HomeMy WebLinkAboutIMPV-07-2023-199597.TIF •
79 CATAWBA COUNTY Case#
,ram. 1MPV-07-2023-199597
H , Public Health Department Subdivision EDGEWATER
d "1 Environmental Health Division PIN# 460717214349
PO Box 389,25 Government Drive,Newton,NC 28658 LOT# 14
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Site Address: 7233 STATIC WAY, SHERRILLS FORD NC 28673
Name on Permit: TYLER GARRITY
Property Size: Acres 0.77
Directions: left off Little Mountain Rd onto Static Way, secound lot on the left after new house on the corner lot
Owner/Authorized Representative Acknowledgement of Permit Receipt
1 certify that I am the owner or authorized agent(owner's authorization required)representing the owner of
the property described above.
XAs the property owner or authorized representative, I have received the above referenced
permit(s)as requested in the application for service EHPR-04-2023-44179, by the following method(s):
Received in Person
Facsimile Transmittal (Return form with signature required)
JElectronic Image Transmittal/E-mail (Return receipt required)
As 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 (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: 07/07/2023
Owner/Authorized Representative Signature
Date
Documentation of Permit(s)Transmittal
(permit transmitted by electronic or other means)
Permit transmitted by (name of person sending permit)
Signature (.I €.....
Date/Time -7)17h3
Method: Fax J 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 Environmental Health l,1,ew 07_ za23- /97s-17
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Parcel: 460717214349, 7233 STATIC WAY 1 in=50ft
SHERRILLS FORD, 28673
This map/report product was prepared from the Catawba County,NC Geospatial 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 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
07/07/2023
DEPARTMENT OF HEALTH AND HUMAN SERVICES Sheet 1 of
DIVISION OF PUBLIC HEALTH,ENVIRONMENTAL HEALTH SECTION PROPERTY ID#:
ON-SITE WATER PROTECTION BRANCH 41 if 1 7 ? COUNTY:_Catawba
SOIL/SITE EVALUATION
for ON-SITE WASTEWATER SYSTEM
(Complete all fields in full)
OWNER J4"4" tom,1 `S,r _ APPLICATION DATE
ADDRESS: DATE EVALUATED: ye6/4.1
PROPOSED FACILITY: Yif r PROPOSED DESIGN FLOW(.1949): tj , PROPERTY SIZE:
LOCATION OF SITE: 712. S ti LAI PROPERTY RECORDED:
WATER SUPPLY: ❑Private IN')ublic ❑Well ❑Spring 0 Other
EVALUATION METHOD: ❑A :er Boring Iit ❑Cut TYPE OF WASTEWATER: ❑Sewage ❑Industrial Process 0 Mixed
P
o SOIL MORPHOLOGY OTHER
F (.1941) PROFILE FACTORS
.1940
g LANDSCAPE HORIZON
POSmON/ DEPTH PROFILE
# SLOPE Ste (IN.) .1942
.1941 .1941 SOIL -1943 .1956 .1944 CLASS
STRUCTURE/ CONSISTENCE! WETNESS/ SOIL SAPRO RESTR <AR
TEXTURE MINERALOGY COLOR DEPTH CLASS HORIZ
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DESCRIPTION INITIAL SYSTEM REPAIR SYSTEM OTHER FACTORS(.1946):
Available Space(.1945) P., Pf SITE CLASSIFICATION(.1948): Ps
System Type(s) 14 � Nes OTHERS PRESENT:EVALUATED BY:
�/4.•
Site LTAR 01 O:"Ar
COMMENTS:
Updated February 2014
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SOIL/SITE EVALUATION 4-N17 S sheet Z ot
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(Continuation Sheet-Complete all field in full)
DEPARTMENT OF HEALTH AND HUMAN SERVICES PROPERTY ID#:
DIVISION OF PUBLIC HEALTH DATE OF EVALUATION: 4,44/ZJ
ENVIRONMENTAL HEALTH SECTION COUNTY:
ON-SITE WATER PROTECTION BRANCH
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o SOIL MORPHOLOGY OTHER
F (.1941) PROFILE FACTORS
1 .1940
E LANDSCAPE HORIZ .1942
POSITION/ ON .1941 .1941 SOIL .1943 .1956 .1944 PROFILE
a SLOPE% DEPTH STRUCTURE/ CONSISTENCE/ WETNESS! SOH, SAPRO RESTR CLASS
TEXTURE MINERALOGY COLOR DEPTH CLASS HORIZ <AR
(IN.)
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COMMENTS:
Updated l ebruary 2014
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Catawba County Environmental Health
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Parcel: 460717214349, 7233 STATIC WAY 1 in=50ft
SHERRILLS FORD, 28673
This map/report product was prepared from the Catawba County,NC Geospatlal 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 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
07/07/2023