HomeMy WebLinkAboutEHPR-11-09-2467 (2).TIF
THIS IS NOT A PERMIT Case # EHPR-11-09-2467
d yid CATAWBA COUNTY HEALTH DEPARTMENT
Plan Review Application for Environmental Services
1842 SM Environmental Health Plan Review - OSWP
,APPLICANT ~ ON\ \ER` CONTRACTOR
MILTON J.POLEMIDLS MILTON J POLEMIDLS
313 ABELIA'RD. 313 ABELIA Kll , _
WAXHAW NC 28 1 73-931 0 WAXHAWNC 28173-9310
NAME TO APPEAR ON PERMIT MILTON J POLEMIDES Pin#: 369607792156
SITE ADDRESS: 6736 EMERALD ISLE DR, Sherrills Ford, NC
DIRECTIONS: 16 TO 150 /TURN ON 150 GOTO 77 TURN LEFT ON MT PLEASANT RD / TURN RT ON EMERALD ISLE DR / LOT ON
LF WOODED LOT
NAME of SUBDIVISION: EMERALD ISLES UNRECORDED Lot # 3 Section/Block/Phase
PROPERTY SIZE: Square Feet Acres .49 Date Platted/Recorded
TYPE OF FACILITY: House Mobile Home X Dimension of Structure Bedrooms 3
Basement: No Water Using Fixtures in Basement:No No. in Family 4
Whirlpool Tub : Gal. Capacity:
MULTIPLEYAMILY RESIDENCE: Units >1 00~ Total Number of Bedrooms
DAYCARE: Number of Children
RESTAURANT: Seats Square Feet Dining Area Square Feet Foodstand/Meat Market Floor Space
TYPE OF BUSINESS: ;Number of Employees- 1st 2nd 3rd
OTHER: (Specify)
Do you aniticipate any additions to Facility?
If so, describe: ADDING AT TIME OF SETUP/ ATTACHED GARAGE / COVERED FRONT PORCH/ MASTER BEDROOM & REAR PATIO
Has any grading, removal, or addition of soil"been done to this property?-'
If so, describe
Are there easements/right-of-ways recorded on this property? NONE
Type of Water Supply: Individual Well Community Well Municipal Semi-Public
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 from the date issued and is not transferable.
Note: You must obtain Zoning Approval prior to locating a home or structure on this property. Any representation by you o house or structure
location should conform to applicable setbacks. I~
Date: ' Q Signature of Applicant or Agent
n Environmental Health Specialist will contact you within 2 workin ays of application date.
If you need further information or assistance please call 828-466-7291
AREA 1
(FOR OFFICE USE ONLY)
Zoning Approval: -Yes No Zoning Approval UDO Zoning Form A
Minimum Setbacks
Front 30 FEE NAME DATE AMOUNT
Side 15 luili~r1, ,iti,,n i,, ( „nsh-uct P~
Rear 30 I111proyement Permit Fee Il/022009 X750:00
Max Hght
TOTAL FEES 5300.00
*If a permit has to be redesigned and / or RETRIPS made to the property, there is an additional $60 charge
11/02/09 13:20
( t
THIS IS NOT A PERMIT WLS #
CATAWBA COUNTY HEALTH DEPARTMENT
Application for Environmental Services
t-19 Septic Repair El Septic Expansion ❑
Improvement Permit Authorization to Construe
Existing Tank Check ❑ New Well Permit ❑ Replacement Well ❑ Well Abandonment E]
1. Name to Appear on Permit PO se-s-
2. Permit Requested By S~}YYl~ Business Phone
Address Home Phone
3. Property Owner Business Phone
Address yA/P 7 Home Phone
4. Name of Subdivision Lot # Sect'on/Block/Phase
Property Address '2 6 if k" l -Z~- vN 7, A✓
Directions to Property: < 1 4l, 2 L 1' i~,^O
2
5. Property Size: Square Feet Acres Date Platted/Recorded
6. TYPE OF FACILITY: Horse Mnhile Home Dimension of Structure S~,Y S-5- Bedrooms* 3
"-An room that will be intended for,IccPilI" at the time ofconstruction,„ for futUl~ consideration ~I1'uild be llw'~ i a
bcdr00111 and Countedon all applications. The number ol'bedroonis vy;ill 1,c coil lirn~c l I-" 'room> i;l"11t1iied'06 house pl~In, as a
LJ~ Cc:_ I]] This mad pLy then for sy L_ni ire ill the future: ~
b dtoow-at the time ul:buildin`a peliit.ils
Basement: yes/no Water Using Fixtures in Basement: yes/no No. in Family
Whirlpool Tub yes/no Gallon Capacity
MULTIPLE FAMILY RESIDENCES: Units Total Number of Bedrooms
DAY CARE: Number of Children
RESTAURANT: Seats Square Feet Dining Area -Square Feet Food stand/Meat Market Floor Space
TYPE OF BUSINESS: Number of Employees 1 st 2nd 3rd
OTHER: (Specify)
7. Do you anticipate any additions to Facility? Ye C/ No
If so, describe:
8. Has any grading, removal, or addition of soil been done to this property? Yes No
If so, describe:
9. Are there easements/right-of-ways recorded on this property? Yes _,o
10. Is a public water supply available on or adjacent to the above property. Yes N/
Check type that is available: [ ] Community well [ ] Semi-public we [ County/City/Township water line
**If No, a Well Permit must be issued with the Septic Permit.**
11. Well Type Applying For: [ ] Individual well [ ] Community well [ ] Semi-Public well
1 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 valid for 5 years or may be non-expiring under certain specified conditions. Improvement Permits and Well
Permits are transferable, but may be revoked if this information, site plans or intended use changes for the proposed facility. An 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. Any representation by you of house or
structure location should conform to applicable setbacks.
**IF A PERMIT HA TO BE REDESIGNED AND/OR RETRIPS MADE TO THE PROPERTY THERE IS AN ADDITIONAL CHARGE.-
.
i
Date O Signature of Owner or Agent
CATAWBA COUNTY PERMIT
ZONINGN AUTHORIZATION (R)
Manufactured Nome
r P. O. Box 389 PERMIT NO: ZONR-11-09-2260
I00A Southwest Blvd > > c
AI I L11~D: 11/0o _/-007
Newton, North Carolina 28658 1SSUID: 11/02/2009
SM Phone: 828-465-8380 l,XPIRI S: 05/01/2010
PAX: 828-465-8962
www.catawbacountvnc.gov
APPLICANT- - QW
VNER
MILTON .1 POLLMIDF'S MILTON J POLLMIDFS
313 ABELIA RD 313 ABELIA RD
WAXHAW NC 28173-9310 WAXHAW NC 2 8 1 73-93 10
PROPERTY ID#: 369607792156 CENSUS TRACT:
STREET ADDRESS: 6736 EMERALD ISLE DR, Slherrills Ford, NC LOTH 3
PRO.IECII DESCRIPTION: 2001DWM0131LEHOME/ 1(iTO150/TURN ON 15000TO77TURNLEFTONMTPLEASANTRD/"TURNRTON
EMERALD ISLE DR / LOT ON t_F WOODED LOT
DIRECTIONS:
COMMENTS: DW MOBILE HOME /W SITE 'BUILT-GARAGE, MASTER BEDROOM / FRONT COVERED PORCH REAR PATIO
FLOOD ZONE? OWNER TYPE: Residential (Private) REQUIRED SETBACKS
100 YEAR FLOOD ZONE PLAIN? No LAND OWNER:
FRONT: 30.00 SIDE: 15.00
FLOOD PLAIN, STRUCTURE? No MAX HEIGHT: 45.00 REAR: 30.00 SIDE, l:
VALUE: 0 CORNER: SIDE 2:
1. Before an inspection can be made by the Building Inspection Office, the applicant must pull a string to designate the side and rear
property lines where the structure is being placed or constructed.
2. [-Ionic shall be placed on the lot in harmony with the site-built structures, or have the front door face the road frontage.
3. All manufactured homes must be underskirted before power can be connected.
4. Only one manufactured home shall be allowed per lot or parcel of land.
5. Florae shall have either deck or porch with steps, located in the front 01'1111C home (minimum SIZC shall measure at least 36 square 1ect).
FEE DESCRIPTION DATE FEE AMOUNT
Residential Zoning Fee 1 1/02/2009 $25.00
TOTAL FEES $25.00
The apmlicant hereby certifies that all information and attachments to this Certificate of Zoning Compiliance are true and correct, and
acknowledges that this nermit was issued on the basis of the information required herein. The applicant further acknowledges that any construction.
alteration or addition which differs from this application shall be Sul'jcct to removal or alteration so as to bring said structure into conformance with the
specifications and standards of the Catawba County "Zoning Ordinance. Such corrective action shall be at the expense of the applicant.
It is the responsibility ol'Applicant to comply with all existing deed restrictions pertaining to the property. Issuance of this permit is not certification of
such compliance and does not relieve Applicant of the duty to comply.
"This "Zoning Authorization Permit shall expire six months from e date of issuance unless a building permit is sect iCAl and remains active.
J ~ f _ x)
l 1'c nl 1 r~l 121A" cZ e
APPLICANT NAM1 (PRINTED) APPLE ' Al' SIGNATURE ZONING APPROVI~D-BY
ZONING FEES ARE NON-REFUNDABLE
COMPANY NAB l.--1
urmit Pegg I of I
Catawba County, North Carolina
This map product was prepared from the Catawba Comtty, NC, Geographic Information System.
N Catawba Count' has made substantial efforts to ensure the accuracy of location and labeling information
A 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 liability, whether direct, indirect
or consequential which arises or may arise front this map product or the use thereof by any person or entity. Legend
Selected Parcel Number: 3696-07-79-2156
1 inch = 60 feet Prepared for:
4'~ : ivl.
-
99.98 100.00 100.00 400.0
4 I 3 ~~2~ 1
( p 41 _
7
149
N N~ ; N
1157
3156- 415E
13.~~ 102) 100
-,e.o n)'7- 3 o f f-
SRS 1977 /
0.20
5.7 87.07`~4 -----_87;n._--= 1 5 90.41 26 4
THIS IS NOT A LEGAL DOCUMENT Monday, November 02, 2009 01:00 PM
CATAWBA COUNTY NC - Parcel Report
Information' Regarding Selected Parcel(s)
Parcel ID.- 3696-07-79-2156
Name: POLEMIDES MILTON J
Name2: POLEMIDES PHOTENI K
Address: 313 ABELIA RD
Address2:
City: WAXHAW
State: NC
Zip: 28173-9310
Account: 198128
Calc Acreage: 0.49
Tax Map: 017 X 01020G
LRK: 17743
Deed Book: 2624
Deed Page: 0595
Subdivision Name: EMERALD ISLES UNRECORDED
Subdivision Block:
Lots: 3
Plat Book:
Plat Page:
Building Number: 6736
Street Name: EMERALD ISLE DR
Site Zip: 28673
Township: MOUNTAIN CREEK
Fire Code: SHERRILLS FORD
City Code: COUNTY
State Road: 1977
Total Bldgs Value: $1,500
Land Value: $93,100
Total Value: $94,600
Year Built:
Year Remodeled:
Last Sale Date: 11/24/2004
Last Sale Amount: $112,500
Neighborhood: 129
Watershed: WS-IV Critical Area
Watershed Split: NO
Voter Precinct: P31
E911 District: COUNTY
Zoning: R-30
Zoning2:
Zoning3:
Zoning Split: N
Zoning Overlay: CRC-O,MUC-O,WP-O,FPM-O
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: 011502
Census Block 2010: 3033
Small Area Plan: SHERRILLS FORD
Agricultural District:
Printed: Monday, November 02, 2009 01:00 PM
10`-28-04_ 02.54PM. FROM-EASTLAND OFFICE 24 E 7045362187 -T-837 P 01/02 F-274
CATA A COUNTY HEALTH DEPARTMENT wrw
' elephone: (828) 465.8270 TDD (822)465-M WLS #C?V/-0 ` 1j
atprovemem Permit AC Rep ' Permit. Operauosl Permit. System Type Well Permit. Replacement Well
Yarper/Agent "d-e-.9 Phone 7D4- : ~ - f/s,3
4ddress rq Subdivision G~~ra~a l3>~T'
r' 9ecrion(BlocklPhase Low ~ _
Lot Size~_4y 4 Duacnons: 14 L 156 L /f/1 - 2! f-
_ Property Address ~
Facilityi Douse Mobile Hoare Businoss Multi-family Other' Pin Number
ather Z°uing Approval #
Bedrooms # Seats k Employees Application Rate o ~S' GPD Flow SQ
Hot Tub or Spa yes/no Special Fixtures Basement /I ~5) 100% Repair Aread5~/no
Basement plumbing yes/no Water Supply- mate. Well Public Scan.Public
p4Cisri6Ydk*B;0t1i99Y*90~ttk"Ss;q;qq~;SfFil9*94499UY*tet~{~~gff9iR1it16t9M904aWgmrY~~siYrYbtD9{';RSi;;s;IIY■tt10• t t OOtt9tt
I`+pe of System: Trench Bed Pamp-)~_ Pump/Panel Panel LPP Otherp 7 [s1
t
Septic. Tank, Size. OW Ptitnp Tank Seze_~ _ Nitrification Field: Total Square Feec- _.Depth of Stone
Bed Size Trrorh Width Total Length of All Trenches (9 Q Number of Trenches
Trench Length /W!,65l Feet on Center Maximum Trench Depth Distance of Nearest Well AO NOT INSTALL SEPTIC WHEN WET" tWELL RECORD REQIJIRFD AT COMPLETION'
r,~tsassssa~wodtnarrr~etrattts*sa~*:xs*tErR 9s*4*tOPa94;iltst*s;;i0; 9~Paar*a***a*;istt+;ssggt49999R9R49P0*;rLit*bi7
To - % Slope (,>~'ttn`-
Tezture e i
Structure
clay min_ /11
S 3'
Soil Wemess
-Soil Depth ~K~k' .
Restsic Hoz. at.
Available spacsu no I '
Overall Class t
m=ents t
s ,
I
Filter Required j
Riser required when ` a is 1
Lank is more than 6 I s {vti i..w/~ d I s ® r
inches det-p.
°"`NO GUARANTEE OR WARRANTY IS IMR IFD OR GIVEN AS TO THE PERFORMANCE OR LENGTH OF TIME THIS SYSTEM
WILL p i'L+NC'nON""
us8tda;{74g98t(tpt.OrMbOfMb.tt~Ywa~itattssakf Yts;al`sssg~i/iFFYPY4w~~PVYFYYtNOyd9ii9t=fist:sass:sit;s;;ssi+Li;;t9091;gMPYFttYMY
`Improvement Permit has no expiration date aitd is tr'ensfcrable, but may be revoked if sire plans.or intended use changes for the proposed
Farility An Authorization to Construct is vali for (5) f"avc years from date issued and is not transferable. Well Permit valid for 5 years
provided site conditions do not change. Well Ideation, installation, and protection must meet state and local regulations, and must be
inspected and approved by a representative of jhe Catawba County HcWth Department before any portion of the installation is out into use.
The siting of the well by the Heslth Department staff is to provide protection 'from kn sible sources of contamination- No volume of
water is guaranteed at any site by the Hrdth Ilepamment.
Permit Date / - t EHS
OwturiAgent, Septic 7an1r [tes laad By oat
EHS Well Installed By Well Grout Approval Dace Well Head
Annmval Date Data EnDlellected
CATAWBA COUNTY, NC
100-A South West Blvd PLAN INVOICE
r--_
- Newton, NC 28658-
°f P 828 465-8399 Monday, November 2 2009
184 2 sM www.catawbacountync.gov
Plan Case: EHPR-11-09-2467 Invoice Number: INV-11-09-256846
Environmental Health Plan Review Invoice Date: 11/02/2009
Fee Name Fee Amount
Authorization to,Construct FCC Adjustable.. _$150.00:`
(New/Expansion) Fee
lmproveli)cnt Permit Fee F Alt-CG S1X0.00
Total Fees Due: $300.00
PAYMENTS
Date Pay Type Check Number Amount Paid Change
11/02/2009 Cash -1 .x300.00 - $0.00.
Total Paid: $300.00
Total Due: $0.00
plan invoiceillba'_;+ti=t-?41~ 41~>9-b?ae-Rh'9c2rccicail.rpr 11/02/2009 13 20