Loading...
HomeMy WebLinkAboutIMPV-08-2023-202214.tif r 1�y, CATAWBA COUNT �►APti• + 1 IlBtf Public Health Department Subdivision 'i�` ,,,,, , 14i Environmental Health Division PIN# 365905083785 '1\/1 PO Box 389,25 Government Drive,Newton,NC 28658 LOT# I:Ll► y Site Address: 2150 CLAREMONT RD, NEWTON NC 28658 Name on Permit: LYNETTE PATRICK Property Size: Acres 27.68 Directions: Turn on to Claremont Rd off of HWY 16,go 3/4 mile land is on left Owner/Authorized Representative Acknowledgement of Permit Receipt XPI 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-08-2023-45113, by the following method(s): Received in Person Facsimile Transmittal (Return form with signature required) 7 Electronic Image Transmittal/E-mail (Return receipt required) gPAs 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(15A NCAC 1SA.1900), and/or Well Construction Standards(15A NCAC 2C.0100), shall apply to the issuance of this pennit and the construction of the wastewater system and/or water supply well permitted. i Permit Issue Date: 08/29/2023 1 Owner/Authorized Representative Signature _P Date G- 4. -3,3 Documentation of Permit(s)Transmittal (permit transmitted by electronic or other means) Permit transmitted by (name of person sending permit) Signature --. ____ - Date/Time Sl/ 311 )3 -- Method: Fax J 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 yotPlease stake a few momentts tto complette our custtomer service survey att http://www.surveymonkey.cam/s/EHCusttomerService ie)-Pl 0ati, etrn ci,po„„ii 08J29/2023 15.56 Nnnit rt,V' ry-$-20zs-20 2IL( .srwt ' ROY COOPER •GrItveorsor ar rW' c11).1 N i_ "-p,ta R 7 M F N. KODY H. KINSLEY•Secretaity 4` 7 ,z.A! HEALTH AND HUMAN SERVICES MARK BENTON •Cldsr,cr Secretary lot Health - . SUSAN KANSAGRA•A4s,clruv"Sir'ritary tier Pistilir.Health L).Y ye. . nt Pub4c Health Submittal heat♦ a; (a2;Improvement Perm t iu'Ia2)Construct on Authorstatson ❑Fee 5 /� IMPROVEMENT PERMIT FOR G.S. 130A-335{a2) County ,J� e,` 4t,)_.b. `-". plN/Lot tdeotiber 3tP.5 9 CCSC, 7_'► b ssucd To Q0..rs.1 o d n ttee l' OFt-4-{�T7 r u K Properly Location .�jSL'1_ ../ Y tv�O fTt Li __— Subdrvisror Id apglicable} _ lot.a _ Block. Section. LSS Report Proveded: Yes Pt. Nol„ --�t^� t1 Y 1 / G If yes,name and lice esse number of LSS' +r? P �`•\i r1 r} ,7 r i ur7 — ►few E itparision System Relocation 2 Change of use 0 proposed Stn.+Ctvre r anber of bedrooms: 3 Router fll Occupant 1 Cursor Design Wastewater Strength a domestic. ❑high strength ❑�ndus rial process Proposed Design Daily Flow GPO Proonse-d 11A,A(lriliiil a .7.0 Proposed)LTAR(Repai*) A 1 rt 1 Li Proposed'Nastebsetcr System Type'' is t \I. AAbet'$' (ln.t la''I Pump Aequrred ❑Yet 0 No ® ►.ray be req,re s PrO00.edWatlewater System type:i?n e 1 -LY5 ;Mtvar} I+umta Required. ❑Yes ®No 0 May be regiored 'Pifoseinctude systemcrassifu-aton forproDc ►se4prrosrrworer rvs±rrsi trpei in wed/don[e eolh 155A SC4C!EA 1961 Table Vial Saoroket System Lott<ati ❑Yes ®No Saprolite System(repair!.0 yes No fill System Iinitiait ❑Yes El No If•,es,spec.ty.❑New 0 E+ stung ♦when adding more N•an 6 inches of foil to system area proy,de.e NI plan) Fil<System(repair) ❑vet 3 No ,1 yes, sootily'❑Nrw ❑Ellisting ;whet,.adding more than 6 inches of fat to system area provide a till punt Usable Sod Depth ores+l `l'r< Usable So Depth(Repay I h'S' Max,Tren h )epth On. r• r� Ma 'tench Depth(Repairs' ...?9'-_- 'Measured on the a wnhift side of the minim AttitiCial Doffing Required El yes 0,1 No II yes, pease spec 1)details ��^^; type of Water Supoty Private will 0 Priem[we,' 2 Snared will ❑fd•anitrpal Supply String t. Other Ura,nt'ietd location meets requirements of Rule 144S Yes E1 No❑ E)raintoeld lotatfo•rt meets requ!rerrnents o1 Akixe.19S8 Yes 20 No Peron;valid for ®Frye years Isrte Dian submitted pursuant to GS 1.30+ 334(11a)) ❑No expiration(plats omitted pursuant to GS 130A-3K fall Pt tit cond scion, + r r �,�r y- J 4aat[l *'-- .tY.14 G17y1 .__ !iti.4.1 C"1,4 �.art�. .G11aca+- eer`-rGi.__Lr ____.. .. . �A�--.. '' Licensed Sou Scientist Print Name D h4.11A-iicen y sed Soil .entist`+'goof are Tt•+�. ......_._.,__ Crate tr a� 1Ca The LSS evaluation is being submitted pursuant to and meets the requirements of G.S.130A•335421. 'See attached site sketch' NC DEPARTMENT OF HEALTH AM)HUMAN SERVICES • O VIEJOM OF Pue�JC HEAR ECEI JED r rota)+ First]5 aia Pansy Rosa:.Bur4itr'i 2.Roar+rti. NC i7319 mikru•:.,y tr4c.+: 1632 Mat Service Center.+2tile+vtt,NC 27641.1632 i WA ncahPo&g,:•. • Ia. 9t9-7D1-585a • rrt:x 919 5-19T2 AUGA 3 !r ?3 OPPOR.Rit.r affAsAA'€,-E tiC110H M5',OYER Environmental Health 2150 Claremont Rd Permit#: IMPV-8-2023-202214 This Section for Local Health Department Use Only Initial submittal received: 8/3/2023 by RP Date Initials G.S.130A-335(a3)states the following: When an applicant for an Improvement Permit submits to a local health department an Improvement Permit application,the permit fee charged by the local health department,the common form developed by the Department and a soil evaluation pursuant to subsection(a2)of this section,the local health department shall, within five business days of receiving the application,conduct a completeness review of the submittal.A determination of completeness means that the improvement Permit includes all of the required components.if the local health department determines that the Improvement Permit is incomplete,the local health department shall notify the applicant of the components needed to complete the Improvement Permit.The applicant may submit additional information to the local health department to cure the deficiencies in the improvement Permit.The local health department shall make a final determination as to whether the Improvement Permit is complete within five business days after the local health department receives the additional information from the applicant.If the local health department fails to act within any period set out in this subsection,the applicant may treat the failure to act as a determination of completeness.The Department shall develop a common form far use as the Improvement Permit. The review for completeness of this Improvement Permit was conducted in accordance with G.S. 130A-335(a3). This Improvement Permit is determined to be: ❑Incomplete(If box is checked,information in this section is required.) The following items are missing: Copies of this were sent to the LSS and the Applicant on Date State Authorized Agent: Date: ©Complete ',/ State Authorized Agent: 711,422, /t v Date: 8/9/2023 This Improvement Permit is issued pursuant to G.S.130A-335(a2)and(a3)using the signed and sealed LSS/LG evaluation(s) attached here. The issuance of this permit by the Health Department in no way guarantees the issuance of other permits.The permit holder is responsible for checking with appropriate governing bodies in meeting their requirements.This permit is subject to revocation if the site plan,plat,or the intended use changes. The Improvement Permit shall not be affected by a change in ownership of the site. This permit is subject to compliance with the provisions of the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit. The Department,the Department's authorized agents,and the local health departments shall be discharged and released from any liabilities,duties,and responsibilities imposed by statute or in common law from any claim arising out of or attributed to evaluations,submittals,or actions from a licensed soil scientist or licensed geologist pursuant to GS 130A-335(a2). Improvement Permit Expiration Date: 8/9/2028 *See attached site sketch* G.S. 130A-335(a2)Common Form 2 V.2023.07 use sJ 11'O be, \S\ IA k wo Gags'.•i. • • s' • 1 ti k ' 74A) ) a'x. a ) 4 1,10.?,,,, p Ei1ld it0 G IJC NnC c,.i tt,.re.Mort 1d 1 ,----- ( ,yr/ / cr er i -0 41, el N gX tz i r* va 44 1 i ......._.. ..._......„ rs le oftl . * s- "..... i- id ie i c t ..., • ,,,,,,) ) ..,----c re---r .q ._,,-4- / • t ...,......... , , ........., / / )7-e4- ‘Erce3 ,. . -1"--- -----'.- 5-0-1 / . -frees 4 ,_.. sNs. \ N. \\ ,\\\ I* \ \ . •i ..,, vs I 1, 1 I• iie _ vell . . 4 C!in.rt tont' i 7 SOIL/SITE EVALUATION FOR ON-SITE WASTEWATER SYSTEM Owner/Applicant: Lynette & Gary Patrick Date Evaluated: 7/25/2023 Address/Phone #: County/ PIN #: Catawba 365905083785 Facility: Residence Design Flow: 360 gpd Property Size: 27.68 acres Location/Road: Claremont Road Subdivision/Lot#: Water Supply Public Private Well X Community well Evaluation Method Auger Boring X Pit Cut Type of Wastewater Sewage X IPWW Mixed Profile Landscape Horizon Texture Structure Consistency Saprolite Soil Soil Profile # Position & Depth Mineralogy Wetness depth classification Slope in. Color & LTAR 1 L cc 0-28/30 C ABK/SBK Fl 28/30- C ABK/SBK Fl mica little 46 PS .275 46 2 L cc 0-20/22 C ABK/SBK Fl 20/22- C ABK/SBK Fl mica <50% 44 PS .275 44 3 L cc 0-17 C ABK/SBK Fl 17-46 C ABK/SBK Fl mica little 46 PS .275 PRESENT USE: FIELD OTHER FACTORS: some small depressions EVALUATED BY: Joe Lynn OTHER(S) PRESENT: Britt, Ms Patrick COMMENTS: site has been farmed for many years Landscape Texture Structure Mineralogy Mineralogy Position consistency consistency Ridge Sand Crumb Moist Moist R S CR Shoulder slope Loamy sand Granular Slightly expansive Expansive S LS GR Nose slope Sandy loam Block like loose Very firm N SL I VF Head slope Loam Subangular Very friable Extremely firm H L SBK VFR EF Foot slope Silt loam Angular Friable FS SIL ABK FR Flood plain Silt Platy Firm FP SI PL Fl Drainage way Sandy clay loam Prismatic D SCL PR Terrace Silty clay loam Absence Wet Wet T SICL A Debris slope Clay loam Slightly sticky Very sticky DS CL SS VS Sandy clay Sticky SC S Concave slope Silty clay Non plastic Very plastic CC SIC NP VP Convex slope Clay Slightly plastic CV C SP Plastic P r Catawba County Environmental Health •w • 11 0 Man-DR g480 • III dAbfrel",.. .. Alt :r q tryr...�►T P Opp1174 i 4 .. A . •2150 `' v., ° 6os v. 051 7.7 • IP r'solo :'/:: - loos o�° Imo,. , 0-.10.61 G Albe e o. '� Gy 500\44.0 ' • t. s+' d3441 ! ~ 25 dfi0d ,' 44 �g tr_Fi 416 �'401 u415r+L� , ,...) �► ,t:`d 5 �,r� 41 •I,11 4/ • 00 4 hr�406 0 ky GOITNER AVE i /Qc't< Parcel: 365905083785, 2150 CLAREMONT RD 1 in=400ft NEWTON, 28658 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 07/31/2023