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Home My WebLink AboutIMPV-2-11-15219.TIF �gA di CATAWBA COUNTY Case # IMPV -2 -11 -15219 G Public Health Department Subdivision F., �` 2 CRESCENT LAND AND TIN Environmental Health Division v c PO Box 389, 100-A Southwest Blvd, Newton, NC 28658 Lot # 277 /842 sM PIN# 461904921433 Applicant/Owner Loretta Czernecki Site Address: 8994 AZALEA RD, Sherrills Ford, NC Property Size: SF 1.45 ACRES Directions: HWY 16 S - E ON HWY 150 - N ON SHERRILLS FORD RD - R MOLLY BACKBONE - R AZALEA Improvement Perm Facility: Primary Residence 3 bedroom house Permit Category: New Septic Bedrooms 3 WATER SUPPLY: Private Well Basement? No Basement Plumbing? No INITIAL SYSTEM SPECIFICATIONS Permit Valid: Expires In Five Years: _X_ No Expiration: Projected Daily Flow 360 9•P•d Proposed Wastewater System: 25% REDUCTION Type: IIIG - OTHER NON -CONV TRENCH SYSTEMS Pump Required ?: No Operator Required ?: NO Permit Conditions: REPAIR SYSTEM SPECIFICATIONS Repair System Required? Required Proposed Wastewater System: 25% REDUCTION Type: IIIE - PPBPS GRAVITY DOSED SYSTEM Pump Required ?: No Operator Required ?: NO 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 'Laws and Rulesjor 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 Robbie Phelps 02/14/2011 AUTHORIZED STATE AGENT APPROVAL DATE Permit Expiration Date: 02/13/2016 No grading or construction activity is allowed in areas designated for system and repair without approval of the Health Department. 02/16/11 15:30 1$p' Permit # Auth -2 -11 -15220 � , CATAV�BA COUNTY Name Loretta Czernecki (� 0 2 Public Health Department Address 8994 Azalea Rd �� ` '-- Environmental Health Division v PO Box 389, 100A Southwest Blvd, Newton NC 28658 PIN# 18 , 2 sM (828) 465 -8270 Fax (828) 465 -8276 TDD (828) 465 -8200 SITE PLAN � 'fi wi_ l l A-.(^ 1 c, t (‘/ -- rJ V9 \ e z 1 ` 6,( - 6 6 ` L't o H 1 P Scale 1 : 0 ,gi _ * CATAWBA COUNTY , Case # AUTH -2 -11 -15220 : ci Public Health Depat'tment Subdivision CRESCENT LAND AND TIN Environmental Health Division \v\ 0 ''' PO Box 389, 100-A Southwest Blvd, Newton, NC 28658 Lot # 277 \84 s° PIN# 461904921433 Applicant/Owner Loretta Czernecki Site Address: 8994 AZALEA RD, Sherrills Ford, NC Property Size: SF 1.45 ACRES Directions: HWY 16 S - E ON HWY 150 - N ON SHERRILLS FORD RD - R MOLLY BACKBONE - R AZALEA Owner /Authorized Representative Acknowledgement of Permit Receipt I certify that I am the owner or authorized agent (owner's authorization required) representing the owner of the p erty described above. 6 As the property owner or authorized representative, I have received the above referenced permit(s) as requested in the application for service EHPR -1 -11 -9008 , by the following method(s): Received in Person Facsimile Transmittal (Return form with signature required) 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 an. . r water supply well permitted. Permit Issue Date: 02/14/2011 C ` 0. Owner /Aut orized Representative Si.natur-,401K44.4 y Date / 4 /1 Documentation of Permit(s) Transmittal (permit transmitted by electronic or other means) Permit transmitted by (name of person sending permit) Signature Date /Time Method: Fax Email US Mail Other Owner's request to send by the above indicated method of transmittal in lieu of signature acknowledges the conditions and statements above. 02/14/11 13:14 Department of Environment, Health, and Natural Resources Sheet: Division of Environmental Health • Property ID: On -site Wastewater Section Lot #: SOIL/SITE EVALUATION File #: for ON -SITE WASTEWATER SYSTEM AppID: ehpr -1 -11 -9008 Owner: Loretta Czernecki Applicant: Address: 8994 Azalea Rd Date Evaluated: Proposed Facility: Design Flow (.1949) 360 Property Size: Location of Site: Property Recorded: Water Supply: [ ] Public [ x ] Individual [ x ] Well [ ] Spring [ ] Other Evaluation Method: [ ] Auger Boring Ix 1 Pit [ ] Cut Type of Wastewater: [ x ] Sewage [ ] Industrial Process [ ] Mixed P R o SOIL MORPHOLOGY b F .1941 PROFILE FACTORS I .1940 .1942 L Landscape Horizon .1941 .1941 Soil .1943 .1956 .1944 Profile E Position/ Depth Structure/ Consistence Wetness/ Soil Sapro Restr Class # Slope% (IN.) Texture Mineralogy Color Depth (IN.) Class Horiz & LTAR 1 0-48 scl,sbk fr,ss,sp 48 0.35 2 0 -48 scl,sbk fr,ss,sp 48 0.35 3 0 -48 scl,sbk fr,ss,sp 48 0.35 Description Initial System Repair System Other Factors (.1946): Available Space (.1945) s s Soil Evaluation By: Robbie Phelps System Type(s) 25% 50% Others Present: Jason Boyd Site LTAR 0.35 0.35 Site Classification (.1948): PS Site Evaluation By: Others Present: . Sheet: COMMENTS: FILE #: Landscape Position Group Texture .1955 LTAR Structure R -Ridge 1 S -Sand 1.2 - 0.8 SG- Single Grain SS- Shoulder Slope LS -Loamy Sand M- Massive LS- Linear Slope CR -Crumb FS -Foot Slope II SL -Sandy Loam 0.8 - 0.6 GR- Granular NS -Nose Slope L -Loam SBK- Subangular Blocky HS -Head Slope ABK- Angular Blocky CC- Concave Slope III SI -Silt 0.6 - 0.3 PL -Platy CV- Convex Slope SICL -Silty Clay PR- Prismatic T- Terrace Loam FP -Flood Plain CL -Clay Loam SCL -Sandy Clay Loam IV SC -Sandy Clay 0.4 - 0.1 SIC -Silty Clay C -Clay Consistence Consistence Mineralogy Moist Wet SEXP- Slightly Expansive VFR -Very Friable NS- Non - Sticky EXP- Expansive FR- Friable SS- Slightly Sticky FI -Firm S- Sticky VFI -Very Firm VS -Very Sticky EFI- Extremely Firm NP- Non - Plastic SP- Slightly Plastic P- Plastic VP -Very Plastic Sketch of Soil Evaluation Locations • la' V`� 1-p-Ps. Co -' H CATAWBA COUNTY U (: ` 'C P 0 Box 389 - Newton, North Carolina 28658 - (828) 465 -8270 - Fax (828) 465 -8276 - TDD (828) 465 -8200 18 42 SM Public Health — Environmental Health Division February 16, 2011 Mr. Shawn Patterson Cobble Creek Custom Homes LLC 1658 Maggie St Catawba, NC 28609 Dear Mr. Patterson: You came into our office today and picked up a permit for 8994 Azalea Rd. We believe that you were not given copies of all of the permits there were issued. Enclosed are two copies of the Improvement Permit, Authorization to Construct and Well Permit that were issued on this property. I apologize for any inconvenience this may have caused you. If you have any questions please feel free to contact me at 828 - 465 -8270. Sincerely, Julia English Administrative Assistant II ,402 TNCAR0 4ry 9 Accredited Healt !1 'O . } Depart m GREATER 2 "Keeping the Spirit Alive Since 1842!" HICKORY �°'�� zoos zoiz v 17 O 1' METRO ' Pc