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Home My WebLink AboutIMPV-12-2023-209287.tif• Authentisign ID.EE98B981-C19D-EE11.8925-604580066161 1 1 ellir s CATAWBA COUNTI Case N 1MPV-I2-2023-209287 ,.. t-�11 Public Health Department Subdivision S�Jat Environmental Health Division P1NN 366602859041 �f.�1, PO Box 389.25 Government Drive.Newton,NC 28658 I.OTN 1 Sits Address: 3916 E MAIDEN RD, MAIDEN NC 28650 Name on Permit: MARIA GONZALEZ Property Size: Acres 1.36 Directions: NC 16, right onto Buffalo Shoals Rd,bear left onto Laney Rd,nghot onto E miden Rd, property is on the left Owner/Authorized Representative Acknowledgement of Permit Receipt ✓) ertit j that I am the owner or authorized agent(owner's authorization required)representing the owner of the property described above. Y( j s the property owner or authorized representative, I have received the above referenced permit(s)as requested in the application for service EHPR-08-2022-41911,by the following method(s): Received in Person _ Facsimile Transmittal (Return form with signature required) IElectronic image Transmittal/ E-mail (Return receipt required) \I j j s 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 I8A.1900), and/or Well Construction Standards(I5A 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: D1/13/2023 a ,, Owner/Authorized Representative Signature kfi1Ailht0hlaAr2AtGoh1Alel `Date 12/18/23 Documentation of Permit(s)Transmittal (permit transmitted by electronic or other means) Permit transmitted by (name of per.s on sending permit) ____4_____ Signature Date/-Time J br 13— Method: Fax J 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 yotPlease stake a few momentts tto complette our custtomer service survey att http://www.surveymonkey.com/s/EHCusttomerService se 11, J. f?A1 tar d s . II AJ10 f2-f cI'Pw"gym I2/O t/202.1 14:48 CATAWBA COUNTY Case# IMPV-I2-2023-209287 Public Health Department Subdivision „� Environmental Health Division PIN# 366602859041 PO Box 389,25 Government Drive.Newton,NC 28658 LOT# 1 s� Site Address: 3916 E MAIDEN RD, MAIDEN NC 28650 Name on Permit: MARIA GONZALEZ Property Size: Acres 1.36 Directions: NC 16, right onto Buffalo Shoals Rd, bear left onto Laney Rd, righot onto E miden Rd, property is on the 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 360 d 9 P. Type of Facility: Primary Residence- Basement? No Basement Plumbing? No Bedrooms: 3 Water Supply: Private Well 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: IIIE-PPBPS GRAVITY DOSED SYSTEM 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 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'Latt's and Rules for Setrage Treatment and Dis&asal Systems' (l5A NCAC I 8A.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 I iealth authorization or permit modification.Please notify Environmental Health of this change prior to system installation,44.4.-ey.---- /--- Zsze,..4.__ 01/13/2023 Authorized State Agent Permit Issuance Date 01/13/2028 Permit Expiration Date No grading or construction activity is allowed in areas designated for system and repair without approval of the Health Department. ehpennn 12101/2023 14:56 E 0, e&‘,,,,„,-or,„,,,2,. ), -,c)0.0,),)_ic3-- L) i 1 i imPV- i2-- 2b?3 - 2oq 282 Catawba County Environmental Health i . .z:‘,,.'),,z,,.,.\\l"\'. cam`'\ 0\ r 'a/ NN i5ir:/ :.) . .3924 n i ,fir O \ b� �4o ,\39 c.r,:s33Q2 D U I-, 10 ti 3842, `- ti • 3 •3830%, * 14�' c\-‘' Parcel: 366602859041, 3924 E MAIDEN RD 1 in=100ft MAIDEN, 28650 • 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 2021 Catawba County NC 01/13/2023 DEPARTMENT OF HEALTH AND HUMAN SERVICES Sheer_ _of_ DIVISION OF PUBLIC HEALTH,ENVIRONMENTAL HEALTH SECTION PROPERTY ID 4: ON-SITE WATER PROTECTION BRANCH COUNTY:_Catawba_ SOIUSITE EVALUATION for ON-SITE WASTEWATER SYSTEM (Complete all fields in full) OWNER: Ma r 1 CI 6r)V1 t/ APPLICATION DATE ADDRESS: —DATE EVALUATED: ipZ1191 �Z PROPOSED FACILITY: _ ARO SED DjySGN FLOW(.194g): 4 PROPERTY SIZE: J / LOCATION OF SITE: Gt, ey / �, PROPERTY RECORDED: WATER SUPPLY: 0 Private 0 Public e ❑Spring n Other EVALUATION METHOD: 0 Au a Boring I9-cit 0 Cut TYPE OF WASTE WATER: +]LSEwage 0 Industrial Process ❑Mixed yeti �. ' •:. a,�: .7' :1' .,' s- .,_:._. ./ �Ji��' k L� r Idt �.�F i s r 3•:X.�' � ix. 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IF.. 4 . rh .,.. 01 r h IJ F 1 } 1. —t" lc. i;'• '[ i� )5 r 7 \ C S l ,If-al II c ./ xr s� leiIDS O.-er6 L j, -Ei , k 2j4 -d-7 C,5.. k -Fs ,5k- ,r '173 C,5 ,-Fi -5Z 1j1 ( I wi;f7- sz H ( IV 1 DESCRIPTION INITIAL SYSTEM REPAIR SYSTEM OTHER FACTORS(.1946): Available Space(.1945) 5 /95' SITE CLASSIFICATION(.I948): �S System Type(s) 7V--5 ~r EVALUATED BY: "jelT /' �� OTHER(S)PRESENT: Site LIAR ) $ t 5 COMMENTS: - Updated February 2014 - w allinIEW • 45 z, t5J( F.. � ; • '''' •• ; -• • . • • '. . 1:). 7_--,?-1.71ci.c #45•.".°KX•75.. -4);z4.: . . .. >1141/1111111kILIPP11111. . ..... .. . . . . ' '''... . :.. . .* . . . .. ''' . ' . . . '. I 1 `. wrrw�rp.rn hi " / . 5( L 14/iter 4, : I 8 . ilillili . • ., ./PL-t-. ...q ---?- ) c • ,_,•6 ill/ , . 1 . 1 i • .. . . iltribg . .. IV II : ' i i • I IIIII . . ' I , )ii ,2'/ I/ • ' . • I IP - ! . r - . iiiiiiiiiiIi1111 ")-0 -;15_,_11 5/400.,i, • , • . .' , I. 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