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�B CATAWBA COUNTY Case # IMPV-5-11-17599
Public Health Department
a r 2 Subdivision
.� Environmental Health Division
v qv ''�' PO Box 389, 100-A Southwest Blvd, Newton, NC 28658 Lot #
4
�g '" PM# 36'7902953018
Applicant/Owner DEWEY LITTLE
Site Address: 4941 E BANDYS CROSS RD, Catawba, NC
Property Size: SF 1.009 ACRES
Directions: NC 16 S FROM NEWTON TO BUFFALO SHOALS RD, TURN LEFT ON BUFFALO SHOALS, TRAVEL APPROX 3 MILE,
TURN RIGHT ON E BANDYS CROSS RD FIRST HOUSE ON RIGHT
Improvement Permit
;�-- ----- INITIAI, SXSTElVI EXISTING - IP F01212EPAIR S�'STEIVI ONI,Y ------ __
_ _----------- -------- --. . _
_._ --- -_
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Faci�ity: primary 12esidence
Permit Category: Other Bedrooms 3
WATER SUPPLY: Private Well �
Basement? No Basement Plumbing? No
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INITIAL SYSTEM SPECIFICATIONS .�.
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Permit Valid: Expires In Five Years: _X_ No Expiration: �
Projected Daily Flow 360 9•P•d
Proposed Wastewater System:
Type: IIA - CONV SYSTEM (SINGLE-FAMILY OR 480 GPD OR LESS)
Permit Conditions:
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
REPAIR SYSTEM SPECIFICATIONS
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' Repair System Required? Required
Proposed Wastewater System: 25% REDUC
. Type: IIIG - OTHER NON-CONV TRENCH SYSTEMS
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 a rpo oved, and may result in failure to approve the
initial system installation, or the suspensioNrevocation 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
applicanUproperty 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 Svstems' (15A NCAC 18A 1900). Neither
Catawba County nor the Environmental Health Specialist warrants that the septic tank system will continue to function satisfactorily
Jason Boyd OS/03/2011
AUTHORIZED STATE AGENT APPROVAL DATE
Permit Expiration Date: OS/O1/2016
No grading or construction activity is allowed in areas designated for system and repair without approval of the Health Department.
OS/03/11 15:28
�BA C'� Permit # EHPR-4-11-10372
� CATAWBA CO�JNT�' Name Dewe Little
f.,� '2 Public Health Department Address 4941 E. Band s Cross Rd
U �e� ,,`��, Environmental Health Division p�# 3697902953018
� PO Box 389, 100A Southwest Blvd, Newton NC 28658
1$ t�Z sM (828) 465-8270 Fax (828) 465-8276 TDD (828) 465-8200
Site Pl�n Improvement Permflt
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"�gp, . CATAWBA COUNTY Case # IMPV-5-11-17599
G Public Health Depairtment '
� � +,� 2 Subdivision
.� Environmental Health Division
v 9� '<' PO Box 389, 100-A Southwest Blvd, Newton, NC 28658 Lot # 4
�$ 2 5M PIN# 367902953018
Applicant/owner DEWEY LITTLE
Site Address: 4941 E BANDYS CROSS RD, Catawba, NC
Property Size: SF 1.009 ACRES
Directions: NC 16 S FROM NEWTON TO BLTFFALO SHOALS RD, TURN LEFT ON BUFFALO SHOALS, TRAVEL APPROX 3 MILE,
TURN RIGHT ON E BANDYS CROSS RD FIRST HOUSE ON RIGHT
Owner/Authorized 12epresentative Ack�owledge�nent of Pe�-mit 12ecei�t
�� 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 EI�PR-4-11-10372 , by the following method(s):
6 G 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 I,aws and 12ules for Sewage 'I'reatment 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: OS/03/2011
Owner/Authorized Representative Signature �
Date .� -� -� /
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Documentation of Permat(s) T�-ansmittal
(per�ait transmitted by electronac or othe� means)
Permit transmitted by (name ofperson sendingpermit)
Signature Date/Time
1Vlethod: Fax Email US Mail Other
Owner's request to send by the above fndicated method of transmittal in lieu of signature
acknowledges the cond'ations and statements above.
OS/03/11 1528
Department of Environment, Health, and Natural Resources Sheet:
Division of Environmental Health Property ID:
On-site Wastewater Section Lot #: 4
SOIL/SITE EVALUATION File #:
for ON-SITE WASTEWATER SYSTEM AppID: EHPR 4-11-10372
Owner: Bradv Little Applicant:
Address: 1582 Buffalo Shoals Rd Date Evaluated: 4/26/2011
Proposed Facility: 3 BR Home Design Flow (.1949) 360 Property Size: 1
Location of Site: Property Recorded:
Water Supply: public [] Individual X Private Well [] Spring [] Other
Evaluation Method: mechanical auger boring by owner [] Cut
Type of Wastewater: X Sewage [] Industrial Process [] Mixed
P
R . , ,
o SOIL MORPHOLOGY b �.
F , _ _ _�sa1 . _. . - . _ ,.. . ' ___ FROFILE FACTORS _ °
I .1940 ` .1942 ,
L Landscape Horizon .1941 .1941 - Soil � .1943 .1956 .1944 Ptofile
_ , _
E� Position/ Depth Structure! �• Consistence Wetness/ SoiL Sapro Restr " Class �
# Slope% (IN:) Texture ., ____ Mineralogy,._ _ ; Color __ _ �_ _ Depth,(IN.) _ Class _ . Horiz & LTAR _,
_ _ _ _ . _
1 LL3% 0-48 SC SS,SP,SEXP, FR 48 .3
2 LL3% 0-48 SC SS,SP,SEXP, FR 48 .3
Description Initial System Repair System Other Factors (.1946):
Available Space (.1945) ps Soil Evaluation By: Jason Bovd
System Type(s) IIIG Others Present:
Site LTAR .3 Site Classification (.1948): PS
Site Evaluation By: Jason Boyd
Others Present: BradyLittle
Sheet:
COMMENTS: Existing well on property must be abdandoned prior to installation of repair FILE #:
Landscaqe Position GrOUp Texture .1955 LTAR Structure
R-Ridge I 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
GClay
Consistence Consistence Mineraloqv
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
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