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HomeMy WebLinkAboutRBPR-07-2015-22064.TIFTHIS IS NOT A PERMIT Case # RBPR-07-2015-22064 CATAWBA COUNTY HEALTH DEPARTMENT PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES Residential Building Plan Review - Building New IMPROVEMENT - AUTM CONST - NEW WELL 10 !15 2e ""i-sc d )v q tR kr P -N, bo,% Applicant SAME AS OWNER,, Owner KENNETH JAMISON, 2612 PENNGATE DR, SHERRILLS FORD NC 28673 C:567-395-5972 �10 Paid By BARB JAMISON, 2612 PENNGATE DR, SHERRILLS FORD NC 28673 C�!!�AME n�I t j ph, 1r TO APPEAR ON PERMIT Kenneth Jamison SITE ADDRESS: 9271 BELLE PINES CT, SHERRILLS FORD NC 28673 PIN # 462801269196 NAME of SUBDIVISION: LAKEPOINTE SOUTH Lot # 16 Section/Block PROPERTY SIZE: Square Feet Acres 0.72 DIRECTIONS: 150 to Sherrills Ford Rd to Island Point Rd to Camden Points Rd turn R go to Belle Pines PRIMARY CONTACT: Owner SEWER TYPE: Septic Tank GA ER _ Y:480 WATER SUPPLY: Private Well ESCRIBE WO 10/13/15 changed to 4 BR per Barbara Jamison" Single Family Dwelling with Unfinished walk -out basement I no bonus rooms - attached garage 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? No 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? Yes Property Easements Description: Utility Easement APPLICATION FOR: New Structure STRUCTURE TYPE: PRIMARY RESIDENCE FACILITY TYPE: Single Family Residence OTHER DESCRIPTION: DESCRIPTION OF EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: NUMBER OF EXISTING BEDROOMS: NEW STRUCTURE DIM:: 6 x 54 # OF NEW BEDROOMS:: ( 3l BASEMENT? es # OF OCCUPANTS PROPOSED CONSTRUCTION BASEMENT FIXTURES? Yes Desired system types (Improvement Permit or Authorization to Construct): ACCEPTED: ALTERNATIVE: OTHER: INNOVATIVE: Other described: 2 PLUMBING REQUIRED? Yes CONVENTIONAL: ANY: YES APPLICATION FOR WELL CONSTRUCTION PROPOSED WELL TYPE: Individual Well REPLACE WELL?: NO E9 - chapplication 10/13/2015 09:07 Page 1 of Public Health Department Subdivision L.AKEPOINTE SOUTH Environmental Health Division PIN# 462801269196 PO Box 389, 100-A Southwest Blvd, Newton, NC 28658 w NAME ON PERMIT: ( KENNETH JAMISON), 2612 PENNGATE DR, SHERRI LLS FORD NC 28673 ( Kenneth Jamison) Site Address: 9271 BELLE PINES CT, SHERRILLS FORD NC 28673 Property Size. Square Feet Acres 0.72 Directions: 150 to Sherriils Ford Rd to Island Point Rd to Camden Points Rd turn R go to Belle Pines 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 6y 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. 1 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. l u derstand that I am solely responsible for the proper identification and labeling of all property lines and corners and making the site acce5s*81e so that a c mpiete site evaluation can be performed. Date:%i c" Signature of Applicant or Agent�%f L, An Environmental Health Specialist will contact you within 5 wVrking days of application date. If you need further information or assistance please call 828-466-7291 AREA1 .s :r"•� �A �, DAifE, . ... FlE'J✓"AMt3IINT`:1 Authorization to Construct Fee (New/Expansion) 07131/2015 $150.00 Fee Improvement Permit l=ee 07/31/2015 $150.00 Well Permit & Inspection Fee 0713112015 $300.00 Authorization to Construct Fee (New/Expansion) 10/13/2015 $150.00 Fee TdTAI�. )r EE$ ,.` `r ' . • "$'750.00 . '.°:' :.l..sci�'ro . . yLr. ';+.., x,• . 5 r.1 -rt;,•... • ',i: �: ��• 4 ', 6". `S, t,, s?i.=�.^: v`. • Kis FEES ARE NON-REFUNDABLE H_ E 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) V9 -chappiication 20113/2015 09;07 Page 2 oro PAYOR Jamison, Barbara PAYMENTS TRANSACTION NUMBER: PAYMENT DATE: PAYMENT TYPE: 149630598 INVOICE NUMBER 10-15-321864 CATAWBA COUNTY 100A SOUTHWEST BLVD NEWTON, NORTH CAROLINA 28658 PHONE: 828.465.8399 www.catawbacountync.gov TRC -545 3 89-13 -10-2015 10/13/2015 Credit Card TOTAL PAYMENTS: RBPR-07-2015-22064 FEE NAME Authorization to Construct Fee (New/Expansion) Fee RECEIPT Tuesday, October 13, 2015 FEE AMOUNT $150.00 $150.00 CASE TYPE: Residential Building Plan Review WORK CLASS: Building New SITE ADDRESS: 9271 BELLE PINES CT, SHERRILLS FORD NC 28673 Applicant SAME AS OWNER, , Owner KENNETH JAMISON, 2612 PENNGATE DR, SHERRILLS FORD NC 28673 C:567-395-5972 Paid By BARBARA JAMISON, 2612 PENNGATE DR, SHERRILLS FORD NC 28673 0:8285147551 **NO PEOPLESOFT ACCOUNT ASSIGNED ** receipt 10/13/2015 09:07 Page I of I Applicant THIS IS NOT A PERMIT Case # RBPR-07-2015-22064 CATAWBA COUNTY HEALTH DEPARTMENT PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES Residential Building Plan Review - Building New IMPROVEMENT - AUTH CONST -NEW WELL SAME AS OWNER, Owner KENNETH JAMISON, 2612 PENNGATE DR, SHERRILLS FORD NC 28673 C:567-395-5972 NAME TO APPEAR ON PERMIT Kenneth Jamison SITE ADDRESS: 9271 BELLE PINES CT, SHERRILLS FORD NC 28673 PIN # 462801269196 NAME of SUBDIVISION: LAKEPOINTE SOUTH Lot 16 Section/Block PROPERTY SIZE: Square Feet Acres 0.72 DIRECTIONS: 150 to Sherrills Ford Rd to Island Point Rd to Camden Points Rd turn R go to Belle Pines PRIMARY CONTACT: Owner SEWER TYPE: Septic Tank GALLONS PER DAY: 360 WATER SUPPLY: Private Well DESCRIBE WORK: Single Family Dwelling with Unfinished walk -out basement / no bonus rooms - attached garage 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? No 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? Yes Property Easements Description: Utility Easement APPLICATION FOR: STRUCTURE TYPE: FACILITY TYPE: Single Family Residence DESCRIPTION OF EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: NUMBER OF EXISTING BEDROOMS: New Structure PRIMARY RESIDENCE OTHER DESCRIPTION: # OF OCCUPANTS PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 62 x 54 # OF NEW BEDROOMS:: 3 BASEMENT? Yes BASEMENT FIXTURES? Yes Desired system types (Improvement Permit or Authorization to Construct): ACCEPTED: ALTERNATIVE: OTHER: INNOVATIVE: Other described: 2 PLUMBING REQUIRED? Yes CONVENTIONAL: ANY: YES APPLICATION FOR WELL CONSTRUCTION PROPOSED WELL TYPE: Individual Well REPLACE WELL?: NO E9-ehapplication 07/31/2015 16 13 Page I of CACATAWBA COUNTY Case ti RBPR-07-2015-22064 Public Health Department Subdivision LAKEPOINTE SOUTH Fnvi[onmental Health Division PIN# 462801269196 PO Box 389, 100-A Southwest Blvd, Newton, NC 28658 NAME ON PERMIT: ( KENNETH JAMISON), 2612 PENNGATE DR, SHERRILLS FORD NC 28673 ( Kenneth Jamison) Site Address: 9271 BELLE PINES CT, SHERRILLS FORD NC 28673 Property Size: Square Feet Acres 0'72 Directions: 150 to Sherrills Ford Rd to Island Point Rd to Camden Points Rd turn R go to Belle Pines 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 acces le s9 that a compple� site evaluation can be performed Date'`/i�.3)//5 Signature of Applicant or Agent✓���/J//�',((tti/,drr°�/?i1�SC�i�1 An Environmental Health Specialist will contact you within 5 working days of application date. Ifyou need further information or assistance please call 828-466-7291 AREA1 FEENAME Authorization to Construct Fee (New/Expansion) Fee Improvement Permit Fee Well Permit & Inspection Fee TOTAL FEES 'DATE- FEE -AMOUNT 07/31/2015 $150.00 07/31/2015 $150.00 07/31/2015 $300.00 $600.00 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) E9 - ehapplicahon 07/31/2015 16 13 Page 2 of 4 C;ATAWBA THIS IS NOT A PERMIT COUNTY CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services Page 1 Improvement Permit ® Authorization to Construct ® Septic Repair ❑ Septic Malfunction ❑ Septic Expansion ❑ New Well Permit [,4 Replacement Well ❑ Well Abandonment ❑ Well Repair ❑ Existing System Inspection (Pre -Approval Required) ❑ Application is for New Construction Dd Existing Facility ❑ Property Address ga11 �1'� �t�PS (� Subdivision Sl�erf1li S 'Fafd IJ P. Lot # Ito Acres �1a a? Section/Block/Phase Driving Directions to Property _15n -j'_t,P�t^t�5 OIC Qr� 1 0 rs[grsd 7t]�Yl� Ilof tJ NAME TO APPEAR ON PERMIT? ® Owner ❑ Applicant ❑ Contractor Applicant Contact Information Name I),ey\A C\ V1 R .:rami s m ( Address% � �a ��P hYlfaQ�r� l> ( C'Y�2Yl^,1Il. 5 Phone ,jZ j-Li�%�� Cell Phone 51,-1.3G S -59-I Owner Contact Informaiion Name SOVVn P (AS Q16 UV- Address Phone I Cell Phone Contractor Contact Information Name Address Phone I Cell Phone WHO WILL BE THE PRIMARY CONTACT? ® Owner ❑ Applicant ❑ Contractor Description of Existing Structures on Site nLrnsP # of Bedrooms *j Structure Dimensions # of Occupants Basement ❑ Yes ❑ No Basement Fixtures C1 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 —V—`No Does the site contain any jurisdictional wetlands" ® Yes KdN,�� Does the site contain any existing wastewater systemsv ❑ Yes f o Is any wastewater going to be generated on the site other than domestic sewage? Yes @'No Is the site subject to approval by any other public agency? Wyes No Are there any casements or right of ways on this property° Describe Existing water supply in use ❑ Individual Well ❑ Community Well ❑ Semi -Public Well ❑ County/City/Township Water Line Is a public water supply available? ** ❑ Yes [ eNo 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) Accepted 0 Alternative 0 Conventional 0 Innovative ❑ Other 9 Any C ATAWB A THIS IS NOT A PERMIT ` coux-ry�n CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services Page 2 Proposed Facility Type ❑ Primary Residence R] New Residence ❑ Addition to Residence # of New Bedrooms *jam Project Description ovanitt t't fliil'v7E_ W Gl ll a� t. ihCiS< r'v>°1"� Structure Dimensions ba' k S # of Occupants 2 Basement ® Yes ❑ No Basement Fixtures ® Yes ® No ❑ Accessory Structure(s) Describe 4 o New Bedrooms *f if applicable Structure Dimensions y V SO # of Occupants Accessory Dwelling ❑ Yes ❑ No Plumbing ❑ Yes ❑ No Describe Plumbing Needed ❑ Multi -Family Residence # Units #Bedrooms per (Jnit* j Total # Bedrooms *T Structure Dimensions ❑ Food Service Specify Type # Scats Floor Space -Entire Food Service Facility (Sq Ft) # Employees per Shift # of Shifts Dining Arca (Sq Ft.) ❑ Business Specific Type of Business Retail Floor Space # of Employees per Shill # 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 Welt ❑ Semi -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 sire increase in the future I 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 CIIARGE (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 (i) 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 ant 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 � J B SignatureofOwner orAgent tit>%/�L A I, Date A Printed Name of Owner or Agent 5 m Parcel Report Parcel Report- Catawba County NC Parcel Information: Parcel ID: 462801269196 Parcel Address: 9271 BELLE PINES CT City: SHERRILLS FORD, 28673 LRK(REID): 800692 Deed Book/Page: 3270/0308 Subdivision: LAKEPOINTE SOUTH Lots/Block: 16/ Last Sale: $55,000 on 2015-03-30 Plat Book/Pago: 41/114 Legal: LOT 16 PLAT 41-114 Calculated Acreage: .720 Tax Map: Township: MOUNTAIN CREEK State Road #: 2797 Tax/Value Information: Tax Rates(pdf) City Tax District: All in County County Fire District: SHERRILLS FORD Building(s) Value: $0 Land Value: $45,300 Assessed Total Value: $45,300 Year Built/Remodeled: / Current Tax BIII Miscellaneous: Building Permits for this parcel. Building Details Watershed: WS -IV Critical Area Voter Precinct: P31 Parcel Report Data Descriptions List all Owners Deed History Report Owner Information: Owner: JAMISON KENNETH R Owner2: JAMISON BARBARA L Address: 2612 PENNGATE DR Address2: City: SHERRILLS FORD State/Zip: NC 28673-9128 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: 2008-03-18 Firm Panel #: 3710462800K 2010 Census Block: 2024 2010 Census Tract: 011503 Agricultural District: Assessment Report Page 1 of 1 L.I,sap/report product was prepared from the Catawba County, NC Geospatial 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 verd¢ation 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 o, liability, whether direct, indirect or consequential which arises or may anse from this map/report product or the use thereof by any or entity © 2015, Catawba County Government, North Carolina ��All rights reserved. hC J- 1 r X11..- r Y nVei It _3lJ http://gis.cataNN,bacountytic.gov/nomap/parcel_report. php?key=462 8 0 12 691 96&typ=P 7/31/2015 Catawba County Environmental Health Cry 2.87 LLE PI' NES T- SC 15 r 194.34 Parcel: 462801269196, 9271 BELLE PINES CT SHERRILLS FORD, 28673 M M IM * 01 An t T 1 in=50ft This map/report product was prepared from the Catawba County, NC Geospattal 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 07/31/2015 '0 L i7 194.34 Parcel: 462801269196, 9271 BELLE PINES CT SHERRILLS FORD, 28673 M M IM * 01 An t T 1 in=50ft This map/report product was prepared from the Catawba County, NC Geospattal 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 07/31/2015 . ., I LINE TABLE 1 UNE I LENGTH I BEARING I L71 9.941 S85'20'24"EI ISTIN R *ILLLUIS. PY..S. 81111 11 ULD S I AT HS V I LLE ROAD SIATE A CORNELIUS, N.C. 28031 ( 7114) 7655134 I CURVE TABLE I CURVE I LENGTH I RADIUS CHORD I CHORD BRG I C7 34.331 20 .0030.271 S36'O6'20"EI C2 15.28 225.001 15.28 583'36'47"EI C3 26.381 225.001 26.371 578'07'14"EI I C41 25.071 225001 25061 571'28'41"E1 BELLE PINES COURT C4LINE ➢C3LIN --- 2 VALLEY CURB 50' PUBLIC R/W 26' BC TO SC f C2TIC LINE - _ C2 If. _ / S85'16'50-=59144, / / 10' UTILITY & DRAINA GE EASEMENT C� 1 / 30' FRONT SETBACK =I �I I 4628-0125-6749 Robert Wagner Marilyn Wagner V e DS 3175 PG 853 / to h' if U `O e LOT 16 F 'I Hit LOC\'1 R NS OF 1111 SIDE A\'D RI AR SE I HAC'R LAYE.NDL\ P 2 wm\ DB 3133 PG 223 LEGEND 40 31,417 SQ.FT. x l 0.721 ACRES mI Edo W #4 REBAR SET � � lh of I..akepointe South = 110 J(r UTILITY PEDESTAL O tPN � Used Houk 1270. Pg. 108 9271 Belle Pores Court 18335 Shin. dk Lori Jamiwn W i C0]SIJLI \\I III GU\ I:R\'IRG Afl'NO 1011 l'Rl' 'AILING LANI)IN .I OP.MENT A. (J 'S0 :1.Conn4i Ph.\'.0 _811:1 V � AND /O\'ISG REp111RENII \'I C I'R I(IR 111 DESIGN UR C'O\'S l ItUCI IU\ OF ANY Plat Book 41, Pg. 114 Catawba Cmmq' INIPRf,CIiNIFN)S j 5', UTILITY DRAINAGE I ala �O EASEMENT ala TJ\ Py41 11RIIA'llfh:1111I1^lEllc \:{111C Sl e: v.Rlh ' I e 194.57, o 4628 0126-9060 Tony C- Cowan F 'I Hit LOC\'1 R NS OF 1111 SIDE A\'D RI AR SE I HAC'R LAYE.NDL\ P UP wm\ DB 3133 PG 223 LEGEND 40 _'0 0 40 11/71711 19SIDESFIt4.\Ck p5 REBAR FOUND O i0• REAR SL (BACK 1 Su\(GS?lll\IJ\11:RIIOtJCU \Ci IIIIN 9Nn1' #4 REBAR SET 0z COMPUTED POINT lh of I..akepointe South = 110 PRnP6Rr1'\IAYBESUBJ6CI I0OIIICRC'IVI:VASI� kl Nkll'UU]\. IS\Sli\fIiCIS nH I21GHIS-UP-II',\}"IlAi MAl'RI:UI RF(0R11 UTILITY PEDESTAL O tPN � Used Houk 1270. Pg. 108 9271 Belle Pores Court 18335 Shin. dk Lori Jamiwn W i C0]SIJLI \\I III GU\ I:R\'IRG Afl'NO 1011 l'Rl' 'AILING LANI)IN .I OP.MENT A. (J 'S0 :1.Conn4i Ph.\'.0 _811:1 V � AND /O\'ISG REp111RENII \'I C I'R I(IR 111 DESIGN UR C'O\'S l ItUCI IU\ OF ANY Plat Book 41, Pg. 114 Catawba Cmmq' INIPRf,CIiNIFN)S IIInl11\III Ail. I 1 ISeA, 41111. PRI IN R I Y 1> SUB If(1 11 if I)LI.I ARA ITUV lit 11 IF "C:C R" KI IRD11I \S I)EEI) 1`1 tl 1R 2011,1-6 I WI ()F 1115 CA I A%% HA COUN IN RE(IR I RY 5 I I IG li I ILL I1A DRAINAO I.ASL\WN I I'FR 1111: "Ci R".I)If 2011. I'1i Il19_' F 'I Hit LOC\'1 R NS OF 1111 SIDE A\'D RI AR SE I HAC'R LAYE.NDL\ P UP Gniphlc bale ORIES14\l1U\0I PROI'USIiDI'RISCIIS\I.SIRIJC'IIJRE 40 _'0 0 40 11/71711 19SIDESFIt4.\Ck 1 i0• REAR SL (BACK &ala of i lrn) mp I Inch = 41) Rei Physical Survey of I.ot lh of I..akepointe South _ I'rufrsiomJ 83qurw ) A, Recorded in Site Addre\c Sune}arc, Inc. PmpenY of ' Used Houk 1270. Pg. 108 9271 Belle Pores Court 18335 Shin. dk Lori Jamiwn Uced Book 2011. Pg 1051 Sherrilk Ford, NC 28673 A. (J 'S0 :1.Conn4i Ph.\'.0 _811:1 70 iB>_ io;2:134 Ph.nlclPa\ Plat Book 41, Pg. 114 Catawba Cmmq' Flanl wrnw Gly IIInl11\III Ail. I 1 ISeA, ni1Dwc I NT.'d B\ I mll 111 l'I� Y!� I)I...111! TJ\ Py41 11RIIA'llfh:1111I1^lEllc \:{111C Sl e: v.Rlh ' I e - .. CATAWBA COUNTY HEALTH I��� PARTME �'�,� Telephone: (704) 465-8270 TDD: (704) 400 N2 1 1 d 7� u tion to Constru ct;iRepair Permit_Oper. Permitr,.System Tyne t%%3 e��a �t _ E� TAA Phone Address Subdivision G/C11.I�c= Eat/, T �/LFi•�i u -.S �7c" /Gly . /1/, Section-/Block/Phase J Lot#1� Lot Size /),,�,.S��.cP_L Directions: PAS 5 /s�k O -D . /S� 1 nT'9 Al Facility: House_ mobile Home_ Business_ Other: Tax Map # Multi -family_ Other Zoning Approval # # Bedrooms # Seats # Employees Application Rate GPD Flow Hot Tub or Spa yes,(�pecial Fixtures 10096 Repair Areyes no Basement es o Basement Plumbi��no Water Supp y: Private Well-__L.,-Public ♦wrawraaarwraawarwwrrwwarwrwaarraararrrrrrrwraaaraarraar�rrrrwraarawararaawwrrraaaawaarrarrrrraa Type of System: Trench Bed Pump Pump/Panel C1 -- Panel LPP Other Tank Size: Septic Tank Size '10on Pump Tank Size /CID/-) Nitrification Field: Total Square Feet.&(2 Depth of Stone , -Bed Size N Trench Width 31 ToLal L•g_ngth of Allyl Trenches a®® Number of Trenches Individual Trench Length/i f8L%�// 6`�/_ Feet on Center Maximum Trench Depth -3C'�. Distance of Nearest Well -DO NOT INSTALL WHEN WET- aarrarrrrrarraaaaarraaaaaaaaraaaaaaaraaerrrraraawarrarawaraaaaraaaaaaar.rarrwraawwrwaaaaaaiarra Topo slope Texture CCrg 7 y Structure6GOcvcl I Clay Min. Soil Wetness Soil Depth t/;Ly. l Restric. Hoz. at V,'4P, Available space s/�'e(3ynol Overall Class g1T9 ,_ Comments: -5cE 60//1 /UOTGS C F �, W/GL//lm� S I� y T�cNcn� I JX3 I 1 � P.g JvE1 s �/e T eE%ri/c PFP-,9 s'I-j I �pQ2Pl .� 7 p 6n. /66/ -DCTGP�M/N�J� (-1T Y nJSYr}C��TlOr1J %) C Au, . sc: rie</f c. P/syS Bc FpQ.E" 4j-rC M IS /4,67/kcc: �'�J2 Hny�M/RG J/VIrU.O-Jr./STiCA/ 2cSutQ�-0 X'RKc Rt /-//hC s/v t cum r�S 0 FG _ sEe .977-wCe�,jCAJS "NO GUARANTEE OR WARRANTY IS IMPLIED OR GIVEN AS TO THE PERFORMANCE OR LENGTH OF TIME THIS SYSTEM WILL FUNCTION" •aaraaaaaaarraaraaarrrwwaaawrawaawraaraaraaarwwaaarrrwrwraraaraaraaraaarrarwarraaaarrraaaaaaawr •Improvement Permit has no expiration date and is transferable, but may be revoked if site plane or intended use changes for the proposed facility. An Authorization to Construct is valid for (5) five y are from date issued and is not transferable. Permit Date f9� �� /Jq� OWne /,L• 714-!' Sanitarianf Inst ed B Date Sanitarian wwte - Office Blue -Z]'rspecLiunOlxm6onPerrmt Yellow - Owner/Agent Green - Buildmg Inspecson Authorization to Construct