HomeMy WebLinkAboutIMPV-07-2023-200665.TIF e. "• Public CATAWBAHealth COUNTYDepartment Case# IMPV-07-2023-200665
Subdivision AMITY ACRES
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, `I Environmental Health Division PIN# 375018302309
PO Box 389,25 Government Drive,Newton,NC 28658 LOT# 27
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Site Address: 1354 TARA LN, NEWTON NC 28658
Name on Permit: *MARSHALL MEYERS
Property Size: Acres 0.36
Directions: NC 16, left onto Claremont Rd, left onto Constance Dr, right onto Tara Ln,property on the right
Owner/Authorized Representative Acknowledgement of Permit Receipt
Aars I certify that I am the owner or authorized agent(owner's authorization required)representing the owner of
the property described above.
V S As the property owner or authorized representative,I have received the above referenced
permit(s)as requested in the application for service EHPR-12-2022-42965,by the following method(s):
Received in Person
Facsimile Transmittal(Return form with signature required)
./ Electronic Image Transmittal/E-mail (Return receipt required)
.j t�S 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
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:07/21/2023 Owner/Authorized Representative Signature D�'1c9r S Iczc /' iflU'? h
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l Date CJ "4(- 23
Documentation of Permit(s)Transmittal
(permit transmitted by electronic or other means)
Permit transmitted by (name of person sending permit)
oilSignature Date/Time -/)V
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 yoiPlease ttake a few momentts tto complette our custtomer service survey att
http://www.surveymonkey.com/s/EHCusttomerService
ehpennit 07/21/2023 10:25 AP
.
DEPARTMENT OF I IEAL11I AND I IUMAN SERVICES Shoe!,l of
DIVISION OF PUBLIC I LEALTI I.ENVIRONMENTAL UEALTI I SECTION PROPERTY ID Y:
ON•SITE WATER PROTECTION BRANCH COUNTY;
SOIL/SITE EVALUATION
for ON-SITE WASTEWATER SYSTEM
I I (Complete all fields in full)
OWNER: /41LV6/44/f /4rgers APPLICATION DATE �O7 22
ADDRESS: DATE EVALUATED;a7.
PROPOSED FACILITY: PROPOSED DESIGN FLOW(.1949): 7 PROPERTY SIZE: ..fib
LOCATION OF SITE: / .S`r/ G/+i G r4 PROPERTY RECORDED: —
WATER SUPPLY: 0 Privateublie 0 Well ❑Spring ❑Other
EVALUATION METHOD: 0 Auer Boring 'it 0 Cut TYPE OF WASTEWATER: wage 0 Industrial Process 0 Mixed
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P
R SOIL MORPHOLOGY OTHER
F (.1941) PROFILE FACTORS
1 .1940
E LANDSCAPE HORIZON .
POSITION! DEPTII .1942 PROFILE
a SLOPE% (IN.) .1941 .1941 SOIL .1943 .1956 .1944 CLASS
STRUCTURE/ CONSISTENCE/ WETNESS/ SOIL SAPRO RESTR <AR
TEXTURE MINERALOGY COLOR DEPTH CLASS 110RIZ
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/ ' SITE CLASSIFICATION(.1948): P.&
Avsta7sbk Space(.1413) Y "�
sown s) 2S.; So �
I EVALUATED BY: �]..J . J4xI
OTHER(S)PRESENT:
Site LIAR s 3
COMMENTS:
-
Updated February 2014
I
Catawba County Environmental Health
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Parcel:375018302309, 1354 TARA LN 11n=40ft
NEWTON,28658
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ao aroma eua aooeaotv d boohoo and lot*M rdonsutan contained on Vas trap or data on err repot,cei r ee cger*y pproe,erd reaorevnerd.
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paraaeaoi,dllatlauh,Mad idea not be hold lobla t r any and el di rnrpes.loss or labasy,wwetner**Amerced or consequential ouch antes or may
adhere*am Ms atapAepmA pradeI sr ever use threat by esti demon or anGlty.
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