HomeMy WebLinkAboutIMPV-07-2023-200168.TIF erd%
CATAWBA COUNTY
(.... Public Health Department Subdivision WHITE EAGLE RANCH
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�! Environmental Health Division a PIN# WHITE 189221
111114.:1PO Box 389,25 Government Drive,Newton,NC 28658 LOT# 5&PT 6
Site Address: 1516 WHITE EAGLE RANCH RD, HICKORY NC 28602
Name on Permit: RUSSELL GILCHRIST
Property Size: Acres 6.01
Directions: S NC 127 Hwy, left Bethel Church Rd, right White Eagle Ranch Rd,on left
Owner/Authorized Representative Acknowledgement of Permit Receipt
yki certify that I am the owner or authorized agent(owner's authorization required)representing the owner of
the property described above.
/ //As the property owner or authorized representative, I have received the above referenced
permit(s)as requested in the application for service RBPR-11-2021-39376, by the following method(s):
Received in Person
Facsimile Transmittal (Return form with signature required)
7 Electronic Image Transmittal/E-mail (Return receipt required)
•f As the property owner or authorized representative I have reviewed and understand the specific conditions
r of the permit issued, and further understand that all applicable regulatory requirements specified under the
t 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: 07/14/2023
Owner/Authorized Representative Signature 10.4.4/61.% «. <
Date - ll f--2 3
Documentation of Permit(s)Transmittal
(permit transmitted by electronic or other means)
Permit transmitted by 4-,...
(name of person sending permit)
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Signature Date/Time g)71->3
Method: Fax I Email US Mail Other
Owner's request to send by the above indicated method of transmittal in lieu of signature
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ei,pennit 07/17/2023 14:22 Of
..t v,A e CATAWBA COUNTY Case# IMPV-07-2023.200168
• - IRPublic Health Department Subdivision WHITE EAGLE RANCH
Environmental Health Division PIN# WHITE 370005189221
PO Box 389,25 Government Drip e.Ne«tun.NC 28658 LO # 5&PT 6
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Site Address: 1516 WHITE EAGLE RANCH RD, HICKORY NC 28602
Name on Permit: RUSSELL GILCHRIST
Property Size: Acres 6.01
Directions: S NC 127 Hwy,left Bethel Church Rd, right White Eagle Ranch Rd,on left
Improvement Permit 1
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: Accessory Structure- Pool house with 1 bedroom
Basement? No Basement Plumbing? No Bedrooms: 2
Water Supply: Public Water Maximum Occupants: 4
INITIAL SYSTEM SPECIFICATIONS
Existing Wastewater System: 25%REDUCTION
System Classification: DIG-OTHER NON-CONV TRENCH SYSTEMS
REPAIR SYSTEM SPECIFICATIONS
Repair System Required? Required
Proposed Wastewater System: 25%REDUCTION
System Classification: IIIB-SYSTEM W/SINGLE EFFLUENT PUMP
Pump Required
Permit Conditions: *This permit is issued to relocate the repair area for the pool house that was compromised
during construction.
*For the initial IP pool house system see permit IMPV-06-2022-173231
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 h> 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
Rulesfor 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.
BofiNf--/611e‘ee �r;tt�i 07/14/2023
Authonzed State Agent Permit Issuance Date
7/14/2028
Permit Expiration Date
No grading or construction activity is allowed in areas designated for system and repair without approval of the Health Department.
dy,.iuiu 08/04/2023 08:54