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HomeMy WebLinkAboutRBPR-02-2016-23232.TIF • gA `. THIS IS NOT A PERMIT Case # RBPR-02-2016-23232 d 45 IR il��. CATAWBA COUNTY HEALTH DEPARTMENT , '. ° '"°' PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES 1842 sM Residential Building Plan Review - Building New 0. 1.•o o .; IMPROVEMENT- AUTH CONST- NEW WELL 0 rk Applicant JIM ESTES, PO BOX 367, TERRELL NC 28682 C:7046410325 Owner PROGRESSIVE PROPERTY SOLUTIONS LLC, 4089 FALLEN PINE RD, SHERRILLS FORD NC 8:7046410325 Paid By GEMINI HOMES OF THE CAROLINAS INC, PO BOX 367, TERRELL NC 28682 NAME TO APPEAR ON PERMIT Progressive Property Solutions LLC SITE ADDRESS: 3934 MCGEE POINT RD, TERRELL NC 28682 PIN # 461714238422 NAME of SUBDIVISION: REDBUD FOREST Lot 5 Section/Block PROPERTY SIZE: Square Feet Acres 1.32 DIRECTIONS: Hwy 150 E/right on Sherrills Ford Rd/right on Hob Ln/left on McGee Point Rd/lot on left PRIMARY CONTACT: Applicant SEWER TYPE: Septic Tank GALLONS PER DAY: 360 WATER SUPPLY: Private Well DESCRIBE WORK: New Single Family Dwelling w/3 Bedrooms 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? No APPLICATION FOR: New Structure STRUCTURE TYPE: PRIMARY RESIDENCE FACILITY TYPE: Single Family Residence OTHER DESCRIPTION: DESCRIPTION OF None EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: NUMBER OF EXISTING BEDROOMS: #OF OCCUPANTS: 1 • PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 57 x 59 #OF NEW BEDROOMS:: 3 BASEMENT? No BASEMENT FIXTURES? No PLUMBING REQUIRED?Yes Desired system types (Improvement Permit or Authorization to Construct): ACCEPTED: ALTERNATIVE: CONVENTIONAL: OTHER: YES INNOVATIVE: ANY: Other described: 25% Reduction APPLICATION FOR WELL CONSTRUCTION • PROPOSED WELL TYPE: Individual.Well REPLACE WELL?: NO E9-ehapplication 02/17/20[6 13 33 Page 1 of4 j8A CATAWBA COUNTY case# RBPR-02-2016-23232 s Public Health Department REDBUD FOREST < - Environmental Health Division Subdivision PO Box 389, 100-A Southwest Blvd,Newton,NC 28658 PlN# 461714238422 1842 NAME ON PERMIT: PROGRESSIVE PROPERTY SOLUTIONS LLC ( ),4089 FALLEN PINE RD, SHERRILLS FORD NC 28673 Progressive Property Solutioi Site Address: 3934 MCGEE POINT RD,TERRELL NC 28682 Property Size: Square Feet Acres 1.32 Directions: Hwy 150 E/right on Sherrills Ford Rd/right on Hob Ln/left on McGee Point Rd/lot on left 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. Ay orized county and state officials are granted right of entry to conduct necessary inspections to determine compliance with applicable laws and,tlf•s. derstand that I am solely responsible for the proper identification nd labeling of all property lines and corners and making the site accessib` •o t Jr • plete si evaluation can be performed. Date: 2_ /7`76 Signature of Applicant or Agent A/- _ L An Environmental Health Specialist will contact you Wien 5 working days of application date. If you need further information or assistance please call 828-466-7291 AREA1 FEENAME DATE :I R.FEE-AMOUNT Authorization to Construct Fee (New/Expansion) 02/17/2016 $150.00 Fee Improvement Permit Fee 02/17/2016 $150.00 Well Permit& Inspection Fee 02/17/2016 $300.00 TOTAL FEES . 5600,00 ;'I 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-ehapplication 02/17/2016 13:33 Page 2 of 4 CATAWBA THIS IS NOT A PERMIT COUNTY CATAWBA COUNTY HEALTH DEPARTMENT `� ' North Application for Environmental Services Page 1 Improvement Permit Authorization to Construct Septic Repair ❑ Septic Malfunction ❑ Septic Expansion ❑ New Well Permit'Replacement Well n Well Abandonment❑ Well Repair ❑ Existing System Inspection (Pre-Approval Required) ❑ Application is for New Construction ❑ Existing Facility ❑ Property Address 3°l&H m& et- ? 2). Subdivision ?cc bud frore S-71- rf-rLr,.z 11 pc 2 ` (0%2- Lot# S Acres /, J1 Section/Block/Phase Driving Directions to Property ily )5(7 E, I� 5 - c.x-s r/7ls rorck 1 4_ b riiIL+ Cr) j Olj Lel . )-o )12,F on ce-rez_ NAME TO APPEAR ON PERMIT?Owner ❑ Applicant ❑ Contractor Applicant Contact Information Name ;Try-, E4'es Address Phone •7o Lt —GN/ — 0325 Cell Phone Owner Contact Information Namerrobcc s ,tc Pro ej4. S.))-›ti�n5 Address 70 3c < 3G ? ?TQrrcii /JC. Phone 7O Ll — I- l - (13 7 '5 Cell Phone Contractor Contact Information Name License# Address Phone Cell Phone WHO WILL BE THE PRIMARY CONTACT? ❑ Owner 2,2cApplicant ❑ 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 propery �ty,,, in question. If the answer to any question is"yes", applicant must attach supporting documentation. ❑ Yes XJ`No Does the site contain any jurisdictional wetlands? ❑ Yes )Ei No Does the site contain any existing wastewater systems? ❑ Yes No Is any wastewater going to be generated on the site other than domestic sewage? ❑ Yes )ENo Is the site subject to approval by any other public agency? / i Yes ❑ No Are there any easements or right of ways on this property? Describe �UJ/c..Q Zr Existing water supply in use ❑ Individual Well ❑ Community Well ❑ Semi-Public Well ❑ County/City/Township Water Line Is a public water supply available? ** ❑ Yes XNo 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) 1 ❑ Accepted ❑ Alternative ❑ Conventional ❑ Innovative jlther LI)h, ❑ Any CATAWBA THIS IS NOT A PERMIT COUNTY CATAWBA COUNTY HEALTH DEPARTMENT „o„;2,,;;— Application for Environmental Services Page 2 Proposed Facility Type ❑ Primary ResidenceX New Residence ❑ Addition to Residence #of New Bedrooms *t Project Description jton e . Structure Dimensions 57 1✓ )C S9 ..b # of Occupants Basement ❑ Yes 'No Basement Fixtures n Yes `RNo ❑ Accessory Structure(s) Describe # of New Bedrooms *.t. if applicable Structure Dimensions # of Occupants Accessory Dwelling ❑ Yes ❑ No Plumbing ❑ Yes ❑ No Describe Plumbing Needed Multi-Family Residence# Units #Bedrooms per Unit*t Total # Bedrooms *-i• 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 n No If Daycare Specify Occupancy Application for Well Con truction/Abandonment/Repair Proposed Well Type Individual Well n Semi-Public Well ❑ Community Well Abandonment Type ❑ Drilled ❑ Bored ❑ Dug n Unknown Well Repair Requested n Yes ❑ No Describe 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 permit 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. 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 a complete site evaluation can be performed. Signature of Owner or Agent Date ' /2 '76 Printed Name of Owner or Ag t 1 A f 5475 Catawba County Environmental Health \ \ co 0 lot ak \ w 508 — — _ ^ . $ �9` 87O 9 3920 I 45$.20 _ J Q.V III yCA` � P• qh . _ o ) S • ilt O ri O / 03976 N iti I Parcel: 461714238422, 3934 MCGEE POINT RD 1in=60ft TERRELL, 28682 This map/report product was prepared from the Catawba County,NC Geospatial 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 02/17/2016 Parcel Report Page 1 of 1 Parcel Report - Catawba County NC Parcel Information: Owner Information: Parcel ID: 461714238422 Owner: PROGRESSIVE PROPERTY Parcel Address: 3934 MCGEE POINT RD SOLUTIONS LLC City: TERRELL, 28682 Owner2: LRK(REID): 803315 Address: 4089 FALLEN PINE RD Deed Book/Page: 3319/0051 Address2: Subdivision: REDBUD FOREST City: SHERRILLS FORD Lots/Block: 5/ State/Zip: NC 28673-8374 Last Sale: Plat Book/Page: 68/148 School Information: Legal: LOT 5 PLAT 68-148 School District: COUNTY Calculated Acreage: 1.320 Elementary School: SHERRILLS FORD Middle School: MILL CREEK Tax Map: Township: MOUNTAIN CREEK High School: BANDYS State Road #: 1843 School Map Tax/Value Information: Tax Rates(pdf) Zoning Information: City Tax District: All in County Zoning District: COUNTY County Fire District: SHERRILLS FORD Zoningl: R-30 Building(s) Value: $0 Zoning2: Land Value: $38,300 Zoning3: Assessed Total Value: $38,300 Zoning Overlay: CRC-O,WP-O Year Built/Remodeled: / Small Area: SHERRILLS FORD Current Tax Bill Split Zoning Districts: / Zoning Agency Phone Numbers Miscellaneous: Firm Panel Date: Building Permits for this parcel. Firm Panel #: Building Details 2010 Census Block: 5031 WaterShed: WS-IV Critical Area 2010 Census Tract: 011504 Voter Precinct: P41 Agricultural District: Parcel Report Data Descriptions List all Owners Deed History Report Assessment Report This map/report product was prepared from the Catawba County,NC Geospatial 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. ©2015, Catawba County Government, North Carolina. All rights reserved. JPPe 1NU \ 3 112m Idad, http://gis.catawbacountync.gov/nomap/parcel_report.php?key=46 1 7 1 423 8422&typ=P 2/17/2016 «off CATA,WBA COUNTY Case# 1VLS2008-00038 '.,t.. .t`) Eublic HP,alth Department •� EnvirOnmenial Health Division Subdivision ` s`:r7 U1,7/ PO Box 389, 100-A Southwest Blvd,Newton.NC 28658 Sect/BL/Ph/Lot# 5 (B28)46528270 FAX(828)465-3276 TDD(328)465.8200 PIN# 911461714238219-5 Applicant/Owner KENNETH POPE • Site Address: 4104 MCGEE POINT RD 90 1- Property Size: SF 1.354 ACRES /. Directions: 16S/150 E/RT SHERRILLS FORD RD/RT MCGEE PT/SEE CORNER MARKER (REDBUD FOREST) AT CORNER . OF HOB LN& MCGEE PT Improvement Permit Permit Valid For: Five years ✓ No Expiration o. Facility(Residential): House z House X Mobile Home Multi-Family Bedrooms 4 New? ' Addition? Projected Daily Flow tints-0 g.p.d Water Supply Private Welt? .• Public? Semi-Public? Basement: Y Basement Plumbing: Y HotTub/Spa: Y / Special Fixtures(explain): Proposed Wastewater System:_RPBP-S/. — d6LEa Type: Proposed Repair: /° �S rcurit aWPS, �e Permit Conditions: - 1, /J / - 1/ //1J .w/V, c✓�p � _ . s_ R6C�.r/ • a�� • - X16 / 7/1 C�/' 'L� pays -U � -- Owner or Legal Repre ntative Signature: _/� _ .j..r�is1 -� Date: *2 Authorized State Agent: ! i J/ 7_!e. , Date: �f acj ^O$' The issuance of this permit by the Health Department does not guarantee the issuance of other permits. It is the responsibility of the applicant/property owner to insure that all Catawba County Planning/Zoning and Building Inspections requirements are met. This Improvement Permit is subject to revocation if the site plan,plat or the intended use changes,or if site conditions are altered. The Improvement Permit is not affected by a change in ownership of the property. This permit was issued in compliance with the provisions of the North Carolina 'Laws and Rules/hr Sewage Treatment and Disposal Systems' (15A NCAC 18A .1900). Neither Catawba County nor the Environmental Health Specialist warrants that the septic tank system will continue to function satisfactorily for any given period of time. Authorization to Construct Wastewater System (Required for Building Permit) See site plan and additional attachments( ). Proposed Wastewater System: Type: Wastewater Flow g.p.d New Repair Expansion Soil LTAR: g.p.d./ft2 Type of Facility: . Basement: Y Basement Plumbing: Y HotTub/Spa: y Special Fixtures(explain): Wastewater System Requirements Tank Size: Septic Tank gal Pump Tank gal Grease Trap gal Drainfield: Total Area: sq ft Total Length: ft Maximum Trench Depth in Trench Width _ It Minimum Soil Cover in Minimum Trench Seperation It Distribution: Distribution Box Serial Distribution Pressure Manifold LPP_ Other Additional Specifications: Authorized State Agent: Date: Permit Expiration Date: /have read and accept the-specifications and all conditions of this permit as indicated. Owner or Legal Representative Signature: Date: Form B r:vr,t.nunAtm»„vmunuum, • - CATAWBA COUNTY •/-71 4`'; Public Health Department Case q WLS2008-00038 1,s‘ _ 'Environmemal Health Division Subdivision �\_ / PO Box 389, 100-A Southwest Blvd,Newton.NC 28658 Sect/Bt./Ph/Lot N 5 Ns. i (828)465-8270 FAX(828)465-8276 TDD(828)465-8200 PIN# 911461714238219-5 Applicant/Owner KENNETH POPE Site Address: 4104 MCGEE POINT RD Property Si SF 1.35 ACRES Directions: 16S/ 150 E/RT SHERRILLS FORD RD/ RT MCGEE PT/SEE CORNER MARKER (REDBUD FOREST) AT CORNER OF HOB LN & MCGEE PT • ® Improvement Permit El Authorization To Construct Well Permit SITE PLAN • /9k(,cc Pf• yi /1/� -r '• tive✓a7 /o a, we'd qr A _ era/ I/0 7°7x70' / Henn c .Sy57,40, M cA ea PAYFS • • IA NS 1010 =40 Scale System components represent approximate contours only. The contractor must flag the system prior to beginning the installation to ensure that proper grade is maintained. Do not install system under wet conditions. This permit is subject of revocation if the site plan or site conditions are altered. �F — ,2p o s Authorize State Agee Date Form C r.-ATLlnnu,V'nngNIV65,,,o n, a \\IC\ IL `sue �� �CP tY**4 t ?� \ ' \ \ N. � oyp0 \ 0\ 0 �L � \ \ ., N \ 4 0., a /' \` �• ' •�° :� \ O `ice \ 0 N-3 \ \\�f� '00��\ \ \ \.`c \ . iitib....'''; y I " ! } LA 0,. to \ / ; S ." ..r\ Q °°c `" `, O vJ o e \, -i ` ? o ;' ti 0 a : \ , \ ,Isa s :;y \q 0.ccg _ / o.•o� CSC r�0 N� 0'Ci! A\ \.,0 ''." n 95, Or \ . . \ , \ ‘ • 1 0 \?.. . . DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES DNISION OF ENVIRONMENTAL HEALTH Sheet of • ON-SITE WASTEWATER SECTION PROPERTY COUNTY: SOIL/SITE EVALUATION covl4rY.Pw+ to • for ON-SITE WASTEWATER SYSTEM OWNER.: APPLICATION DATE ADDRESS: PROPOSED FACIISTY: DATE EVALUATED: 3.-ay-C,B PROPOSED DESIGN FLOW(.1949):- PROPERTY SIZE: LOCATION OF SITE: P?A.1 k.k4j /0-I-<. P)r `7 j � PROPERTY RECORDED: . WATER SUPPLY: Et Private 0 Public 0 U Spring a Other • EVALUATION METHOD: U 4ugerBoring M"Pit 0 Cut TYPE.OF WASTEWATER: LW Sewage 0 Industrial Process 9 laed ...... _.............. :': . :'::::: _::::::SOIL: C.Kr.',''ioty: i"iii��iiiiiiiii:i:i= .:,I !da.;E i:::::::::::iiii:::::i s: :iii iiliiiiii iiiiiiii:i:i!iiii?iiiiiii::::::i€iii`::::::::::: : :i i:iiiit:ii= [:Ea:.......LAAA=tttii :':.._(?Rt,::::: :f[:[:: f6S:I:�(:f::;::T.:::[(S-I f[:[:f ::::::::::::C:::::::: :::::::::::::::: ;...... .14St:::::i:::::::::::::::..:...... :::::E-atEtEtt .. :::�:::,::::S.GiPgii i _:::ZA>r.::.: .'. 1941 ._..._....... ::::...........t94 ................:: :::: . .......... ............9,::.[:[a::::;11:1915.61:Fi ...: ..-............ ' _ t9Q1 :: SOIL; :I9Q3 t45K .1344 :;1;;;;i:POSrrQ_OW .DEP t::. ETRUCTORE CONSLSr tA1C.j 11�ETNRSSf :::::$214::::: ...£AP.ko.. ...G1 STit._-,P.I;OF.I1;E: "::°:::Si:OB3�°f.:......,W:::::: .'�: :r a'tEURE :..:::: I:::: glIg:: ::: :`::GQtAR ::::DEPTH::::..eLASg CLASS.:: F1Y3R1� CY y S L- 'LfA ! : 5S 1 Lt-39 .9.-cut. seer ,& ,.sbic AS I i s c I . • 50`' SL .35 • i I 2 . SS D-u 'Si- I ps I 3 rr5 ,s t_ • •- I cr, Cir,5. • 3 SS 5-30 r, th,j I S I AAA SI, Cr PS doss a� I Ss" . . SL . 3 f H . I o- ad • sL i rt- SI i fy- S• a s-5(P o, � 7( stf- Pc 4 S SU . . . 3 DFSclu noN ii INITTAL SYSTEM I REPAIR SYSTEM OTHER FACTORS(.1946): Available snare(.1945] I SITE CLASSIFICATYON(.1948):' 3 • i SY+�Type(s) . EVALUATED BY: S iliSan , tit;I I e r- OTHER(S)PRESENT: Site LTAR CONN.ENT.S: I ' 1 • . DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES DIVISION OF ENVTRONNMEITAL HEALTH Sheet ..2oj ,;ON-SITE WASTEWATER SECTION PROPS Oi.nq ': SOIL/SITE EVALUATION Ci�uwlx for ON-SITE WASTEWATER SYSTEM OWNER.: APPLICATION DATE ADDRESS: PROPOSED FACILITY:- DATE EVALUATED: Z-or LOCATION OF y 1414 RuCI S w OPOSED DESIGN FLOW(.1949): PROPERTY SIZE: • WATER SUPPLY: LY Private Public ' PROPERTY RECORDED: EVALUATION a W,/°7 Spring Otber METHOD: � Auga Boring u'Pit O Cut TYPE OF WASTEWATER: Sewage 0 Industrial Process 0 Mixed • i ; aiimin!!ni tii:aii.,- iii • i::: ::::::::::::-::::::::::::::::::::::::.:::::::::.................. ...:::::::::::: ::::::::................................... . .. ....... . � .::::.::::::::_::::: ::�:::::�:[::::[[:::::::::::::s:::::iiii:iiiiii'isiiiii;::_::::s:::;is:;:':ii€i"ii ;:::::t:::;:_:i::::i::::; ii:iii;::';° ::: : :i; [i:ttt!t[t:t::::[:::[:t- ::::::::::::J iiQii ;;I:::iii ff ii;;iii_s :::: ::::::::::':: iiSZS a:' ':' .-..': "':`""."°":':L'iiii:� :ii :::::::::::: iii;i:;i?iii''ER iii;iiiii:a:::::::::::::::::::::is:::::ii i i:ii`iiiiIii::: iiiinii;E:::::ii€ii i'i: tL hKL?YtP�D7;OGY .. z ::. :: : : .. . 1941 ::::::::::::::::: t: . : :::::::::::::t::::::;: . ..:..::::..........:::::.::::.::-::::::::::::::::::::::: ::...:::::::::;:s': i =:::i:i:: i: i ::: E MR SORT .:::::::.......":: .:::..:_..-:' ."'..::.':::'.i.!i: i::::::i :: 1942: `;`' »'::i:: :......... '!iiy,iiii;ROSC..':.: iDEPTx. ......5'lRbC.GUIEEf tNi y. C{SNS1STEtCIt £T LSSf 5011 5AP$O51ft FxOF[L . :::.SLOPztt :,.:.(TN .,.. }erriaRE ....::hIL ERALOG:Y COLOR:: ..:DEPTH.. .. . CLASS.... te;;tiss :xoRn p.. / L i- s . • SS 1.33 Sbicis I ••- Ps 5' 35.S4 s; - • I r, bk se( A- 5vtt 3 SS . h>lc '&?1 o( i,k--Ftr [ . i SS O-ID sL • Cr, Se i r (o-.3o 0,-cc 54_,stt i • 305d61c pS cK'- Sc 1 Sp_„ SL I 3 II 0-10 L ,r 3:i C.,- j /0-V0 p. s t � P S X1053 S t bk‘4 &- j3 I •DESCRIPTION INITIAL SYSTEM I REPAASYST°Jd OTHER FACTORS(.1946): - SITE CLASSIFICATION(.1945): . EVALUATED BY: Su ch. t )'A, I t2 r COMMENTS: ' • lia ® OTHER(S)PRESENT: