HomeMy WebLinkAboutAUTH-10-2023-206602.tif r ,
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it: Neill- Public Health Department Subdivision SHERWOOD SHORES
s Environmental Health Division PIN# 461902652562
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PO Box 389,25 Government Drive.Newton,NC 28658 1.01# 15
Site Address: 8666 DOG LEG RD, SHERRILLS FORD NC 28673
Name on Permit: HETTION BOOKER
Property Size: Acres 0.47
Directions: NC16, Left onto Balls Creek Rd,right W Bandys Cross Rd, Left Buffalo Shoals Rd, Right E Bandys, Right
Sherrills Ford Rd, Left Mollys Backbone, Right Azalea, Left Dog Leg Rd, Property on Left
Owner/Authorized Representative Acknowledgement of Permit Receipt
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-01-2023-43175,by the following method(s):
Received in Person
_ Facsimile Transmittal (Return form with signature required)
J 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: 10/16/2023
Owner/Authorized Representative Signature
Date
Documentation of Permit(s)Transmittal
(permit transmitted by electronic or other means)
Permit transmitted by (name of person sending permit)
Signature4
}
Date/Time �v�j 1/73
Method: Fax I Email US Mail Other
Owner's request to send by the above indicated method of transmittal in lieu of signature
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ehpemrit 10'18'2023 14:55
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.Sy% • CATAWBA COUNTY Case# AUTH-10-2023-206602
4 .fi.Ill 2 Public Health Department Subdivision SHERWOOD SHORES
„ri c "1 Environmental Health Division PIN 461902652562
PO Box 389,25 Government Drive,Newton.NC 28658 LOT# 15
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Site Address: 8666 DOG LEG RD, SHERRILLS FORD NC 28673
Name on Permit: HETTION BOOKER
Property Size: Acres 0.47
Directions: NC16, Left onto Balls Creek Rd, right W Bandys Cross Rd, Left Buffalo Shoals Rd, Right E Bandys, Right
Sherrills Ford Rd, Left Mollys Backbone, Right Azalea, Left Dog Leg Rd, Property on Left
Authorization to Construct Permit
Permit Category: New Septic Wastewater Flow: 240 g.p.d.
Type of Facility: Primary Residence-New House
Basement? No Basement Plumbing? Bedrooms: 2
Water Supply: Private Well Maximum Occupants: 4
Soil LTAR: .275 g.p.d./ft2
WASTEWATER SYSTEM REQUIREMENTS
Proposed Wastewater System: 50% REDUCTION HORIZONTAL
System Classification: IIIB-SYSTEM W/SINGLE EFFLUENT PUMP
Septic Tank: New Tank: 1,000 gal
Pump Tank 1 000 gal Grease Trap_gal
Dosing Volume 126 gal Pump Specs: 27.18 GPM @ 11 TDH
Pressure Head 2 ft Draw Down 6 in
Drainfield: Total Area: 465 sq ft Total Trench Length: 155 ft
Aggregate Depth: in Maximum Trench Depth on Downhill Sidewall: 20 in
Minimum Soil Cover: 6 in Minimum Trench Separation: 8 ft on center
Number of Drain Lines: 4 Trench Width: 3 ft
Distribution: Pressure Manifold
Pre Treatment: NONE
Pump Required
Additional Specifications:
*See presssure manifold sheet for tap sizes.
See also attached site plan.
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
>>>>> Do not install system under wet conditions <<<<<
PROPOSED REPAIR
Repair System Required? Not Required Soil LTAR: g.p.d.ft2
Proposed System:
System Classification:
ehpermii l0.'18/2023 15:17
r` CATAWBA COUNTY Case# AUTH-10-2023-206602
•
1.,mk. Public Health Department Subdivision SHERWOOD SHORES
Environmental Health Division PIN# 461902652562
PO Box 389,25 Government Drive,Newton,NC 28658 LOT# 15
w
Site Address: 8666 DOG LEG RD, SHERRILLS FORD NC 28673
Name on Permit: HETTION BOOKER
Property Size: Acres 0.47
Directions: NC16, Left onto Balls Creek Rd, right W Bandys Cross Rd, Left Buffalo Shoals Rd, Right E Bandys, Right
Sherrills Ford Rd, Left Mollys Backbone, Right Azalea, Left Dog Leg Rd, Property on Left
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 Authorization to
Construct Permit is subject to revocation if the site plan,plat or the intended use changes,or if site conditions are altered. The Authorization to
Construct 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 Sewage Treatment and Disposal Systems' (I5A 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.
fillb(
10/16/2023
Authorized State Agent Permit Issuance Date
10/16/2028
Permit Expiration Date
No grading or construction activity is allowed in auras designated for system and repair without approval of the Health Department.
ehpennn 10/18/2023 14:55
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