HomeMy WebLinkAboutIMPV-6-11-18734.TIF �� CATAWBA COUNTY Case # IMPV-6-11-18734
y - � G Public Health Department
� , 2, Subdivision
¢ Environmental Health Division
`• ��'�' PO Box 389, 100-A Southwest Blvd, Newton, NC 286�8 Lot #
1842 � PIN# 376�01360012
Applicant/Owner CLAUDETTE S HUFFMAN
Site Address: 6912 RIVER BEND RD, Claremont, NC
Property Size: SF 7.599 ACRES
Directions: HWY 16 N TURN ONTO RIVER BEND RD (THE ENTRACE PASSED OXFORD CHURCH) APPROX 3 MILES YOU
PASS SHELL HOLLAR iST BRICK HOME ON LEFT BROWN WITH YELLOW TRIM
Improvement Permit
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'; `, ; INITIAL SYSTEM EXISTING IP FOR REPAIR S�STEM ONLY ''
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Faci�ity: primary Residence
Permit Category: Other Bedrooms '
WATER SUPPLY: Private Well
Basement? Yes 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: CONVENTIONAL =
Type: IIB - CONV SYSTEM WITH < 750 LINEAR FEET OF LINE
Permit Conditions: IP for as built for existing system for roof over existing porch.
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REPAIR SYSTEM SPECIFICATIONS
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Repair System Required? Required
Proposed Wastewater System: 2 REDUCTION
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 approved, 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 Zaws and Rules for SewaQe Treatment and Disnosa/ Svstems' (15A NCAC 18A .1900). Neither
Catawba County nor the Environmental Health Specialist warrants that the septic tank system will continue to function satisfactorily
Susan Bumgarner 06/07/2011
AUTHORIZED STATE AGENT APPROVAL DATE
Permit Expiration Date: 06/OS/2016
No grading or construction activiry is a!lowed in areas designated for system and repair without approval of the Health Department.
06/08/ 11 08:51
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V a CATA1�'BA COUNTY �• '� Case # IMPV-6-1 1-18734
G Public Health De aRment
- ,��' � t. P Subdivision
-�: d i� Environmental Health Division
-"� �; `� PO Box 389, 100-A SoutMvest f31vd, Nc�won, NC 28658 Lot #
�8 ti w PN# 376501360012
ApplicanUOwner CLAUDETTE S HUFFMAN
Site Address: 6912 RIVER BGND RD, Garemont, NC
Property Size: SF 7.599 ACRES
Directions: H�VY 16 N TURN ONTO RIVER BEND RD ('I'FIE ENTRACE PASSED OX1=0RD CHURCH) APPROX 3 MILES YOU
PASS SHELL 1IOLLAR IS"C BRICK FIOME ON LEF'"I' BROWN WITl1 YELLOW TRIM
Owner/Authorized Representative Acknowledgement of Permit 12.eceipt
� I certify that I am the owner or authorized agent (owner's authorization required) representing the owner of the
property described above.
_ As the properly owner or authorized representative, I have received the above referenced permit(s) as
requested in the application for service EHPR-6-11-11099 , 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 I)isposal Systems (15A NCAC
i 18A .1900), and/or Well Construction Standards (15A NCAC 2C .0100), shall apply to the issuance of
this permit and the constniction of the wastewater system and/or water suppiy well permi[ted.
Permit Issue Date: 06/07/2011
Owner/Authorized Representative Signature -�'—
Date � -e rt�
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Documentation of Permit(s) Transmittal
(permit transmitted by electronic or other means)
Permit transmitted by (name ofperson sendingpermi!)
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.
„ 06/03/11 08:51
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