HomeMy WebLinkAboutOP-10-2023-206632.tif Cair)lf- w CATAWBA COUNTY Case# OP 10 2023 206632
Public Health Department Subdivision OLDE SCHOOL SUB
, 4, Environmental Health Division PIN# 279120800993
PO Box 389,25 Government Drive,Newton,NC 28658 LOT# 37
Site Address: 5222 OLDE SCHOOL DR, HICKORY NC 28602
Name on Permit: FRANCISCA GOBERNA
Property Size: Acres 0.41
Directions: Startown Rd, left onto Sandy Ford Rd, right onto Zion Church Rd, left onto Bethel Church Rd, right onto
Wallace Dairy Rd, lefto onto Olde School Dr, property ont he right
Operation Permit
Permit Category: Repairs Wastewater Flow: 360 g.p.d.
Type of Facility: Primary Residence-
Basement? NO Basement Plumbing? No Bedrooms: 3
Water Supply: Public Water Maximum Occupants: 6
System Type:
Description: REPLACEMENT OF SEPTIC TANK ONLY
System Code: System Code Description:
Types V and VI systems expire In 5 years.
Owner must contact Environmental Health 6 months prior to expiration for permit renewal.
System Installation Comments: A new septic tank(GST 1000, STB 160, dated 8/14)was installed and the existing tank
was crushed and abandoned.
PERMIT CONDITIONS:
1.All maintenance, monitoring, &performance requirements shall be in accordance with 15A NCAC 18.1900, Rule.1961
2. Operation&Maintenance Specifics:
Subsurface system operator required? Yes No_X_
This system has been installed in compliance with applicable NC General Statutes,Rules for Sewage Treatment and Disposal.
Mike Bumgarner#2688 10/13/2023
System Installer Installation Date
411d 8i re Peek;43)
1 10/16/2023
Authorized State Agent Permit Issuance Date Form F
eiipriniit 10/16/2023 17:02
Catawba County Environmental Health
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Parcel: 279120800993, 5222 OLDE SCHOOL DR 1 in=40ft
HICKORY, 28602
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Copyright 2023 Catawba County NC
08/02/2023