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Home My WebLink AboutRBPR-07-2012-15994.TIFContractor Owner THIS IS NOT A PERMIT Case # RBPR-07-2012-15994 CATAWBA COUNTY HEALTH DEPARTMENT PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICE' Residential Building Plan Review - Buildi g Addition IMPROVEMENT 704 RENOVATIONS, LLC, 20939 LAKEVIEW CIR, CORNELIUS NC 28031- B:(704)604-3366 DALE BRADLEY, 7396 BAY COVE CT, DENVER NC 28 )37 CA08-639-8168 NAME TO APPEAR ON PERMIT DALE BRADLEY SITE ADDRESS: 7396 BAY COVE CT, DENVER NC 28037 NAME of SUBDIVISION: PROPERTY SIZE: Square Feet Acres 1.15 -22VI�iorA . t � ., 11<, � Ira.. PIN # 460603346337 Lot # Section/Block DIRECTIONS: HWY 16 S/ LFT ON CAMPGROUND RD/ LFT ON CATAWBA BURRIS RD / RT ON BANKHEAD RD/ RT ON SALLYBROOK LN/ RT ON BAY COVE/ 2ND LOT ON RT/ PEBBLE BAY PH 5 LOT 218 JUST AFTER GATE PRIMARY CONTACT: Contractor SEWER TYPE: Septic Tank GALLONS PER DAY: 480 WATER SUPPLY: Community Well Public water is **NOT** available for this property. DESCRIBE WORK: ADDING SUNROOM 31 X 20 ON REAR OF DWELLING APPLICATION FOR: Existing Structure STRUCTURE TYPE: PRIMARY RESIDENCE FACILITY TYPE: Single Family Residence OTHER DESCRIPTION: DESCRIPTION OF SINGLE FAMILY EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: 63 X 70 hillMRFR f1F EXISTING BEDROOMS: 4 PROPERTY EASEMENTS: none NEW STRUCTURE DIM:: ( 31 X 20 Sunroom) BASEMENT? No # OF OCCUPANTS: 2 PROPOSED CONSTRUCTION BASEMENT FIXTURES? PLUMBING REQUIRED? No I understand that this is a formal application for a well permit, Improvement permit or Authorization to Construct a ground absorption sewage disposal system to serve the above described facility on this property and authorize Catawba County Health Department employees to go on this property for evaluation purposes. I certify the above information to be correct and understand that an Improvement Permit issued as a result of this information is transferable and may be eligible for a non -expiring date, but may be revoked if this information, site plass or intended use changes for the proposed facility. A Well Permit and Authorization to Construct issued by this department is valid for (5) five years from the date issued and is not transferable. Note: You must obtain Zoning Approval prior to locating a home or structure on this property. An / representation by you of house or structure location should conform to applicable setbacks. Date: Signature of Applicant or Agent An Environmental Health Specialist will contact you within 2 working days of application date. If you need further inform atio er-assTst-a cc please call F 28-466-7291 Area 1 MINIMUM SETBACKS FRONT: 30 SIDE: 15 REAP: 30 MAX HEIGHT I W t'I IM►`/:11►I 10 Improvement Permit (Existing) Fee TOTAL FEES DATE FEE AMOUNT 07/17'2012 $90.00 $90.00 45 CHANGE WORK ORDER REQUIRING REDESIGN AND/OR RETRIP WILL INCURE AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) Fel - ehapplication 07/17/2012 16:48 Page 1 of 3 THIS IS NOT A PERMIT Case # RBPR-07-2012-15994 ' CATAWBA COUNTY HEALTH DEPA TMENT PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES Residential Building Plan Review - Building Addition IMPROVEMENT Contractor 704 RENOVATIONS, LLC, 20939 LAKEVIEW CIR, CORI` ELIUS NC 28031- B:(704)604-3366 Owner DALE BRADLEY, 7396 BAY COVE CT, DENVER NC 28(37 CA08-639-8168 NAME TO APPEAR ON PERMIT DALE BRADLEY SITE ADDRESS: 7396 BAY COVE CT, DENVER NC 28037 PIN # 460603346337 NAME of SUBDIVISION: Lot # Section/Block PROPERTY SIZE: Square Feet Acres 1.15 DIRECTIONS: HWY 16 S/ LFT ON CAMPGROUND RD/ LFT ON CATAWBA BURRIS RD / RT ON BANKHEAD RD/ RT ON SALLYBROOK LN/ RT ON BAY COVE/ 2ND LOT ON RT/ PEBBLE BAY PH 5 LOT 218 JUSTAFTER GATE PRIMARY CONTACT: Contractor SEW�R TYPE: Septic Tank GALLONS PER DAY: 480 WATER .-UPPLY : Community Well Public water is **NOT** available for this property. DESCRIBE WORK: ADDING SUNROOM 31 X 20 ON REAR OF DWELLING APPLICATION FOR: Existing Structure STRUCTURE TYPE: PRIMARY RESIDENCE FACILITY TYPE: Single Family Residence OTHER DESCRIPTION: DESCRIPTION OF SINGLE FAMILY EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: 63 X 70 NUMBER OF EXISTING BEDROOMS: 4 # OF OCCUPANTS: 2 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 31 X 20 BASEMENT? No BASEMENT FIXTURES? PLUMBING REQUIRED? No I understand that this is a formal application for a well permit, Improvement permit or Authorization to Construct a ground absorption sewage disposal system to serve the above described facility on this property and authorize Catawba County Health Department employees to go on this property for evaluation purposes. I certify the above information to be correct and understand that an Improvement Permit issued as a result of this information is transferable and may be eligible for a non -expiring date, but may be revoked if this information, site plans or intended use changes for the proposed facility. A Well Permit and Authorization to Construct issued by this department is valid for (5) five years om the date issued and is not transferable. Note: You must obtain Zoning Approval prior to locating a home or structure on this pro erty. Anv presentation by you of house or structure location/should conform to applicable setbacks. 1 Date: / ' / li Signature of Applicant or Agent An Environmental Health Specialist will contact you wit - 'n ays of appltc tion date. If you need further information or assistance please all 2 -466-7 MINIMUM SETBACKS FRONT: 30 SIDE: 15 REAR: 30 MAX HEIGHT: 45 FEENAME Improvement Permit (Existing) Fee TOTAL FEES DATE FEE AMOUNT 07/17,'2012 $90.00 $90.00 CHANGE WORK ORDER REQUIRING REDESIGN AND/OR RETRIP WILL. INCURE AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) C9 - ehappl �aUon 07/17/2012 13:32 Page 1 of 3 THIS IS NOT A PERMIT b CATAWBA COUNTY HEALTH DEPARTMENT c Application for Environmental Services Page 1 184 5m Improvement Permit Authorization to Construct ❑ Se ?tic Repair ❑ Septic Malfunction ❑ Septic Expansion ❑ New Well Permit ❑ Replacement Well ❑ Well Abandonment ❑ Well Repair ❑ Existing System Inspection (Pre -Approval Required) ❑ Application is for New Construction ❑ Existing Facility ❑ Property Address LO l3Pr1 CrVE C ` ' SubdivisionL? %: 'B A4 tC-^JV 0V Z.i503'� Lc t # '- j Acres I d . i ,Section/Block/Phase -PA ^� 5— Driving Directions to Property �+llL (-� ��A-�`�, 9b. � i �U,,J � � r a NAME TO APPEAR ON PERMIT? ® Owner ❑ Applicant contractor OApplicant Contact Information V I Name %'C_ev/tJ11Pn.L1 �d Ca Address rqLyJ3 �i�i'%t.[ G�/(% C�%.i� r f �G�^✓cZ� O5 9 29 0-31 Phone�?a _ &de -1 - 3 (/j I Cell Phony (� 1- , Owner Contact Information �" Name D�� S "vl c C �9-/ I Address -7310 • . 4 4/ L'0r/G G `e � �� V Q I Phone 416P - 40 �3 G � PCell Phone Contractor Contact Information H I Name 6,417 tW&( `�4_1 Address = I Phone I Cell Phon Z WHO WILL BE THE PRIMARY CONTACT? ❑ Owner ❑ Applicant ontractor Z QDescription of Existing Structu son Site 'Avlel # Bedrooms * j Structure Dimensions sions t # of Occupants e i Basement ❑ Yes [ o Basement Fixtures ❑ Yes 2_ C� Planned Future Ad itions or Improvements (B� ing PermitNOT requested at this time) C /� O Describe �� i��0� � O� �' �2 W. Proposed Future Structure Dimensions ,'?I ' r X � # of Bedrooms *'I if applicable Qer ? Are there easements or right-of-ways recorded on this property ❑ Yds Describe Is a public water supply availabl on or adjacent to the above property ** El Yes [:]No Check type available ['Community Well ❑ Semi -Pubes Well ❑ County/City/Township Water Line Existing water supply in use ❑ Individual Well Fommunity Well ❑ Semi -Public Well ❑ County/City/Township Water Line ❑ I WOULD LIKE TO SCHEDULE A COMBINED FLAGGIN AND SOIL EVALUATION (SEE COMBINED EVALUATION PROCEDUES) Va13A oG THIS IS NOT A PERMIT cr ' CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services Page 2 184 Pro ed Facility Type Primary Residence ❑ Newc�esidenc� Addition to Residence # of New Bedrooms * j Project Description `f,/ al✓v% Structure Dimensions ''3 j ' 4vX 00 ° .® # of Occupants Basement ❑ Yes ® o Basement Fixtures ❑ Yes LJ'No F-1 Accessory Structure(s) e Descnb. # of New Bedrooms *'I if applicable Structure Dimensions # of Occupants Accessory Dwelling ❑ Yes ❑ No Plumbing ❑ Yes ❑ No Describe Plumbing Needed ❑ Multi -Family Residence # Units .. �� u �r11i11a1 #Bedrooms per Unit*T Total # Bedrooms * j Structure Dimensions ❑ Food Service Specify Type # Seats Floor Space -Entire Food Service Facility (Sq Ft) # Employees per Shift # of Shifts Dining Area (Sq. Ft.) ❑ Businessp Type mess „..., Retail Floor Space Specific of Bu p s e — # of Employees per Shift # of Shifts ❑ Other Facility Type Specify, If Church # of Seats Kitchen ❑ Yes [:]No If Daycare Specify Occupancy Application for Well Construction/Ab andonm, en, t/Repair . . ., , , Proposed Well Type ❑ Individual Well ❑ Semi -Public Well ❑ Community Well Abandonment Type ❑ Drilled ❑ Bored ❑ Dug ❑ Unknown Well Repair Requested ❑ Yes ❑ No Describe Calculated Design Flow, Commercial f Additional information may be required to determine design flow from certain facilities. This value will be determined during consultation with on- site staff. *Any room that will be intended for sleeping at the time of construction or for future consideration should be noted as a bedroom and counted on all applications. The number of bedrooms will be confirmed by rooms identified on house plans as a bedroom at the time of building permit issuance. This may prevent the need for septic system size increase in the future. j If structure is plumbed but no bedrooms, calculated design flow is required. * * If No, a well permit must be issued with the Authorization to Construct. Note: You must obtain Zoning approval prior to locating a home or structure on this property. Any representation by you of house or structure location should conform to applicable setbacks. ® CHANGE WORK ORDER REQUIRING REDESIGN AND/OR RETRIP WILL INCURE AN LW ADDITIONAL CHARGE (SEE FEE SCHEDULE) LW CL I understand that this is a formal application for Environmental Services and authorize Catawba County Environmental Health employees to go on this property for evaluation purposes. I certify the above information to be correct and understand ® that an Improvement Permit issued as a result of this information is valid for 5 years or may be non -expiring under certain V specified conditions. Improvement Permits and Well Permits are transferrable, but may be revoked if this information, site plans or intended use changes for the proAno facility. ' Authorization to Construct issued by this department is valid for CA (5) five years from the date issued and isns e bSignature of Owner or AgentPrinted Name of Owner `,00r�r Agent - Date �-'% %' —%04-- N 1 inch = 50 feet l� Catawba County, North arolina This map product was prepared from the Catawba County, NC, Geospatial Information System. Catawba County has made substantial efforts to ensure the accuracy of locatior and labeling information contained on this map. Catawba County promotes and recommends the indepe ident verification of any data contained on this map product by the user. The County of Catawba, its employees, agents and personnel disclaim, and shall not be held liable for any and all damages, loss or liability, whether direct, indirect or consequential which arises or may arise from this map product or the use thereof by any person or entity. Selected Parcel Number: 4606-03-34-6337 Prepared for: %}o� r)W ' �4 86 105- 218 01, Q V .07A N 9g THIS IS NOT A LEGAL DOCUMENT \ I i ,r-1 26 1,4.88 1` r28.65 af=i- \ `, Date/: �7/17/2012 Time: 12:55:11 PM CATAWBA COUNTY NC - Parcel Report Information Regarding Selected Parcel(s) Parcel ID: 4606-03-34-6337 Name: BRADLEY DALE M Name2: BRADLEY SONNIE K Address: 7396 BAY COVE CT Address2: City: DENVER State: NC Zip: 28037-5518 Account: 159769980 Calc Acreage: 1.15 Tax Map: LRK: 803085 Deed Book: 3065 Deed Page: 0603 Subdivision Name: PEBBLE BAY PH 5 Subdivision Block: Lots: 218 Plat Book: 65 Plat Page: 145 Building Number: 7396 Street Name: BAY COVE CT Site Zip: 28037 Township: MOUNTAIN CREEK Fire Code: SHERRILLS FORD City Code: COUNTY State Road: Total Bldgs Value: $333,100 Land Value: $50,300 Total Value: $383,400 Year Built: 2009 Year Remodeled: Last Sale Date: 2/18/2011 Last Sale Amount: $355,000 Neighborhood: 131 Watershed: WS-IV Critical Area Watershed Split: NO Voter Precinct: P41 E911 District: COUNTY Zoning: R-30 Zoning2: Zoning3: Zoning Split: N Zoning Overlay: CRC-O,WP-0 Zoning District: COUNTY Split Zoning Dist: N Split Zoning Dist(1): 0 Split Zoning Dist(2): 0 School District: COUNTY Elementary School: SHERRILLS FORD Middle School: MILL CREEK High School: BANDYS School Split: NO P&Z Case Number: Census Tract 2010: 011504 Census Block 2010: 4017 Small Area Plan: SHERRILLS FORD Agricultural District: Printed: Tuesday, July 17, 2012 12:54 PM CATAWBA COUNTY Public Health Department QEnvironmental Health Division ti PO Box 389, 100-A Southwest Blvd, Newton, NC 28658 %$ w Applicant/Owner TOM PALMER Site Address: 7396 BAY COVE CT, DENVER, NC Property Size: SF ACRES Directions: Case # OP -3-10-5505 Subdivision Lot # PIN# 460603346337 Catawba County Health Department Operation Permit IIIG - OTHER NON -CONY TRENCH SYSTEMS System Type: (In accordance with Table Va) Description: 25% REDUCTION Types V and VI systems expire in 5 years. Owner must contact health department 6 months prior to eiiration for permit renewal. System Installation Comments: STB #612, Dellinger/1250 Gallon PERMIT CONDITIONS: 1. All maintenance, monitoring, and performance requirements shall be in accordance with 15A NCAC 18.1900, Rule .1961 2. Operation & Maintenance Specifics: Subsurface system operator required? Yes No_x_ If yes, see attached sheet for additional operation conditions, maintenance and reporting. This system has been installed in compliance with applicable North Carolir a General Statutes, Rules for Sewage Treatment and Disposal, and All conditions of the Improvement Permit and Construction Authorization. S & S Grading #3294 SYSTEM INSTALLER Robbie Phelps AUTHORIZED STATE AGENT 03/17/10 09:15 03/08/2010 INSTALL\TION DATE 03/17/2010 DATE OF OPERATION PERMIT ISSUANCE Foran F A 4 CATAWBA COUNTY I N ret # Public Health Department Ad ess Environmental Health Division v PO Box 389, 100A Southwest Blvd, Newton NC 28658 PIN 1$ Z SM (828) 465-8270 Fax (828) 465-8276 TDD (828) 465-8200 SITE PLAN for 0? �5 C o V, f— Scale ' � 10 W1s2009-00308 Tom Palmer 7396 Bay Cove CT --�� For Office Use•On{v 1 IMPROVEMENT PERMIT Catawba County Public Health Department *CDP File Number. , 3 3 4 0 County ID Number• WLS2009,00308 Environmental Health Division .•t, '"� P.0 Box 389, 100-A Southwest BlvdEvaluated Fora:. NEW Newton NC 28658 PE�'MIT VALID UNTIL ! S' 06/05/2014 Phone, (828)-465-8270 Fax: (828) 465-8276 *NOTE TO INSPECTIONS DIVISION: Building Permits cannot be issued with this Improvement Permit. Applicant: TOM PALMER Property Owner --'TOM PALMER HOMES INC Address. PO BOX 2387 Address. PO BOX 2387 I; City- DAVIDSON city. DAVIDSON State/Zip NC 28036 j State/Zip. NC 28036-638 Phone #, Phone #. Property Location & Site Information //Address/Road #: Subdivision. PEBBLE BAY PH 5 Phase: Lot. 218 7396 BAY COVE CT DENVER NC Directions Structure. SINGLE FAMILY HWY 16 S/ LFT ON CAMPGROUND RD/ LFT ON CATAWBA BURRIS RD/ RT ON BANKHEAD RD/ # of Bedrooms' 4 RT ON SALLYBROOK LN/ RT ON BAY COVE/ 2ND # of People LOT ON RT/ PEBBLE BAY PH 5 LOT 218 JUST 'Water Supply, COMMUNITY AFTER GATE \\ Svstem Specifications Initial Svstem 'Site Classification PS Minimum Trench Derth• 1 8 Inches Design Flow: 4 8 6 Maximum Trench Depth. 2 4 Inches Soil Application Rate, 3 Septic Tank: 1 12 0 0 Gallons 1 -Piece: OYes ®No 'System Classification/Description TYPE III G. OTHER NON -CONY. TRENCH SYSTEMS Pump Required Oyes Q No O May Be Required Pump Tank Gallons ' Proposed System 25% REDUCTION J 1 -Piece OYes ONo // Repair System Required-OYes 0 N ONO, but has Available Space Repair Svstem ^� *Site Classification, PS Minimum Trench Depth, 1 8 Inches Soil Application Rate, 3 Maximum Trench Depth: a 4 Inches ;System Classification/Description Pump Required- @Yes O No (:)Maybe Required TYPE III B. SYSTEM W/SINGLE EFFLUENT PUMP Pump Tank 1 -1 0 0 Gallons `Proposed System 25% REDUCTION Page 1 of 3 CDP File Number' 32340 WLS2009-00308 County ID Number: *Site Modifications I • ❑ Open Fill Sheet No grading or construction activity is allowed in areas designated for system and repair without approval of Health Department. *Permit Conditions The issuance of this permit by the Health Department in no way guarantees the issuance of other permits. The permit holder is responsible for checking with appropriate governing bodies in meeting their requirements. The Improvement Permit shall be valid for 5 years from date of issue with a site plan (means a drawing not necessarily drawn to Site Plan scale that shows the existing and proposed property lines with dimensions, the location of the facility and appurtenances, the site for the proposed Wastewater system, and the location of water supplies and surface waters). Plat The Improvement Permit shall be valid without expiration with plat (means a property surveyed prepared by a registered land surveyor, drawn to a scale of one inch equals no more than 60 feet, that Includes: the specific location of the proposed facility O and appurtenances, the site for the proposed Wastewater system, and the location of water supplies and surface waters. Plat also means, for subdivision lots approved by the local planning authority and recorded with the county register of deeds, a copy of the recorded subdivisions plat that Is accompanied by a site plan that is drawn to scale). The Department and Local Health Department may impose conditions on the issuance and may revoke the permits forfailure of the system to satisfythe conditions, the rules, or this article. This permit Is sub)ect to revocation If the site plan, plat, or Intended use changes (NCGS 130A335(f)). The person owning or controlling the system shall be responsible for assuring compliance with the laws, rules, and permit conditions regarding system location, Installation, operation, maintenance, monitoring, reporting, and repair (.1938(b)). Applicant/Legal Reps, Signature Required? (R)Yes O No pplicanULegal Reps. Signature: L� 7 `Issued By: 1919 - Susan Miller Authorized State Agent:1`4c/-,� r ��•.� •T Date: J Date of Issue: 6/ 5/ x 0 0 9 OValid without Expiration? 01 -land Drawing @Import Drawing **Site Plan/Drawing attached.** Page 2 of 3 Total Time:(HH:MM) 0 0 Hours 0 0 Minutes / Applicant Address. City State/Zip: Phone #- CONSTRUCTION For Office Use Only AUTHORIZATION I°CDP File Number 3 .1 3 4 0'. Catawba County Public Health Department County ID Number: wLSM9-00308 Environmental Health Divisionvaluated For: NEW J P O Box 389, 100-A Southwest Blvd PERMIT VALID UNTIL Newton NC 28658 Phone- (828)-465-8270 Fax: (828) 465-8276 TOM PALMER Property Owner- TOM PALMER HOMES INC PO BOX 2387 Address. PO BOX 2387 DAVIDSON City DAVIDSON NC Add resslRoad # 7396 BAY COVE CT DENVER NC Structure* # of Bedrooms # of People \ `Water Supply: 28036 j State/Zip / \Phone # Propertv Location /& Site Information Subdivision: PEBBLE BAY PH 5 SINGLE FAMILY 4 COMMUNITY "Site Classification PS Design Flow: 4 8 0 NC 28036-6387 Phase Lot, 218 Directions HWY 16 S/ LFT ON CAMPGROUND RD/ LFT ON CATAWBA BURRIS RD/ RT ON BANKHEAD RD/ RT ON SALLYBROOK LN/ RT ON BAY COVE/ 2ND LOT ON RT/ PEBBLE BAY PH 5 LOT 218 JUST AFTER GATE System Specitications Minimum Trench Depth 1 8 Inches Minimum Soil rover, 6 Inches Son Appllcatlon Rate. 3 "System Classification/Description: TYPE III G. OTHER NON -CONY TRENCH SYSTEMS *Proposed System 25% REDUCTION Nitrification Field No. Drain Lines Total Trench Length Trench Spacing Trench Width. Aggregate Depth Sq. ft Maximum Trench Depth a 4 Inches Maximum Soil Cover 1 a Inches `Distribution Type GRAVITY - SERIAL Septic Tank: 1 a 0 0 Gallons 1 -Piece. OYes @No Pump Required. OYes (�No O May Be Required Pump Tank. Gallons 4 1-Piece.OYes ONo 4 0 0 f} GPM --vs-- ft TDH 9 Inches O C Feet O C Dosing Volume, _ Gallons 3 . Inches Feet Grease Trap Gallons inches Pre -Treatment: O NSF OTS -1 OTS -11 Septic Tank Installer Grade Level Required OI OII 0111 01V Page 1 of 3 CDP File Number' 32340 WLS2009-00308 County ID Number: Open Pump System Sheet Repair System Required: (@Yes O No O No, but has Available Space Repair Svstem Trench Spacing:9 Olnches O.C. *Site Classification: PS – +t+ Feet O.C. Trench Width: 3 Olnches Design Flow: 4 8 0 – Q Feet Soil Application Rate: 3 Aggregate Depth: inches .� Minimum Trench Depth: 1 • g Inches *System Classification/Description: TYPE III B. SYSTEM W/SINGLE EFFLUENT PUMP Minimum Soil Cover: *Proposed System: 25% REDUCTION Nitrification Field No. Drain Lines \ Total Trench Length: 4 0 0 ft. 6 Inches Maximum Trench Depth: a 4 Inches Maximum Soil Cover: 1 a Inches Sq. ft. "Distribution Type: PRESSURE MANIFOLD Pump Required: =Yes ONo ()May Be Required Pre -Treatment: O NSF OTS -1 OTS -11 *Site Modiflcations No grading or construction activity is allowed in areas designated for system and repair without approval of Health Department. *Permit Conditions The issuance of this permit by the Health Department in no way guarantees the issuance of other permits. The permit holder is responsible for checking with appropriate governing bodies in meeting their requirements. Stay 10'min from property lines, 5' min from the house. Install system level and on contour. This Authorization for Wastewater System Construction shall be valid fora person equal to the period of validity of the Improvement Permit, not to exceed five years, and maybe issued at the same time the Improvement Permit Issued (NCGS 130A -336(b)). If the Installation has not been completed during the period of validity of the Construction Permit, the information submitted in the application for a permit or Construction Authorization is found to have been Incorrect, falsified or changed, or the site is altered, the permit or Construction Authorization shall become invalid, and may be suspended or revoked (.1937(8)). The person owning or controlling the system shall be responsible for assuring compliance with the laws, rules, and permit conditions regarding system location, installation, operation, maintenance, monitoring, reporting and repair (1938(b)). Applicant/Legal Reps. Signature Required? 3'' es ONO — j� �App'licant/Legal Reps. Signature-``" "0 Date: / / *Issued By: 1919 - Susan Miller Date of Issue: 6 / 5 / a 0 0 9 Authorized State Agent: Malfunction Log OYes OHand Drawing Olmport Drawing Total Time:(HH:MM) **Site Plan/Drawing attached.** Hours 0 0 Minutes Page 2 of 3 CDP File Number: 32340 Drawing Type: Construction Authorization Click below to import an image from an external location: County File Number: WLS2009-00308 Date: R r" Co a C. - Page 3 of 3 "sWNW,: t ..7,. •t:'.tt 4' ' Vii• 2-q 01 +I I ie_ • waw -� � �e Se�-h� 44,4- 6h ACV ej bf �vt hnc - _Dvt�' Wb GAV4 j&�air 6yea) will If�w+cti�. sc�l • z . I I �' �'0� Ut �� i�IK i-�• �.� t5 r�a'icl�— d J b7� q P WINcr r" Co a C. - Page 3 of 3 "sWNW,: t ..7,. •t:'.tt 4' ' Vii• 2-q 01 +I I ie_ • waw -� � �e Se�-h� 44,4- 6h ACV ej bf �vt hnc - _Dvt�' Wb GAV4 j&�air 6yea) will If�w+cti�. sc�l • z . I I �' �'0� Ut �� i�IK i-�• �.� t5 r�a'icl�—