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Home My WebLink AboutIMPV-05-2023-196811.TIF .44►1.a • CAIANBACOUNT) Public Ilealth Department Subdivision 2 ,--. '' Environmental Health Division PIN# 367703417267 (...._ Pt)Box 389,25 Government Drive,Newton,NC 28658 LOP, 3 Site Address: 4145 FISHERMANS LN,MAIDEN NC 28650 Name on Permit: JAMIE&AMY LAITY Property Size: Acres 3.36 Directions: 16 S, R on Buffalo Shoals, L Olivers Cross Rd, L on Burton, R on Fishermans property on Right Owner/Authorized Representative Acknowledgement of Permit Receipt ys,I /fri_` I certify that I am the owner or authorized agent(owner's authorization required)representing the owner of the property described above. f, A e. ' As the property owner or authorized representative, I have received the above referenced tp4irtnit(s)as requested in the application for service RBPR-08 2022 41839,by the following method(s): Y Received in Person Facsimile Transmittal (Return form with signature required) Electronic Image Transmittal/E-mail (Return receipt required) " As the property owner or authorized representative I have reviewed and understand the specific conditions I pfthe permit issued, and further understand that all applicable regulatory requirements specified under the North Carolina Laws and Rules for Sewage Treatment and Disposal Systems(I5A 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::::tivc Signature // _ Date- '/J /2i-) / 1 Documentation of Permit(s)Transmittal (permit transmitted by electronic or other means) Permit transmitted by _ (name of person sending permit) Signature Date/Time Method: Fax 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 yoaPlease ttake a few momentts tto complette our custtomer service survey an http://www.surveymonkey.com/s/EHCusttomerService 05:30i2o23 09 12 rt • CATAWBA COUNTY Case# IMPV-05 2023-196811 Public Health DepartmentSubdivision Environmental Health Division PIN# 367703417267 y PO Box 389,25 Government Drive,Newton,NC 28658 LOT# 3 Site Address: 4145 FISHERMANS LN, MAIDEN NC 28650 Name on Permit: JAMIE&AMY LAITY Property Size: Acres 3.36 Directions: 16 S, R on Buffalo Shoals, L Olivers Cross Rd, L on Burton, R on Fishermans property on Right 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: 25% REDUCTION System Classification: IIIG-OTHER NON-CONY TRENCH SYSTEMS REPAIR SYSTEM SPECIFICATIONS_ Repair System Required? Required Proposed Wastewater System: 25%REDUCTION System Classification: IIIG-OTHER NON-CONY TRENCH SYSTEMS Permit Conditions: *See AC 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. 37VL ()PW1 05/26/2023 Authorized State Agent Permit Issuance Dale 5/26/2028 Permit Expiration Date No grading or construction activity is allowed in areas designated for system and repair without approval of the Health Department. ehpernut 05/30/2023 09:14 Catawba County Environmental Health R8f1-08 -Z-ZI -Lfi831 /oS_Zs23' 0481i 0 1zo, TKP✓' 73 l9be!S ACV 4µl1,, o5 Arai ,Jybl Wtil ds _i23- 19(0$/ , 1 1 11� \ 40 t h 1 f $o �Q- go 4SZ Dry vC 00 ss( ' j.�r 1 S ,p V \ r r (o`C( �1`� kidd426.50 ar �{0 4 iis 25' 21.85 • 0 4229 inch .4159 N 8' .c Q- In cn ci 1m A r, 427.58 a 0 —.... 2 Seiected Parcels lin=80ft This map'reivit woduct was prepared from Cho Catawba County.NC Geospatral Information Seances. Catawba County has made substan al efforts ".,ie:;or 74 av:ay;!ir, voi and la•,etrg mf',rmatuon contained on Ihrs map or data on Mrs report Catawba County promotes and recommends r,e,,r3e'i-_de...,m r,r ate,,,or any 'via c..00aArrrd on true map/rep/A Voduct by the usor The County of Catawba.mts employees.agents,and pirvi-•J 11- ar- aril t.oaff rvt Le hell labia for any and as damages.Ions or habemty,whether direct.irWuect or consequential which anses or may alas Irvin Vie mapIrprwt voduot or me use thereof by any person r,r entsty. Copyright 2023 Catawba County NC 05/26/2023 DEPARTMENT OF HEALTH AND HUMAN SERVICES Sheet l G., -�I_„?- DIVISION OF PUBLIC HEALTH,ENVIRONMENTAL HEALTH SECTION PROPERTY ID I: 31 _ j ON-SITE WATER PROTECTION BRANCH COUNTY: ti`A SOIL/SITE EVALUATION for ON-SITE WASTEWATER SYSTEM -�- n (Complete all fields in full) OWNER: Ja/►1j6 �. 1JM ti j,.y _ APPLICATION DATE 5 g ADDRESS:%Qt �S 7/ �Lrt / M"(fall 1/C Z1 fi0 DATE EVALUATED: PROPOSED FACILITY: •/r1 a tJL PROPOSED DESIGN FLOW(.1949): ZLO 6PD PROPERTY SIZE: J t(L LOCATION OF SITE: I/ S �i;5h 41r CA1 /11,41V,n Al( ZKP(d0 PROPERTY RECORDED: WATER SUPPLY: l9'Private ❑Public L 'Well O Spring ❑Other �� _ EVALUATION METHOD: ❑Au goer Boring L+lPit ❑Cut TYPE OF WASTEWATER: PI Sewage ❑Industrial Process 0 Mixed f �. • • r R 0 SOIL MORPHOLOGY OTHER a (.1941) PROFILE FACTORS 1 .1940 I. LANDSCAPE HORIZON - POSITION/ DEPTH .1942 PROFILE a SLOPE% (IN.) .1941 .1941 SOIL .1943 .1956 .1944 CLASS STRUCTURE/ CONSISTENCE/ WETNESS/ SOIL SAPRO RESTR &LTAR TEXTURE MINERALOGY COLOR DEPTH CLASS HORIZ LS 0-20 L 56k ',,ss,sihExf t pc 1 �-N Be NAM yg 3Y ti CL 1•j Ss,51p! �° co ado a Zqs . U- Zz C SBJC , is�,5tx' L 5 zz-% C W58JC 1_351ft iic 2 3r; - Cl_ 8C PA3S S S $ Do/0 O. 1-5 3 4 — DESCRIPTION INITIAL SYSTEM REPAIR SYSTEM OTHER FACTORS(.1946): ?J 6 6SITE CLASSIFICATION(.1948): �� Available Space(.1945) MM p EVALUATED BY: 6 An Q. !'l° M System Type(s) L Pio aZ5 /0 Ma OTI IER(S)PRESENT': tuii kilth Site LTAR D. Z -5 0. Z-S _ COMMENTS. _ _ -- IJpdated February 2014 Catawba County Environmental Health RBPg ..05_ Zone - u1539 TMpv- 05 —Zo22 - 11( 8I1 •4145 0°' 11thco If 40 h iA it go 167, Lot ``ovyt W.* wi 81'4 ( t ��r `�� /\LL�'426.50 �Q� t 21.85 ¢ 30 SSoto ' 101 ik , trt 14159 ,, im r Q CV CD ' cP s ! 427.58 O ' 0 — rh cn 2 Selected Parcels 1 in=80ft ' This map/report product was prepared from the Catawba County,NC Oeospatlal 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 me !report product by the ueor.The County of Catawba,its employees,agents,and personnel,disclaim,and shalt not be held liable for any and all damages,loss or liability,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 05/26/2023