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HomeMy WebLinkAboutIMPV-05-2023-196500.tif .4ctiti> CATAWBA COt'YrV ('au It IMPV-05-2023-196500 !+' ruhhC Health Department Subdivision ROCKING HORSE RIDGE SE, „� ,7 Environmental Health Division ('INl! 367602799523 C`( PO Box 3B4,2S Government Drive.Newton.NC2B65B LOTN 22 XI w site Address: 4775 APPALOOSA LN,MAIDEN NC 28650 Name on Permit: HALEY LARSEN Property Size: Acres 1.63 Directions: S NC 16 Hwy right Anderson Mountain Rd,left Rocking Horse Dr, right Appaloosa Ln on right Owner/Authorized Representative Acknowledgement of Permit Receipt Mi .ertify that I am the owner or authorized agent(owner's authorization required)representinE the owner of the property described above. )043 As the property owner or authorized representative, I have received the above referenced permit(s)as requested in the application for service E11YR-03-2023-43700,by the following method(s): Received in Person Facsimile Transmittal(Return form with signature required) 1 Electronic Image Transmittal/E-mail (Return receipt required) 16s 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(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:05/23/2023 Owner/Authorized Representative Signature � -4. j��/� P S Date .5...c m_. T_ , � f Documentation of Permit(s)Transmittal (permit transmitted by electronic or other means) Permit transmitted by (name of person sending permit) SignatureE ._. ._ Date/Time Dl 33i)3 Method: Fax j 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 yosPlease ttake a few momentts tto complette our custtomer service survey aft httn://www.surveymonkey.com/s/EliCusttomerService !n @ia(Ssbt/ l)uss Am 1, t11 212i127 IS i$ I r • County: Catawba IMPROVEMENT PERMIT FOR G.S. 130A-335(a2)/5L2022-11 PIN/Lot Identifies 367602799523 Issued To: Haley Larsen Property Location: 4775 Appaloosa Ln, Maiden NC 28650 Subdivision: Rocking Horse Ridge tot it: 11 Block: - Section: 2 LS5 Report Provided: Yes Q No❑ If yes,name and license number of LSS: Miranda Stamper, 1258 New❑r Repair❑ Expansion ❑ System Relocation ❑ Proposed structure: 4 bedroom residence Proposed Wastewater System Type: PPBPS (Initial) Subsurface Drip (Repair) Fill System:❑Yes Q No If yes,specify: ❑New ❑Existing (when adding more than 6 inches of fill to system area please provide a fill plan) Proposed Design Daily Flow: 480 GPD Proposed LTAR(Initial): 0.35 Proposed LTAR(Repair): 0.15 Design Wastewater Strength: Q domestic ❑high strength ❑industrial process Number of bedrooms: 4 Number of Occupants: 8 max Other: Pump Required: ❑Yes ❑ No ®May be required based upon final location and elevations of facilities Artificial Drainage Required: ❑Yes QNo If yes,please specify details: Type of Water Supply: Private well ❑Public well ❑Municipal Supply ❑Spring ❑Other: Drainfield location meets requirements of Rule.1945: Yes No❑ Drainfield location meets requirements of Rule.1950: Yes E No❑ Permit valid for:0 Five years[site plan submitted pursuant to GS 130A-334(13a)] ❑ No expiration[plat submitted pursuant to GS 130A-334(7a)] Permit conditions: Licensed Soil Scientist Print Name: Miranda Stamper Miranda Stamper Digitally signed by Miranda Stamper _ Licensed Soil Scientist Signature: oain 2023.05.2310.50.06-04'00• Date: The L55 evaluation is being submitted pursuant to and meets the requirements of G.S. 130A-335(a2). 'See attached site sketch* 4775 Appaloosa Ln County: Catawba This Section for Local Health Department Use Only Initial submittal received: 3/14/23 by RP Date Initials Permit Number: IMPV-05-2023-196500 G.S. 130A-335(a4) states the following: 'If a local health department fails to act on an application for an improvement permit submitted pursuant to subsection(a3)of the section within 10 business days of receipt of a complete application, the local health department shall issue the improvement permit.' In accordance with G.S. 130A-335(a3)the improvement permit application is: ❑ Incomplete(If box is checked, information in this section is required.) The following items are missing: Copies of this were sent to the LS5 and the Owner on Dote State Authorized Agent: Date: ❑ Denied (See attached report.) Copies of this were sent to the LSS and the Owner on Dote State Authorized Agent: Date: © Complete %ILState Authorized Agent: eL4 Date of Issuance: 5/23/23 This Improvement Permit is issued pursuant to G.S. 130A-335(a2), (a3),and (a4)using the signed and sealed LSS/LG evaluation(s) attached here. The issuance of this permit by the Health Department in no way guarantees the issuance of other permits. The permit holder is responsible for checking with appropriate governing bodies in meeting their requirements. This site is subject to revocation if the site plan,plat,or the intended use changes,or if information submitted in the application was falsified, inaccurate or misleading. The Improvement Permit shall not be affected by a change in ownership of the site. This permit is subject to compliance with the provisions of the Laws and Rules for Sewage Treatment and Disposal and to conditions of this permit. The location and identification of all property lines,easements,water lines,and other appropriate utilities shall be the responsibility of the owner. The Department,the Department's authorized agents,and the local health departments shall be discharged and released from any liabilities,duties,and responsibilities imposed by statute or in common law from any claim arising out of or attributed to evaluations,submittals,or actions from a licensed soil scientist or licensed geologist pursuant to GS 130A-335(a2). Improvement Permit Expiration Date: 5/23/28 *See attached site sketch* r LINE SCHEDULE 4775 APPALOOSA LN, MAIDEN NC. LINE NUMBER COLOR FIELD ELEVATION LENGTH(FT) DESIGN LENGTH SECTION 2, LOT 22 ROCKING HORSE RIDGE (FT) 1 ORANGE 0.0 76 ° 4-BEDROOM GRAVITY T&J PANEL SYSTEM 2 WHITE 2.0 113 0 (VERTICAL) 3 GREEN 4,4 120 36 LINES 3A-4, 5A-6A TOTAL 228 LINEAR FT 4 RED 6.2 51 51 LTAR 0.35 5 YELLOW 7.1 100 68 50% REDUCTION 8' OC 6 BLUE 8.3 90 73 28" MAX TRENCH BOTTOM (LOW SIDE) TOTAL TOTAL 550 228 4-BEDROOM TS1 PRETREATMENT DRIP IRRIGATION SYSTEM (AMERICAN PERC-RITE) CONDITIONS: MUST BE INSTALLED BY A LICENSED SEPTIC LINES 1-2, 3B, 5B TOTAL 3840 SOFT LIAR 0.15 INSTALLER. DRAINFIELD AREA MUST MAINTAIN NATURAL 6 8' TRENCH BOTTOM CONTOURS&SLOPE. IMPROPER OR EXCESSIVE GRADING WILL VOID THIS DESIGN AND BOSS IS NOT LIABLE. FOR GENERAL USE NOT A SURVEY PRELIMINARY NOT FOR CONSTRUCTION INFORMATION FOR INSTALLER: END FEED LINES 3-5 WITH DROP BOXES I I I i } SYSTEM LINE SCALE: 1 REPAIR LINE — — — — 1" = 40 ft. 6A ,,,,, \ ` 5A ` _.3A 71- / 4 / i / �J ? 6B ' Q/ 4L" / QF / / 4ti'�1, / / ,__ ,6�o 5� ,...-- A, �o / <'5B O� 3 — h , // \\ 3B ,/ 1 ` }. / \ ? r ' . W N, w a N �� \ .. ?` a to n �' • N w 4 N. J N HOUSE / N r4 LOT 22 BOSS Benfield Outdoor Services&SolutruiHALEY LARSEN MAIDEN,NC UMOrMy*NM R4.M orern4M.NC ami? rw:.54-0. .95,4 �aeY woeereoeecou 4775 APPALOOSA LN, CATAWBA COUNTY DATE 4/791B DRAWN BY:WOO Off BY:M3 r 1. 4775 APPALOOSA LANE,MAIDEN NC VICaiT1'Y NAM 4-BEDROOM GRAVrTY PANEL BLOCK SYSTEM 6 i. 1 TOTAL 228 LINEAR FEET 3 LTAR 0.35 d 50%REDUCTION 4-BEDROOM TSI PRETREATMENT DRIP REPAIR SYSTEM LTAR 0.15 iM FOR GENERAI.USE NOT A SURVEY PRELIMINARY NOT FOR CONSTRUCTION 1 -.111Minm..--__Ia0110141. ...._ `r oZ N. IZ / . ► . ,* // '_ `�+ -irt Irk .51- J Pt"' N 0 // / ICI\ \\ /4, ` ‘4`�2,,�+� 6Z-9178d /4 \ . c _ 1 £Z ,w Dr 3,60,Illt N \\..........„ ............/i M\a H.LVAIad,OS N'l VS001VddV SYSTEM LINE } I I I t SCALE: REPAIR LINE 1" = 80 ft. LOT 22 BOS Benfield Outdoor Services&Solutions 4775 APPALOOSA LN,MAIDEN,NC CATAWBA COUNTY FOOYA ••I 2,1N, HALEY LARSEN NOQYAN1A8SYSOeS.COw a41E:4/1923DPAWNeY:MCBO BY,NE5 Sheet I of 1 PROPERTY ID 4: 1 S 3 COUNTY: eaii+ SOIL/SITE EVALUATION for ON-SITE WASTEWATER SYSTEM (Complete all fields in full) OWNER: Larsen Lot 4 11 Mtn 2 APPLICATION DATE: ADDRESS:4rrs Appaloosa Lane _ DATE EVALUATED: 2A1123 PROPOSED FACILITY: 4 bedroom PROPOSED DESIGN FLOW(.1949): 400 PROPERTY SIZE: 1.63 aa.. LOCATION OF SITE: Rocldng Mese Ridge PROPERTY RECORDED: WATER SUPPLY: 0 Private 0 Public 0 Well 0 Spring 0 Other EVALUATION METHOD: 0 Auer Boring 0 Pit 0 Cut_ TYPE OF WASTEWATER: 0 Sewage 0 Industrial Process 0 Mixed r R SOIL MORPHOLOGY OTHER F (.1941) PROFILE FACTORS I .1940 E LANDSCAPE HORIZON POSITION/ DEPTH PROFILE # SLOPE% (IN.) .1942 .1941 .1941 SOIL .1943 .1956 .1944 CLASS STRUCTURE/ CONSISTENCE/ WETNESS/ SOIL SA PRO RESTR &LTAR TEXTURE MINERALOGY COLOR DEPTH CLASS HORIZ P1 L 20% 0-13 GR SL NS NP FR 20" ROCK 0.35 13-20 SBK CL SEXP NS NP Fl - - @20" ON HIGH SIDE P2 L 20% 0-12 GR SL NS NP FR FREE 32" ROCK 0.35 12-32 SBK CL SEXP SS SP Fl WATER ON - @32" @40" HIGH ON SIDE HIGH SIDE P3 L 16% 0-14 OR SL NS NP FR 55" 0.35 14-42 SBK CL SEXP SS SP Fl FEW - ROCKS- - - 42-55 SBK CL NS NP Fl NOT LIMITIN G P4 L 10% 0-12 GR SL NS NP FR „ 64 0.35 12-64 SBK CL SS SP Fl P5 L 10% 0-7 GR SL NS NP FR 36" 0.35 7-14 SBK SCL SEXP SS SP Fl - _ - 35-40% 14-36 SBK CL SEXP S SP Fl A---,---„,--,ei, SOIL s:%ROCK @12" ,,,,, .....‘ . S-* n , , z. �.. • DESCRIPTION INITIAL SYSTEM REPAIR SYSTEM OTHER FACTORS(.1946): . , ` i 1 U 1't Available Space(.1945)234 LF 3200 Sq ft SITE CLASSIFICATION(.194 It ` • (� 1 a System Type(s) PPBPS $UI�8UIfaK�e Drip EVALUATED BY: Mirandase.• 1 '� Q r Site LIAR 0.35 0.15 OTHER(S)PRESENT: ' ' ^ ' � �. COMMENTS:PIT I NOT IN USE _ 01 2 -i f qC5 -NOir(}H Updated Maio]2072