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Home My WebLink AboutAUTH-5-11-17985.TIF �gp CATAWBA COUNTY Case # AUTH-5-ll-17985 � G Public Health Department ti � Subdivision SHERWOOD SHORES ,� Environmental Health Division � av '< PO Box 389, 100-A Southwest Blvd, Newton, NC 28658 Lot # 20 �842 �M PIN# 461902758371 ApplicanUOwner DAN PLISZKA i!� P(,�,5-� �•,��3 i Site Address: 8855 DOG LEG RD, Sherrills Ford, NC Property Size: SF 0.519 ACRES Directions: HIGHWAY 16 S- TURN LEFT ONTO SHERRILLS FORD RD - TURN LEFT ONTO MOLLYS BACKBONE RD - TURN RIGHT ONTO AZALEA - TURN LEFT ONTO DOG LEG RD - PROPERTY ON RIGHT IN SI-IARP CURVE ABOUT 2 MILES - GRAVEL CUL-DE-SAC - METAL ROOF, LAKE FRONT Authorization to Construct I'ermit Authorization to Construct Wastewater System (Required for Building Permitl * See site plan and number of additional attachments (�. Proposed Wastewater System: *KEPLACEMENT OF SEPTIC T ANK ONLY* Wastewater Flow 480 g.p.d Type: **** no system c ass **** Q Soil LTAR: g.p.d./ft2 Permit Category: Repairs Type of Facility: Primary Residence Basement? Yes Basement Plumbing? Yes Bedrooms: 4 VUastewater System Reauirements Tank Size: New Tank 1,000 gal Pump Tank gal Grease Trap gal Dosing Volume gal Pump Specs: GPM @ TDH Pressure Head ft Draw Down in Drainfield: Total Area: sq ft Total Length: ft Maximum Trench Depth in Aggregate Depth in Trench Width ft Minimum Soil Cover in Minimum Trench Separation �•� ft on center Number of Drain Lines Distribution: 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 iVOT INSTALL SYSTEflA UNDER VVET CONDITIONS ««< 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 applicandproperty 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 S stv ems (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. Jason Boyd OS/16/2011 AUTHORIZED STATE AGENT APPROVAL DATE Permit Expiration Date: OS/14/2016 No grading or construction activity is allowed in areas designated for system and repair without approval of the Health Department. OS/16/11 10:04 �1B Permit # EHPR 5-11-10831 G CATAWBA COUNTY (.,� `�' 'Z Public Health Department Name Dan Pliszka ,-j Address 8855 DogLe Rd d t Environmental Health Division `� ' a� � PO Box 389, 100A Southwest Blvd, Newton NC 28658 P�# 461902758371 I8 4 2 SM (828) 465-8270 Fax (828) 465-8276 TDD (828) 465-8200 Site Plan Authorization to Construct l�epair � ►� o � L�� ►� � �6 ` � �� m <• �� S �c�" c J C �° `^ � ��n � S � �. --� : }- n� ve � � �„��S a��6_ 000�q � �� F r o,� a�� ,�� X 1� Tl S� �� p� a..�c. l c},�� C y l 1 +-. 0 (� �� .S �' - � .. ` _ I � 1� 1 V e Mt.. l /,=k ��- 1 S� . `� � L�AK�.� G r �S� <�n� �� t � I 1 �-�c ()T'�1 T�� lC �,�„w,P� � � ��,��-�-� t� n�,..� lr�v o�� (I�� -E-�� Ic � �� ,, � i s -�� l' �e � ( � c..2 w. e Tn �' � r" -�� .^ k v �1 � \ � � �+z -�- k � ( �� r ��' �` � � Y ��. � � � � �J y��- ...� � n rn � � � 5 O � -f , /' � `''` L c � � �J � �r o N, c� �c c. �C. � l r i /'J �p !' o � 1 1 l ��, i� � � � � � � � 1 ( � I� �.1 y re.. � � r� Scale � � � � �- .. -E � r� /� � c , /' G -� o� � Q ,, ,� � - �. l � �--� � `l � n �� ro _�- �►„ e_ .n-1� r-� vc. �'-� o r o ��. ��. . � o� s v 5{�- '^" �o c� e CATAWBA COLMT'Y Case # AUTH-5-11-17985 Public Heald� Department . Emironmental Health Division Subdivision $�WppD SHORES PO Box 389, IOaA Southwest Blvd, Newton, NC 28658 �t � 20 � P�# 46190275837t App�icant/owner DAN PLISZKA Site Address: 8855 DOG I.EG RD, Sherrills Ford, NC Property Slze: SF 0.519 ACRES DireCUons: HIGHWAY 16 S- TIJRl�3 LEFT ONTO SHERRII.LS FORD RD - TURN LEFf ONTO MOLLYS BACKBONE RD - TURN RIGHT ONTO AZALEA - TURN LEFT ONTO DOG LEG 4tD - PROPERTY ON RIGHT IN SHARP CURVE A$OUT 2 MiLES - GRAVEL C1TL-D�SAC - METAL ROOF, LAKE FRONT Owne�/Authorized Representative AckiaowledgeaneIDt of Permit lteceipt � certify that I am the owner or autfiorized agent (owner's suthorization 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 EHPit-5-11-10831 , by the following method(s): Received in Person Facsirnile Transmittal (Return form with signature required) �Electronic Image Transmittal/ E-mail (Return receipt required) �s the property owner or authorized representative I have reviewed and understand the specific conditions of the permit issued, and fiuther 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 pemut and the construction of the wastewater system and/or water supply well permitted. Permit Issue Date: O5/16/2011 � � Owner/Authorized Representative Signature Date J' '" � �2 � � � Documentation of Permit(s) 7['ransmittal (permit transmitted by electronic or other �eans) Permit trans 'tted by (name of person sending permit) Signature �a Date/Time J � 1 �� Method: Faz Y Email US Mail Other Owner's request to send by the above indicated method of transmittal in lieu of signature aclmowledges the conditeons and statements above. j t�, it:a�s 4'S3� �b�t t sou�,, os,��,�► �o:�