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Home My WebLink AboutIMPV-10-2023-206599.tif r , w• CATAWBA COUNTS' it: Neill- Public Health Department Subdivision SHERWOOD SHORES s Environmental Health Division PIN# 461902652562 Attralitillit 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 We wantt tto hear from yoiPlease ttake a few momentts tto complette our custtomer service survey att http://www.surveymonkey.com/s/EHCusttomerService hssrf>t-ih 3be grail. ehpemrit 10'18'2023 14:55 6 —_ 0CATAWBA COUNTY Case IMYV-10-2023-206599 Pu Department ision Subdivision SHERWOOD SHORES Environmental Health Div PIN# 461902652562 PO Box 389,25 Government Drive,Newton,NC 28658 LOT# 15 9,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 Improvement Permit AN AUTHORIZATION TO CONSTRUCT MUST BE ISSUED PRIOR TO BUILDING PERMITS THIS PERMIT IS NOT FOR SEPTIC INSTALLATION 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 INITIAL SYSTEM SPECIFICATIONS — Proposed Wastewater System: 50%REDUCTION HORIZONTAL System Classification: IIIB-SYSTEM W/SINGLE EFFLUENT PUMP Pump Required REPAIR SYSTEM SPECIFICATIONS Repair System Required? Not Required Permit Conditions: 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. 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 it'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 Sewage Treatment and Disposal Sj^stems' (I5A NC AC I 8A.19011). Neither Catawba County nor the Environmental I lealth 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. 10/16/2023 Authorized State Agent Permit Issuance Date 10/16/2028 Permit Expiration Date No grading or construction activity is allowed in areas designated for system and repair without approval of the Health Department. cli pel m i i 101t s/2023 14:47 . If) I Cip F w I . f"j f--I0 -202 .5` 04S-11 I4v , - 1o_ 2a-21—Q46o2 IA F a S 00'12'29"E 99.90' 'N [O'7 II a).N tF', • I ��tt� I 1 I •ZR ch,hiro°,,,,..0ja1 m I N 1 1\.:1///1 "N, / -. --..,..., s-.._ N(I/ tv. I ai I �7)) \'7' I R N , \ \ \ 1 I �1-..\. • \ \ •\'7 1 : �� 0 1 a; 6 1 C 111) o I p \ I O 1 T&I Blocks per line • M tiw,,�ce,\,, �,,`, 30'=7 Q \` ,.`,n'ti\\,, ,�`\ti 45'=10 1,,,,,\.\,�\, \,W, ,{ I , \,.`�`ti'\\,`„•\\,\',,,`,``,. 35'.8 II \,, ,`,,`e• "'' (. • 45'=10 • 26 r I ; IN Total:155'.35 blocks total , J ''." vt--ct ( i , . /-' Lo ,, .t ' wEt }// ",- I . --- ,38W 99.92' N. � _ _ . . N0542 w \ Q co NG o o LO DOG LEG RD '...4-;r roT o z 601 PUBLIC R\w z i , 30 ____ ..ter DEPARTMENT OF HEALTH AM)HUMAN SERVICES Shur_ of DIVISION OF PUBLIC HEALTH,ENVIRONMENTAL HEALTH SECTION PROPERTY ID M: ON-SITE WATER PROTECTION BRANCH COUNITY: Catawba SOIL/SITE EVALUATION for ON-SITE WASTEWATER SYSTEM �� (Complex*all fields in MI) OWNER: •r _ APPLICATION DATE ADDRESS: _ _ 1 DATE EVALUATED: PROPOSED FACILITY: P OPOSED N (,,1909): PROPERTY SIZE: - ��G'�- . LOCATION OF SITE: 14/ PROPERTY RECORDED: WATER SUPPLY: 0 Private L Public r e Lt Spring fl Other _ _ EVALUATION METHOD: 0 Auger Boring LYE li Cut TYPE OF WASTEWATER: f18tewage L'industrial Process U Mimed t ' ti. sy l -�; c�+�y,, '1. • Cam,t a .j5. ,i, , ; ..k { , 1., — 1,qt, '� -- 1 ff:'.1 / r •'� • tom, I. ' . .iip •- • •1 • „ .1l41 t' '-(• i a' •.'�. A. r • • • - :' •. 'ititig .•, .LL. .n101t.•i• .[ 11•,40 I 1 AR`-K �';E ""..-- it 'err f i COLOR DRt11 t, b c — CL r it f. 1 S' c If SE 1 ,1- 6 CCL 'Pr ,if .Z 0- '0 +(L. W C� fr ,,ice 2 Xi 10-Z dg .5,;L WM: CrIf. ,, S L ! 3 11^, kt ,tps 6; CL A/X -1< )2 c 050K , f-t .5f91 'fe�' , , 3 . 4 DESCRIPTION INITIAL SYSTEM REPAIR SYSTEM OTHER FACTORS(.1946): Avulabk Space(.14s5} < /,5 S1T'E CLASSIFICATION(.194R): • Sysum Type(,) / `'I EVALUATED BY:_ — __. _ — t� /r �� OTHER(S)PRESENT: -- - _ __ - __ 1 Site LIAR ✓h ? COMMIXES: lleetteed Peary2Ot4 — — -- bn ,_ ::),./__s //3c> • ' I ' Catawba 9ounty Environmental Health 6_ 10 ct, tAN kiJts ) c-io C2 l• 10 Y 200.00 J • F 5_6L I 3'2 'rl.„.43 2- 01 P I 3 .R tm o r- O N 210.30 V T O g �� N , 1� $ rr *Mer ;��Y d g DrIvcL.lCt.) L)t C K 115-+ fi 4(0 _ �I Tlj s 445.0 f 154.75 155.31 �j .. 'I00 6 G -( Cz wsye Wet -,- 1/ C tL,'s6 IQ �--. 'it 1I- )7d,(s, (L 1 _, .8680. .: i8 ) $ a o N $O tV ■ _-__ Parcel:461902652562, 8666 DOG LEG RD 1 in=50ft SHERRILLS FORD, 28673 Na • mapFraport product was prepared from the Catawba County,NC Geospatlal Information Services. Catawba County has made substantial efforts to ensure the acwracy 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 maplrapori product by dal user.The County of Catawba.Its employees.agents,and personnel.disclaim.and shall not be hold liable for any and en damages,lose or Nobility.whether direct,indirect or consequential whidi arises or may orbs from this maprreport product or the use thereof by any person or entity. Copyright 2021 Catawba County NC 01/11/2023