HomeMy WebLinkAboutIMPV-10-2023-206034.TIF ���r��7 CATAWBA COUNTY
tl 12y, Public Health Department
yr- Environmental Health Division Subdivision
%\/0 PO Box 389,25 Government Drive,Newton,NC 18658 PINS 470002753029
1:IV a
LOTS
Sits Address: 7723 MONBO RD,CATAWBA NC 28809
Hams on Permit *ROCK RIDGE CONSTRUCTION
Property Sin: Acres 1.82
Directions: Sherrilts Ford RD,Keep left to get onto Long Island rd, Keep Right to get onto Monbo RD, Turn Left property
on Righit
Owner/Authorized Representative Acknowledgement of Permit Receipt
K�(/I certify that I am the owner or authorized agent(owner's authorization required)
the property described above, q d)representing the owner of
%
r` Ot)As the property owner or authorized representative,I have received th
e above referenced
permit(s)as requested in the application for service RBPR-08-2023-05102,by the following method(s):
Received in Person
Facsimile Transmittal(Return form with signature required)
J Electronic Image Transmittal/E-mail (Return receipt required)
'01 As the property owner or authorized representative 1 have reviewed and understand the s of the permit issued, specific conditions 1
and further understand that all applicable regulatory requirements specified under the
North Carolina Laws and Rules for Sewage Treatment and Disposal Systems(1 SA 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: 10/05/2023
Owner/Authorized Representative Signet
Date /6// 3
__ __.
Documentation of Permit(s)Transmittal
(permit transmitted by electronic or other means)
Permit transmitted by (name ofperson sending permit)
Signature Date/Time /0/6))3
Method: Fax yy I 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 yoiPlease hake a few momentts tto complete our custtomer service survey att
http://www.surveymonkey.com/s/EHCusttomerServIce
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IPermit#:1Pv-ID7102-3464 03y I
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�, ROY COOPER• Governor
�. �, °, -afs NC DEPARTMENT Or
KODY H. KINSLEY • Sc;cre?kar
I I... i HEALTH AND y
N.
I ;� c° MARK BENTON • Deputy Secretary for Health
V. � � ,�.� HUMAN SERVICES
Yin,„04%. SUSAN KANSAGRA•Assistant Secretary for Public Health
Division of Public Health
Submittal Includes: ®(a2)Improvement Permit ® (a2)Construction Authorization ❑Fee$
IMPROVEMENT PERMIT FOR G.S. 130A-335(a2)
County: Catawba
PIN/Lot Identifier: 470002753029
Issued To: Jacob Hollar
Property Location: 7723 Monbo Road Catawba, North Carolina 28609
Subdivision(if applicable) Lot#: Block: Section:
LSS Report Provided: Yes® No❑
If yes,name and license number of LSS: Steven Randal Cannon # 1291
New® Expansion ❑ System Relocation ❑ Change of Use ❑
Proposed Structure: House
Number of bedrooms: 3 Number of Occupants: Other:
Design Wastewater Strength:®domestic ❑high strength ❑industrial process
Proposed Design Daily Flow: 360 GPD Proposed LTAR(Initial): .3 _ Proposed LTAR(Repair): .3
Proposed Wastewater System Types: Accepted Mg (Initial) Pump Required: ❑Yes ®No ❑May be required
Proposed Wastewater System Type*: LPP Horizontal PPBPS IVa (Repair) Pump Required: ❑Yes ❑No M 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 ®No Saprolite System(repair):❑Yes N No
Fill System(Initial): ❑Yes ®No If yes,specify: ❑ New ❑Existing (when adding more than 6 inches of fill to system area provide a fill plan)
Fill System(repair):❑Yes M No If yes,specify:❑ New ❑Existing (when adding more than 6 inches of fill to system area provide a fill plan)
Usable Soil Depth(Initial): 39" Usable Soil Depth(Repair): 38"
Max.Trench Depth(Initial): 27" Max.Trench Depth(Repair)#: 26" 1Measured on the downhill side of the trench
Artificial Drainage Required: ❑Yes ❑X No If yes,please specify details:
Type of Water Supply:®Private well ❑ Public well ❑Shared well ❑Municipal Supply ❑Spring ❑Other:
Drainfield location meets requirements of Rule.1945: Yes® No❑ Drainfield location meets requirements of Rule.1950: Yes® 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:
Licensed Soil Scientist Print Name: Ste e R. Can n
Licensed Soil Scientist Signature: .(11-' - l Y NK� Date: September 24, 2023
The LSS 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 • DIVISION 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 I AFFIRMATIVE ACTION EMPLOYER
8.4.90444 7723 Monbo Rd Permit#: IMPV-10-2023-206034
This Section for Local Health Department Use Only
Initial submittal received: 9/29/2023 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 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: Date: 10/5/2023
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: 10/5/2028
*See attached site sketch*
G.S. 130A-335(a2)Common Form 2 V.2023.07
Design Specifications for Proposed Wastewater Systems
Applicant: Jacob Hollar
Property Address: 7723 Monbo Road
Catawba, North Carolina 28609
Pin #470002753029
Acres: 1.82
Catawba County, North Carolina
Source of Water Flow 3 Bedroom House
Wastewater Treatment Systems Accepted/Horizontal PPBPS
Septic Tank 1,000 gallons
Estimated Daily Flow 360 gallons/day
Wastewater Treatment: Initial Accepted
Loading Rate .3 g/d/sq.ft.
Drainfield Size 300 feet of Accepted
Slope 5 percent
Slope Correction 2 inches
Trench Bottom Depth 27 inches on downslope
Wastewater Treatment: Repair Horizontal PPBPS
Loading Rate .3 g/d/sq.ft.
Drainfield Size 200 feet Horizontal PPBPS
Horizontal Panels Install panels on 8 feet centers
Distribution Device LPP
Slope 5 percent
Slope Correction 2 inches
Trench Bottom Depth 26 inches on dossnslope
1
Nitrification Lines Elevation and Length
Applicant: Jacob Hollar
Physical Address: 7723 Monbo Road
Catawba, North Carolina 28609
Pin # 470002753029
Acres: 1.82
Catawba County, North Carolina
Initial
Line Flag Line Elevation Flagged Length Design Length
Color
1 Orange 4.87' 60' 60'
2 Pink 5.35' 65' 65'
3 White 6.08' 75' 75'
4 Blue 6.62' 60' 60'
5 Red 7.10' 40' 40'
Total 300' Total 300'
Repair
Line Flag Line Elevation Flagged Length Design Length
Color
1 Red 5.16' 74' 17
2 Orange 6.18' 66' 15
3 Blue 6.62' 60' 14
"Total 200' 46 Panels
2
8:02 PM Sat Sep 23 ••• ^40%'•
Jacob Hollar v Eli Q U 0 Done
111 0 Trimble Connect Dennis Hollar tJ
•
Ja•.•� rla Mo
- J . 0 >la% : "; - 1 Co i + - 7723 Monbo Road
Dat. - �•�I+,4,,,,aars ,, ,. j1 '*$
..!. /I a AA:'-‘,;,- . ,Ii�;...�t ,_ II .
i
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C�C Existing
a,� Pink • t: Well �O
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Pit 4 Pump and backlit'tank :,, ;ite
/ • ice:
Pit 3 �,Aril Or
ystem:Acc-• -i 300' Install chambers I: el .nd on
•;, grade at 27"tre h ••ttom on
60 down I s' e
ink 65'
Ai/S6
hite 75'
Iron
lue 60' „11(1/
Red 40'
300' co
Iron
1
Sheet of
• .
PROPERTY ID tl: __
COI JNTY.(1,4444...
SOIL/SITE EVALIA IION
Or ON-SITE WASTEWATER SYSTEM
(Complete all fields in lull)
—......
OWNER: JAe0 J - APPLICATION DATE
ADDRESS: Ofi- -r-a-1-,-...-4 , ".....c.__ DA E,VALUATED: Ag7
PROPOSED FACILITY: l'A.m.dose- PROPOSED DESIGN Fl hAV GI 949): 3Z-0 — PROPERTY SIZE: I
I.00ATION OF SITE: 77;3 iVa,4 4c) 12!) CAVie, ,--c-- PROPERTY RECORDED: _ _
WATER SUPPLY: i riTa-t-c L Public '.' Well : ' Spring _' Other -
FNALIJATION METHOD: _I Auger Boring li'llit : i Cut TYPE OF WASH AVA I IR: ' •_.: . t. .al Process I Mixed
• • • ' 4Fp ii .
I
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E ••
.1940
LANDSCAPE HORIZON
POSITION/ DEPTH
# SLOPE%
1
2
3
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-q" 1 SOIL MORPHOLOGY
.1941 (.1941)
.1941 .1942 .(47 ,i iktAthiOlits . '
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i 4fitt;.
t-,i 171:1,e,4":/;.k..:\,If:. v: ' FILE
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STRUCTURE/ CONSISTENCE/ WETNESS/ SOIL s ry,1! .),.. R
TEXTURE MINERALOGY COLOR
5,e— it., s ig- o /a yt ezt
sd. ui-ilk 5s sy•L 5.470 gyi ch
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iv -tit e 54/2 510 $470 75 71 cif z-/W
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DESCRIPTION INITIAL SYS ITN REPAIR SYSft.M OTIIIIIR FACI ORS(.1946):
1
sill:ci.AssiFICATioN(.1948): -_
Available Space(.1945) ...., ..e'' -
---
i i iv) l..:VALTIATED I3Y: 5/44.-- al>4*I"--
System Type(s)
jereetS /7, P5/9.5 onIER(s) piti',SIM --
Site LTAR / S . 3
COMMENTS:
.._____....__ ___..._. •. ______, .__
Updated February 2014
SOIL/SITE EVALUATION Sheer of
(('onlrnrcatFon Sheer-Complete all.fiel<l in 1r1ll)
•
PROPERTY 11)#:
I)ATE OF EVALUATION: ,EZ7
COUNTY: Weir,
. rtc�, )Io))4
P 4O SO ,
o SOIL MORPHOL •
OGY ()THE r . WO
F (.1941) PROFIj. WI g' ��srft O
1 .1940
L LANDSCAPE
19 F S'
E HORIZ �� �n i�t
POSITION/ ON .1941 .1941 SO ",Air-� t., 1 19.. PROFILE
SLOPE% DEPTH STRUCTUREI (:ONSIS"T}:V('E/ «'ET. :S/ �;1 t S CLASS
i( ,, •/.
TEXTURE MINERALOGY COL, 'yi :O <AR
(IN.) • ..4. ���
4 6-1/ 2 5,,- �s /0 x 1 ,�
LI'IG n SC�. W 5g 55 S r 7S`� � •
S l /G =51' e., sS/c s ,,a s.474 /c)i' sib
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COMMENTS:
Updated February 2014
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