HomeMy WebLinkAboutIMPV-07-2023-200730.TIF ,
I . „I v:IIIY CATAWBA COUNTY
` �i1� Public Health D` `t`neM Subdivision DOUGLAS CORNERS
16
f fs Environmental Health Division
PING 268703242977
'IL.,/ Goverment PO Box 389,25 Goverent Drive,Newton,NC 28658
t i t LOTN 17
Sao Address: 3817 AMBER DR,VALE NC 28168
?tampon P.rmit: •OAKWOOD HOMES
Pmporty Size: Acres 0.64
Directions: Left Radio station RD,:efet Long DR,Right Hay 10,Left Banoak, Left West Lee Dr,Right Amber Dr end 3817
Amber Dr
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Owner/Authorized Representative Acknowledgement of Permit Receipt
xDo I 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
i permit(s)as requested in the application for service RBPR-03-2023-43882,by the following method(s):
Received in Person
_ Facsimile Transmittal(Return form with signature required)
✓Electronic Image Transmittal/E-mail (Return receipt required)
i
)D As the property owner or authorized representative I have reviewed and understand the specific conditions
X
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
4 c&eOwner/Authorized Representative Signature
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I Date a 7' Z 3 _ 1
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Documentation of Permit(s)Transmittal
(permit transmitted by electronic or other means)
Permit transmitted by __ _ _ (name of person sending permit)
Signaturecie Ig1 )3 ! !
` Date/Time ! ! I
Method: Fax 'Y Email US Mail Other ()
Owner's request to send by the above indicated method of transmittal in lieu of signature
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ehpermit 07/27/2023 D7:23
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CATAWBA COUNTY Case# IMPV-07-2023-200730
Public Health Department Subdivision DOUGLAS CORNERS
it,:^ * Environmental Health Division PIN# 268703242977
PO Box 389,25 Government Drive,Newton,NC 28658 L.OT# 17
9.
Site Address: 3817 AMBER DR, VALE NC 28168
Name on Permit: *OAKWOOD HOMES
Property Size: Acres 0.64
Directions: Left Radio station RD,:efet Long DR, Right Hay 10. Left Banoak, Left West Lee Dr,Right Amber Dr end 3817
Amber Dr
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 360 g p d
Type of Facility: Primary Residence- New house
Basement? NO Basement Plumbing? NO Bedrooms: 3
Water Supply: Private Well Maximum Occupants: 6
INITIAL SYSTEM SPECIFICATIONS
Proposed Wastewater System: 50% REDUCTION VERTICAL
System Classification: IIIE- PPBPS GRAVITY DOSED SYSTEM
REPAIR SYSTEM SPECIFICATIONS
Repair System Required? Required
Proposed Wastewater System: 50%REDUCTION VERTICAL
System Classification: IIIE-PPBPS GRAVITY DOSED SYSTEM
Permit Conditions:
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 Sewa2e Treatment and Disposal Systems'(15A NCAC I8A.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.
Ic1 IPe:k 07/24/2023
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Authorized State Agent Permit Issuance Date
7/24/2028
Permit Expiration Date
No grading or construction activity is allowed in areas designated for system and repair without approval of the Health Department.
riq,cinin 08/04/2023 07:51