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.
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'(I5A NCAC I 8A.1900). Neither Catawba County nor the Environmental I lealth
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 Fnvironmental I lealth of this change prior to system installation.
05/03/2023
Authorized State Agent i crnur I„uance(late
5/3/2028
Permit Expiration Date
No grading or construction activity is allowed in areas designated for system and repair without approval of the Health Department.
05/19/2023 10:26
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LINE TABLE ,-, .p. JAMES H.
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LINE BEARING LENGTH SANDRA R. ALEXANDER
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W 26.44' 4 r
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L2 N 19'07'24" W 15.29' a
L3 N 16'40'70" E 22.82'
L4 S 05'49'20" E 15.00'
L5 S 0549'20" E 24.50'
L6 N 39'02'40" W 12.54' k
LAKE NORMAN 7 '
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/ NOTES
, Z k 1) DVS PROPERTY MAYSUBJECT
TO ANY EASEMENTS AND/OR
Z / i•• RIGHTS OF WAY O
2) F RECORO
ACREAGE COMPUTED BY THE
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3) COORDINATE METHOD.
UNDERGROUND POWER
0. 25 IV S I' OF / 4) NO GRID MONUMENT FOUND WITHIN
11
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SCALE IN FEET ,
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DEPARTMENT OF HEALTH AND HUMAN SERVICES Sheet I of l
DIVISION OF PUBLIC HEALTH,ENVIRONMENTAL HEALTH SECTION PROPERTY ID#:
ON-SITE WATER PROTECTION BRANCH 1 Ur COUNTY:_Catawba_
SOIL/SITE EVALUATION
for ON-SITE WASTEWATER SYSTEM
,/ (Complete.I1 fields in full)OWNER.: /(f(4.3 APPLICATION DATE
ADDRESS: DATE EVALUATED: ' 77/2I
PROPOSED FACILITY: 2I- pROPOSED DESIGN FLOW(.1949): 'Z`(i PROPERTY SIZE:
LOCATION OF SITE: j 7 zo Lr A.i~IC PROPERTY RECORDED:
WATER SUPPLY: 0 Private ❑Public [ ell n Spring U Other
EVALUATION METHOD: ❑A Boring ��Pit ❑Cut TYPE OF WASTEWATER: 0 Sewage 0 Industrial Process 0 Mixed
SOIL MORPHOLOGY OTHER
(•1941) PROFILE FACTORS
.1940
LANDsCAn HORIZON
POSmON/ DEPTH 1942 PROM&
M SLOPE% .) .1941 .1%1 SOIL -1943 .1956 .1944 CLASS
STRUCTORLJ CONSISTLNCEI yawns/ SOIL SAPRO RUM <AR
3ZXTIJ= MIBILRAIOGY COLOR DEPTH CLASS HORIZ
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LS -3L `:16 _ cL F A St-
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DESCRIPTION INITIAL SYSTEM REPAIR SYSTEM OTHER FACTORS(.1946):
Available Space(.1945) SITE CLASSIFICATION(.1948): �S
I}po(s>,n �Z (,J �,� EVALUATED BY: 51,4
syste c�•� �,r1
S OTHER(S)PRESENT:
Site LTAR 3S- p,
COMMENTS:
Updated February 2014
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Catawba County Environmental Health
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