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HomeMy WebLinkAboutIMPV-10-2023-205818.tif i Permit#: [A v4v-2ot3-205ai'j' •; ROY COOPER•Governor { NC DEPARTMENT OF . HEALTH AND KODY H. KINSLEY•Secretary HUMAN SERVICES MARK BENTON•Deputy Secretary for Health SUSAN KANSAGRA•Assistant Secretary for Public Health Division of Public Health Submittal Includes: QQ (a2)Improvement Permit ❑(a2)Construction Authorization ❑Fee$ IMPROVEMENT PERMIT FOR G.S. 130A-335(a2) County: Catawba PIN/Lot Identifier: Property ID 3704-1155-0311 Issued To: Pride Design Construction Inc. Property Location: 543 30th Avenue NW, Hickory, NC Subdivision(if applicable) Lot#: Block: Section: LSS Report Provided: Yes❑✓ No 0 If yes,name and license number of LSS: Constance M Adams IIC#1186 New Q Expansion ❑ System Relocation 0 Change of Use ❑ Proposed Structure: Single family house Number of bedrooms: 2 Number of Occupants: 4 Other: Design Wastewater Strength:0 domestic 0 high strength ❑industrial process Proposed Design Daily Flow: 240 GPD Proposed LIAR(Initial): 0.3 Proposed LIAR(Repair): N/A Proposed Wastewater System Type*: 25% reduction Illbg (Initial) Pump Required: 0 Yes ❑No 0 May be required Proposed Wastewater System Type*: N/A (Repair) Pump Required: ❑Yes ❑No ❑May be required *Please include system classification for proposed wastewater system types in accordance with 15A NCAC 18A.1961 Table V(a) Saprolite System(Initial): ✓❑Yes 0 No Saprolite System(repair):❑Yes ❑No Fill System(Initial):0 Yes ❑Q No If yes,specify:❑New ❑Existing (when adding more than 6 inches of fill to system area provide a fill plan) Fill System(repair):0 Yes 0 No If yes,specify:0 New ❑Existing (when adding more than 6 inches of fill to system area provide a fill plan) Usable Soil Depth(Initial): 23"+1 oar Sap Usable Soil Depth(Repair): N/A Max.Trench Depth(Initial)': 13" Max.Trench Depth(Repair)': N/A 'Measured on the downhill side of the trench Artificial Drainage Required: ❑Yes El No If yes,please specify details: Type of Water Supply:❑Private well 0 Public well ❑Shared well Q Municipal Supply ❑Spring ❑Other: • Drainfield location meets requirements of Rule.1945: Yes El No 0 Drainfield location meets requirements of Rule.1950: Yes❑Q No❑ Permit valid for;❑✓ Five years(site plan submitted pursuant to GS 130A-334(13a)] ❑No expiration[plat submitted pursuant to GS 130A-334(7a)] Permit conditions: No cut on uphill side 01 proposed house. Keep construction uteri es end stockpiles out of(franked area See attached soil scientist report for details. Licensed Soil Scientist Print Name: Co tance M Adams _ Licensed Soil Scientist Signature: 4r c '/�l%. � Date: 9/24/2023 The 155 evaluation is being submitted pursuant to and meets the requirements of G.S.130A-335(a2). *See attached site sketch* NC DEPARTMENT OF HEALTH AND HUMAN SERVICES • DMSION OF PUBLIC HEALTH LOCATION:5605 Six Forks Road.Building 3,Raleigh,NC 27609 MAILING ADDRESS 1632 Mail Service Center,Raleigh,NC 27699-1632 www.ncdhhs.gov • TEL 919.707-5854 • FAX 919-845-3972 AN EQUAL OPPORTUNITY/AFFIRMATIVE ACTION EMPLOYER E<ea. 543 30th Ave NW Permit#: IMPV-10-2023-205818 This Section for Local Health Department Use Only Initial submittal received: 9/26/2023 by RP Dote 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 Deportment shall develop a common form for 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: "L�"�'� l/ Date: 10/2/2023 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: 10/2/2028 *See attached site sketch* G.S. 130A-335(a2)Common Form 2 V.2023.07 Septic System Proposal Prepared for Pride Design Construction Inc. By Constance M. Adams, LSS Site: 543 3oth Avenue NW, Hickory, NC PIN 3704-1155-0311 Catawba County, NC / Proposed development: 2 bedroom house ! y Total Design Daily Flow: 24o gallons per day(gpd) , ,�._' Repair area: not required(Deed book io66 pg 371 dated March 27, 19750 t'a 'k Septic tank size: woo gallons minimum ��\. Pump tank size: t000 gallons minimum NORItA �• Initial System (soil pits 1, 3-6—see p 3-4) Soil depth: 12"-24" Depth to unsuitable horizon: 33"-55" Slope: 5-15% Overall Long-term acceptance rate: .3 gallons per day/square foot trench bottom(GPD/sf) Proposed system type: Pump to 25% reduction Recommended trench width: 36" Recommended trench depth: 13"with 6-12"fill cover Total trench length: 200 feet on 9 foot centers Comment: Location of the drainfield is as shown on the Septic System Proposal Map(page 2). 210 feet of line has been laid out in the field. Recommended installed line lengths are as shown in parentheses,with the top two lines connected in series to total 56 feet. A pressure manifold to split the flow into 4 parts is recommended as follows: three schedule 80 3/4"taps and one schedule 80 1/2"tap. Connect one each of the 3/4"taps to the 14'+42" (56'total,top 2 lines),the 54'line,and the 58'Iine; connect the 1/2"tap to the 34'line. Pressure head should be set at 1.5' to 2'. • The bottom two lines (58' and 34') are only 8-to'uphill from the house. In order to ease this situation somewhat, the 62'line is proposed to be shortened to 58'. The 34'line can be shifted 5' closer to the driveway in order to shift it away from the house if preferred. In addition,NO CUT can be made to the uphill side of the house. In addition,building activities in this area should be kept to a minimum and should not disturb the soils in any way. No construction materials should be stockpiled in this area; construction materials should be delivered and stored on the downhill or driveway side of the house. This is a saprolite system. If a well is drilled a too' setback is required. This is a type IIIbg system. This LSS evaluation is being submitted pursuant to and meets the requirements of G.S. 13oA- 335(a2)• Pg 1 of 4 Septic System Proposal Map Prepared for: Pride Design Construction,Inc Site: 543 30�'Avenue NW, Hickory Prepared by: Constance M Adams,LSS Date:9/24/2023 Page 2 of 4 3 0 fL A vt. 1V ICJ Ed df .1 EoP Pt-!o3' C3E3 < —A__.- 4 a '\ I — Press u,,e. an i-Co cD a +'v\,� 6 3 (Ad ao 3(Y"-Ea P s \ 0' ' a 15c Ind SO ` 2_ti-63 ® ke r 1tl' J- CorvueL1 31�� 5 6 Conned /i'- A 12, CI 0�a (uo cu- T) ko be. 'sh ckea on4o 1 97 Pit) N eroP .y�,‘„.. r cr s Z$ v wal' • Fy C.i AA- a' ha,'st c 10 39' � A , , 1s ❑ ,�. pii- 5 y m o g- O Auuec-bow i J tJ 1\ P(. I a 2.' Sc,le-; I"=30' . DEPARTMENT OF HEALTH AND HUMAN SERVICES Sheet ( of 2, DIVISION OF PUBLICl-I±ALTN.ENVIRONMENTAL HEALTH SECTION PROPERTY ID#: 3/I ON-SITE WATER PROTECTION BRANCH COUNTY. SOIL/SITE EVALUATION for ON-SITE WASTEWATER SYSTEM (Complete all fields in full) OWNER: 1't at. It=b-i. Co h c_ • _,n.s�'Mt �.>i- APPLICATION DATE ADDRESS: DATE EVALUATED'-ViT2,3 PROPOSED FACILITY: 2_a.a_ IROPOSED DESIGN FLOW (.1949): 2 _ PROPERTY SIZE: LOCATION OF SITE: S .t .ram-tom tk. _ PROPERTY RECORDED: (US- _ WATER SUPPLY: ❑Private 'Public 7 Well IJ Spring Other EVALUATION METHOD: 0 Auler Boring Pit -Cut TYPE OF WASTEWATER: tjtiSewage E Industrial Process \1i\ed R SOIL MORPHOLOGY OTHER F (.1941) PROFILE FACTORS 1 .1940 LANDSCAPE. HORIZON POSITION/ DEPTHPROIILE .1942 k SLOPE% 41 N•) .1941 .1941 SOIL .1943 .1956 .1944 CLASS STRUCTURE/ CONSISTENCE/ WETNESS/ SOIL SAPR RESTR &LTAR TEXTURE MINERALOGY COLOR DEPTH 0 HORIZ CLASS J ) 1 1'4) ('%-- }, Sv I1 ilN,S,AC ' r--- S'p -, —, J_ ' PS P< 40 2R. rtiL_ Ct C " ZA, / Ug 1 , • 1 Us I j 2 �, >A\.+ ' I Ir s j1L "e'- g_iz Ps la mu8 ? v3r' �; ) b"(r'lj ! /r 0 . 11 i ti4s6k .Ft" < cz , .1; itrOSL-sy -' ''k' ,S4._ II Ps Ps ,Li 4 r 2 fz_ ( 'ita I'. 4TO DESCRIPTION INITIAL SYSTEM REPAIR SYSTEM OTHER FACTORS(.1946): - .v;: r SITE CLASSIFICATION(.1948): Q3 -_ • Available Space(.19d51 V � +- EVALUATED BY: C , IMS ti irm Typos) 02570 ke� Y`OTHEWS)PRESENT: —� site I TAR b ,3 COMMENTS. . b Updated February 2llld SOIL/SITE EVALUATION Sheet eZ of (Continuation Sheet-Complete all field in lu/lb DEPARTMENT OF HEALTH AND HUMAN SERVICES PROPERTY ID#:3tot},IISS-03( DIVISION OF PUBLIC HEALTH DATE OF EVALUATION: 9 11Lt2e0-3 - ENVIRONMENTAL HEALTH SECTION (;Atia ON-SITE WATER PROTECTION BRANCH • • • • • t' SOIL MORPHOLOGY OTHER F (.1941) PROFILE FACTORS .1940 LANDSCAPE HORIZ .1942 POSITION! ON .1941 .1941 SOIL .1943 .1956 .1944 PROFILE a SLOPE% DEPTH STRUCTURE/ CONSISTENCE/ WETNESS/ SOIL SAPRO RES'TR C1..0.SS (IN.) TEXTURE MINERALOGI' COLOR DEPTH CLASS HORIZ &L fAR -- (( ii4-SIL—.4.47CL—sLi. Sly Li -13 II11JLC - - c s- (3-LEI 111 x-C •S{ 107 •. PS P 2 % 11lqSL &e f/ i-f r 2±-1 COMMENTS: Updated February 2014