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HomeMy WebLinkAboutIMPV-5-11-18040.TIF �g CATAWBA COUNTY Case # IMPV-5-11-18040 Public Health Department d� � � Environmental Health Division Subdivision HICKORY SPINNERS 3710 v v '�' PO Box 389, 100-A Southwest Blvd, Newton, NC 28658 Lot # 5 1S SM P�N# 371019626205 Applicantlowner DAVID M HESS Site Address: 1095 COLJNTRY CLUB RD, Newton, NC Property Size: SF 0.55 ACRES Directions: SOUTH ON 321 BUS/ RT HWY 10/ 3.5 MU RT ROBINSON RD/ 1.8 MIL/ LF ON SANDY FORD RD/ 2 MU LF ONTO COUNTRY CLUB RD/ ON RT Improvement Permit - --- ------______�_____�__� �___----- --_ __.----. - ----_- ---- __�______ ___-- _ ---------- -- ! _ _:_- -__._ _ _ __ _INg�'IL�I. S�'STEIV� EX�S'�'INU - IP �'OR R.F'.P1�IR SyST'ElV�' 01�1LY!! ---- ------___.__-_ _._ _ ._ �__ _ __ -- ___-- ---._ _ - ---- - __ Faci�iry: primary Resadence Permit Category: �ther Bedrooms 4 WATER SUPPLY: Public Water Basement? No Basement Plumbing? No ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- INITIAL SYSTEM SPECIFICATIONS - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Permit Valid: Expires In Five Years: _X_ No Expiration: Projected Daily Flow 480 9•P•d Proposed Wastewater System: 25% REDUCTION Type: IIIG - OTHER NON-CONV TRENCH SYSTEMS Permit Conditions: ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- REPAIR SYSTEM SPECIFICATIONS ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- Repair System Required? Required Proposed Wastewater System: 50% REDU CTION Type: IVA - ANY SYSTEM WITH LPP DISTRIBUTION PUMP REOiJIRED ***** OPERAT012 REOUIItEI3 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 apqroved, 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 applicant/property owner to insure that all Catawba County PlanningJZoning 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 Disnosal Svstems' (15A NCAC 18A .1900). Neither Catawba County nor the Environmental Health Specialist warrants that the septic tank system will continue to function satisfactorily Megen McBride OS/17/2011 AUTHORIZED STATE AGENT APPROVAL DATE Permit Expiration Date: OS/15/2016 No grading or construction activity is allowed in areas designated for system and repair without approval of the Health Department. 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I''=yo� cn��awaA co���rv / Pi,nl�c�lea]thQeparanenr - �4 .��j Environmental Hcalth Division Subdi�'icion H]CKpRY 5P[I�I�ERS 3710 PCl $ox 389, 10�1A Southwest Blvd, NewTOn, NC 2Rt�5R Lot d 5 '" �'�# 371O19626205 ApplicarrtlOwner DAVID M HESS 51te Addt�ess: 1095 COUNl`AY Ci,tiB RD, �iewton, NC Property Size: SF Q,� ACRES Direcdons: 5UL1Tti QN 32l BUS� RT HV1�Y IQ! 3.5 Mi,' R'I' ROt31NSC)N R1)� 1.8 MILJ I.F ON SANDY FURD RD! 2 14111: F' nN'I'U COIJNTRY' CLUB fZD' ON R'I' Ow��r/Aaathmr�ed �t�pres�nt�tive Ac�o�vledgeane�t af Permit Receipt _ I certify that I am the owner or authori2ed agent (owner's authorization required) representing the awrer of the property described ab�ve, _ As the property owner or authorized representative, I have recei�c�ed the above referenced permit(s) as requested in the application for service EHPR-3-11-99�5 , by the following method(s): Received in Person � Facsimile Transmiital (Retum form with signature required) _ Electranic Image TransmittaL' E-tnail (Return reccipt required} As the pr�perty owner or authorized representative I have reviewed and understand the specific conditions of the permit issued, and further understand that all a�plicable regulatory requirements specified under the North Csralieia Laws and Rules for Se�vag� 'Treatment a�ad Dasposal Syste�s (15A NCAC l�A .1900), and/or Well Construction Sta�dards (ISA NCAC 2C .U100}, shall apply to the issuance of this permit and the construction of the wastewater system and/or water supply wcll permitted. Permit Issue Date: 05/17/2011 Owner!Authorized Representative 5ignature _5�.: � .- �-�� / �-'� -�� � ` ; -`}L�-'"��� �`-�i- �-} r �;, - Date �!!'%�j° Docaarnen�ation a4' ��erareeg�s.l �`r��s�it��i (Permit srans�a�fied �ry el��krowec oz� �t�re�- �eans) Permit transmitted b}' _ (namz of person sercding permitj Signature r t ( �- ___ __ DatelTime� 1��! ( f Q: C/ � P19ethod: Faa �Eenaal US M��i ()thea Owner's request to send by the above indica�ed �et�hod of tra�smnittal an lieu of sig�ature acknawledges the co�ditaox�s �nd s��e�emts above. �G1 �1.� Y9,���l11! �SUyllLDdliS.((.yi•. a3n;,� i io�o� �\ DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES Sheet _ of _ DNISION OF ENVIRONMENTAL HEALTH PROPERTY 1D #: ON-SITE WASTEWATER SECTION ' COUNTY: SOId.,/SITE EVAI,UATION for ON-SITE WASTEWA�'ER SYS�'EM OWNER: �a�� �� eSS APPLICATION DATE E ' 3"� � �5 ADDRESS: DATE EVALUATED: S 13 � PROPOSED FACILIT'Y: � BQ Hv�� PROPQ SED DESIGN FLOW (.1949): � PROPERTY SIZE: O, 55 acrrS � LOCATIONOF SITE: lDqS ('���v� CLJb R,ol. NevJ-�r, �Iv PROPERTYRECORDED: WATER SUPPLY: � Private � Public � Well � Spring � Other EVALUATION METHOD: �, Auger Boring � Pit � Cut TYPE OF WASTEWATER: Sewage � Industrial Process 0 Mixed ..... ...........................: :.::::::::::::::::::: ::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::: ::::::::::::::::: : : :::::::. :::::::: :::::::::: �::::::::::::::::::::::::::::::::::::::: :: :::::: ::::::::::::::::::: ::::: p :::: :::::::::::::::::::::::::::: ::::::::::::::::::::: ::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::: ::::::::::::::::: ::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::�:::::::::: :::::::::::::::::: :::::: ::::::::::::::::::::::::::: ::::::::::::::::::::: ::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::: :::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::: :: : ::::::::::::::::: ::::::::: ::::: ::::::::: : R ::: :::::::::::::::::::::::::::: ::::::::::::::::::::: :::::::::::: :::":: :: :: ::::: : ::: : :::::::: :: ::::::::::::::::::::::::::::::::::::: :::::::::::::::::::::::::..::.::::::::.::::::::::::::::::::::::::::.::::.:::..::.:..:::.::::::::::::: :::::..::.:.:.:..:::::::: ::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::: ::::::::::::::::::::::::: ::::� :::::::::::::::::::::::::soi : z: - :::::;::::::::::::::::::::::::::::::::: ; ...................._......................... � ... ............:...........:... .:................... ........................................................................................... ..:: aTHER::::::::::::::::::,::::::::::..:::::::::::::::::::::::::::::::::::::::::::::: ::::::::::::::::::::::::: : ::.::: :::: : ::::: :: :.. :: F ::::::: ::::.:.::::::: :::::::::::::: :: :::::::..:::: 194I.:::'.:::::. .::::::::::::::`::::::.:::::::::::: ..,; ::::::r::::.::.:::::::: ::.::.::::::::::::�::::::::.:::: .: ............ ....................................f...........) .......................................................... :.PROFXLE�'A�'�'t��::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::s::: � :::::::::::..:::::: : ::::: .. ,_ ..,..... .... .. ... 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RES'Fit . ::; CI.ASS:::: `::::[::SLOFE::%::. :: : YN. :::: ; � '.TEXTIlRE.':::'. :::. ; ::: MINERALOGY:.::: : :.CULOR;:;:: `:::DEPTH : :::C�ASS ... .. .:.:: .: ; �:::::� ::::::: ::::::::.:::::::::::::::::::::::::::::::::::: ::::::::::::::::::::::::::::::::::::::::::::: ..........::....:.::........ :.............::....... .................::..... .....::..::.::::..:.... .... .. : : ......... ....................... ........................ ....................... ....&.I,TA[t ... ................... ..................... ............................................. ............................................. ............................ ....................... ........................ ....................... ......................... o � u, sbl� -(_r Ss. sex 1 ` _ _ f� y� o , 3 � i �.. �� r I �S I 2 _ !�3 _ _ � 0-3 I 3 � � � 4 � � � ��� DESCRIPTION INTTTAL SYSTEM REPAIIt SYSTEM OTHER FACTORS (.1946): Available Space (.1945) t�s' SITE CLASSIFICATION (.1948): I �j� System Type(s) EVALUATED BY: � v ��'J � �� OTHER(S) PRESENT: S�S�e^- ISuvKaa.✓4�P�/� DuVC�.- Sor � Site LTAR O, 3 V COMMENTS: \ � x ��� �1DIe� ��-�����e�� - �55� �e�. �� p¢c� — � ��� � � � ���� I � � �rri ���"` . � �, � c3.