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HomeMy WebLinkAboutRBPR-07-2015-21969.TIFApplicant THIS IS NOT A PERMIT Case # RBPR-07-2015-21969 CATAWBA COUNTY HEALTH DEPARTMENT PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES Residential Building Plan Review - Manufactured Home WPROVEMENT TODD KRAFT, 7784 SKYLINE DR, SHERRILLS FORD NC 38673 C:704-308-0264 Owner TODD KRAFT, 7784 SKYLINE DR, SHERRILLS FORD NC 28673 C:704-308-0264 NAME TO APPEAR ON PERMIT Todd Kraft SITE ADDRESS: 7784 SKYLINE DR, SHERRILLS FORD NC 28673 PIN # 460604736971 NAME of SUBDIVISION: MOBILE HOME ESTATE Lot 8 49 Secuon/Block PROPERTYSIZE: Square Feet Acres 045 DIRECTIONS: Slanting Bridge / Wildlife Ln/ Skyline Dr/ 2nd on right PRIMARY CONTACT: Owner SEWER TYPE: Septic Tank GALLONS PER DAY: 240 WATER SUPPLY: Private Well -, DESCRIBE WORK evised.8645fr5—unanging o 2 bedroom Modular 28x58 w/ front & rear decks WALK THROUGH (/jRREQUIRED BY MC TO VERIFY BEDROOMS` replacing SW Mobile with DW mobile home 28 x 65 SITE INFORMATIAN Do any of the following apply to the property for which this application is applied9 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: PRIMARY RESIDENCE FACILITY TYPE: Mobile Home OTHER DESCRIPTION: DESCRIPTION OF Double wide modular EXISTING STRUCTURES ON SITE (IF ANY DIM EXISTING STRUCTURE: 14 x 60 NUMBER OF EXISTING BEDROOMS: # OF OCCUPANTS: PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: Ax 58 w/ front deck 8x12, back deck 12x58 # OF NEW BEDROOMS:: U2 Desired system types (Improvement Permit or Authorization to Construct). ACCEPTED ALTERNATIVE CONVENTIONAL, OTHER INNOVATIVE ANY YES Other described: F9 - dwpphu[ wn 01/21/2016 16 03 Page 1 of 4 A CATAWBA COUNTS' Case # RBPR-07-2015-21969 . $ Public I lealth Department Subdivision MOBILE HOME ESTATE Environmental I lealth Division PIN# 460604736971 PO Boa 389. 100-A Southwest BIN d, Newton. NC 28653 Ig �� NAME ON PERMIT: ( TODD KRAFT), 7784 SKYLINE DR, SHERRILLS FORD NC 28673 ( Todd Kraft) Site Address: 7784 SKYLINE DR, SHERRILLS FORD NC 28673 Property Size: Square Feet Acres 0.45 Directions: Slanting Bridge / Wildlife Ln/ Skyline Dr/ 2nd on right 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 that a complete site'g,`aluahon can be performed. Date: / / —,-30 /(o Signature of Applicant or Agent 4 � An Environmental Health Specialist will contact you within 5 working days of application date. If you need further information or assistance please call 828-466-729 t AREA1 ,., FEENAME' DATE ' ; FEE"AMOUNT- Authorization to Construct Fee (New/Expansion) 07/17/2015 $300.00 Fee Improvement Permit Fee 07/17/2015 $15000 ;TOTAL FEES . 011$456.00 FEES ARE NON—REFUNDABLE ONCE A SITE VISIT IS MADE OR WORK ON A PLAN REVIEW HAS COMMENCED SYSTEM REDESIGN AND/OR RETRIP WILL INCUR AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) I,) - ehapP! i, .ii n m 01/21/2016 16 03 Page 2 of 4 Applicant THIS IS NOT A PERMIT Case # RBPR-07-201 -21969 CATAWBA COUNTY HEALTH DEPARTMENT PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES Residential Building Plan Review - Manufactured Home IMPROVEMENT - AUTH CONST - EXPANSION TODD KRAFT, 7784 SKYLINE DR, SHERRILLS FORD NC 28673 (2:704-308-0264 Owner TODD KRAFT, 7784 SKYLINE DR, SHERRILLS FORD NC 28673 C:704-308-0364 NAME TO APPEAR ON PERMIT Todd Kraft SITE ADDRESS: 7784 SKYLINE DR, SHERRILLS FORD NC 28673 PIN # 460604736971 NAME of SUBDIVISION: MOBILE HOME ESTATE Lot # 49 Section/Block PROPERTY SIZE: Square Feet Acres 045 DIRECTIONS: Slanting Bridge / Wildlife Ln/ Skyline Dr/ 2nd on right PRIMARY CONTACT: Owner SEWER TYPE: Septic Tank GALLONS PER DA _ WATER SUPPLY: Private Well DESCRIBE WORKRevised 8/15/15 - Changing to 2 Bedroom Modular 28x58 v / front & rear decks: WALK THROUGH REQUIRED BY MC TO VERIFY BEDROOMS* replacing SW Mobile with DW mobile home 28 x 65 SITE INFORMATION Do any of the following apply to the property for which this application is applied9 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: STRUCTURE TYPE: New Structure PRIMARY RESIDENCE FACILITY TYPE: Mobile Home OTHER DESCRIPTION: DESCRIPTION OF Double wide modular EXISTING STRUCTURES ON SITE (IF ANY DIM EXISTING STRUCTURE: 14 x 60 NUMBER OF EXISTING BEDROOMS: # OF OCCUPANTS: CONVENTIONAL ANY YES lig- chaPpliCHw,n 08/18/2015 11 35 Page I of PROPOSED CONSTRUCTION NEW STRUCTURE DIM:(__L8 _ x 58 w/ front deck 8x12, back deck 12x58 # OF NEW BEDROO Desired system types (Improvement Permit or Authorization to Construct)' ACCEPTED ALTERNATIVE, OTHER INNOVATIVE Other described. CONVENTIONAL ANY YES lig- chaPpliCHw,n 08/18/2015 11 35 Page I of CATAWBA COUNTY Case n Subdivision RBPR-07-2015-21969 (18 Public Health Department MOBILE HOME ESTATE i�` Environmental He:dth DivisionPIN# 460604736971 PO Bov 389, 100-A Southwest Biv(L Newton. NC 28658 NAME ON PERMIT: ( TODD KRAFT), 7784 SKYLINE DR, SHERRILLS FORD NC 28673 ( Todd Kraft) Site Address: 7784 SKYLINE DR, SHERRILLS FORD NC 28673 Property Size: Square Feet Acres 045 Directions: Slanting Bridge / Wildlife Ln/ Skyline Dr/ 2nd on right 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 unders>ad­trarI>nn solely responsible for the proper identification and labeling of all property lines and corners and making the site acces,uation can be performed Date. rim— (�" / ,� Signature of Applicant or Agent Ute( An Environmental Health Specialist will contact you within5 v5 orking days of application date. If you need further information or assistance please call 828-466-7291 AREA1 1f Illlll+l"in10� nlf 6un,l., II a,. i• FEENAME .;;!!IJ�IU l'..;,; .. t..,.,... !r.J 1I:il.?DATE :JIIII'''LiFEE�AMOUNT�'1� Authorization to Construct Fee (New/Expansion) 07/17/2015 $300.00 Fee Improvement Permit Fee 07/17/2015 $150.00 s.r, IitiJ" 0 1 �• 1qqq,'j��� f ,.i;t!ti't,1' tl�,TOTALIEES, du$450.00l;« ...:��f�,Ja ul11 L:JaIJIiiiLpwm urt.i,i•..�t,,,.,,,i{„„ry�WWCL.,HI!.IIIBII§Itl!n�J.!WN'. ,LIp,,,,,a,u�.,.I ^fi _�....,.,,,� FEES ARE NON-REFUNDABLE ONCE A SITE VISIT IS MADE OR WORK ON A PLAN REVIEW HAS COMMENCED SYSTEM REDESIGN ANDIOR RETRIP WILL INCUR AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) F-9 - ehapphc,pian 08/18/2015 1135 Page 2 of 4 D ©v I r `15rn� 5ris! a 2 (1 M q N li moo"LIGHT BAY d w•"•�. C"i:. :/n=ee-.,�?'omm��`-rrd ROAD \® ED - _ - t,+'.',�OLD P. e?s • , I `\ v` s.'i�e / `.�. I p •� sa2 It q.�. IF 31 Is' ( ' esus ° ° � wry, o � �� •` s �� �, ^ �`.""\ r +J` __ r : Pe i y o \\ s '� 39 40 / 41 ,... r—'•,,,I i ,�', �- e b)+. s ; �: _ .: ,; !. _tel c rte.. �\sr;. ° Y%j� a /�� (� /AA POR TION (� 0 F/±�a /✓\®f6 ILIZ 9409\. 1� bsJ�Q� � Z \ ' ejas551 1 • 24 c� e \ ea Oil• \\ a PROPERTY OF .� r —Za S 2\, •:'\ A-& B. REALTY COMPANY MOUNTAIN CREEK TWSP CATAWBA CO, NC •,C'., ) " SCALE I"=100 OCTOBER 3,1963 • -KEITH H NOEH- i \ a„ xc. xeOIITcisr L -IT suave rox HE 111 sr, I..HL.TIE, H I . TO II.H. 1 / .. ��i..wwta• c� 61., .[ .e.µe` : —. u,�` eFi ^'e• �Y �. us n.6..q �T i1' --Fl-'^' TFC/l .. 1?-., Applicant 'PHIS IS NOTA PERMIT Case # R13PR-07-2015-21969 CATAWBACOUNTY HEALI'H DEPARTMENT PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES Residential Building Plan Review - Manufactured Home IMPROVEMENT - AUTH CONST - EXPANSION TODD KRAFT, 7784 SKYLINE DR, SHERRILLS FORD NC 28673 0:704-308-0264 Owner TODD KRAFT, 7784 SKYLINE DR, SHERRILLS FORD NC 28673 (':704-308-0264 NAME TO APPEAR ON PERMIT Todd Kraft SITE ADDRESS: 7784 SKYLINE DR, SHERRILLS FORD NC 28673 PIN # 460604736971 NAME of SUBDIVISION: MOBILE HOME ESTATE 49 Lot ft Section"Block _ PROPERTY SIZE: Square Feel Acres 0.45 DIRECTIONS: Slanting Bridge 1 Wildlife Ln! Skyline DO 2nd on right PRIMARY CONTACT: Owner SEWER TYPE: Septic Tank GALLONS PER DAY: 480 WATER SUPPLY : Private Well DESCRIBE WORM: replacing SW Mobile with DW mobile home 28 x 65 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? jUri APPLICATION FOR: New Structure STRUCTURE TYPE: PRIMARY RESIDENCE FACILITY TYPE: Mobile Home OTHER DESCRIPTION: DESCRIPTION OF I singlewide mobile home EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: 14 x 60 NUMBER OF EXISTING BEDROOMS: # OF OCCUPANTS: PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 28 x 65 # OF NEW BEDROOMS:: 4 Desired system types (Improvement Permit or Authorization to Construct): ACCEPTED: ALTERNATIVE: CONVENTIONAL.: OTHER: INNOVATIVE ANY YES Other described: E9 - chapplicanon 07/17J2015 14:05 Page 1 of 4 SeA CATAWBA COUNTY Case # R.BPI2-07-2015-21969 T Public Ilealth Department MOBILE HOME ESTATE F, 1. Subdivision Environmental Health Division PIN# 460604736971 PO Box 389, 100-A Southwest Blvd, Newton, NC 28658 t 2 su NAME ON PERMIT: ( TODD KRAFT), 7784 SKYLINE DR, SHERRILLS FORDNC 28673 ( Todd Kraft) Site Address: 7784 SKYLINE DR, SHFRRILLS FORD NC 28673 Property Size: Square Fect Acres 0.45 Directions: Slanting Bridge / Wildlife Ln/ Skyline DO 2nd on right 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 andrulesI understanYrj,fh/�t I am solely responsible for the proper identification and Labeling of all p erty Tines and comers and making the site accessi I ��ite e—huation car be performed Date: %/7—/� SignatureofApplicantorAgent An Frivironmental Health Specialist will contact you within 5 working days of application date. If you need further information or assistance please call 828-466-7291 AREA1 FFENAME DATE FEE. AMOUNT Authorization to Construct Fee (New/Expansion) 07/17/2015 $300.00 Fee Improvement Permit Fee 07/17/2015 $150.00 TOTAL FEES $450.00 FEES ARE NON-REFUNDABLE ONCE A SITE VISIT 1S MADE OR WORK ON A PLAN REVIEW HAS COMMENCED SYSTEM REDESIGN AND/OR RETRIP WILL INCUR AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) E9 - ehapphcavon 07/17/2015 14 05 Page 2 of 4 .1' .7� V IB THIS I5 NOT A PERI�FZT CATANVBA COUNTY HEALTH DEPARTMENT Application lar Environmental Services Page I Improvement Permit ❑ Authorization to Construct;] Septic Repair ❑ Septic Nlalfunction ❑ Septic ltspansion New Well Permit I'] Replacement Well ❑ Well Abandonment ❑ Well Repair ❑ Existing System Inspection (Pre -Approval Required) ❑ Application is for New Construction El Existing Facility ❑ Property Address �L/ (�/ _ %r'n !//1I Subdivision A e,12,2, f iZ � f'04 /Ytr Lot # Acres _ y� ii� { Section/BiocklPbase Driving Directions to Property A14', /(/.r Dh - r, 41L(r i �[L� L_i/-L �YI%- l�4 /fAY CE'.f'��C�r✓ NAXIE TO APPEAR ON PERi1/IT? 0 Onnier ❑ Applicant ❑ Contractor Applicant Contact Information Name rib c r) n 1 Address -7 7 � z/ Phone 7 ( Cell Phone Owner Contact Information Name Address Phone Cell Phone Contractor Contact Liformation ) Name j Address Phone I Cell Phone i WIIO WILL BE THE PRIMARY CON'T'ACT? �wncr ❑ Applicant ❑ Contractor Description ofExisting Structures on Site �y Y (� t# of Bedrooms *-1 �9' �9- Structure Dimensions # of Occupants-2,— Basement ccupants-2,_Basement ❑ Yes L.No Basement Fixtures 'C] Yes No The Applicant sha11 notify the local health department upon submittal of this application if .my of the following apply to the property in question. If the answer to any question is "yes", applicant must attach supporting documentation. 0 Yes 0 No Doe,; the site contain any jurisdictional wetlands:' V' "es R2 No Does the site contain any existing wastewater systems? In Yes P -M Is any wastewater going to be generated on the tate other than domestic sewage? 0 No is the site subject to approval by any other public agency? 0 Yes 0-1'�ro Are there anv casements or right of ways on this property? Describe Existing water supply in use ,� Individual We11 ( Community \Jell ❑ Semi-1'ublic Well ❑ County/City/Township Water Line Is a public water supply available? 'r"' ❑ Yes NNo If . _ ; d Improvement Permiotrization to Construct, - If applying for an I p strnct, Please Indicate Desired System Type(s): stew can be rant in order of your preference) ❑ Accepted Cl Alternative 0 Conventional 0 Innovative 0 Other d Any ATA & THIS IS NOT A PERMIT couxT3 YV CATAWBA COUNTY HEALTH DEPARTMENT Application for Enviromnental Services Page 2 Proposed Facility Type ❑ Primary Residence 9f New Residence ❑ Addition to Residence # of New Bedrooms *t Project Description J x)& It %%nom eylo O/V beorvT— /d Structure Dimensions 'R X 6C # of Occupants 2 Basement ❑ Yes 54 No Basement Fixtures ® Yes ® No ❑ Accessory Structure(s) Describe # of New Bedrooms *T if applicable Structure Dimensions # of Occupants Accessory Dwelling ❑ Yes ❑ No Plumbing ❑ Yes ❑ No Describe Plumbing Needed ❑ Dlulti-Family Residence # Utrits #Bedrooms per Unit*j Total # Bedrooms *t Structure Dimensions ❑ Food Service Specify Type # 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 ❑ Serru-Public Well ❑ Community Well Abandonment Type ❑ Drilled ❑ Bored ❑ Dug ❑ Unknown Well Repair Requested ❑ Yes ❑ No Describe Calculated Design Flow, Commercial j 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. 7 If structure is plumbed but no bedrooms, calculated design (low is required. ** If No, a well permit must be issued with the Authorization to Construct. SYSTEM REDESIGN AND/OR RE TRIP 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 deparhncut is valid for (5) five years from the date issued and is not transferable; Improvement Permits and Well Permits are transferrable. Permits maybe 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 comers and making the site accessible so that a complete site evaluation can be performed. Signature of Owner or Agent Date 7'/7',,9-01� Printed Name of Owner or Agent Catawba County Environmental Health Parcel: 460604736971, 7784 SKYLINE DR SHERRILLS FORD, 28673 1 in=50ft This map/report product was prepared from the Catawba County, NC Geospanal Information Services. Catawba County has made substantial efforts to ensure the accuracy of location and labeling information contained on this map or data on this report. Catawba County promotes and recommends the independent verification of any data contained on this map/report 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/report product or the use thereof by any person or entity. Copyright 2014 Catawba County NC 07/17/2015 Parcel Report Parcel Report- Catawba County NC Parcel Information: Parcel ID: 460604736971 Parcel Address: 7784 SKYLINE DR City: SHERRILLS FORD, 28673 LRK(REID): 18159 Deed Book/Page: 3261/1603 Subdivision: MOBILE HOME ESTATE Lots/Block: 49/ Last Sale: Plat Book/Page: 12/39 Legal: LOT 49 PLAT 12-39 Calculated Acreage: .450 Tax Map: 01 7A 02022 Township: MOUNTAIN CREEK State Road #: 1936 Tax/Value Information: Tax Rates(pdf) City Tax District: All in County County Fire District: SHERRILLS FORD Buildings) Value: $0 Land Value: $31,800 Assessed Total Value: $31,800 Year Built/Remodeled: / Current Tax Bill Miscellaneous: Building Permits for this parcel. Building Details Watershed: WS -IV Critical Area Voter Precinct: P41 Parcel Report Data Descriptions List all Owners Deed History Report Owner Information: Owner: GROUT EWA M Owner2: KRAFT TODD Address: 7784 SKYLINE DR Address2: City: SHERRILLS FORD State/Zip: NC 28673-9254 School Information: School District: COUNTY Elementary School: SHERRILLS FORD Middle School: MILL CREEK High School: BANDYS School Map Zoning Information: Zoning District: COUNTY Zoningl: R-30 Zoning2: Zoning3: Zoning Overlay: CRC-O,WP-O Small Area: SHERRILLS FORD Split Zoning Districts: / Zoning Agency Phone Numbers Firm Panel Date: 2007-09-05 Firm Panel #: 3710460600J 2010 Census Block: 4022 2010 Census Tract: 011504 Agricultural District: Assessment Report Page 1 of 1 L ap/report product was prepared from the Catawba County, NC Geospahal Information Services. Catawba County has made substantial efforts to ensure the cy of location and labeling information contained on this map or data on this report Catawba County promotes and recommends the independent verification data contained on this map/report product by the user The County of Catawba, its employees, agents, and personnel, disclaim, and shall not be held liable for d all damages, loss or liability, whether direct, indirect or consequential which arises or may an se from this map/repos product or the use thereof by any or entity © 2015, Catawba County Government, North Carolina. All rights reserved. 17 � S��,cP�.j�rinsrtvl_ $v 6-0 � W http://gis.catawbacountync.go\,/nomap/pareel_report.php?key=460604736971Rtyp=P 7/17/2015 CATAWBA COUNTY HEALTH DEPARTMENT COMPLETION PERMIT FOR SEPTIC TANKS (Ground Absorption Sewage Disposal System — G. S. 130-13C) r OWNER OR CONTRACTOR/ Avim ADDRESS LOCATION -7Z 'el �� J SUBDIVISION NAMF HOUSE (—) MOBILE HOME (-1,' BUSINESS (�) NO. BEDROOMS () NO. BATHROOMS ( ) GARBAGE DISPOSAL UNIT: Yes (—) No (—). SIZE OF TANK v[(Ll Total Gallons NITRIFICATION FIELD Ft. WATER SUPPLY: P P B 1C (—) INSTALLED BY CERTIFICATE OF COMPLETION BY h Lrj DATEINSTALLED PERMIT N° 562 DATE S 9 keel eq ->1 LOT NO. SECTION OR BLOCK No Health Deparrt e HD 2-74 CATAWBA COUNTY HEALTH DEPARTMENT NEWTON, NORTH CAROLINA COMPLETION PERMIT FOR SEPTIC TANKS PERMIT No- 6896 J n DATE: 1/r2 OWNER %!�//�C/ ADDRESS BUILDING CONTRACTORSUBDIVISI0 -IL T LOCATION C� ✓^^ LO 7J�y LOT SIZE BLOCK OR SECTION HOUSE ( ) MOBILE HOME ( ) BUSINESS ( ) OTHER ( ) FHA -VA LOAN ( ) SEPTIC TANK: (SIZE GALS) WATER SUPPLY: NO. BEDROOMS NO FIXTURES INDIVIDUAL PUBLIC GARBAGE DISPb L UNIT:YES (--T7I0 ( ) IF WELL, TYPE: BORED DRILLED DUG AUTO WASHING MACHINE: YES ( ) NO ( ) DISTANCE FROM SEPTIC TANK OR NETREST NITRIFICATION FIELD: SQ.FT. POLLUTION: FT. 1) NUMBER OF LINES SEPTIC TANK INSTALLED BY: 2) LENGTH AND WIDTH OF LINES PERt11T FEE � a) BED SYSTEM ( ) CERTIFICATE OF COMPLETION BY: --b) TRENCH SYSTEM ( ) -- -- 3) DEPTH OF STONE IN LINES REMARKS: ADEQUATE FALL (GRADE) ON: 1) BUILDING (HOUSE) SEWER LINE: YES ( ) NO ( ) 2) NITRIFICATION LINES: DATE INSTALLED: YES ( ) NO ( ) SEPTIC TANK LAYOUT HEALTH DEPARTMENT COPY .1 3