HomeMy WebLinkAboutIMPV-09-2023-205332.TIF ��+iej CATAWBACOUNTY Case# I M PV-09-2023-205332
a -t.�?� Public Health Department Subdivision STORYBROOK PH 3
►0(�„�•ft Environmental Health Division PINK 369701182992
liptat 1P PO Box 389,25 Government Drive,Newton,NC 28658 LOTH 8
Site Address: 3497 STORYBROOK LN, SHERRILLS FORD NC 28673
Name on Permit: 'D&E PROPERTIES, LLC
Property Size: Acres 1,30
Directions: Hwy 16 S to Mt Buleah, right on Little Mountain, Right on Storybrook
Owner/Authorized Representative Acknowledgement of Permit Receipt
I 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 EHPR-07-2023-44884,by the following method(s):
Received in Person
Facsimile Transmittal (Return form with signature required)
V Electronic Image Transmittal/E-mail (Return receipt required)
As 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 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.
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Documentation of Permit(s)'Transmittal
(permit transmitted by electronic or other means)
Permit transmitted by (name of person ending permit)
SignatureC)..c..,
Date/Time q�)u1)3
Method: Fax ./ Email US Mail Other
Owner's request to send by the above indicated method of transmittal in lieu of signature
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http://www.surveymonkey.com/s/EHCusttomer$ervice
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eiiirCATAWBA COUNTY Case IMPV-09 2023 205332
,ii
Public Health Department Subdivision STORYBROOK PH 3
� Environmental Health Division PIN# 369701182992
PO Box 389,25 Government Drive,Newton,NC 28658 LOT# 8
a
Site Address: 3497 STORYBROOK LN, SHERRILLS FORD NC 28673
Name on Permit: *D&E PROPERTIES, LLC
Property Size: Acres 1.30
Directions: Hwy 16 S to Mt Buleah, right on Little Mountain, Right on Storybrook
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
Basement? No Basement Plumbing? No Bedrooms: 3
Water Supply: Private Well Maximum Occupants: 6
INITIAL SYSTEM SPECIFICATIONS
—
Proposed Wastewater System: LOW PROFILE CHAMBER
System Classification: IIIG-OTHER NON-CONY TRENCH SYSTEMS
REPAIR SYSTEM SPECIFICATIONS
Repair System Required? Required
Proposed Wastewater System: DRIP IRRIGATION
System Classification: VA-SAND FILTER PRETREATMENT
Pump Required ***** Operator Required
Permit Conditions: Keep all parts of septic system and any future repair minimum: 50'from any individual well,
50'from creek, 50'from retention pond on adjacent lot, 10'from property lines, 10'from any
water or utility lines, 5'from porches.
Lines to be installed on contour.
Do not grade,drive,or fill over system or repair area.
System will require shallow placement with low profile 25%reduction to meet vertical setback
to wetness conditions. Cover to be brought in as needed to maintain minimum 6"uniform
cover over the system.
Future repair will require pretreat to drip irrigation with design by engineer.
chpenuit 09.272023 12:43
•
CATAWBA COUNTY Case ElIMPV-09-2023-205332
Public Health Department Subdivision STORYBROOK PH 3
Environmental Health Division PIN# 369701182992
PO Box 389,25 Government Drive.Newton,NC 28658 LO'i'# 8
W
Site Address: 3497 STORYBROOK LN, SHERRILLS FORD NC 28673
Name on Permit: *D&E PROPERTIES, LLC
Property Size: Acres 1.30
Directions: Hwy 16 S to Mt Buleah, right on Little Mountain, Right on Storybrook
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 Sett'ake Tiratment 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.
09/25/2023
Authorized State Agent Permit Issuance Date
9/25/2028
Permit Expiration Date I,
No grading or construction activity is allowed in areas designated for system and repair without approval of the Health Department.
chpeim i t 09/27/2023 12:43