HomeMy WebLinkAboutIMPV-10-2023-206314.tifN. ,
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a CATAWBA COUNTY Case# AUTH-09-2023-205551
Public Health Department Subdivision JEWELL PLACE
•(........� Environmental Health Division PIN# 365704648698
PO Box 389,25 Government Drive,Newton,NC 28658 LOT# 4
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Site Address: 2665 WATER PLANT RD, MAIDEN NC 28650
Name on Permit: *CMH HOMES, INC./DBA OAKWOOD HOMES#712(NEWTON)
Property Size: Acres 1.18
Directions: 321/left Prison Camp Rd/Right Jack Whitner Rd/Rt St James Rd/left Fred Beard Rd/right Providence Mill
Rd/left Water Plant Rd
Owner/Authorized Representative Acknowledgement of Permit Receipt
4 _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 RBPR-05-2023-44451,by the following method(s):
Received in Person
Facsimile Transmittal(Return form with signature required)
1 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.
Permit Issue Date: 09/27/2023
Owner/Authorized Representative Signature
Date
Documentation of Permit(s)Transmittal
(permit transmitted by electronic or other means)
Permit transmitted by (name ofperson sending permit)
Signature Date/Time 1 V1 it 133
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 youPlease ttake a few momentts tto complette our custtomer service survey att
http://www.surveymonkey.com/s/EHCusttomerService
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Parcel: 365704648698, 2665 WATER PLANT RD 1 in=50ft
MAIDEN, 28650
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
10/17/2023
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DEPARTMENT OF HEALTH AND HUMAN SERVICES Sheet _of
DIVISION OF PUBLIC HEALTH,ENVIRONMENTAL HEALTH SECTION PROPERTY ID M:
ON-SITE WATER PROTECTION BRANCH COUNTY: Catawba
SOIL/SITE EVALUATION
for ON-SITE WASTEWATER SYSTEM
(Complete all fields in full)
OWNER: APPLICATION DATE
ADDRESS: DATE EVALUATED:
PROPOSED FACILITY: P OPOSED I4�1 FL ( 949): t F� PROPERTY SIZE:
LOCATION OF SITE: � y -- , PROPERTY RECORDED:
WATER SUPPLY: 0 Pn ate lic ❑Well ❑Spring 0 Other
EVALUATION METHOD: 0 A .er Boring Pi(T❑Cut E OF WASTEWATER: wage C Industrial Process ❑Mixed
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DESCRIPTION INITIAL SYSTEM REPAIR SYSTEM OTHER FACTORS(.1946):
SITE CLASSIFICATION(.1948):
Available Space(.1945)
EVALUATED BY:
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OTHER(S)PRESENT:
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COMMENTS: '
Updated February 2014
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DEPARTMENT OF HEALTH AND HUMAN SERVICES Sheet of
DIVISION OF PUBLIC HEALTH,ENVIRONMENTAL HEALTH SECTION PROPERTY ID N:
ON-SITE WATER PROTECTION BRANCH COUNTY: Catawba_
SOIIISITE EVALUATION
for ON-SITE WASTEWATER SYSTEM
(compote all fields In full)
- "�— _ APPLICATION DATE
ADDRESS:
PROPOSED FACILITY: DATE EVALUATED:
PROPOSED DESIGN FLOW(.1949): PROPERTY SIZE:
LOCATION OF SITE: PROPERTY RECORDED:_
WATER SUPPLY: 0 Private El Public 0 Well 0 Spring 0 Other
EVALUATION METHOD 0 Auer Boring 0 Pit ❑Cut TYPE OF WASTEWATER: 0 Sewage ❑Industrial Process ❑Mixed
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DESCRIPTION INITIAL SYSTEM REPAIR SYSTEM OTHER FACTORS(.1946):
Available Space(.1945) �� SITE CLASSIFICATION(.1948): i�
System Type(s) ��. 1� EVALUATED BY: �`
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OTHER(S)PRESENT: (12
Site LIAR
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COMMENTS:
Updated February 2014
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Parcel: 385704648698, 2865 WATER PLANT RD MAIDEN, `� I�G
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Owners: MCCARTNEY PATRICIA, 28650 1-6 I
Owner Address: 2665 Av � I �t
WATER PLANT RD
Values-Buildl t / j ng(s): $92,000, Land: $17 700 Total:$109 700 () 6 f l 2- 'G' >
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Parcel: 365704648698, 2665 WATER PLANT RD 1 in=50ft
MAIDEN, 28650
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
09/27/2023
ePIN#ra CATAWBAlCOUNTY Case# IMPV-10-2023-206314
.f. Public Health Department
Subdivision JEWELL PLACE
Environmental Health Division
36570464/3698
PO Box 389,25 Government Drive,Newton,NC 28658 LOT# 4
Site Address: 2665 WATER PLANT RD, MAIDEN NC 28650
Name on Permit: *CMH HOMES, INC./DBA OAKWOOD HOMES#712(NEWTON)
Property Size: Acres 1.18
Directions: 321/left Prison Camp Rd/Right Jack Whitner Rd/Rt St James Rd/left Fred Beard Rd/right Providence Mill
Rd/left Water Plant Rd
Improvement Permit
AN AUTHORIZATION TO CONSTRUCT MUST BE ISSUED PRIOR TO BUILDING PERMITS
THIS PERMIT IS NOT FOR SEPTIC INSTALLATION
Permit Category: Other
Wastewater Flow 240 g.p.d
Type of Facility: Primary Residence
Basement? No Basement Plumbing? Bedrooms: 2
Water Supply: Private Well Maximum Occupants: 4
INITIAL SYSTEM SPECIFICATIONS
Existing wastewater System: CONVENTIONAL
System Classification: IIA-CONV SYSTEM(SINGLE-FAMILY OR 480 GPD OR LESS)
REPAIR SYSTEM SPECIFICATIONS
Repair System Required? Required
Proposed Wastewater System: 50%REDUCTION HORIZONTAL
System Classification: IIIE-PPBPS GRAVITY DOSED SYSTEM
Permit Conditions: *This permit is issued to designate repair area for the new 2br home.
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 existina 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 Sewaue Treatment and Disposal Systems' (15A NCAC 18A.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.
/— 4e,...4___
10/10/2023
Authonzed State Agent Permit Issuance Date
10/10/2028
Permit Expiration Date
No grading or construction activity is allowed in areas designated for system and repair without approval of the Health Department.
10/10/2023 09:53