HomeMy WebLinkAboutAUTH-5-11-17520.TIF �gA CATAWBA COUNTY Case # AUTH-5-11-17520
Public Health Department
¢ , 2 Subdivision W L WHISNANT ESTATE
.� Environmental Health Division
v� 't' PO Box 389, 100.A Southwest Blvd, Newton, NC 286�8 Lot # 4
18 2 5M PIN# 268802872860
Appiicant/Owner RYAN MATTHEW GUTHRIE
Site Address: 6322 W NC 10 HWY, Hickory, NC
Property Size: SF 0.93 ACRES
Directions: HIGHWAY 10 W- GO THROUGH PROPST CROSS ROADS ABOUT 1.5 MILES SARDIS LUTHERAN CHURCH IS ON
THE LEFT - HOUSE ABOUT 1/2 MILE ON RIGHT PAST CHURCH - 4TH HOUSE ON RIGHT BEFORE PROVIDENCE
CHURCH RD
Authorization to Construct 1'ermit
Authorization to Construct Wastewater System (Required for Buildina Permit)
* See site plan and number of additional attachments (_�.
Proposed Wastewater System: 25% REDUCTION Wastewater Flow 360 g _ p. d
Type: II - O THER NON-CONV TRENCH SYSTEMS
Soil LTAR: 0 • 3 g.p.d./ft2
Permit Category: Repairs
Type of Facility: Primary Residence
Basement? Yes Basement Plumbing? Yes Bedrooms: 3
Wastewater System Requirements
Tank Size: Existing Tank Unknown Size Pump Tank gal Grease Trap gal
Dosing Volume gal Pump Specs: GPM @ TDH
Pressure Head ft Draw Down in
Drainfield: Total Area: 900 sq ft Total Length: 3 00 ft Maximum Trench Depth _ 30 in
Aggregate Depth in Trench Width 3 • 0 ft
Minimum Soil Cover 12 in Minimum Trench Separation 9 � 0 ft on center
Number of Drain Lines 4
Distribution: Serial
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.
»»> DO NOT IIVSTALL SYSTEIl� UNDER WET COMDITIO ««<
Proaosed Repair
System Class: Proposed System: Distribution Type::
Soil LTAR: g.p.d./ft2
The issuance of this permit by the Health Department does not guarantee the issuance of other permits. It is the responsibility of the
applicanUproperty owner to insure that all Catawba County Planning/Zoning and Building Inspections requirements are met. This
Authorization to Construct Permit is subject to revocation if the site plan, plat or the intended use changes, or if site conditions are
altered. The Authorization to Construct 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 Svstems' (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.
Megen McBride OS/02/2011
AUTHORIZED STATE AGENT APPROVAL DATE
Permit Expiration Date: 04/30/2016
No grading or construction activity is allowed in areas designated for system and repair without approval of the Health Department.
O5/02/11 0827
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DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES Sheet _ of _
DMSION OF ENVIRONMENTAL HEALTH PROPERTY ID #:
ON�ITE WASTEWATERSECTION ' COUNTY:
SOIL/SITE EVALUATION
(I�n 1 for ON-SITE WASTEWATER SYSTEM
OWNER: f�yc� � I' w'�1t-�bJ C^v't � �+ ei APPLICATION DATE �I - I� I I L;-F� PI� `!� . I I_�� 2`j
A D D R E S S: DATE EVALUATED: � 25-II
PROPOSED FACILITY: B � � PROPOSED DESIGN FLOW (.1949): 3 b o PROPERTY SIZE: �� � u I 3 t1c r�+;
LOCATIONOFSITE: Io�32Z— NG Ib I-Al�y ���k°YY PROPERTYRECORDED:
WATERSUPPLY: � Private � Public � Well Spring 0 Other a S° S y�.��
EVALUATION METHOD: � Auger Boring � Pit � Cut
TYPE OF WASTEWATER: � Sewage � Indus�ial Process 0 Mixed
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DESCRIPTION L SYSTEM REPAIIt SYSTEM OTEiER FACTORS (.1946):
STTE CLASSIFICATION (.1948):
Available Space (.1945) �S
EVALUATED BY: , ��t t �i1
System Type(s) L� G OTHER(S) PRESENT: S a� w`'�'
Siu LTAR �,
COMMENTS:
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Fax sent by : 8284308471 VISCOTEC 05-17-11 18:30a Pg: 1/1
CATAWBA COITnTY Casc # ptJTH_5_11-17520
''-� ,� Public Hcsith Ikparnrent Subdivisi�n W L WH[StiAM ESTA7E
Q � Environmenml Hcalth Di�u�on
PO Box 389, 100.A Sou'.hwcct Blvd, Newtor4 NC 2$653 Let S1 4
�� „ 1'1�Ttt 268802R72660
ApplicandOwner ]ZyqN M1�TTHEW GLJTH�tIE
Stte Addres8: G32� \V NC 10 }-���1', Hickory NC
Property Size: SF 0.93 ACRES
DirHCtiott_�: H1GHVl'AY 10 W- GO T}�IROUGH PkOPST CROSS ROADS ABOUT 1.5 M1LES SAEtllIS LCJT�RAN CHURCH 1S ON
"fl-IE LEFT - HOUSF. AROUT ll2 MILE ON RIGHT PAST CHURCH - 4TH HOU5E ON RIGHT' BEFORE PROVIDENCE
CHURCH RD
Owner/Authori2ed Representative Acknowledgetnent af Permit Receipt
� i certify that I arn the ow-ner or authonzed ugent (owner's authorization required) representing the oumer of the
property described above,
�I As the property owner or authorized representative, I have received the abave referenced permit(sj as
requested in the application for service EHpR-4-11-10529 ; by the following method(sj:
Received in Pezson
Facsimile Transmittal (Return form with si�nature requiredj
,. �lec�onic Image Transmittal/ E-mail (Return receipt required)
✓�s the properiy,owner or authori2ed representative I have reviewed and understand the speci6c
conditions of the perzr►it issued, and further understand that all applicable regulatory requirements specified
under the North Carolina Laws and Rulcs for Sewage TreAt and DisposAl Systems (15A NCAC
18A .190U), audlor Well Construction Standards (15A NCAC 2C .0100), shall apply to the issuance of
this permit and the canstruction o�the wastewater system andlor water supply we11 perm.itted.
Permit Issue Date: OS/02/2011
Owner/Authorized Reptesentative Signature ��
Date S�'��
Uoc�mentation of Permit(s) Transmittal
(permit transmitted by electrooic or other mcans)
Permit transmitted by U/� � _(rwme of persof� sending pern�itj
Signature Date/Time ,5 3 ��
�-Tethod: Fa� �Email US Mait Ot6er
Oa�ncr's request to send by the above indicsted method of transmittal iu lieu of signature
acknawledges the conditions and statements above_
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