HomeMy WebLinkAboutIMPV-05-2023-195979.tif t
4.H�ei: CATAWBACotUNTY
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.i,Kt(...... Public Health Department Subdivision
tinvironmenlal Ileelth lJivision PIN# 461602577965
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f'p Box 3R9,25 Government ikivc,Newton,NC 2865A i f)'1'N 2
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Site Address: 4496 KISER ISLAND RD,TERRELL NC 28682
Name on Permit: 'NEST HOMES LLC
Property Size: Acres 0.54
Directions: S on NC 16,E on Hwy 150,approx 7 miles, Right on Kiser Island Rd,Kiser Island Rd to parcel on Left
Owner/Authorised Representative Acknowledgement of Permit Receipt
XPI certify that I am the owner or authorized agent(owner's authorisation required)representing the owner of
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property described above.
f" 'fp1s the property owner or authorised representative, I have received the above referenced
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it(s)as requested in the application for service RBPR-01-2022-39866,by the following method(s):
Received in Person
Facsimile Transmittal (Return form with signature required)
/ Electronic Image Transmittal/E-mail (Return receipt required)
j As the property owner or authorized representative I have reviewed and understand the specific conditions
(`' he 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:05/17/2023
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Owner/Authorized Representative Signature _
Date___ 5/2Iiig.._
Documentation of Permit(s)Transmittal
(permit transmitted by electronic or other means)
Permit transmitted by . (name ofperson sending perm/!)
Cr , Date/'lime_ 6t)4/)3
Method: Fax 'I 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 yoLPlease ttake a few momentts tto comptette our custtomer service survey an
http://www.surveymonkey.com/s/EHCusttomerService
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1151 R/2023 14.3A
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CATAWBA COUNTY Case II IMPV-OS 2023-195979
Public Health Department Subdivision
�� Environmental Health Division
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PINT! 461602577965
PO Box 389,25 Government Drive,Newton,NC 28658
LOTH 2
Site Address: 4496 KISER ISLAND RD, TERRELL NC 28682
Name on Permit: *NEST HOMES LLC
Property Size: Acres 0.54
Directions: S on NC 16, E on Hwy 150, approx 7 miles, Right on Kiser Island Rd, Kiser Island Rd to parcel 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 360 g.p d
Type of Facility: Primary Residence
Basement? Yes Basement Plumbing? Yes Bedrooms: 3
Water Supply: Private Well Maximum Occupants: 6
INITIAL SYSTEM SPECIFICATIONS
Proposed Wastewater System: 50%REDUCTION HORIZONTAL—Alternating Dual Field Nitrification System
System Classification: IVA-ANY SYSTEM WITH LPP DISTRIBUTION
Operator Required
REPAIR SYSTEM SPECIFICATIONS
Repair System Requiredi Install with Initial System
Proposed Wastewater System: 50%REDUCTION HORIZONTAL
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'(I5A 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,f_______
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05/17/2023
Authorized State Agent Permit Issuance Date
5/17/2028
Permit Expiration Date
No grading or construction activity is allowed in areas designated for system and repair without approval of the Health Department.
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