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EHPR-11-2023-45953.TIF
IPermit#:TA fir Z A-Y?ogl7o ROY COOPER•Governor NC DEPA AND RTMENT RTMENT OF0 KODY H.KINSLEY•Secretary HbE C MARK BENTON•Deputy Secretary for Health SUSAN KANSAGRA•Assistant Secretary for Public Health Division of Public Health Submittal lndudes: 'LJ' ( )Improvement Permit _1a2)Construction Authorization ❑Fee$ IMPROVEMENT PERMIT FOR G.S. 130A-335(a2) 1 County: Cct \Uhcl PIN/Lot Identifier: y(G Of?/f Ll5-0'33ie Issued To: 1112 4-0.)-ry.S L '( Property Location: i0.gern;nc C rf 1 %ay;lis t'or,l ,ik. ' * T13 • d .S�i t cidit a-c ia,srHe- 404/511 Subdivision(if applicable) )acka iel(„L IL , tote: 18 Block: Section: US Report Provided: Yes No 0 if yes,name and license number of L55. �^^w+c I aS l}v4;y eso[(cn 4 1)3 1 New Q— Expansion 0 System Relocation 0 Change of Use 0 . Proposed Structure: L, clru4,n alRS;Liri}Ma) Number of bedrooms: LI Number of Occupants: R Other: Design Wastewater Strength: mastic ❑high strength 0 industrial process Proposed Design Daily Flow: y 6Q GPDII Proposed LTAR(Initial): O. 3 Proposed LTAR(Repair): C' 3 Proposed Wastewater System Type•:l 1 rr 6 n .- G ncvi 1 [9'f y (Initial) Pump Required: ❑Yes 0 May be required Proposed Wastewater System Types:0 r r i M -5. n 6 f lL M c(i..-Lc' erre�b.L (Repair) Pump Required: laYinn No ❑May be required •Please Include system dassfflcabon for proposed wastewater system types in accordance with SSA NCACI8A.1961 Table V(a) Saprollte System(Initial):❑Yes Qdti d Saproiite System(repair):❑Yes lafc Fill System(initial):❑Yes ❑N,If yes,specify:0 New 0 Existing (when adding more than 6 inches of fill to system area provide a fill plan) Fill System(repair):❑Yes 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): i8 5 Usable Soil Depth(Repair); /9'-5 Max.Trench Depth(Initial)t: 30 Max.Trench Depth(Repair)*: 30 'Measured on the downhill side of the trench Artificial Drainage Required: ❑Yes [..}-N5 If yes,please specify details: Type of Water Supply:0 Private well ❑Public well 0 Shared well unicipal Supply ❑Spring 0 Other: Drainfield location meets requirements of Rule.1945: Yes No❑ Dralnfleid location meets requirements of Rule.1950: Yes['rNo 0 Permit valid for.age years[site plan submitted pursuant to GS 130A-334/13a)) ❑No expiration(plat submitted pursuant to GS 130A-334(7a)) Permit conditions: e. + e C1cS,/. Licensed Soil Scientist Print Name: `J Licensed Soil Scientist Signature: �.tc ,,,�e-t,. Date:. (I JCi .702.S The 1S5 evaluation Is being submitted pursuant to and meets the requirements of G.S.130A•335(e2). *See attached site sketch* NC DEPARTMENT OF HEALTH AND HUMAN SERVICES • DIVISION OF PUBLIC HEALTH LOCATION:5805 Six Forks Road,Budding 3,Raleigh,NC 27609 MAILING ADDRESS:1832 Mall Service Center,Raleigh,NC 27699-1632 www.ncdhhs.gov • TEL:919-707.6854 • FAX:919-845-3972 AN EQUAL OPPORTUNITY/AFFIRMATIVE ACTION EMPLOYER Permit#: IMPV-11-2023-208170 SaddlebrooK Lot 18 This Section for Local Health Department Use Only Initial submittal received: 1 0/30/2023 by RP Dote 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 deportment 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 os 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 / jam State Authorized Agent: / )�1,ti Date: 11/9/2023 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: 11/9/2028 *See attached site sketch* G.S. 130A-335(a2)Common Form 2 V.2023.07 NC DEPARTMENT OF ROY 'Governor limioviumEs 'copyK�Y-e„o,ea,ry 0 ` MARK INEKTON•Deputy ate, ry for Health SUSARA- rrt fleorelry tar Publip Fye� Minion• of Public Nolen for Services This °",In conjunction with the APPi departments to be used for• MM '" biped in Si.130N-3 43!and- �� ( 3J,Is nN for lOcal). �,�14�(Q3)am(a5)"mats e,as(a2 Improvement Per amordence with G.S.mit �3�and(asl. health nfor: ' ZbrrAertlrortmggy 2i7mproventent Permit I 3at!Construction °" 0 Please check one of the followirw Pa)+tepNr/ca,,,,tr�tbn won E"rlew Construction ear frstlon_Requested Provldedj System ❑ Changeof the ❑ Repair iii-rirmit Property Owner N0 Non-Expiring �am Requested(plat proNdad,as ds�in G.S.134�3347e) Property Owner Mal�Addreas; al PropertyOwner Phan Number , Pr'OPerty Owner Erna9 Applicant Name: Applcant MailingAddress: Applicant Phone Nkanber: Applicant Email Address: 4; Does the include,or is subject to,any ar the =Nav Ores E Prswousli` lur orr� ❑Yes o Existing or Proposed easement;, Approval by other public&gander ! encroachments,or other area> 0D legal restrictions A site plan or plat is required,Q the site sketch submitted kiwi the tW proposed a wattmeter proposed OWEN,se structures,'ppurte wastewater sy muststems the fallowing: (C)misting and proposed to propa�y lhrats!or other tbad rimer :) arms (Di and I edadn Proposed water supPbos.walk wines.gdpdwecsr and(E waasr,drainage se and a stlr3 and artificial drainage.as applicable. Requesting DMH$review:Ores BC I underxgrtd that the documentation and area to issue a n as in 3 +�3StaZ},ta3},(a5},and(sd�sebdud to this IPPlislitinn t method:ad and state ssay the �ly +d*w with . . property k this�and fan*I the duconduct nvie for anlaws and rules. I understand that if the applmation ication ation in AppIkalm!int 'mprovement /� %/.%��, / �I:falsified,drar�d,or the,lb.ls sabered, Owner's . , ,� ... �. s/Ap.� Date: �1 � �73 dirff ...��.�. Dam: ll 3 NC t; k ooAnora MOB 8br Forlas 1IN O� • MINOR �w�c I�Lns . seam AMIN&taxi Mil yrp��' r Center.R Raleigh,roc 27eoe o React.aNCs 2reeo.tesx w ra.n ceihs.gov • t • Nut eta.asatesz AN main ceParrnaerrriemmeTne Acme sra>tovER IPermit#: ROY COOPER•Governor 6 RfR-i) ,)DJ3 -/S`ts3 r: - NC DEPARTMENT OF KODY H. KINSLEY•Secretary ' ; HEALTH AND MARK BENTON•Deputy Secretary for Health �:� Ai. �:;� HUMAN SERVICES SUSAN KANSAGRA•Assistant Secretary for Public Health Division of Public Health Submittal Includes: (a2)Improvement Permit -Construction Aut horization) El Fee$ IMPROVEMENT PERMIT FOR G.S. 130A-335(a2) County: k41/41/41b k PIN/Lot Identifier: Li(o oq 0 LI J'-0 73!8 Issued To: 'jR 4-Arbi,S L.0 e Property Location: alorh,rla Cove f I Sherri ils i-dre, NC, d8t1 l3 Sucld le,�-,•,(( Sc�i j �• �tJrSrt{�- //�OT-�8 Subdivision(if applicable) 5 add t tb rc,,;iC Lot#: 18 Block: Section: LSS Report Provided: Yes No❑ If yes,name and license number of LSS: (‘-I'^uc I It I1)P 7 G l lan S #r 1)3 New ril--------- Expansion ff❑ System Relocation 0 Change of Use 0 Proposed Structure: L) fCitan RCS;d•cn 4-,a) Number of bedrooms: 9 Number of Occupants: 8 Other: Design Wastewater Strength:lad mestic 0 high strength 0 industrial process Proposed Design Daily Flow: °'I e0 GPD lProposed LTAR(Initial): O. 3 Proposed LTAR(Repair): 0' 3 Proposed Wastewater System Type*:4((rp�rppprtri Ob���I/6,/�errludiy„I_ &((r cvi I-y (Initial) Pump Required: ❑Yes [C}�❑May be required Proposed Wastewater System Type*:�17DIJ-• (l"b IPaluIi••-ut.. f);%L.L. (Repair) Pump Required: Efrern No ❑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):0 Yes El-Nt Saprolite System(repair):❑Yes La►o Fill System(Initial):❑Yes yes,specify:ElNew 0 Existing (when adding more than 6 inches of fill to system area provide a fill plan) Fill System(repair):El 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): /8-57 s' Usable Soil Depth(Repair): /9'-. " Max.Trench Depth(Initial?: 30 Max.Trench Depth(Repaid*: 39 *Measured on the downhill side of the trench Artificial Drainage Required: ❑Yes &Miff yes,please specify details: Type of Water Supply:❑Private well ❑Public well ❑Shared well lal unicipal Supply ❑Spring ❑Other: Drainfield location meets requirements of Rule.1945: Yes No❑ Drainfield location meets requirements of Rule.1950: Yes Q 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: s,V. � J Licensed Soil Scientist Print Name: l U+s tr / 6•• / . Licensed Soil Scientist Signature: f'c t (; 7._ Date: /C)/Z 74? The LSS evaluation is being submitted pursuant to and meets the requirements of G.S.130A-335(a2). *See attached site sketch* RECEIVED NC DEPARTMENT OF HEALTH AND HUMAN SERVICES • DIVISION OF PUBLIC HEALTH LOCATION:5605 Six Forks Road,Building 3,Raleigh,NC 27609 O C MAILING ADDRESS:1632 Mail Service Center,Raleigh,NC 27699-1632 www.ncdhhs.gov • TEL:919-707-5854 • FAX:919-845-3972 AN EQUAL OPPORTUNITY/AFFIRMATIVE ACTION EMPLOYER Environmental Health 4' Permit#: Saddlebrook lots: 1-5, 7-11, 13, 14, 16-20, 22, &23 This Section for Local Health Department Use Only Initial submittal received: 1 0/30/2023 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 deportment falls 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 th&s Improvement Permit5was conducted in accordance with G.S. 130A-335(a3).j119r�lmprovement Permit,-determined to be: a ©Incomplete(If box is checked, information in this section is required.) The following items are missing: Cannot issue a stand alone IP with the the(a2)Construction Authorization box checked on the IP common form. Copies of this were sent to the LSS and the Applicant on 11/3/23 State Authorized Agent: "wv Date Date: 11/3/23 ❑Complete State Authorized Agent: Date: 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: *See attached site sketch* G.S. 130A-335(a2)Common Form 2 V.2023.07 SOIL & FURE T ' SMICES OF THE CAROLINAS, PA www.soilandforestryservices.com Project#: 23-0015 September 6th, 2023 VR Farms LLC Attn: Ray Short Email:vrshortjr@aol.com RE: Soil &Site Evaluation for a 4 Bedroom Residence at Saddlebrook Subdivision Lot 18,0.77 ac Parcel, PIN#(460904507318)Sherrills Ford, NC 28673. Mr. Short: At your request Soil & Forestry Services of the Carolinas(S&FS) has performed soil/site evaluations on parcel noted above.The Lot size is noted on the attached survey map&soil evaluation form.The purpose of our work was to identify soil areas with potential to support subsurface wastewater disposal systems and provide design details for Session Law submittal to Catawba County Health Department. Site Conditions At the time of our evaluation land cover on the property was partially cleared/graded for the house pad and open field.Topography within the evaluated area was gentle slope near the house site and proposed drainfield area. Property lines and corners were marked at the time of the evaluation by Jordan-Grant Surveying.The surveyor provided an Autocad File of a survey with house envelopes as a basemap.The proposed septic layout was located via GPS&tape measures and used to produce the attached Site Plan.The house envelope was located via Surveyed by Derek Bunton Surveying. Backhoe pits were located via GPS. Methodology We evaluated soil areas through the use of backhoe pits.Soil morphological conditions including color, texture, structure, etc.were reviewed in the field with five backhoe pit locations on the property flagged and located via tape measure.All of the backhoe pits are located in or adjacent to the proposed septic layout.Soil suitability was determined by referencing 15A NCAC 18A.1900"Laws and Rules for Sewage Treatment and Disposal Systems".Soil&Site Evaluation Forms were utilized to record the soil morphological data for each pit.The house envelope was located via survey. An on-ground layout of system and repair was performed using a laser level. Pin flag locations of the layout were also located by GPS and tape measures. Detailed system & repair information is summarized in the following paragraph for this Lot. Saddlebrook Subdivision- Lot 18(See Attached Design) The septic layout for this lot (9'centers)yielded a total of 781 linear feet of line.The primary system is proposed as 408 linear feet of Accepted (25% Reduction) drainfield with gravity distribution. Trench depth is specified at 30 inches(Low Side).The repair system is proposed as 267 linear feet of Modified Conventional (50% Reduction) drainfield with low pressure distribution. Trench depth is specified at 30 inches(Low Side).There is 373 linear feet of repair available. Session Law Requirements All information needed to issue the IP must be submitted with the application.The application shall include all information described in 15A NCAC 18A.1937(d) and be accompanied by a signed and dated statement from the applicant(owner or owner's legal representative)that reads as follows: "The LSS/LG evaluation(s)attached to this application is to be used to issue an Improvement Permit in accordance with G.S. 130A-335(a2)and(a3)." Owner / Date Print Name , +n—/ ' /1141 �, lc Signature 4 III eVi / /u' The LSS evaluation shall include a statement r-ring the LSS seal and signature that reads as follows: "The LSS evaluation is being submitted pursuant to and meets the requirements of G.S. 130A- 335(a2)." Disclaimer This report reflects the findings of S&FS, PA. This LSS evaluation is being submitted pursuant to and meets the requirements of G.S. 130A-335(a2)."Any site modifications that impact the proposed septic areas on the site may nullify this design for Lot 18-Saddlebrook Subdivision,Sherrills Ford, NC 28673. System design requirements and site requirements shall be adhered to for installation and Operations Permits to be issued by the local Health Department. If you have questions regarding these requirements a Pre-Construction meeting should be scheduled to discuss. Please contact S&FS if you have any questions regarding this report or the attached information. S&FS also offers septic system inspection, wetland delineation and fore ,*se 4ces. SOIL . Sincerely, Q S t `.�.. 0- A. RO V -per/��r'in It,;I ''Y J J/ ; --J Cr) i2 ,4, ; r 0.-A051)A / " • 07 0110 • M .7‘tl\ 12 3 A w Op Cls S. Ashley Rollans, LSS NO RTH Attachment: Septic Design IPPF dl �.. & FORESTRY SERVICES OE THE CARCILINAS, PA www.soi la ndforestryservices.com Attached is a proposed design for an Accepted Septic System with gravity dist. for a 4 bedroom single family residence at Saddlebrook subdivisoin Lot 18 Sherrills Ford, NC 28673, Catawba County, PIN#: (460904507318) Contents: Page Information for the Installer 1 Design Information Design Specifications 2-3 Layout Specifications - 4 Site Plan/System Plan 5 Calculations 6 SOIL Profile Descriptions 7 S .��LA. FAO jK Application - - � - 8-9 gr CA Form ---- ---- �-tr _` ✓ ��!� . 10 IP Form o e-�- --- '';, = • 11 /4r. 123A Ov Application for Services — �,e---- - �� 12 NORTM September 6,2023 Project#: 23-0015 Design By: Soil& Forestry Services of the Carolinas, PA 1 INFORMATION FOR THE INSTALLER: The permit should be read very carefully prior to bidding. The following are details that must be considered along with all other considerations. - Tanks shall be approved by NC DHHS, and certification supplied by the manufacturer. - Tanks shall be water tested prior to installation. - The installer shall be responsible to the owner for placement of the tanks and to insure that final grades are returned to the original natural grade,with exception of added structural features. - The supply trench shall be compacted to eliminate cavities left during initial fill placement. - Installation of the system shall be during dry conditions in order to protect the soil structure. - All fittings shall be pressure rated fittings. - All joints shall be cleaned with PVC pipe cleaner and a heavy bodied glue applied to weld all joints. - Where required by the county health department,post installation inspections by the designer must be scheduled 5 week days in advance. - Trenches shall be carefully excavated so the bottom is within 2"from the highest to . the lowest points of elevation within the trench. If the bottom elevation needs adjusting after it has been trenched, it will be done by removing high points rather than filling low points. It is extremely important to insure that trenches are not over excavated during initial trenching. All fine grading within the trench will be hand done with a shovel. No loose material will be left in the trench - All pipe openings in the tanks shall be properly grouted. This also applies to the joints around the riser. - All tanks shall be properly back filled and compacted to prevent slump at a later date. - Earth dams, constructed of relatively impervious material, shall be installed at the beginning and end of each lateral. - No heavy equipment shall be used on the field during or after installation. The use of a small loader(i.e. Bobcat) or a trencher(i.e. Ditch Witch 2300/2310) may be used for installation. - Elevations at pinflag locations should be checked by the installer prior to beginning trenches. - Septic tank riser shall be a minimum of 6" above finished grade. - System is specified as a gravity 25%reduction(Accepted) installation. - Repair is specified as a PPBPS (50%Reduction) with low pressure distribution. 2 GRAVITY ACCEPTED SYSTEM FOR WASTEWATER TREATMENT Owner/Applicant: VR Farms LLC Address: 7172 Long Island Rd Catawba,NC 28609 Phone: 704.516.2344 County: Catawba Location: Palomino Court-Lot 18 Sherrills Ford,NC 28673 Source of Wastewater Flow: 4 Bedroom Single Family Residence Estimated Gallons Per Day Flow: 480 System Flow: N/A Design Specifications Drainfield Size: 408 Loading Rate(gpd/ft.2): 0.3 Depth of Gravel in Trench: N/A Gravel Size: N/A Max.Trench Depth (LOW SIDE): 30 in. Repair Trench Bottom 30 in. Trench Width: 36 in. Septic Tank Size: 1000 Estimated Supply Line Length: 10 Supply Line Diameter: 4 in. SCH 40 PVC Supply Line Volume: 6.53 Dosing Volume: N/A Supply Manifold: N/A Supply Manifold Length: N/A Supply Manifold Volume: N/A Recommended Float Controls: N/A Recommended Control Panel: N/A Pressure Head: N/A Friction Head: N/A Elevation Head: N/A Total Dynamic Head: N/A Threaded Union: N/A Gate Valves: N/A Check Valves: N/A Anti-Siphon Hole: N/A Additional Comments: Soil suitability was performed by Soil & Forestry Services of the Carolinas, PA 3 Palomino Court- Lot 18 ACCEPTED SYSTEM DESIGN FLOW(gpd): 480 SOIL APPLICATION RATE (gpolft.2): 0.3 TOTAL AREA TRENCH BOTTOM: 1224 TOTAL LATERAL LENGTH: 408 NUMBER OF FIELDS: 1 LATERAL LENGTH REQUIRED PER FIELD: 400 SUPPLY LINE LENGTH: 10 TOTAL DYNAMIC HEAD: N/A MANIFOLD SIZE: N/A DOSING VOLUME: N/A PUMP TANK DRAW DOWN*: N/A SEPTIC TANK SIZE: 1000 4 Layout Specifications -Palomino Court-Lot 18 Project#:23-0015 LAYOUT FOR 4 BEDROOM HOME September 6,2023 FLAG FLAGGED DESIGN LINE# COLOR BS HI FS ELEVATION LINE LENGTH LINE LENGTH TBM INSTR. 1 l BLUE 44 44 2 YELLOW 64 64 3 PINK 48 48 4 ORANGE 102 102 5 RED 113 102 6 PINK 114 102 7 BLUE 106 102 8 YELLOW 91 91 9 ORANGE 41 41 10 RED 31 31 11 PINK 27 27 Total 781 754 SOIL LOW SIDE LINE LTAR SYSTEM LTAR TRENCH TRENCH LENGTH GPD/FT2 TYPE GPD/FT2 SYSTEM DISTRIBUTION DEPTH *System 408 0.300 ACCEPT. 0.300 25%RED GRAVITY 30" Repair 373 0.300 MOD. 0.300 50%RED LOW 30" CONY. PRESSURE Notes: **A1I measures in feet **Nitrification lines are demonstrated on contour via colored pin flags **Nitrification lines were located by GPS and tape measure. ' . 54' S 85 ° q� >> (T • 9p. 7g ' 35 E 6c w��E • 1 48. 89 ' o 02 6 ' 6 ��Q o� O q 2 �1 10� <1 10 B 54' �'I' �� SCALE p15 0' 'a. c102�, 0 2 �5 10 1„=40' �11 ' ,�02� - 9 ��1 0 2 1 V , C i 3 6 lc? .D1 tk(?) jc .q— /D' ' ( r? Ix Cc' Z cb co �102 �i P14 Ln R, �� N 6� / � � �O rj' ° cY) 1 '•)‘ 0.:•14.- 01 / O.€ 1,110 p20N �� 1 . 775 o, AC �2ti ACRE o HE 21 71 . 108 �' NOvsE S o SLAB Ity "- ACRES oN �6 0� �,�� i' 6 2�' 12 2s Z • s V 5 g>_ C, • CALCULATIONS Location Palomino Court- Lot 18 Sherrills Ford, NC 28673 Project Number 23-0015 Lot No: 18 No. of Bedrooms 4 Design Flow 480 gal/day LTAR 0.300 gal/ z ft day PPBPS? (YES OR NO) NO Supply Line Length 10 ft. Supply Line Volume 6.53 gal. FRICTION FACTOR INTERPOLATER Required Feet of Line 400 ft. 2" SCH 40 PVC Amount of Line from Layout 408 ft. GPM f 20 0.84 Gallons per Minute N/A gai/min -0.88 25 1.27 Required Septic Tank Capacity 1000 gal. -1.28 Septic Tank Size 1000 gal. 30 1.78 -1.76 Panel Volume N/A gal. 35 2.37 #of Panels N/A -2.25 Dosing Volume N/A gal. 40 3.03 43.07 3.48 45 3.77 48.14 4.28 50 4.58 57.11 5.89 60 6.42 Tank Draw Down N/A Pump Run Time Elevation Head N/A ft. Pressure Head N/A ft. Friction Factor N/A ft./100 ft. (From the interpotater.) Friction Head N/A ft. Total Dynamic Head (+15%) N/A ft. Sheet 1 of 1 PROPERTY ID#: 460904507318 COUNTY: Catawba SOIL/SITE EVALUATION for ON-SITE WASTEWATER SYSTEM (complete all fields in full) OWNER: VR FARMS LLC APPLICATION DATE: ADDRESS: 7271 Long Island Rd,Catawba NC 28609 DATE EVALUATED: j-z.f Z-3 PROPOSED FACILITY: 4 Bedroom Residential-480 GPD PROPERTY SIZE: C).77 ' _ LOCATION OF SITE: Saddlebrook subdivision,Sherrills Ford NC 28673-Lot 18 PROPERTY RECORDED: ,„,� WATER SUPPLY: ❑Private ❑ Well ❑ Spring 0 Other County water EVALUATION METHOD: E Auger Boring ❑Pit ❑Cut TYPE OF WASTEWATER: 0 Sewage ❑ Industrial Process ❑ Mixed P R O SOIL MORPHOLOGY OTHER F .1940 HORIZON (.1941) PROFILE FACTORS PROFILE LANDSCAPE I DEPTH CLASS POSITION/ EL <AR SLOPE°/ (IN.) .1941 .1941 .1942 .1943 .1956 .1944 STRUCTURE/ CONSISTENCE/ SOIL SOIL SAPR RESTR TEXTURE MINERALOGY WETNESS! DEPTH CLASS HORIZ mina 0-20 BRC WMSBK FR SS SP 20-52 RBCL WFSBK FR SS SP __ C SAP 11 L!5% 52" N/A PS 0.325 0-5 BSCLWFSBK FR SS SP COMPACTED 5-18 BRCL WFSBK FR SS SP F SAP 12 L/5% 18-64 VAR SL MASS FR SS SP 18" PS N/A PS 0.35 0-14 BSCL WFSBK FR SS SP 13 L/7% 14-44 RBC WMSBK FR SS SP 53" N/A PS 0.3 44-53 RBCL WFSBK FR SS SP F SAP 0-10 DISTURBED COMPACTED 10-18 RBC WMSBK FR SS SP 14 U5% 18-57 RBCL WFSBK FR SS SP C SAP 57" N/A PS 0.325 0-13 FILL 13-19 BSCL WMSBK FR SS SP 15 U9% 19-48 RBC WMSBK FR SS SP 55" N/A PS 0.3 48-55 RBCL WFSBK FR SS SP F SAP S0: L vc� y�,��, S r,1 CIS\yam f/ '''N`<•‘,t, i (1/4\k‘.. ; i '4, '‘,4.4\- DESCRIPTION INITIAL SYSTEM REPAIR SYSTEM OTHER FACTORS(.1946): SITE CLASSIFICATION(.1948): PS Available Space(.1945) PS PS EVALUATED BY: Ashley Rollans System Types(s) Accepted 25%-Gravity PPBPS 50%-Low Pressure OTHER(S)PRESENT: Chad Wagner&Mason Freeman Site LTAR 0 3 0.3 COMMENTS: 4 e srnrE,4y �I � ROY COOPER"Governor . NC DEPARTMENT OF P�OOV t•l,6CINSLEY•Secretary HEALTil i1G`�li> HUMAN AN r�f;fi �i/fi(. (4 0 II1IARK E E?NTON•Deputy Secretary for Health SUSAN i(ANSAGRA n Assistant Secretary for Public Health Division of Public Health Application for Services This application,in conjunction with the common form established in G.S. 130A-335(a3)and(a5),is optional for local health departments to be used for applications submitted in accordance with G.S.130A-335(a2),(a3),and(a5). (hereinafter,G.S. 130A-335(a3)and(a5)permits referred to as(a2)Improvement Permit and(a2)Construction Authorization] Applying for: l2)Improvement Permit (a2)Construction Authorization ❑ (a2)Repair/Construction Authorization Please check one of the following: lEtiew Construction ❑ Expansion 0 System Relocation 0 Change of Use 0 Repair (rear Expiration Requested(site plan provided) 0 Non-Expiring Permit Requested(plat provided,as defined in G.S. 130A-334(7a) Property Owner Name:yR. gater.% LIZ Property Owner Mailing Address:dal( .( a1SLeC1�1 Property Owner Phone Number; -)04- l 03C.Ny Property Owner Email Address: VC S\ (A C Q 401.Cori, Applicant Name: V t2 c c -'S LLC Applicant Mailing Address:1A t LOY asSlovr.et d CC4-uAA sic f: clf"(0( Applicant Phone Number: ntj-\- Applicant Email Address: t/(4 -c c jc j7, tkOk.(;UY--, Does the property include,or is subject to,any of the following: ❑Yes ErIClo Previously identified jurisdictional wetlands ID Yes [a'No Existing or proposed easements,rights-of-way,encroachments,or other areas subject to legal restrictions []Yes o Approval by other public agencies A site plan or plat is required,OR the site sketch submitted from the LSS/AOWE,must include the following: (A)existing and proposed facilities,structures,appurtenances,and wastewater systems (B)proposed wastewater system showing setbacks to property line(s)or other fixed reference point(s) (C)existing and proposed vehicular traffic areas (D)existing and proposed water supplies,wells,springs,and water lines;and (E)surface water,drainage features,and all existing and proposed artificial drainage,as applicable. Requesting DHHS review: Oyes 9lo I understand that the documentation and fees,as required In G.S. 130A-335(a2),(a3),(a5),and(a6),attached to this application are to be used to issue an Improvement Permit and/or Construction Authorization pursuant to G.S.130A-335(a2),(a3),and(a5). understand that authorized county and state officials are granted right of entry to the property indicated on this application to conduct necessary inspections to determine compliance with applicable laws and rules. I understand that if the information in the application for an Improvements Permit and/or Constructlo Auth rizati Is falsified,changed,or the site is altered,then the Improvement Permir;,and struction Auth ati sha valid. 1 y, Applicant Signature: it c , Date: 0 � /i 1 Owner's Signature; (, Date: 2„'I NC DEPARTMENT OF HEALT AND HUMAN SERVICES • DIVISION OF PUBLIC HEALTH LOCATION:5605 Six Forks Road,Building 3,Raleigh,NC 27609 MAILING ADDRESS:1632 Mall Service Center,Raleigh,NC 27699-1632 www.ncdhhs,gov • TEL:919-707-5854 FAX;919-845-3972 AN EQUAL OPPORTUNITY/AFFIRMATIVE ACTION EMPLOYER �$ � THIS IS NOTA PERMIT Case# EHPR-11-2023-45953 a CATAWBA COUNTY HEALTH DEPARTMENT PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES 4842 5M Environmental Health Plan Review- OSWP IPa2 Permit Fee Applicant TINA LITTLE,7257 LONG ISLAND RD,CATAWBA NC 28609 TINATO WNEBUILDERSLLC@GMA1L.COM Owner *VR FARMS LLC,7271 LONG ISLAND RD, B:8284687175 C:7045162344 VRSHORTJR@AOL.COM NAME TO APPEAR ON PERMIT *VR Farms LLC SITE ADDRESS: PALOMINO CT,SHERRILLS FORD NC 28673 PIN# 460904507318 NAME of SUBDIVISION: SADDLEBROOK 18 Lot# Section/Block PROPERTY SIZE: Square Feet 33,541.20 Acres •77 DIRECTIONS: E NC 150 HWY,LEFT SHERRILLS FORD RD,ON RIGHT PAST MOLLYS BACKBONE RD PRIMARY CONTACT: Applicant SEWER TYPE: Septic Tank GALLONS PER DAY: 480 WATER SUPPLY: Public Water DESCRIBE WORK: a2 IP only for property subdivision SITE INFORMATION Do any of the following apply to the property for which this application is applied? If the answer to any of the questions below is"YES",then supporting documentation is required: Does this site contain any jurisdictional wetlands? No Does this site contain any existing wastewater systems? No Is any of the wastewater going to be generated on the site other than domestic sewage? No Is the site subject to approval by any other public agency? No Are there any easements or right-of-ways on this property? No APPLICATION FOR: New Structure STRUCTURE TYPE: PRIMARY RESIDENCE FACILITY TYPE: House OTHER DESCRIPTION: DESCRIPTION OF EXISTING STRUCTURES ON SITE(IF ANY) DIM EXISTING STRUCTURE: NUMBER OF EXISTING BEDROOMS: #OF OCCUPANTS: 8 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 50 X 70 #OF NEW BEDROOMS:: 4 BASEMENT? No BASEMENT FIXTURES? No PLUMBING REQUIRED? EMPLOYEES PER SHIFT: NUMBER OF SHIFTS: TOTAL EMPLOYEES: SEATING CAPACITY: TOTAL FLOOR SPACE(SQ FT): Desired system types(Improvement Permit or Authorization to Construct): ACCEPTED: ALTERNATIVE: CONVENTIONAL: OTHER: INNOVATIVE: ANY: Other described: La;ph;:qu n 11/02/2023 12:45 Page I of3 B s CATAWBA COUNTY Case# CHPR-l 1-2023-45953 •t. , . Public Health Department Subdivision SADDLEBROOK d ,n Environmental Health Division PIN# 460904507318 PO Box 389, 100-A Southwest Blvd,Newton,NC 28658 /g 94 NAME ON PERMIT: *VR FARMS LLC ( ),7271 LONG ISLAND RD, *VR Farms LLC ( ) Site Address: PALOMINO CT,SHERRILLS FORD NC 28673 Property Size: Square Feet 33,541.20 Acres .77 Directions: E NC 150 HWY, LEFT SHERRILLS FORD RD,ON RIGHT PAST MOLLYS BACKBONE RD Completed applications are valid for a period of 2 years.Improvement Permits are valid:with complete site plan=60 months(5 years);with complete plat =without expiration. An Authorization to Construct will remain valid as long as the Improvement Permit is valid.An Authorization to Construct issued for septic repair is valid for 60 months(5 years).Permits may be revoked if the information on this application/site plan changes or if the intended use for the proposed facility changes. Permits may be revoked if site conditions are altered such that they effect permit conditions or installation requirements I have read this application and certify that the information provided herein is true,complete and correct. Authorized county and state officials are granted right of entry to conduct necessary inspections to determine compliance with applicable laws and rules. I understand that I am solely responsible for the proper identification and labeling of all property lines and corners and making the site accessible so that a complete site evaluation can be performed. The undersigned is the owner of the property or legal agent of the owner. Date: Signature of Applicant or Agent If you need further information or assistance please call 828-465-8270 AREA4 FEENAME DATE FEE AMOUNT IPa2 Permit Fee 11/02/2023 $150.00 TOTAL FEES $150.00 FEES ARE NON-REFUNDABLE ONCE A SITE VISIT IS MADE OR WORK ON A PLAN REVIEW HAS COMMENCED SYSTEM REDESIGN AND/OR RETRIP WILL INCUR AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) chapplicau,m 11/02/2023 12:45 Page 2 of 3 catawba county pubic health Application for Environmental Health Services THIS IS NOT A PERMIT Application is for: ❑ New Construction ❑Existing Facility 1 Li Improvement Permit ❑Authorization to Construct ®New Septic ❑Septic Repair/Malfunction ❑Septic Relocation ❑ Septic Expansion ❑ Existing System Inspection or Reconnection ❑ New Well ❑Replacement Well ❑Well Abandonment ❑Well Repair Property Address Acres .77 Subdivision Saddlebrook Lot 18 Driving Directions to Property Take hwy 10 to Murry Mill road, turn left on to Sherrill Ford rd site is on the left Describe work install new septic Applicant Name Tina Little Applicant Address 7257 Long island rd Catawba, Catawba NC 28609 Phone 828-468-7175 Email tinatownebuilderslle@gmail.com Owner Name Owner Address VR Farms ( Virgil Ray Short Jr Phone 704-516-2344 Email vrshortjr@aof.com Contractor Name Contractor Address Bumgamer Septic Tank Phone 828-396-1795 Email bseptictank@gmail.com Name to Appear on Permit? ®Owner ❑Applicant ❑Contractor Who will he the Primary Contact? ❑Owner ® Applicant ❑Contractor Proposed New Construction-Residential Primary Residence ® New Residence ❑ Addition to Residence #of New Bedrooms*j' 4 #of Occupants Project Description Structure Dimensions,also specify dimensions of decks&porches (Choose One) ❑Basement 0 Crawl Space Slab If Basement,Will There Be Water Using Fixtures In Basement 0 Yes ❑ No Retaining Wall>2' ❑ Yes 0 No Accessory Dwelling #of New Bedrooms*fi #of Occupants Structure Dimensions (Choose One) 0 Basement ❑Crawl Space ❑ Slab If Basement,Will There Be Water Using Fixtures En Basement ❑Yes ❑ No Retaining Wall>2' ❑ Yes ❑ No Accessory Structure(s)Describe Structure(s)Dimensions Plumbing ❑ Yes ❑No Describe Plumbing Needed (Choose One) 0 Basement ❑Crawl Space ❑ Slab If Basement,Will There Be Water Using Fixtures In Basement ❑Yes ❑ No Retaining Wall>2' ❑ Yes ❑ No Multi-Family Residence #of Apartments #Bedrooms per Apartment*t Total#Bedrooms in Structure*j• #of Occupants Structure Dimensions (Choose One) ❑Basement ❑Crawl Space ❑ Slab If Basement,Will There Be Water Using Fixtures In Basement ❑Yes ❑ No Retaining Wall>2' 0 Yes ❑ No Well Con'traction/AbandonmentfRepair Proposed Well Type ❑ Individual Well ❑Semi-Public Well ❑Community Well Abandonment Type ❑ Drilled ❑ Bored ❑ Dug ❑ Unknown Well Repair Requested ❑Yes ❑No Describe Will Certified Well Contractor Install Water Line or Electrical Line from Well Head to Pressure Tank?❑Yes ❑No Environmental Health Catawba County Government Center, 25 Government Drive I PO. Box 389, Newton, NC 28658 Phone: (828) 465-8270 I Fax: (828)465-8276 I EHAdmin@CatawbaCountyNC.gov Existing Structures on Site Describe Structure Dimensions #of Bedrooms* #of Occupants Basement ❑ Yes ❑ No Basement Plumbing ❑ Yes ❑ No F:xisting Water Sup" r ❑ Individual Well 0 Shared Well—Number of Connections ❑Community Well ❑County/City/Township Water Line Is a public water supply available?** ® Yes 0 No Commercial ❑ Proposed New Construction ❑ Existing/Change of Use ❑Repair Food Service Specify Type #Seats Dining Area(Sq.Ft.) #Employees per Shift #of Shifts Church #of Seats Daycare ❑ Yes ❑No #of Children #of Employees per Shift #of Shifts Commercial Kitchen 0 Yes ❑No Residential Kitchen 0 Yes ❑No Daycare#of Children #of Employees per Shift #of Shifts Business/Other Specify Type Structure Dimensions Retail Floor Space #of Employees per Shift #of Shifts Other Information Calculated Design Flow,Commercial t (This value will be determined by EH staff) The Applicant shall notify the local health department upon submittal of this application if any of the following apply to the property in question. If the answer to any question is"yes",applicant must attach supporting documentation. ❑Yes PI No Does the site contain any jurisdictional wetlands? ❑Yes IN No Does the site contain any existing wastewater systems? El Yes No Is any wastewater going to be generated on the site other than domestic sewage? ❑Yes l5i)No Is the site subject to approval by any other public agency? El Yes No Are there any easements or right of ways on this property? Describe If applying for an Improvement Permit or Authorization to Construct,Please Indicate Desired System Type(s): (systems can be ranked in order of your preference) ❑Accepted 0 Alternative El Conventional 0 Innovative ❑ Other 0 Any *Any room that will be intended for sleeping at the time of construction or for future consideration should be noted as a bedroom and counted on all applications.The number of bedrooms will be confirmed by rooms identified on floor plans as a bedroom at the time of building permit issuance. This may prevent the need for septic system expansion in the future. t If structure is plumbed but has no bedrooms,calculated design flow will be determined by EH Staff. **If No,a well permit must be issued with the Authorization to Construct. RETRIP TO THE PROPERTY AND/OR SYSTEM REDESIGN WILL INCUR AN ADDITIONAL CHARGE(SEE FEE SCHEDULE) Environmental Health soil/site evaluations require digging,augering,and/or probing into the ground.Property owner/applicant is responsible for marking all underground utilities, including but not limited to:underground power,cable,telephone,gas,water lines,and irrigation systems/sprinkler systems.Catawba County Environmental Health is not responsible for damage to unmarked utilities. Completed applications ate valid for a period of 2 years.Improvement Permits are valid:with complete site plan=60 months(5 years); with complete plat=without expiration. An Authorization to Construct will remain valid as long as the Improvement Permit is valid.An Authorization to Construct,issued for septic repair is valid for 60 months(5 years).Permits may be revoked if the information on this application/site plan changes or if the intended use for the proposed facility changes.Permits maybe revoked if site conditions are altered such that they effect permit conditions or installation requirements. I have read this application and certify that the information provided herein is true,complete and correct. Authorized county and state officials are granted right of entry to conduct necessary inspections to determine compliance with applicable laws and rules. I understand that I am solely responsible for the proper identification and labeling of all property lines and corners and making the site accessible so that a complete site evaluation can be performed. The undersigned is the owner of the property or legal agent oft r. Signature of Owner or Legal Agent Date Printed Name of Owner or Legal Agent Catawba County Environmental Health I. sP s V19, .CB 7 TM n. (`��7476 41 �1•s.7462 �'� Li r ,m 675.20 ^s 714,75 25.CA 113_73 {tj_j ti N to h i:17,\r"\------44". '-'2r5lr:" --"'''n"'—'2-'''''25trfTr----*.......—.2.r,4.zr,..._.e..rrrrX93Yr'fTh*iffr..•.-...-=,...._,...2t3tr , . 'fir cr`749 i 1500 '" 4 ,s • •7648 z:t. z-- --- 307.'1. ° •7552 ?71 cy 1 ae 42 i4' 7 �—4.____-_-__-_-_ 7456 1'.(1', - 3 3 b5 16 .13 211., SHERRIi-LS FORD RD 4 •7655 i •7473 t r so 0 T. I Parcel: 460904507318, 7552 SHERRILLS FORD 1in=300ft RD SHERRILLS FORD, 28673 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 11/02/2023 Parcel Report - Catawba County NC Parcel Information: Owner Information: Parcel ID: 460904507318 Owner: VR FARMS LLC Parcel Address: 7552 SHERRILLS FORD RD Owner2: City: SHERRILLS FORD, 28673 Address: 7271 LONG ISLAND RD LRK(REID): 803342 Address2: Deed Book/Page: 3801/0784 City: CATAWBA Subdivision: GABRIEL PARK-PH 1 State/Zip: NC 28609-8241 Lots/Block: 2-7/ School Information: Last Valid Sale: Plat Book/Page: 67/131 School District: COUNTY Elementary School: SHERRILLS FORD Legal: LOT 4 PLAT 67-131 Middle School: MILL CREEK Calculated Acreage: 20.920 High School: BANDYS Tax Map: Township: MOUNTAIN CREEK School Map State Road #: 1848 TaxNalue Information: Tax Rates Zoning Information: City Tax District: All in County Zoning District: COUNTY County Fire District: SHERRILLS FORD Zoning1: R-20 Building(s) Value: $0 Zoning2: Land Value: $51,900 Zoning3: Assessed Total Value: $51,900 Zoning Overlay: wp-o Year Built/Remodeled: / Small Area: SHERRILLS FORD Tax Revaluation 2023: Info, COMPER Split Zoning Districts: / Online Appeals Zoning Agency Phone Numbers Valid Sales (COMPER) for this parcel Contact Tax Dept. at 828-465-8436 Current Tax Bill Miscellaneous: Firm Panel Date: Building Permit Address Search for this parcel. Firm Panel #: If available, Building Permits for this parcel. Septic 2010 Census Block: links are not permits. 2010 Census Tract: 011503 Septic Final Permits prior to 08/2018, contact Agricultural District: PROXIMITY Environmental Health. Building Details WaterShed: WS-IV Protected Area Voter Precinct: P31/ Voting Map Parcel Report Data Descriptions List all Owners Deed History Report Assessment Report 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. ©2023, Catawba County Government, North Carolina.All rights reserved. 4'A C CATAWBA COUNTY 111 100A SOUTHWEST BLVD �., NEWTON,NORTH CAROLINA 28658 RECEIPT U .1►_ S+ PHONE: 828.465.8399 7\ �� Thursday, November 2, 2023 18 4 Z sM www.catawbacountync.gov PAYOR: *VR Farms LLC *VR Farms LLC PAYMENTS TRANSACTION NUMBER: TRC-76857280-02-11-2023 PAYMENT DATE: 11/02/2023 PAYMENT TYPE: Check 702 INVOICE NUMBER ACCOUNT FEE NAME FEE AMOUNT 11-23-429978 110-580200-663000 IPa2 Permit Fee $150.00 TOTAL PAYMENTS: $150.00 EHPR-11-2023-45953 CASE TYPE: Environmental Health Plan Review WORK CLASS: OSWP SITE ADDRESS: PALOMINO CT,SHERRILLS FORD NC 28673 Applicant TINA LITTLE,7257 LONG ISLAND RD,CATAWBA NC 28609 TINATOWNEBUILDERSLLC@GMAIL.COM Owner *VR FARMS LLC,7271 LONG ISLAND RD, B:8284687175C:7045162344 VRSHORTJR@AOL.COM **NO PEOPLESOFT ACCOUNT ASSIGNED** receipt 11/02/2023 12:42 Page 1 of 1