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HomeMy WebLinkAboutEHPR-11-09-2514 (2).TIF THIS IS NOT A PERMIT Case # EHPR-1 1-09-2514 CATAWBA COUNTY HEALTH DEPARTMENT 9®' v~,~s oaa© Plan Review Application for Environmental Services 1842 ski Environmental Health Plan Review - Repair APPLICA=NT OWNER; (()NTRACTO'K DUANE.RINKUS DUA~NERINKUS 5926 TAURUS, DR :59261TAURUS DR DENVER NC 28037 DENVER NC 28037 704-489-6103 704-489-6103 NAME TO APPEAR ON PERMIT DUANE RINKUS Pin#: 368616838095 SITE ADDRESS: 5926 TAURUS DR, Denver, NC DIRECTIONS: HWY 16 S/ LT ON GRASSY CREEK/ LT ON SAGITARIUS/ LT ON TAURUS NAME of SUBDIVISION: STONECROFT PH 6 Lot # 84 Section/Block/Phase PROPERTY SIZE: Square Feet Acres 1.45 Date Platted/Recorded TYPE OF FACILITY: House Mobile Home Dimension of Structure Bedrooms Basement: No Water Using Fixtures in Basement: No. in Family 5 Whirlpool Tub : Gal-.,Capacity: MULTIPLE FAMILY RESIDENCE: Units 1 00 ' Total Number of Bedrooms DAYCARE: Number of Children j` 3 RESTAURANT: Seats Square Feet Dining Area Square Feet Foodstand/Meat Market Floor Space TYPE OF BUSINESS: ifNumber of Employees1st 2nd 3rd OTHER: (Specify) Do you aniticipate any additions to Facility? If so, describe: 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'? 'NA Type of Water Supply: Individual Well X 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 norrexpiring 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 of house or structure location shouldreonform to applicable setbacks. Date: l~ - U Signature of Applicant or Agent. lG,4 An Environmental Health Specialist will contact you within 2 working days of application date. If you need further information or assistance please call 828-466-7291 AREA1 (FOR OFFICE USE ONLY) Zoning Approval: _Yes No Zoning Approval UDO Zoning Form A Minimum Setbacks Front 30 FEE NAME --DATE ,m AMOUNT n Side 10 Efiuthuri~utiun tr t vusu uct 11;,oajr)-Fl.I ~I/04/200J - '13-06:700 Rear 10 TOTAL FEES $300.00 Max Hght *If a permit has to be redesigned and / or RETRIPS made to the property, there is an additional $60 charge 11 /04/09 10:52 THIS IS NOT A PERMIT WLS# CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services F7! IP r AC S.T. Rpr. F- S.T. Exp. F- Exist. S. T. r Well Permit 17! Replacement Well 1. Name to Appear on Permit: 2. Permit Requested Business Phone: Address: Home Phone: 3. Property Owner: Business Phone: F- Address: Home Phone: 4. Name of Subdivision: - Lot - Section/Block/Phase: Property Address: Directions to Property: Date Platted/Recorded - - 5. Property Size: Square Feet Acres House C' Mobile Home - F6-xw, ' 6. TYPE OF FACILITY: Dimension of Structure Bedrooms*-- * intended for sleeping atahe time of construction odor future;consideratbh should,be noted as a bedrooni,and eounted`66 al► Any<,room that will be pp ber of bedrooms will be co6firrn4-by rooms itlened on the house plans as a bedroom at the time ul61ng - permit issuance a lications._ The num This'may prevent the'need for system;size increase in thefuture w Basement: (7) Yes Q No Water Using Fixtures in Basement: Yes No No. in Family: Whirlpool Tub: (7)Yes (No Gallon Capacity: MULTIPLE FAMILY RESIDENCES: Units I Total Number of Bedrooms DAY CARE: Number of Children RESTAURANT: Seats Square Feet Dining Area F Square Feet Food Stand/Meat Market Floor Space TYPE OF BUSINESS: No. of Employees 1 st 1-77, 2nd F-- 3rd OTHER : (Specify) -__J 7. Do you anticipate any additions to Facility? Yes )3,"'N 0 If so describe 8. Has any grading, removal, or addition of soil been done to this property? (7 Yes 6'N_o If so describe No 9. Are there easements/right-of-ways recorded on this property? (-Yes 10. Is a public water supply available on or adjacent to the above property? ~ res (-,No Check type that is available: 1- Community Well F7 Semi-public Well ; County/City/Township water line 11. Well Type Applying For: F Individual Well F_ Community Well Semi-public Well F_ Irrigation Well F7 Geothermal Well 12. Monitoring Well Request:CYes (-No # of Wells: F- Name of Site: I understand that this 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 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 of house or structure location should conform to applicable set backs. **IF A PERMIT HAS TO BE REDESIGNED AND/OR RETRIPS MADE TO THE PROPERTY, THERE IS AN ADDITIONAL CHARGE." Signature of Owner or Agent: Date: o 7 ~Print Form , 1 Z CATAWBA COUNTY HEALTH DEPARTMENT Telephone: (828) 465-8270 TDD: (828) 465-8200 1\ 1 H Z ~'J'J J I Z S Vl' It[>,~tu~ent~ut P rout l e,rair !'crtnil. C)It~ratit,n I'cintit. ~sl~nt I}'I>~-- Wcll I'crnlit h~~~l I,cul ut 11~;. Owner/Agent V ~r r Phone ) y~ 2J2~5 ,S _ Address Subdivision ~~f uYwc SectionJBIock/Phase Lot// Lot Size Directions: t l a r cH Gr LruC ( ~r Property Address rnvrvV r Facility: Hous Mobile Home Business Multi-family Other: Pin Number 1 1 G / ! 7 ) N,F2-~' y Other . Zoning Approval i/ # Bedrooms tt Seats # Employees . Application Rate t), GPD Flow ! Hot Tub or Sp yes/0 Special Fixtures Basement yes/&~ 100% Repair Areal/no Basement Plumbing yes/0 Water Supply: Private Well Public Semi-Public Type of Syste : Trench ✓ Bed Pump Pump/Panel Panel LPP Other Septic Tani, S e l] C' 0 Pump Tank Size Nitrification Field: Total Square Feet 12 o y Depth of Stone ( 2 Bed Size Trench Width S 6 Total Length of All Trenches 1-t V u' Number of Trenches ~J/ / Feet on Center Trench Length 0(j / i oo'l 1 vv / Maximum Trench Depth ) 6 , Distance of Nearest Well /tom f 'Dk) .A'0'1' 1.A, CALL SEPTIC WHEN WVET* 11.1- 1,FC 1,1) itl.aiU11,V1) :A f l u\ll't.l•' I' I ().'N Topo % Slope Texture - - --i 1 Structure 1 I I fikl%J-r+M Clay Min. Soil Wetness I 5 `U it d ill, 1','l Soil Depth I r } Restric. Hoz. t !Available spac yes/no I Overall Class PS U Comments: I I " I i ,i < I l/J OX I ~ ~ l~uudv- D I I ,r1V I r t~ I }-7 8 i iitcr i1cyuire I I i:i;rr rcyuircd "hcu I ~ ~ hulk i~ nwre t tan U I iucl,es deep. I 1 T1~IE 1I'IS SY..S I'1 1V1.~ WILL FUNC ION** (.vtat~a.lt 1"brw n Tttutyru~en~cut Perutit has no expiration date and is trausfcrable, but uta~ be 1'ec'0kcd itsitc plau~ Ur iuu•n(Jcd use chaugc~ fur tits l):upo-'d faciii[N. All A tborizztti0u to COnstt'uct is talid fur (S) five )ears 1'1'0111 date issued and is 110t uuuii'crublc. \Vell 1'crutit valid iu; pro ided si[e e uditiuns do nut chanbe. 1Vell location, installation, and protection nuts! Meet ,utte and !oral 1-ef;uli60tts, and unt.ti[ be iu,l,cetcd and tppruv'cd b5 a rt•preseut:uiNT of the Catawba C'otiut)' Health Departlucnt before W) 1)01'tiou 01' the i11staltati011 i~ intt iittu u;c. fbc siting of tl c t,cll 1) the Health Dcparuucat staff is to pruvidc proLeCtiou I'ront kliM%I p0. iblc sources of •u n[aluinatiuu. NO ruluulc ul , .t; r k ~uuru [Iced at nu.' site by the Ilea1t11 Ucpat•ttttent. Permit Date - V EHS ✓V *wrter/Agen Septic Tank Installed By Date EHS Well Installed By Well Grout Approval Date Well Head Approval Date Date Sample Collected Date of Result Results EHS 11'Itile Ullicr l rllu~~ thcncrr.l~~nl ['ink Ituililin,- In~l,cclinu :\ulhuri;:wun iu ll~nslntci Catawba County, North Carolina P. This map product eras prepared from the Calcnrba County, NC, Geographic b formalion System. N Calcnrba Counhh has made sub.rimuinl of o is to ensure the accuracy of localion and labeling information comcritled on this map. Catawba Count - promotes and recommends the independent verification ofany loto, contained on this mop product by the user. The Coumv of Colau•ba, its employees, agetns cmcd personnel disclaim, ancd shall uat be held liable for anv and oll damages, loss or liability, whether direct, indirect or consequenial which arises or may arise from this map product or the use thereof by any person or easily. Legend Selected Parcel Number: 3686-16-83-8095 1 inch= 60 feet Prepared for: >S v~ 9274 ~ c~j X23 r, 96 ,~o . goo , ~ - ~o ~ Oo oo. • moo - Plat,58-180 \ Pt 95 CIO 84 \ S c\ OO Pt 95 O O O0 \ 1.45A V O 9 8095 'o ,4 0~0 CYI Ncs C/ ,~z , 'yam i Plat 67-90 Z~ . 83 9 ro 1.48A 4.r' 8838 CO 99 c9 W C J, HIIS IS NOT A LEGAL DOCUMENT / Wednesday, November 04, 2009 10:13 AiNI - T ? N CATAWBA COUNTY NC - Parcel Report Information Regarding Selected Parcel(s) Parcel ID: 3686-16-83-8095 ,-Name: ' RINKUS DUANE D Name2: RINKUS SHANNON K Address: 5926 TAURUS DR Address2: City: DENVER State: NC Zip: 28037-7658 Account: 196270 Calc Acreage: 1.45 Tax Map: LRK: 802387 Deed Book: 2590 Deed Page: 0661 Subdivision Name: STONECROFT PH 6 Subdivision Block: Lots: 84 Plat Book: 58 Plat Page: 180 Building Number: 5926 Street Name: TAURUS DR Site Zip: 28037 Township: MOUNTAIN CREEK Fire Code: SHERRILLS FORD City Code: COUNTY State Road: Total Bldgs Value: $242,500 Land Value: $20,100 Total Value: $262,600 Year Built: 2004 Year Remodeled: Last Sale Date: 7/2/2004 Last Sale Amount: $211,500 Neighborhood: 129 Watershed: WS-IV Protected Area Watershed Split: NO Voter Precinct: P41 E911 District: COUNTY Zoning: R-40 Zoning2: Zoning3: Zoning Split: N Zoning Overlay: WP-O Zoning District: COUNTY Split Zoning Dist: N Split Zoning Dist(1): 0 Split Zoning Dist(2): 0 School District: COUNTY Elementary School: BALLS CREEK Middle School: MILL CREEK High School: BANDYS School Split: NO P&Z Case Number: Census Tract 2010: 011502 Census Block 2010: 4051 Small Area Plan: SHERRILLS FORD Agricultural District: Printed: Wednesday, November 04, 2009 10:39 AM