HomeMy WebLinkAboutIMPV-05-2023-195502.tif 1 CAT%%ttA COI'NTl' Case IMI'V-05-2O23.195502
.0 Y Public Ilcalth Department Subdivisionct. „-• Environmental Ilcalth Division PIN/ 367703329641
\ w PO lies 1K9,25 Gnvernmcnt Drive NcNtml,NC 2X65X I orti 1
Site Address: 4374 BURTON DR, MAIDEN NC 28650
Name on Permit: MICHAEL PASSMORE
Property Size: Acres 3.31
Directions: S Olivers Cross Road, Burton Dr on left in curve
Owner/Authorized Representative Acknowledgement of Permit ReceiptIt
certify'that I am the owner or authorized agent(owner's authorization required)representing the owner of
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the described above.
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104 s the property owner or authorized representative. I have received the above relcrenced 11
permit(s)as requested in the application li)r service E11PR-03-2023-13705, by the following method(s):
Received in Person
Facsimile Transmittal (Return form with signature required)
J Electronic Image Transmittal/Email (Return receipt required)
OrlAs the property owner or authorized representative 1 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(I5A 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: 05/11/2023 •
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Documentation of Permit(s)Transmittal
(permit transmitted by electronic or other means)
•
Permit transmitted by (name a/•person sending perm!)
11
Signature 1 X.,
-- - _ 1)ate/Time 63I4)3
Method: Fax .! Email US Mail Other
Owner's request to send by the above indicated method of transmittal in lieu of signature
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� . CATAWBA COUNTY Case# IMPV-05-2023-195502
Public Health Department Subdivision
d in- .i Environmental Health Division PIN# 367703329641
PO Box 389,25 Government Drive,Newton,NC 28658 LOT# 1
8• SM
Site Address: 4374 BURTON DR, MAIDEN NC 28650
Name on Permit: MICHAEL PASSMORE
Property Size: Acres 3.31
Directions: S Olivers Cross Road, Burton Dr on left in curve
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 480 d
9.P•
Type of Facility: Primary Residence
Basement? No Basement Plumbing? No Bedrooms: 4
Water Supply: Private Well Maximum Occupants: 8
INITIAL SYSTEM SPECIFICATIONS
Proposed Wastewater System: 25% REDUCTION
System Classification: IIIG-OTHER NON-CONY TRENCH SYSTEMS
REPAIR SYSTEM SPECIFICATIONS
Repair System Required? Required
Proposed Wastewater System: 50%REDUCTION VERTICAL
System Classification: IIIB-SYSTEM W/SINGLE EFFLUENT PUMP
Pump 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
Rulesjor 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 Health authorization or permit
modification.Please notify Environmental llealth of this change prior to system installation.
/1,444_,e.. -- /- Zcy___ ____
05/11/2023
Authorized State Agent Permit Issuance Date
5/11/2028
Permit Expiration Date
No grading or construction activity is allowed in areas designated for system and repair without approval of the Health Department.
dip:rmit 05/122023 13:30
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Catawba County Environmental Health
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Parcel: 367703329641, 4390 BURTON DR 1 in=100ft
MAIDEN, 28650
This map/report product was prepared from the Catawba County, NC Geospatiat 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 all damages,loss or Lability,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
05/11/2023
DEPART MEN OF HEALTH AND HUMAN SERVICES Sheet_ of
DIVISION OF PUBLIC HEALTH,ENVIRONMENTAL,HEALTH SECTION PROPERTY ID#:
ON-SITE WATER PROTECTION BRANCH COUNTY: Catawba
SOIL/SITE EVALUATION
•
for ON-SITE WASTEWATER SYSTEM
(Complete all fields in full)
OWNER: _ hat- I -Pa..55 Q f' _- APPLICATION DATE
ADDRESS: DATE EVALUATED:
PROPOSED FACILITY: _ P OPOSED ESIG�j FI O�'(.1949): 1-1-6 PROPERTY SIZE: �� �� 25
LOCATION OF SITE: �ji5c
1 4 .r 5y• U` //Y.�.l./CvL 4,1( G PROPERTY RECORDED:
WATER SUPPLY: 0 Private 0Public W'eTI L Spring l Other _ o
EVALUATION METHOD: O Auer Boring L.tir-TJ Cut TYPE OF WASTEWATER: 1 ge L'Industrial Process Ll Mixed
�q •a SOIL MORk,)ri[O pGY t. : ()limit1 e,. - 'r';
' ° (11)9
.� PROM'E FACTORS' '
^"' LANDSCAPE `IIOiR1Z(ltli ,' J ..
ti-pos,' J 1i 'i' DEPTH' Pi�OvFILE•
ip42 i. • • -a
a al! '), SLOPE% Om) ' .1941 _ .1941 + S01L 1943 .1936. .1944 1
.'STRUCTURE/ CONS1STF Cll i WETNESS! ' SOIL .SAIRO RESTR ; &L'TAR 'i.k
TEXTURE MINBRA�Y COLOR-• ` DEPTH CLASS 11ORIZ'
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DESCRIPTION INITIAL.SYSTEM REPAIR SYSTEM OTHER FACTORS(.1946):
----
Available Space(.] 45) l JSITE CLASSIFICATION(.1448): --__—__
'JP D /y� - EVALUATED BY: �7 ----
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System Type(s)
OTHER(S)PR :
Site LIAR 3
COMMENTS:
Updated February 2014
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