HomeMy WebLinkAboutAUTH-08-2023-201772.TIF CATAWBA Col Nil'
!L -i Public Ilcalth Department Subdivision CRESTVIEW DEV
s.,��s' hnvironmental Ilcalth Division PIN), 365914249309
��,,,„," PO I3ns 389,25 Government Drive.Newton.NC' _'Kh58 LUTe 17-20
Site Address: 2283 HILLSIDE DR, NEWTON NC 28658
Name on Permit: CESAR GUERRERO
Property Size: Acres 0.45
Directions: NC 16, right onto Crestview Dr,left onto Hillside Dr, property on the right
Owner/Authorized Representative Acknowledgement of Permit Receipt
�I certify that I am the owner or authorised agent km autht�ri/<ntion required}representing the owner of
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the property described:Mine.
)(at'As the property owner or authorized representative. I have received the above referenced
permit(s)as requested in the application fur service EHPR-05-2023-44470,by the following method(s):
Received in Person
Facsimile Transmittal (Return form with signature required)
f_ Electronic Image"Transmittal/ E-mail (Return receipt required)
LmitAs the property owner or authorized representative I have reviewed and understand the specific conditions
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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 I8A.1900),
4 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:08/03/2023
Owner/Authorized Representative Signature`yr
,� nate3/Jl/23
Documentation of Permit(s)Transmittal
(permit transmitted by electronic or other means)
Permit transmitted by (name of person sending permit)
-
Signature Qeei Date/Time u b!b3
Method: Fax v 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 Case#
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Ir f III Public Health Department Subdivision CRESTVIEW DEV
d apt Environmental Health Division PIN# 365914249309
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PO Box 389,25 Government Drive,Newton,NC 28658 LOT# 17-20
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Site Address: 2283 HILLSIDE DR,NEWTON NC 28658
Name on Permit: CESAR GUERRERO
Property Size: Acres 0.45
Directions: NC 16, right onto Crestview Dr, left onto Hillside Dr,property on the right
See also attached site plan.
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.
>>>>> Do not install system under wet conditions <<<<<
PROPOSED REPAIR
Repair System Required? Required Soil LIAR: 3 g.p,d.lft2
Proposed System: 50%REDUCTION VERTICAL
System Classification: IIIE-PPBPS GRAVITY DOSED SYSTEM
Pump*May Be* Required
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 Authorization to
Construct Permit is subject to revocation if the site plan,plat or the intended use changes,or if site conditions are altered. The Authorization to
Construct 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' (15A NCAC l8A.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.
' , .-...-N,„,_ P
08/03/2023
Authorized State Agent Permit Issuance Date
8/3/2028
Permit Expiration Date
No grading or construction activity is allowed in areas designated for system and repair without approval of the Health Department.
Ape,rii.i 08/09/2023 09:33