HomeMy WebLinkAboutIMPV-11-2023-208545.TIF g: CATAWBA COUNTY ..... . .. _„_.. -.,,,_ ._
F.T .j.IR ,� Public Health Department Subdivision ANNIE TRACE PH 2
4 .� '� Environmental Health Division PIN# 377108994143
PO Box 389,25 Government Drive,Newton,NC 28658 i o r# 19
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Site Address: 2677 1ST AVE NW,CATAWBA NC 28609
Name on Permit: STEFAN KULCSAR
Property Size: Acres 0.35
Directions: NC 10 left onto 5th St SW, Left onto Old Catawba, Right onto Davis St, Right to stay on Davis St
Owner/Authorized Representative Acknowledgement of Permit Receipt
X 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-07-2023-44935, by the following method(s):
Received in Person
/ Facsimile Transmittal(Return form with signature required)
I. 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: 11/15/2023
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)
Signature E Date/Time n`l vh3
Method: Fax 4 Email US Mail Other
Owner's request to send by the above indicated method of transmittal in lieu of signature
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http://www.surveymonkey.com/s/EHCusttomerService
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rLpemiit 11/22/2023 05:03
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CATAWBA COUNTY Case# IMPV-11-2023-208545
. . .
Public Health Department Subdivision ANNIE TRACE PH 2
ec,„;.„,,,...1
Environmental Health Division PIN# 377108994143
PO Box 389,25 Government Drive,Newton,NC 28658 LOT# 19
Witaitiw
Site Address: 2677 1ST AVE NW, CATAWBA NC 28609
Name on Permit: STEFAN KULCSAR
Property Size: Acres 0.35
Directions: NC 10 left onto 5th St SW, Left onto Old Catawba, Right onto Davis St, Right to stay on Davis St
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 360 g.p.d
Type of Facility: Primary Residence-SFD
Basement? No Basement Plumbing? No Bedrooms: 3
Water Supply: Public Water Maximum Occupants: 6
INITIAL SYSTEM SPECIFICATIONS
Proposed Wastewater System: 50%REDUCTION VERTICAL
System Classification: IIIE-PPBPS GRAVITY DOSED SYSTEM
REPAIR SYSTEM SPECIFICATIONS
Repair System Required? Required
Proposed Wastewater System: 50%REDUCTION VERTICAL
System Classification: IVA-ANY SYSTEM WITH LPP DISTRIBUTION
Pump Required ***** Operator Required
Permit Conditions: *DO NOT CUT OR FILL OVER SYSTEM AREA
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 I lealth 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 Sewage 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 I lealth of this change prior to system installation.
,f1..............-- n coons
11/15/2023
Authorized State Agent Permit Issuance Date
11/15/2028
Permit Expiration Date
No grading or construction activity is allowed in areas designated for system and repair without approval of the Health Department.
ehpcnmit 11/22/2023 05:03
• Catawba County Environmental Health
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DIUPAR1MUUNT OF HEALTH AND HUMAN SERVICES • 5brtl 1/ of I
DIVISION OF PUBLIC III1A1.111.ENVIRONMENTAL IMAM l SECTION • PROPERTY 1D N J J f jIV:
ON.SI11i WA1TX PROTECTION BRANCH COUNTY'
SOIL/SITE EVALUATION
for ON-SITE WASTEWATER SYSTEM
(Complete all Geld&in Pon)
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0OWNER:: KL/IC SC+F _ APPLICATION DATE 7/19/1
ADDRESS: DATE EVALUAXED:
PROPOSED FACILITY: SFO PROPOSED DESIGN FLOW(.1949): 36O PROPERTY SIZE: e ,f-<
LOCATION OF SITE: ZG 77 /AWE. N(i PROPERTY RECORDED: 1
WATER SUPPLY: 0 Private .0E Public 0 Well D Spring 0 Other
EVALUATION METIJOD: 0 Auer Boring,,lePit 0 Cut TYPE OF WASTEWATER: XSSewage 0 Industrial Process 0 Mixed
•
o SOIL MORPHOLOGY OTHER
F (.1941) PROFILE FACTORS
I .1940
E LANDSCAPE HORIZON , -
POSITION/ DEPTH .1942 PROFILE
I SLOPE% (IN.) .1941 .1941 SOIL .1943 .1956 .1944 CLASS
STRUCTURE! CONSISTENCE/ WETNESS! SOIL SA PRO RESTR <AR
TEXTURE MINERALOGY COLOR DEPTH CLASS HORIZ
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DESCRIPTION INITIAL SYSTEM REPAIR SYSTEM OTHER FACTORS(.1946):
Available Space(.1915) t% !/
' // SITE CLASSIFICATION(.1948): PS
' EVALUATED BY:
sr=TYPO V b?‘ OTHER(S) RESENT: ! v445
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Update!Pi6resq 2014
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Catawba County Environmental Health
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Parcel:377108994143,26771ST AVE NW 1 in=40ft
CATAWBA,28609
T1is product was prepared horn tlia Catawba County,NC Gsospatlal Information Services. Catawba County has made substantial efforts
b yr..pgaary d for aebon and Iabelrg krforrrratbn oonEsin an Ih map or data on this report.Catawba County promotes and recommends
the verification of any data contained on Ills report product by the user.The County of Catawba,its employees,agents,and
personnel,cat: and shag not be held gable for any and ail damages,loss or liability,whether direct,indirect or consequential which arises or may
arise frorn this snap/repot product or the use thereof by any person or win.
Copyright 2023 Catawba County NC
09/11/2023
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