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HomeMy WebLinkAboutRBPR-07-2013-17731.TIFTHIS IS NOT A PERMIT Case # RBPR-07-2013-17731 CATAWBA COUNTY HEALTH DEPARTMENT PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES Residential Building Plan Review - Deck/Porch IMPROVEMENT Contractor JAMES SWANSON, P. O. BOX 593, HILDEBRAN NC 28637 C:828-612-1605 Owner ERIC LIECK, 2161 STERLING RIDGE DR, NEWTON NC 28658 H:828-606-9190 HOME: 828-606-9190 NAME TO APPEAR ON PERMIT Eric Lieck SITE ADDRESS: 2161 STERLING RIDGE DR, NEWTON NC 28658 NAME of SUBDIVISION: STERLING RIDGE PIN # 364917110417 Lot # 31 Section/Block PROPERTY SIZE: Square Feet Acres 0.55 DIRECTIONS: Left before Hwy Patrol Station on 321, turn right at 2nd rd, 4th house on right PRIMARY CONTACT: Contractor SEWER TYPE: Septic Tank GALLONS PER DAY: 360 WATER SUPPLY : Public Water DESCRIBE WORK: 16x20 deck no ele" Needs Newton zoning b4 bld permit 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? APPLICATION FOR: New Structure STRUCTURE TYPE: PRIMARY RESIDENCE FACILITY TYPE: Single Family Residence OTHER DESCRIPTION: DESCRIPTION OF single family dwelling EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: 70x30 NUMBER OF EXISTING BEDROOMS: 3 # OF OCCUPANTS: 2 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 16x20 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 accessible so that WcoS plete site evaluation can be performed. Date: ��71; 3 Signature of Applicant or Age —An Environmental Health Specialist will contact you thin 2 workingof application date. If you need further information or assistance please call 828-466-7291 AREA1 FI - ehapplicatio❑ 07/25/2013 13:13 Page 1 of 4 �ypA CATAWBA COUNTY Case # Public Health Department Subdivision Environmental Health Division PIN# Q v tea► PO Box 389, 100-A Southwest Blvd, Newton, NC 28658 Ig 2 NAME ON PERMIT: ERIC LIECK, 2161 STERLING RIDGE DR, NEWTON NC 28658 Site Address: 2161 STERLING RIDGE DR, NEWTON NC 28658 Property Size: Square Feet Acres 0.55 Directions: Left before Hwy Patrol Station on 321, turn right at 2nd rd, 4th house on right MINIMUM SETBACKS FRONT: SIDE: REAR: FEENAME Improvement Permit (Existing) Fee TOTAL FEES RBPR-07-2013-17731 STERLING RIDGE 364917110417 MAX HEIGHT: DATE FEE AMOUNT 07/25/2013 $90.00 $90.00 SYSTEM REDESIGN AND/OR RETRIP WILL INCUR AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) L4 - chapplreatwn 07/25/2013 13:13 Page 2 of THIS IS NOT A PERMIT COUNTY f CATAWBA COUNTY HEALTH DEPARTMENT North Carol V—�Tv_ I�, V Application for Environmental Services �///�jI Page 1 Improvement Permit a 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 El Property Address //o j fr - ). ___) k, rip , R Al (• Driving Directions to Property !` _Tk; , - 'A �. �, • � NAME TO APPEAR ON PERMIT? ❑ Owner ❑ Applicant Applicant Contact Information Subdivision Lot # Acres Section/Block/Phase P, ontractor Name Address g,, u-�— Phone ���. i Z /� o� Cell Phone Owner Contact Information Name �"v /,., �N Address 2/, i S - I r w Phone p -j*_ Zoo 6 5'/ �,o ' I Cell Phone Contractor Contact Information Name � .� -�-, , 5 Address A/ Phone �L�- 3 �i� 3Z ;,� Cell PhoneS— WHO WILL BE THE PRIMARY CONTACT? ❑ Owner ❑ Applicant ❑ Contractor Description of Existing Structures on Site # of Bedrooms *t Structure Dimensions # of Occupants Basement [:]Yes ❑ No Basement Fixtures ❑ Yes ❑ No The Applicant shall notify the local health department upon submittal of this application if any of the following apply to the property in question. If the answer to any question is "yes", applicant must attach supporting documentation. ❑ Yes Cho - Does the site contain any jurisdictional wetlands? `Yes .moo Does the site contain any existing wastewater systems? ❑ Yes 0.11 0_f Is any wastewater going to be generated on the site other than domestic sewage? El Yes 6'No Is the site subject to approval by any other public agency? ❑ Yes 0 -N -o Are there any easements or right of ways on this property? Describe Existing water supply in use ❑ Individual Well ❑ Community Well ❑ Semi -Public Well �my/City/Township Water Line Is a public water supply available? ** ❑ Yes ❑ 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) 0 Accepted 13 Alternative ❑ Conventional ❑ Innovative 13 Other 0 Any CATA �j BA THIS IS NOT A PERMIT Cou, TI ��Y CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services Proposed Facility Type ❑ Primary Residence ❑ New Residence ©Ad t iod n to Residence # of New Bedrooms *t Project Description I6 4 x.p 9-1 Structure Dimensions # of Occupants Basement ❑ Yes �o Basement Fixtures ❑ Yes [9 -N -T ❑ Accessory Structure(s) Describe # of New Bedrooms *f if applicable Structure Dimensions # of Occupants Accessory Dwelling ❑ Yes [:]No Plumbing ❑ Yes �o� Describe Plumbing Needed U Multi -Family Residence # Units #Bedrooms per Unit*t Total # Bedrooms *'I Structure Dimensions U Food Service Specify Type X./ ,/I # Seats Floor Space -Entire Food Service Facility (Sq Ft) # Employees per Shift # of Shifts Dining Area (Sq. Ft.) ❑ Business Specific Type of Business Retail Floor Space # 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/Abandonment/Repair Proposed Well Type ❑ Individual Well ❑ Semi -Public Well ❑ Community Well Abandonment Type ❑ Drilled ❑ Bored ❑ Dug ❑ Unknown Well Repair Requested ❑ Yes ❑ No Describe Page 2 Calculated Design Flow, Commercial t 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 pen -nit issuance. This may prevent the need for septic system size increase in the future. T 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. SYSTEM REDESIGN AND/OR RETRIP WILL INCUR AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) 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. 1 understand that I am solely responsible for the proper identification and labeling of all property lines and corners and making the site accessible so that a complete site evaluation can be performed. Signature of Owner or Agent % ,M.�- Date ?— 2-5--13 Printed Name of Owner or Agent .,} r,► ; J( M Catawba County, North Carolina This map product was prepared from the Catawba County, NC, Geospatial Information System. N Catawba County has made substantial efforts to ensure the accuracy of location and labeling infonmation contained on this map. Catawba County promotes and recommends the independent 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 hability, 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: 3649-17-11-0417 I inch = 40 feet i 30 N\ O '1 ILAL VV ,` 1 V ! %J �' THIS IS NOT A LEGAL DOCUMENT I I i �y 2149 959&- 247 , 40 04' 33 Prepared for: I I � au **W i 1173 0357' I y C m Date. 7/25/2013 Time:1:02:17,;PM 11f � CATAWBA COUNTY NC - Parcel Report Information Regarding Selected Parcel(s) Parcel ID: 3549-17-11-0417 Name: CRISCI GIOVANNAA Name2: Address: 2161 STERLING RIDGE DR Address2: City; NEWTON State: NC Zip: 28658-8949 Account: Calc Acreage: 0.55 Tax Map: LRK: 903275 Deed Book: 3037 Deed Page: 1571 Subdivision Name: STERLING RIDGE Subdivision Block: Lots: 31 Plat Book: 56 Plat Page: 131 Building Number: 2161 Street Name: STERLING RIDGE DR Site Zip: 28658 Township: NEWTON Fire Dist: City/Tax: NEWTON State Road: Total Bldgs Value: $86,600 Land Value: $17,100 Total Value: $103,700 Year Built: 2003 Year Remodeled: Last Sale Date: 8/17/2010 Last Sale Amount: $100,000 Neighborhood: 113 Watershed: Watershed Split: NO Voter Precinct: P32 E911 District: NEWTON Zoning: R-20A Zoning2: Zoning3: Zoning Split: N Zoning Overlay: Zoning District: NEWTON 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: 011601 Census Block 2010: 1031 Small Area Plan: Agricultural District: Printed: Thursday, July 25, 2013 01:00 PM CATAWBA COMYT HEALTH DEPARTMENT � F� Tele ne: (828) 465-827 TDD: (828) 465 8200 WLS # d60 ,00910 IP AC Rpr, m ., fir, Print. Sys. Type Well Print.—Replacament Well Well Rpr. Print. Owner/Ag nt �11 t al /1 F+/�i+x,`�,�L.9 Phone Subdivision Address L-U�lttlUt�`( tai Section/Block/Phase LdL Lot Size 65 Directions: .S L) __5 ^y eP64i ;fit Cc:t� Ok. r�S hf Property Address1% I �S�e-r fel %%� Facility: House Mobile Home 13usiness Multi -family . Other. Pin Number 53.5gje, 40 -?1/ `Uy% Other Zoning Approval # jV4A,J1-e # Bedrooms # Seats Employees . Application Rate , :35 GPD Flow 51 Hot Tub or Spa yes/no Special Fixtures Basement yes/&) 100% Repair Area/If s/no Basement Plumbing yes/no Water Supply: Private Well Publie'� Semi -Public Type of System: Trench Bed Pump Pump/Panel Panel LPP r �S 20'Sl c2Pel . rttL Septic Tank Size o0 S 4 j Pump Tank Size Nitrification Field: Total Square Feet 103L) Depth of Stone k)111 -- Bed Size Trench Width J k Total Length of All Trenches 3y5 Number of Trenches S" Trench Length l q6 / !(I�/� Feet on Center C%( Maximum Trench Depth dl -1--J Distance of Nearest Well (O *DO NOT INSTALL SEPTIC TVHEN WET* -WELL RECORD REQUIRED AT COMPLETION* Topo 21—Y % Slope Texture Structure (L- } (? R Clay Min. ! Soil Wetness /� 5 SoilDepth 7 4 sf Restric. Hoz, at I Available spacSu no j Overall Class I 2 4 7- y a Comments: I I -r) I ��� I I I , I — Filter Required (0� Riser required when tank is more than 6 inches deep. I **NO GUARANTEE OR WARRANTY IS IMPLIED OR GIVEN AS TO THE PERFORMANCE OR LENGTH OF TIME THIS SYSTEM WILL FUNCTION" *Improvement Permit has no expiration date and is transferable, but may be revoked if site plans or intended use changes for the proposed facility. An Authorization to Construct is valid for (5) five years from date issued and is not transferable, Well Permit valid for 5 years provided site conditions do not change. Well location, installation, and protection must meet state and local regulations, and must be inspected and approved by a representative of the Catawba County Health Departittent before an - portion of the installation is put into use. The siting of the well by the Health Department staff is to provide protection from known ssible s. urces of contamination. No volume of water is guaranteed at any site by the Health Department. Permit Date EIHS .� OwnerlAgent /�y �;,, t;r Septic Tank Installed Y /}i1lL t= 46 tiers, ✓s,d �N�4L Date/0 -.?J -al EHS .f _ Well Installed By Well Grout Approval Date Well Head Approval Date Date Sample Collected Date of Results Results EHS White - office Yolow - o net/,\gees Piny. - BWidin„ t'dSj7CCSlOi1 AU4t1URZ 1hh11 LU CORSINCt OPERATION PERMIT / For Office Use Only Catawba County Public Health Department 'CDP File Number 3 3 8 0 3 Environmental Health Division wLS2009-00486 P.0 Box 389, 100-A Southwest Blvd County ID Number: �,'''=J• S � ' Newton NC 28658 valuated For. REPAIR Phone: (828)-465-8270 Fax: (828) 465-8276 \ Applicant: PHILLIP MINGUS _N\� //,Property Owner: PHILLIPS B MINGUS Address: 2161 STERLING RIDGE DR Address: 2474 CEDAR VALLEY DR City: NEWTON City: CONOVER State/Zip: NC 28658 State/Zip: NC 28613-832 i \ Phone #: \Rhone #: / \ Property Location & Site Information �^ Address/Road #: Subdivision: STERLING RIDGE Phase: Lot: 31 "fl 2161 STERLING RIDGE DR s NEWTON NC Directions Structure: MOBILE HOME HWY 321 S - LEFT SMYRE FARM RD - RIGHT STERLING RIDGE DR - 4TH LOT ON RIGHT # of Bedrooms: 4 # of People: 2 \ 'Water Supply: PUBLIC / "IP Issued by: "System Classification/Description: TYPE III G. OTHER NON-CONY. TRENCH SYSTEMS `CA Issued by: 1439 - Cash, Mike Design Flow: 4 8 0 Distribution Type-,GRAVITY - SERIAL Soil Application Rate: 0 3 5 "Pre-Treatment: Drain field 46L4 wa4 o.1W 4o exis4jnA_s Nitrification Field Sq. ft' `System Type: EZFLow EZ 1003T No. Drain Lines 1 Installer: 1st Choice Septic & Landscaping Total Trench Length: 5 0 ft. Certification #: 1879 Trench Spacing: _ g Inches O.C.Feet O.C. 'EHS: 2246 - Megen McBride Trench Width: 3 Olnches – Q Feet Aggregate Depth: inches Minimum Trench Depth; Inches —_ Minimum Soil Cover: Inches Approval Status Maximum Trench Depth: 3 Inches ® Approved ❑ Disapproved Maximum Soil Cover: 1 8 Inches k.;Ur rile Numoer uounty lu Ivumoer: _. Septic.Tank .._ Manufacturer: 'Dellinger Lat. STB: 794 Long: Gallons: 1909 Installer: 1st Choice Septic Date: 1 0/ 0 a a 0 0 8 Certification #: 1879 'Filter Brand: POLYLOK PL -68 `EHS: 2246 - Megen McBride ST Marker: ❑ Yes ❑ NO Approval Status Reinforced Tank: EJYes ElNO Approved ElDisapproved / K�,P\ iece Tank: ❑ Yes ❑ NO / Tank _ Manufacturer: _ _Pump Installer: PT: Certification #: Gallons: `EHS: Date: Approval Status Riser Sealed ❑ Yes ❑ NO ❑ Approved ❑ Disapproved Riser Height: ❑ Yes ❑ No (Min. 6 in.) Reinforced Tank: El Yes El No 1 Piece Tank: ❑ Yes -1 NO Supply Line Pipe Size: _ _ inch diameter Installer: Pipe Length: feet Certification #: "Schedule: 'EHS: Pressure Rated ❑ Yes ❑ NO Approval Status Approved fittings ❑ Yes ❑ No ❑ Approved ❑ Disapproved Pump Requirement / Pump Type: / Installer: Dosing Volume: - Gal Certification #: Draw Down: Inches "EHS: 'Chain: Approval Status Valves Accessible ❑ Yes ❑ No ❑ Approved ❑ Disapproved Plow Adjustment Valve ❑ Yes ❑ NO Check -valve ❑ Yes ❑ No PVC Unions ❑ Yes ❑ No Vent Hole ❑ Yes ❑ No Anti -siphon Hole El Yes ❑ NO / CDP File Number J00VJ NEMA 4X Box or Equivalent Box 12 inches Above Grade Box Adj. To Pump Tank Conduit Sealed Pump Manually Operable 'Activation Method: County ID Number: ----- Electric Equipment ❑ Yes ❑ No Installer: ❑ Yes ❑ No Certification #: ❑ Yes ❑ No ❑ Yes ❑ No *EHS: ❑ Yes ❑ No Approval Status ❑ Approved ❑ Disapproved Alarm Audible ❑ Yes ❑ NO Alarm Visible ❑ Yes ❑ No 2246 - Megen McBride `Operation Permit completed ba: Authorized State Agent: —�'r Date of Issue: 0 8/ 3 1/.1 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 1 BA .1900 et. Seq., and all conditions of the Improvement Permit and Construction Authorization. This property is served by a TYPE iii G. sewage septic system. Rule .1961 requires that a Type TYPE iii G. septic system meet the following criteria: Minimum System Review By The Local Health Department: NIA Management Entity: OWNER Minimum System Inspection/Maintenance Frequency By Certified Operator: NIA Reporting Frequency By Certified Operator: NIA 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. (S,Hand Drawing Qlmport Drawing **Site Plan/Drawing attached.** Total Time:(HH:MM) 0 0 Hours 0 0 Minutes CDP File Number: 33803 Drawing Type: Operational Permit Drawing S�s4p-v ► hs4c IW t +ws �er}cd I)raP 16 ns were vSJ County File Number: wLs2009-00486 Date: 0 8/ 3 1/ 0 0 9 Q Inch Scale: 0 Block Q NIA C61°t 2001, Sher titno� R�do�2 D'r• gjrc�es Se 9 hem 4t�\ 6\ is EZ Flow w ' CONSTRUCTION For Office Use Only 1 �� AUTHORIZATION `CDP File Number 3 3 8 0 3 % ,,j ti Catawba County Public Health Department County ID Number: WLS2009-00486 I � Environmental Health Division Evaluated For: REPAIR �!�•.� �.J;''~' P.O Box 389, 100-A Southwest Blvd PERMIT VALID UNTIL: Newton NC 28658 0 7/ a 8% a 0 1 4 Phone: (828)-465-8270 Fax: (828) 465-82766 Applicant: PHILLIP MINGUS / Property Owner: PHILLIPS B MINGUSD Oe Sc - Address: 2161 STERLING RIDGE DR Address: 2474 CEDAR VALLEY DR City: NEWTON State/Zip: NC Phone #: dress/Road M 2161 STERLING RIDGE DR NEWTON NC Structu re: # of Bedrooms: # of People: 'Water Supply: City: CONOVER 28658 ! State/Zip: NC // hone #: Propertv Location& Site Information MOBILE HOME 4 2 PUBLIC r*Sitesification: ( Design Flow: 0 4 8 0 28613-8321 Subdivision: STERLING RIDGE Phase: Lot: 31 1 Directions HWY 321 S - LEFT SMYRE FARM RD - RIGHT STERLING RIDGE DR - 4TH LOT ON RIGHT S.ystetn 5pecitications Minimum Trench Depth: 1 8 Inches Minimum Soil Cover: 6 r Inches Maximum Trench Depth: a 4 Inches Soil Application Rate. 03 Maximum Soil 5 MiSil C 1 a Inches *System Classification/Description: *Distribution Type: GRAVITY • SERIAL TYPE III G. OTHER NON•CONV. TRENCH SYSTEMS Septic Tank: 1 0 0 0 Gallons *Proposed System: 25% REDUCTION 1 -Piece: ® Yes O No Nitrification Field1 0 3 1 Sq. ft.Pump Required: ()Yes ONo O May Be Required No. Drain Lines Total Trench Length: Trench Spacing: Trench Width: \Aggregate Depth: Pump Tank. Gallons 6 1-Piece:OYes QNo 3 4 3 ft. GPM --vs-- ft. TDH 9 Qlnches O.C. *Feet O.C. Dosing Volume: Gallons 8 Inches — 3 0 Feet Grease Trap: Gallons inches Pre -Treatment: O NSF OTS -I OTS -II Septic Tank Installer Grade Level Required: OI ®ll 0111 OIV / Page 1 of 3 ' CDP File Number 33803 County ID Number: WLS2009-00486 Repair Svstem Reauired:©Yes O No ONo. but has Available S /Repair Svstem *Site Classification: S Design Flow: 4 8 0 Soil Application Rate: 3 5 *System Classification/Description: TYPE III B. SYSTEM WISINGLE EFFLUENT PUMP `Proposed System: 25% REDUCTION Nitrification Field No. Drain Lines Total Trench Length: 1 0 3 Sq. ft. 5 1 8 Inches Minimum Soil Cover: 3 4 3 ft ❑ Open Pump -System Sheet Trench Spacing: — 9 Inches O., i Feet O.C. Trench Width: Inches 3 . 4 Feet Aggregate Depth: inches Minimum Trench Depth: 1 8 Inches Minimum Soil Cover: 6 Inches Maximum Trench Depth: a 4 Inches Maximum Soil Cover: 1 Inches *Distribution Type: PRESSURE MANIFOLD Pump Required: *Yes ONo O May Be Required Pre -Treatment: O NSF OTS -1 OTS -II *Site Modifications No grading or construction activity is allowed in areas designated for system and repair without approval of Health Department. Existing septic tank shall be properly abandoned and a new 1000 gallon tank set greater then or equal to 10' from newly marked property lines. New line is to be installed below lowest existing line. Portion of existing system extending to and beyond property line must be disconnected or abandoned to greater then 5' from existing (new) property line as marked. New serial distribution or distribution boxes are to be installed as appropriate. System to contain (6) 57' lines. "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. Preconstruction Conference with septic system installer is required. This Authorization for Wastewater System Construction shall be valid for a person equal to the period of vaiicilty of the Improvement Permit, not to exceed five years, and may be Issued at the same time the Improvement Permit Issued (NCGS 130A336(b)). If the installation has not been completed during the period of validity of the Construction Penult, 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 (.1 937(g)). 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 Requir ?/j*Yes /YO] No Applicant/Legal Reps. Signaturf- / v G' t� Date: G 9 *Issued By: 1439 -Cash. Mike Date of Issue: 0 7� a 8 a 0 0 9 Authorized State Agent: Malfunction Log OYes *Hand Drawing Olmport Drawing Total Time:(HH:MM) **Site Plan/Drawing attached.** Pana 9.nf l Hours Minutes CDP File Numher: 33803 Drawing Type: Construction Authorization Drawing, County ID Number: W1.S2409-04486 Date: 0 7/ a 8 / a 0 0 9 *Inch Scale: 1 QBlock = 5 ft. QN/A rZ 54.I1'Ai Page 3 of 3