HomeMy WebLinkAboutRBPR-07-2013-17626.TIFTHIS IS NOT A PERMIT Case # RBPR-07-2013-17626
CATAWBA COUNTY HEALTH DEPARTMENT
PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES
Residential Building Plan Review - Swimming Pool
IMPROVEMENT
Owner JEREMY HARDIN, 120 ROCKING J RD, MAIDEN NC 28650
H:828-310-8090 HOME 828-310-8090
NAME TO APPEAR ON PERMIT
Jeremy Hardin
SITE ADDRESS: 120 ROCKIN J RD. MAIDEN NC 28650 PIN # 364610268748
NAME of SUBDIVISION: Lot #PT 1 & PT 2 Section/13lock
PROPERTY SIZE: Square Feet 61,419.60 Acres 1 41
DIRECTIONS: 321 Business right on 8th Ave across from Galaxy Grocery Store, turn right on Rocking J, log house on left at end of
road
PRIMARY CONTACT: Owner SEWER TYPE: Septic Tank
GALLONS PER DAY: 360 WATER SUPPLY : Public Water
DESCRIBE WORK: " Needs Maiden zoning -14x28 In ground swimming pool
SITE INFORMATION
Do any of the following apply to the property for which this application is applied?
If the answer to any of the questions below is "YES', then supporting documentation is required:
Does this site contain any jurisdictional wetlands? No
Does this site contain any existing wastewater systems? Yes
Is any of the wastewater going to be generated on the site other than domestic sewage? No
Is the site subject to approval by any other public agency? Yes
Are there any easements or right-of-ways on this property? No
APPLICATION FOR: New Structure
STRUCTURE TYPE: ACCESSORY STRUCTURE
FACILITY TYPE: Accessory Structure OTHER DESCRIPTION:
DESCRIPTION OF single family dwelling
EXISTING STRUCTURES
ON SITE (IF ANY
DIM EXISTING STRUCTURE: 54x52
NUMBER OF EXISTING BEDROOMS: 3 # OF OCCUPANTS: 2
PROPOSED CONSTRUCTION
NEW STRUCTURE DIM:: 18x28
Desired system types (Improvement Permit or Authorization to Construct)
ACCEPTED ALTERNATIVE: CONVENTIONAL
OTHER* INNOVATIVE ANY YES
Other described
Improvement Permits issued as a result of this information are valid for 5 years or may be non -expiring under certain specified conditions An
Authorization to Construct issued by this department is valid for (5) five years from the date issued and is not transferable, Improvement Permits and Well
Permits are transferrable Permits may be revoked if the information on this application, site plans or intended use changes for the proposed facility
I have read this application and certify that the information provided herein is true, complete and correct Authorized county and state officials are granted
right of entry to conduct necessary inspections to determine compliance with applicable laws and rules I understand that I am solely responsible for the
proper identification and labeling of all property lines and corners and making the site acce ible so that a c plete site evaluation can be performed
Date: %- �-%.3 Signature of Applicant orA-cut ,Aw � .
An Environmental Health Specialist will contact you N` in 2 o mg days of application date.
If Vou need further information or assistance plea call 828-466-7291
AREA1
MINIMUM SETBACKS FRONT: SIDE: REAR: MAX HEIGHT
E73
14-ehappli,:awn 07/05/2013 11 47 Page I of
a,n CATAWBACOUNTti ca�ct; RBPR-07-2013-17626
Public Health Department Suhdn ismn
1r'
8nvironmental I-Icalth Division PIN# 364610268748
vv PO Box 389, 100-A Southwest Bk,d. Newton, NC 28698
NAME ON PERMIT: JEREMY HARDIN, 120 ROCKING J RD, MAIDEN NC 28650
Site Address: 120 ROCKIN J RD, MAIDEN NC 28650
Property Size: Square Fen 61,419.60 Acrce 1.41
Directions: 321 Business right on 8th Ave across from Galaxy Grocery Store, turn right on Rocking J, log house on left at end of
road
FEENAME DATE FEE AMOUNT
Improvement Permit (Existing) Fee 07/05/2013 $90.00
TOTAL FEES $90.00
SYSTEM REDESIGN AND/OR RETRIP WILL INCUR AN ADDITIONAL CHARGE
(SEE FEE SCHEDULE)
[ q - rhepphauu, m 07/05/2013 11 43 Page 2 of 4
Jul 02 13 10.36a SunQest GieenQuest 8284657370 �j p.I
CATA�VBA TI ITS IS NOT A PERMIT�eF'--' `' `��
CATARBA COUNTY HEALTH DEPARTMENT
< Application for Environmental Services Page 1
Improvement Permit +' Authorization to Construct ❑ Septic 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 I Z \ Q(aj� Subdivision
tL)'� >,� 1 , y N Lor # Acres
� �� Sectio n/Bloc W Phase
D wing Directions to Property _ 7 t2 A,.ifi Ae S < - 4w,? /�Y or 4o e4 14, , 1�6r0 4rt Iio/rl
nalayI �� onJn �c �tnc T_ F',Y/ oJoC O�
NAViE TO APPEAR ON PEW IIT? I210wner ❑ .Applicant ❑ Contractor
Applicant Contact Information
Address 1'Z,'� �(. 3'- t �;,, �A 4 c, �L
Phone gZS - 31 6-,Z C a Cell Phone
Owner Contact Information
Name J o w..M V Anro /!
Address 11,-) t�C'Y%.ti n --y— r2oj
Phone RZZ-,5Z2-,g 2775
Contractor Contact Information
NameCSI , r. t e s,�f-" Zl 1 G
Address ItS_'f >_Aek ICl 40e -
Phone gLS- - (16S—(�Pvl�i-
Cell Phone RZ3? -{ 547 -/CJ/ Z
Ma_ �r "C _ T
Cell Phone
WHO «'ILL BE THE PRIMARY CONTACT? [26w•ner ❑ Applicant ❑ Contractor
Description of Existing Structures on Site "Z& u t e-
/C�4rR�.�
# of Bedrooms *T Structure Dimensions.lCi -Z ;z of Occupants a
Basement ❑ Yes Z�No Basement Fixtures ❑ Yes o
The Applicant shall notify the local health department upon submittal of this application if any of fire following apply to
the property in question. If the answer to any question is "yes", applicant must attach supporting documentation.
❑ Yes 2 10 Does the site contain any jurisdictional wetlands?
C Yes lZI-<_1 o Does the site contain any existing wastewater systems?
G Yes 11K, 0 Is any wastewater Loin_ to be generated on the site other than domestic sewage?
❑ Yes U -N< Is the site subject to approval by any other public agency'
❑ Yes Are there any easements or right of ways on this pronem"? Describe
Existriingwater supply in use [_f Individual Well ❑ Community Well LlSemi-PublicWell
t�t.rninty.%CityiTownship Fater Line Is a public water supply available'? ❑ No
If applying for an Improvement Permit or Authorization to Construct, Please Indicate Desired System Type(s)-
(systems; can be ranked in order of your preference) �� P
ED Accepted ElAlternatme 0 Conventional 0 Luievative 5y ther /0-e./ ❑ Any
Jul 02 13 10:36a SunQest Green Quest 8284657370 p.2
S IS NOT A
IT
LATA^ C ITAWBA COUNTY HEALTH EIEPARTMEIT
�1Application for Environmental Services Page 2
Proposed Facilih, Type
❑ Primary Residence ❑ News Residence ❑ Addition to Residence g of New Bedrooms *t
Project Description
Structure Dimensions'o'Occupants
Basement ❑ Yes ❑ No Basement Fixtures ❑ Yes ❑ No
0 AccessoryStructure(s) Describe P.� Al carlc'-m-h,
"of New Bedrooms 't if applicable n Structure Dimensions
ri of Occupants — Accessory Dwelling ❑ Yes (yam' No
Plumbine �'es No Describe Plumbing Needed Pum/1 A%Jreirnr
❑ Multi -Family Residence � Units ':Bedrooms per unit*t
Total 9 Bedrooms *r Structure Dimensions
Food Service Specify Type
xt Seats Floor Space -Entire Food Service Facility (Sq Ft)
Employees per Shift Iof Shifts Dining Area (Sq. Ft.)
[� Business Specific Type of Business Retail Floor Space
f of Employees per Shift _ n of Shifts
❑ Other Facility Type Specify
If Church rt of Seats Kitchen ❑ Ycs ❑ No If Daveare Specify Occupancy
Application for Nell Construction/AbandoumenURepair
Proposed Well Type ❑ Individual Well ❑ Semi -Public Well ❑ Community Well
Abandonment T}'pe ❑ Drilled ❑ Bored ❑ Dug ❑ Unknown
Well Repair Requested ❑ Ycs ❑ No Describe
Calculated Design Flow, Commercial f Additional information may he required to determine
design flow from certain facilities. This value will be determined during consultation with on-site staff.
*Any room that wilt be intended for sleeping at the time of construcu on 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 One future.
i If structure is plumbed but no bedrooms. calculated desien llow is required-
` If No. a well permit must be issued with the Authorization to Construct
SYSTEM REDESIGN AND/OR RETRIP WILL INCUR AN ADDITIONAL CHARGE (SEE FEE SCHEDULE)
Improvement Permits issued as a ies'alt of this information we valid for 5 years or may be nen-expiring under certain specified
conditions. An Authorization to Construct issued by this department is valid for (5) five }ears from the date issued and is not
transferable; Improvement Pcrmi:s and Well Permits are transferrable. Permits maybe revoked if the information on this application,
site plans er intended use changes for the proposed facility.
I have read this application and certify that the omformauon provtded herein is true. complete and correct. Authorized county and state
officials are granted right of entry to conduct necessary inspections to detemnine compliance with applicable laws and rules_ i
understand that I am solely responsible for the proper identification and labeling of a I I property lines and comers and making One ±iie
accessible so that a complete site evaluation can be performed.
Signature of Ow-rter or Agent / �f"� f �/ Date 7
Printed Name of Owner or Agent l a rents `I
Catawba County, North Carolina
This map prodrut ods prepared from t in Catawba County NC, Geospaltal Information System
N Catawba Coty hos made suhstanual el ILn� to cn.ure the diu
crar of location and labeling information
contained on this map Catmeba Cour N prionrco and recommends the Independent Net fi,7utwit ol'anN
data contained nn this map product by the user I he C'ouraN of Cotawha, Its emplm ces, tgenis and
personnel disclaim, and shall not be held liable Im .or, and all damaged, lo.s or liability, whethet direct, Indirect
or consequential which onscs of map arise G,nr Ihu map product or the use thereof by any person or entrq
Selected Parcel Number: 3646-10-26-8748
1 inch= 50 feet
Prepared for:
,500
I - r
,00 00
M , /
1\.4`1 A
8748 �',, A, CD
8676 2.62A
Plat 64-104 1 740
/`/"6.06 pt 2
5.95 /� \ (125) 1 pt 1
co 12495 / 100.01 ```
6.16
to
THIS IS NOTA LEGAL DOCUMENT / Date: 7/5/21113 Time: 11:25:14ANI
7 I fff
CATAWBA COUNTY NC - Parcel Report
Iniormation.Regarding Selected Parcel(s)
Parcel ID:
3646-10-26-8748
Name
HARDIN JEREMYA
Name2
Address
120 ROCKIN J RD
Address2:
City
MAIDEN
State
NC
Zip
28650-8488
Account.
Calc Acreage.
1.41
Tax Map'
066N 02032E
LRK:
35864
Deed Book'
2919
Deed Page:
1871
Subdivision Name:
Subdivision Block'
Lots'
PT 1 & PT 2
Plat Book,
64
Plat Page'
104
Building Number
120
Street Name:
ROCKIN J RD
Site Zip'
28650
Township.
NEWTON
Fire Dist:
MAIDEN RURAL
Cityrrax.
State Road.
Total Bldgs Value.
$152,100
Land Value.
$13,700
Total Value:
$165,800
Year Built:
2008
Year Remodeled:
Last Sale Date:
9/13/2007
Last Sale Amount:
$15,000
Neighborhood'
113
Watershed:
Watershed Split.
Voter Precinct:
P20
E911 District:
MAIDEN
Zoning:
R-20
Zonmg2.
Zoning3.
Zoning Split:
N
Zoning Overlay.
Zoning District:
MAIDEN
Split Zoning Dist:
N
Split Zoning Dist(1)
0
Split Zoning Dist(2). 0
School District:
COUNTY
Elementary School: MAIDEN
Middle School.
MAIDEN
High School
MAIDEN
School Split:
NO
P&Z Case Number'
Census Tract 2010: 011702
Census Block 2010:
5032
Small Area Plan
Agricultural District.
Printed Friday, July
05, 2013 11:25 AM
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P�^u\HcSih Ucp.i r;rY.nt
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Case it WLS2008-00665
Ln\ncn ll,wmd 11VAIII Dinslen
Su hit i visioil
Pe Itfls IF`) IOU A tiuuih\resi Ithd N:\\Inn N(' '56;5
Sect/ ISI_/PIV I_ol d I & 2
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(5231d(?s'70 FAX IS's116;-s'76 TDD15'5)4(o STU
PINif ;64610268748
Applicant/Owner )E.RLNIlI1ARDIN
Site Address: 120 ROCKIN J RD MAIDEN NO Dq 1 5 DogleC4�
Property Size: SF 41 ACRES /
Directions: 321 BUS TO MAIDEN/ RT ON 8TH AVE/ ROCKIN J IS NEAR END OF 8TH AVE/ PROPERTY IS AT THE END OF
ROCKIN J RD
Improvement Permit
Permit Valid For: Five years No Expiration
Facility (Residential). House
I-hlriSe \ tsluhilc Humetvlulu-Paumlo 6eelmonis i New? _ Addition?
Projected Daily Flow _24 g pad Water Supply Private Welly Public? ✓ Semi -Public?
BabcmentN_ Bi lsclll Plus hing Hut'I'uh/spa N --- Special Futures Ic\pl:un)
Proposed Wastewater System:
Proposed Repair:
Permit Conditions:
Owner or Legal Representative Signature:
Authorized State Agent:
Type:
Date:
Date:
The issa:ure of [Ills Penni[ by the Health Depaniucni don riot eu:u;mlec the Issuance oI other peinnls li is the respunsihlhq of the applicant/property
u\vnei to insuic that all Catn\cha County Plannine/Zoinne and limldin Inspccuuns iapurements are nut 'Phis lmpru\ement Permit is subject to
revocation it the site plan, plat or the intended use changes, or it site cunchtlous are altered. The Improvement Veiink is not affected b) a change in
o\\ Ilei ship III the properly. 'I'll, permit was issued in compliance \\ illi (he pro\ i.sions of the North Ciwolinn "Laws and Rules Fur Seoluee 7reatmeni
and Dfspn.sal Scstems' ( ISA iN CAC ISI\ .1900). Neither Catawba Cuunh nor the llin irunmcnlal health Specialist warrants that the Septic tank
s\Slem will continue to I'linctiun salisfacturily for au)r given IMIOLI ul'time.
_..... ..._...... ............ ......... ..... ..... ...... ........... .... ......... .._................._._... 1......s
Authorization to Construct Wastewater Svstem (Required for Building Permit)
' .Ser sur plan nod uddirinn,rl nrtuchments ( )
Proposed Wastewater System: $`'lo rcci'ty Type: Wastewater Flow 610 g.p.d
NeW V __ Repair Expansion Soil LTAR. .j q.p.d./ft2
Type of Facility: i_
QfrvC_ —.—_ ---.- _-- -- ----- -
8axincul' ��_ Basement Plwnbing HwTuh/Sita Special FiNuil-CS (ca Pl;un)
Wastewater Svstem Requirements
Tank Size: Septic rank j000 gal Pump Tank / 000 gal Grease Trap gal
Drainfield: Total Area sq It Total Length: 1`3o(D it Maximum Trench Depth in
Trench Width 3 ft Minimum Soil Cover G� ininimum Trench Seperation h
Distribution: Distribution Box � _ Serial Distribution— Pressure Manifold �LPP Other—
Additional
t er
Additional Specifications: KLtP,11ACtY-( VLSI ilq P)aS-k'(, 0,t'-._�_pt_Ci f=S(. P_i'I L 1DwL i +ar'ks
Authorized State Agent:
Permit Expiration Date
I hn1 e rend and neeepi the spec rfirarfons and ,dl c unrAtmn+ Ill rhn pelmil as 11 h"acd,
Owner or Legal Representative Signature: / ',. /_
5unn. Ill
Date: —7"
Date: %- '
Forth B
\J
. Vul.muul\h„�n in'f
CAT;\\{'ISA COUN'1'1'
fi \U LS2UOS-000GJ
��, I Enirunnsntal lir,illh Uinsinn
Su hdn',$I on
v
�• ; I'O ISoa :39 Inn -A Sum hwnl Rlcd Ncwbm NC 286i8
SccIB L/Ph/Eol k I & l
._ (32814(6-8270 FAX (%_814()-5176 TDD IS_hl d65-81nn
I'INk 304610208748
ApplicanUOwner JEREMY HARDIN
Site Address: 120 ROCKIN J RD MAIDEN NC
Property Si SR 1 41 ACRL-S
Directions: 321 BUS TO MAIDEN/ RT ON 8TH AVE/ ROCKIN J
IS NEAR END OF 8TH AVE/ PROPERTY IS AT THE END
OF ROCKIN J RD
Improvement Permit Authorization To Construcl ® Well Permit
SITE PLAN
2ao,gs' Do hid .ill arc�lradc aer
,Coo S It7' n ;r, &cm pnpOLI
aS`Ya
O I rp it (pu"p) �(' Col��ftl l LUJ rt Sly✓�viL
'VLA\siaU sySk� le��I
co, � htct� j Irl twc
� i'k Sl��l�ow place I1�,1�
v°
'' I�ou�i�uue,til U�SirlSPlc�4,�,
play
wad , itiil-us+ cz( cu e,
ol,
I U0
Seale
System components represent approximate contours only The contractor must flag the system prior to beginning the
Installation to ensure that proper grade Is maintained. Do not Install system under wet conditions. This permit Is subject of
revocatl n if the site plan or site conditions are altered.
,n'aL t /J1,— y-3-06
Authorized State Agent Date
Folin C
\I,, ..... v...... c,.,...
\ Phone #. / \hone #:
Property Location & Site Information
Address/Road #: Subdivision: Phase:
120 ROCKIN J RD
OPERATION PERMIT
NC
For Vince use Umv
\
# of Bedrooms
Catawba County Public Health Department
`CDP. File Number a 4 a:
9 5
*Water Supply:
Ir
Environmental Health Division
1I
�ti1p1u
WLS2008=00663,
.
*CA issued by:
1919 - Susan Miller
P.0 Box 389, 100-A Southwest Blvd
At
County ID Number: .
Newton NC
28658
valuated For NEW
Phone: (828)-465-8270 Fax: (828) 4655--8276
Applicant:
JEREMY A HARDIN
\ Property Owner: JEREMY A HARDIN
\
\
Address:
4410 AUGUSTA RIDGE CRT
Address:
245 GOLF COURSE RD
City:
DENVER
City
MAIDEN
State/Zip.
NC 28037
State/Zip:
NC 28650
\ Phone #. / \hone #:
Property Location & Site Information
Address/Road #: Subdivision: Phase:
120 ROCKIN J RD
MAIDEN
NC
Structure:
SINGLE FAMILY
# of Bedrooms
3
# of People:
2
*Water Supply:
PUBLIC
PIssued
by:
2031-Yrigoyen,Page
*CA issued by:
1919 - Susan Miller
Design Flow:
3 6 0
Soil Application Rate0 3
Nitrification Field
No. Drain Lines
Total Trench Length:
Trench Spacing:
Trench Width:
Aggregate Depth,
Lot: 1 & 2 �—
�o
Directions
321 BUS TO MAIDEN/ RT ON 8TH AVE/ ROCKIN J
IS NEAR END OF 8TH AVE/ PROPERTY IS AT THE
END OF ROCKIN J RD
'System Classification/Description:
TYPE III B. SYSTEM W/SINGLE EFFLUENT PUMP
`Distribution Type: PRESSURE MANIFOLD
'Pre -Treatment: N/A /
Drain field
9 0 0 Sq. ft.
3
3 0 0 ft.
9 0Inches O.C.
-— �Feet 0C.
3 OInches
_ — OFeet
inches
Minimum Trench Depth:
Minimum Soil Cover:
Maximum Trench Depth: 3 0
Maximum Soil Cover: 1 $
Inches
Inches
Inches
Inches
Page 1 of 4
'System Type: INFILTRATOR QUICK 4 STANDARD
Installer: Jackie Woods
Certification #: 2349
`EHS. 2246 - Megen McBride
Approval Status '
fl Approved 0 DisappYo6ed
j
CDP File Numtier 24295 County ID Number: WLS2008-00663
/ Septic Tank \ _
/ Manufacturer. Fraio Lat. ® \
STB: (No STB number or date on plastic tanks) Long'
Gallons 1000 Installer: Jackie Woods
Date: Certification #: 2349
'Filter Brand: 'EHS: 2246 - Megan McBride
ST Marker: ❑ Yes rS11 N0 Approval Status
Reinforced Tank: ❑ Yes ❑ No '.,Approved ❑ Disapproved /
1 Piece Tank: Q Yes ❑ NO /
Pump Tank
anufacturer: Pump tank buried could not get Installer: Jackie Woods \
manufacturer or PT number \
PT Certification #: 2349
Gallons: 1000 'EHS: 2246 - Megan McBride
Date: Approval Status
Riser Sealed V Yes ❑ No :Q Approved,❑ Disapproved
Riser Height: 0 Yes ❑ No (Min. 6 in.) -
'Reinforced Tank: ElYes ❑ No
\
\Piece Tank: ❑ Yes ❑ No
Supply Line
Pipe Size: a inch diameter Installer Jackie Woods
Pipe Length: $ 5 feet Certification #: 2349
'Schedule: 40 'EHS: 2246 - Megan McBride
Pressure Rated ® Yes ❑ No i' .. . A r . el�StaI -
Approved fittings : Yes El No v ov
Q Approved El Disapproved
Pump Requirement _
Pump Type: Zoeller Installer:
Dosing Volume: - Gal Certification #:
Draw Down: Inches *EHSt 2246-Megan McBride
Chain:". Approval Status 1 i
Valves Accessible 9 Yes El No "® Appro v.ed ❑ ' DisapproJed
Flow Adjustment Valve Mi Yes ❑ No
Check-valve X Yes ❑ No
PVC Unions M Yes ❑ No
Vent Hole Al Yes ❑ No
Anti-siphon Hole ❑ Yes ❑ No /
Page 2 of 4 /
CDP File Number 24295
NEMA 4X
Box or Equivalent
®
YeS
Box 12 inches Above Grade
Q
Yes
Box Adj. To Pump Tank
9
Yes
Conduit Sealed
Yes
Pump Manually Operable
Yes
'Activation Method:
County ID Number: vvLs2008-00663
Electric Equipment
❑ No Installer: \
❑ No
Certification #:
❑ No
❑ No 'EHS 2246 - Megen McBride
❑ No. .,;,,.
Approval Status'
4 Apploved ❑, Disapproved
Alarm Audible % Yes ❑ No
Alarm Visible 0 Yes ❑ No
2246 - Megen MCBrice
`Operation Permit completed1t1pbfy:�/-_�t�t -
Authorized State Agent: Y' W!�(A/l�t— V J/—W
Date of Issue: 0 5/ a 0/ a 0 0 9
This system has been installed in compliance with applicable NC General Statutes Article 11, Chapter 130A, Rules for
Sewage Treatment and Disposal, 15A NCAC 18A .1900 et. Seq., and all conditions of the Improvement Permit and
Construction Authorization. This property is served by a TYPE III B sewage septic system.
Rule .1961 requires that a Type TYPE III B septic system meet the following criteria:
Minimum System Review By The Local Health Department. 5 YRS.
Management Entity: OWNER
Minimum System Inspection/Maintenance Frequency By Certified Operator:
NIA
Reporting Frequency By Certified Operator: NSA
Rule .1961 requires that a Type IV and V septic systems designed for a home/business owner must maintain a valid contract
with a public management entity with a certified operator or a private certified operator for the life of the septic system.
Rule .1961 requires that Type VI septic systems designed for a home/business owner must maintain a valid contract with a
public management entity with a certified operator for the life of the septic system.
Rule. 1961 (2) (e) requires a contract shall be executed between the system owner and a management entity prior to the
Issuance of an Operation Permit for a system required to be maintained by a public or private management entity, unless the
system owner and certified operator are the same. The contract shall require specific requirements for maintenance and
operation, responsibilities of the owner and systems operator, provisions that the contract shall be in effect for as long as the
system Is in use, and other requirements for the continued proper performance of the system. It shall also be a condition of
the Operation Permit that subsequent owners of the systems execute such a contract.
iN Hand Drawing O Import Drawing
**Site Plan/Drawing attached.**
Total Time:(HH:MM)
0 0 Hours 0 0 Minutes
Page 3 of 4
CDP File Number: 24295
Drawing Type: Operational Permit
Drawin
4 'ZNSPcdJ
T"Ks,%vgki�ivL,
3Jj0JO —JAW
( Ck"�,rcvd
�Av�,k -t
5`t�lo°1
Qressu.�
Nor
County File Number: WLS2008-00663
Date: 0 5/ x 0 / x 0 0 9
0Inch
Scale: 0Block = ft.
N/A
e o'
loo' SI
lo°'
reel°
Y
a
Page 4 of 4
scQh�
Tank
\I