Loading...
HomeMy WebLinkAboutRBPR-02-2016-23284.TIF 4.1j8/6.s: . THIS IS NOT A PERMIT Case # RBPR-02-2016-23284 / a CATAWBA COUNTY HEALTH DEPARTMENT Ur_ �n {•U ¢\' '�', c PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES ' N./ rM Residential Building Plan Review - Manufactured Home O t-D o X IMPROVEMENT 0 . 13 , oNd k1;M Applicant tYTON HOMES (BOBBI LASAGE), PO BOX 132,TAYLORSVILLE NC 28681 C:8282173168 Land Owner HUBERT COOK,2743 LYNN MOUNTAIN RD, VALE NC 28168 Owner PRESTON J. &ALEXIS M. ZIMMERMAN,2739 LYNN MOUNTAIN RD, VALE NC 28168 B:8282178312 C:9804297812 NAME TO APPEAR ON PERMIT Preston J. & Alexis M. Zimmerman SITE ADDRESS: 2739 LYNN MOUNTAIN RD, VALE NC 28168 PIN # 267801458497 NAME of SUBDIVISION: Lot# 3 Section/Block PROPERTY SIZE: Square Feet Acres 0.92 DIRECTIONS: Right Southwest Blvd/right W C St/right Gracie Ln/right Lynn Mtn Rd/before Wildlife RD PRIMARY CONTACT: Applicant SEWER TYPE: Septic Tank GALLONS PER DAY: 360 WATEK$UPPLY: Well DESCRIBE WORK: Trade Out w/ SW mobile home 16x76, Decks: front& back 6x6 change out SW mobile with a 2016 SW**home being setup in same location- home facing Lynn Mtn R*** Home must meet appearance criteria ---Screen or Remove Towing Tongue, Front Deck must be minimum of 3 sq ft, home must be masonry underpinned (can use vinyl if singlewide). Home must be parallel to road and must face front of property **If this new home is a replacement for an existing home—that existing home must be removed from the site within 30 days of the issuance of the Certificate of Compliance** 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? APPLICATION FOR: New Structure STRUCTURE TYPE: PRIMARY RESIDENCE FACILITY TYPE: Mobile Home OTHER DESCRIPTION: DESCRIPTION OF SW mobile home (to be removed) EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: 14 x 60 NUMBER OF EXISTING BEDROOMS: 3 #OF OCCUPANTS: 3 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: SW mobile home 16x76, Decks: front& back 6x6 #OF NEW BEDROOMS:: 3 Desired system types(Improvement Permit or Authorization to Construct): ACCEPTED: ALTERNATIVE: CONVENTIONAL: OTHER: INNOVATIVE: ANY: YES Other described: IN-ehapplicalion 03/03/2016 08:50 Page 1 of 4 sa CATAWBA COUNTY Case n RBPR-02-2016-23284 ;C !':f1 i. Public Health Department Subdivision G Environmental Health Division PINt ,LLQ -c 267801458497 PO Box 389, 100-A Southwest Blvd, Newton,NC 28658 /8. :w NAME ON PERMIT: ( PRESTON J. &ALEXIS M. ZIMMERMAN),2739 LYNN MOUNTAIN RD, VALE NC 28168 ( Preston J. &Alexis M. Zimmerman) Site Address: 2739 LYNN MOUNTAIN RD, VALE NC 28168 Property Size: Square Feet Acres 0.92 Directions: Right Southwest Blvd/right W C St/right Gracie Ln/right Lynn Mtn Rd/before Wildlife RD 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. Date: Signature of Applicant or Agent An Environmental Health Specialist will contact you within 5 working days of application date. If you need further information or assistance please call 828-466-7291 AREA2 �rr . 77 w.. 1 m> —7;- , .. /i . r !EEENAMEt„ t t i'.+ r ,,..: %�v- - - - , '•,,,',,' DATE t.itt FEEAMOUNTe Improvement Permit Fee 02/25/2016 5150.00 .r fTOIALFEES ey' t 3'.r. '` ait IGI 'I51§00 �t} 5 5; 4,} . ,';tl it :,r.,ri nitt,45: Sash.. f8".- %,- 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-chapplication 03/03/2016 08:50 Page 2 o14 44y,A �� THIS IS NOT A PERMIT Case # RBPR-02-2016-23284 r'T Eft Q _ �' CATAWBA COUNTY HEALTH DEPARTMENT ° ` 11:11.1. f 0 `i '9 417 ~c PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES ' • 1842 sM Residential Building Plan Review - Manufactured Home gtte ro �,.o .; Re IMPROVEMENT .o _ � 9_ L Applicant CLAYTON HOMES (BOBBI LASAGE), PO BOX 132,TAYLORSVILLE NC 28681 C:8282173168 Land Owner HUBERT COOK, 2743 LYNN MOUNTAIN RD, VALE NC 28168 Owner PRESTON J. & ALEXIS M. ZIMMERMAN,2739 LYNN MOUNTAIN RD, VALE NC 28168 B:82821783I2 C:9804297812 NAME TO APPEAR ON PERMIT Preston J. & Alexis M. Zimmerman SITE ADDRESS: 2739 LYNN MOUNTAIN RD,VALE NC 28168 PIN # 267801458497 NAME of SUBDIVISION: Lot# 3 Section/Block PROPERTY SIZE: Square Feet Acres 0.92 DIRECTIONS: Right Southwest Blvd/right W C St/right Gracie Ln/right Lynn Mtn Rd/before Wildlife RD PRIMARY CONTACT: Applicant SEWER TYPE: Public Sewer GALLONS PER DAY:..... 360 WATER SUPPLY: Private Well DESCRIBE WORK. rade Out w/SW mobile home 16x76, Becks: front & back 6x6) . ., )111-mobile with a 2016-SW-*"home being setup iFrs me location- home facing Lynn Mtn R*** Home must meet appearance criteria---Screen or Remove Towing Tongue, Front Deck must be minimum of 3 sq ft, home must be masonry underpinned (can use vinyl if singlewide). Home must be parallel to road and must face front of property **If this new home is a replacement for an existing home-that existing home must be removed from the site within 30 days of the issuance of the Certificate of Compliance** 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? APPLICATION FOR: New Structure STRUCTURE TYPE: PRIMARY RESIDENCE FACILITY TYPE: Mobile Home OTHER DESCRIPTION: DESCRIPTION OF SW mobile home (to be removed) EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: 14 x 60 NUMBER OF EXISTING BEDROOMS: 3 #OF OCCUPANTS: 3 ----PROFIOSED-CONST CTION NEW STRUCTURE DIM:: SW mobile home 16x76, Decks: front& back 6x6 #OF NEW BEDROOMS:: 3 —__ Desired system types(Improvement Permit or Authorization to Construct): ACCEPTED: ALTERNATIVE: CONVENTIONAL: OTHER: INNOVATIVE: ANY: YES Other described: E9-chappl ication 02/26/2016 11:05 Page I of 4 ,p CATAWBA COUNTY Case# RBPR-02-2016-23284 (tom c,,,- Public Health Department Subdivision . w, „`�,- Environmental Health Division PIN# 267801458497 "*e`'- PO Box 389. 100-A Southwest Blvd,Newton. NC 28658 18 2 :. NAME ON PERMIT: (PRESTON J. &ALEXIS M. ZIMMERMAN), 2739 LYNN MOUNTAIN RD, VALE NC 28168 ( Preston J. &Alexis M. Zimmerman) Site Address: 2739 LYNN MOUNTAIN RD, VALE NC 28168 Property Size: Square Feet Acres 0.92 Directions: Right Southwest Blvd/right W C St/right Gracie Ln/right Lynn Mtn Rd/before Wildlife RD 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. Date: Signature of Applicant or Agent An Environmental Health Specialist will contact you within 5 working days of application date. If you need further information or assistance please call 828-466-7291 AREA2 {",,r uo s fi ry°I r��i iti a'/ iad FIT: F m !S "ic�i"i'C�1 Y FEENAMF ° 4 a ( '�'rr ^ s ° DATF +sc FEEAMOUNT x Improvement Permit Fee 02/25/2016 $150.00 LA ` a. TOTAL FEES Ixl It r2 t E11$11 :$1 6t,4i!. S1b0 000E t nt T 06/i.,eN—4/ , /J i 6/ :an/a06 `oCCEA M26i a,SGaa/e A 4-..t .6 i/E.o.',.:°'mod 666i z!;S 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-ehapplicadon 02/26/2016 11:05 Page 2 of 4 gIA .G , THIS IS NOT A PERMIT Case # RBPR-02-2016-23284 FY it a, R CATAWBA COUNTY HEALTH DEPARTMENT 0_'; ,o ;;tt•'"ttyt arr wv►a l �° PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES . ti' �8 2 5H Residential Building Plan Review - Manufactured Home 0 •o . ' ••IMPROVEMENT :'''' o' • Applicant CLAYTON HOMES .(BOBBI LASAGE), PO BOX 132. TAYLORSVILLE NC 28681 C:8282173168 Land Owner HUBERT COOK,2743 LYNN MOUNTAIN RD. VALE NC 28168 Owner PRESTON J. &ALEXIS M. ZIMMERMAN, 2739 LYNN MOUNTAIN RD, VALE NC 28168 B:8282178312 C:9804297812 NAME TO APPEAR ON PERMIT Preston J. & Alexis M. Zimmerman SITE ADDRESS: 2739 LYNN MOUNTAIN RD, VALE NC 28168 PIN # 267801458497 NAME of SUBDIVISION: Lot# 3 Section/Block PROPERTY SIZE: Square Feet Acres _ 0.92 — DIRECTIONS: Right Southwest Blvd/right W C St/right Grade Ln/right Lynn Mtn Rd/before Wildlife RD PRIMARY CONTACT: Applicant SEWER TYPE: Public Sewer GALLONS PER DAY: 360 WATER SUPPLY: Private Well DESCRIBE WORK: change out SW mobile with a 2016 SW **home being setup in same location- home facing Lynn Mtn R*** Home must meet appearance criteria ---Screen or Remove Towing Tongue, Front Deck must be minimum of 3 sq ft, home must be masonry underpinned (can use vinyl if singlewide). Home must be parallel to road and must face front of property **If this new home is a replacement for an existing home-that existing home must be removed from the site within 30 days of the issuance of the Certificate of Compliance** 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? APPLICATION FOR: New Structure STRUCTURE TYPE: PRIMARY RESIDENCE FACILITY TYPE: Mobile Home OTHER DESCRIPTION: DESCRIPTION OF SW mobile home EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: 14 x 60 NUMBER OF EXISTING BEDROOMS: 3 #OF OCCUPANTS: 3 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 16 x 76 #OF NEW BEDROOMS:: 3 • Desired system types (Improvement Permit or Authorization to Construct): ACCEPTED: ALTERNATIVE: CONVENTIONAL: OTHER: INNOVATIVE: ANY: YES Other described: E9-chapplicaion 02/25/2016 17:41 Page 1 of 4 ,gA CATAWBA COUNTY Case# RBPR-02-2016-23284 111r-2', Public Health Department Subdivision , -- - n H Environmental Health Division PIN# 114W 1.5 267801458497 t PO Box 389, 100-A Southwest Blvd,Newton.NC 28658 /g 2 sM NAME ON PERMIT: ( PRESTON J. & ALEXIS M. ZIMMERMAN), 2739 LYNN MOUNTAIN RD, VALE NC 28168 ( Preston J. &Alexis M. Zimmerman) Site Address: 2739 LYNN MOUNTAIN RD, VALE NC 28168 Property Size: Square Feet Acres 0.92 Directions: Right Southwest Blvd/right W C St/right Gracie Ln/right Lynn Mtn Rd/before Wildlife RD 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 identificati n la li g of all property lines and corners and making the site accessi:,1 so at a complete site evaluation/pan be performed. Date: �� �� Signature of Applicant or Agent '�,++r / An'? tronmental Health Specialist will contact you within 5 • or -d. p i ion date. If you need further information or assistance please call 828-466-7291 AREA2 •FEENAME DATE FEE AMOUNT Improvement Permit Fee 02/25/2016 $150.00 TOTAL FEES $150.00, 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-ehappl iention 02/25/2016 17:41 Page 2 of 4 CATA '[ , y, THIS IS NOT A PERMIT cuuN l Yr«BJL,� CATAWBA COUNTY HEALTH DEPARTMENT ,„n=cp,- -r--, Application for Environmental Services Page 1 Improvement Permit Authorization to Construct❑ Septic Repair❑ Septic Malfunction❑ Septic Expansion ❑ New Well Permit❑ Replacement Well ❑ Well Abandonment ❑ Well Repair ❑ Existing System Inspection (Pre-Approval Required) ❑ -7Application is for New Construction ❑ Existing Facility ❑ Property Address,7. X39 I14V1n nYfrJ; Subdivision N/k Vale- t M-G d g Ron Lot# 3 Acres �” p Section/BlocWPhase Driving Directions to Property Fe 8(50,0\ \TQ, j BIva -ht. O MM-n _ S1- Tus-m ® 121kctt Lnl Tik p r�3tb Lira yv pd IVIem (S Ot t \D 0 ufi U-Ft (1' Dmsm Ma IOUtN p2, e2-13‘? NAME TO APPEAR ON PERMIT?X Owner ❑ Applicant ❑ Contractor (J%� Applicant Contact Information I � Name (a-sY >4 s gI Paido i Ls&e, 2__- Address � ecyl Il uri L- , C� . h< /&(a t .S Phone � _217_ 31 top, Cell Phone S252,-?17—3 Ito S Owner Contact Information Name Alex 15 71 ivl rrn�l 1 l Address �^�2 I i 'VQ .� Mc_ (p 0 Phone air r —21,7" $3 1 ?- Cell Phone 'so_q2q- 7,5.5/2._, Contractor Contact Information Name Address Phone Cell Phone WHO WILL BE THE PRIMARY CONTACT? ❑ Owner 'd" Applicant ❑ Contractor Description of Existing Structures on Site an 7a A. ' OVVI.a #of Bedrooms *j Structure Dime• nsions II-1X(00 #of Occupants 3 Basement ❑ Yes No Basement Fixtures 0 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 No Does the site contain any jurisdictional wetlands? )(Yes o Does the site contain any existing wastewater systems? ® Yes o Is any wastewater going to be generated on the site other than domestic sewage? 7114Yes No Is the site subject to approval by any other public agency? El Yes No Are there any easements or right of ways on this property? Describe Existing water supply in use X Individual Well ❑ Community Well ❑ Semi-Public Well ❑ County/City/Township Water Line Is a public water supply available? ** ❑ Yes )No 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 ❑Alternative ❑ Conventional ❑ Innovative ❑ Other ❑ Any gem ALTANA m A THIS IS NOT A PERMIT ' ` CATAWBA COUNTY HEALTH DEPARTMENT ; ,cm„n Application for Environmental Services Page 2 /3 Nm Proposed Facility Type 2 ] ' n ❑ Primary Residence New Residence ❑ Addition to Residence #of New Bedrooms *t 3 ,fl (Yx("�'., Project Description Nat - lJX W Structure Dimensions • 7 - #of Occupants Basement ❑ Yes a No Basement Fixtures 0 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 ❑ Multi-Family Residence#Units #Bedrooms per Unit*t • • 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 ❑ Semi-Public Well ❑ Community Well Abandonment Type ❑ Drilled ❑ Bored ❑ Dug ❑ Unknown Well Repair Requested ❑ 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. C16411--Y4 41001e,.Cj45/ Signature of Owner or Agent �� Date c)-124/ Printed Name of Owner or Agent 7 4 • • ► ,A Q(,' '4 / Catawba County Environmental Health V • 775 er,..._______yer-- liP • . - ,1•.57 NS 45 ow _ow Ai wed n �Y o y' a 0 aft °J ` bei • Aw rte!` fir ,moo lir s.00 it 52.os • • 5 2 2 Parcel: 267801458497, 2739 LYNN MOUNTAIN 1in=50ft • RD VALE, 28168 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 • 02/25/2016 Parcel Report Page 1 of 1 Parcel Report - Catawba County NC Parcel Information: Owner Information: Parcel ID: 267801458497 Owner: COOK HUBERT LEE Parcel Address: 2739 LYNN MOUNTAIN RD Owner2: COOK RACHEL T City: VALE, 28168 Address: 2743 LYNN MOUNTAIN RD LRK(REID): 7647 Address2: Deed Book/Page: 1045/0138 City: VALE Subdivision: State/Zip: NC 28168-7507 Lots/Block: 3/ Last Sale: School Information: Plat Book/Page: 27/134 School District: COUNTY Legal: LOT 3 3 PL 27-134 PL 27-134 Elementary School: BANOAK Calculated Acreage: .920 Middle School: JACOBS FORK Tax Map: 008 B 02004C High School: FRED T FOARD Township: BANDYS School Map State Road #: 1108 Tax/Value Information: Tax Rates(pdf) Zoning Information: City Tax District: All in County Zoning District: COUNTY County Fire District: COOKSVILLE Zoningl: R-40 Building(s) Value: $0 Zoning2: Land Value: $7,400 Zoning3: Assessed Total Value: $7,400 Zoning Overlay: WP-O Year Built/Remodeled: / Small Area: PLATEAU Current Tax Bill Split Zoning Districts: / Zoning Agency Phone Numbers Miscellaneous: Firm Panel Date: 2007-09-05 Building Permits for this parcel. Firm Panel #: 3710266800J Building Details 2010 Census Block: 2011 WaterShed: WS-III Protected Area 2010 Census Tract: 011802 Voter Precinct: P2 Agricultural District: PROXIMITY 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. 1DROF \SO http://gis.catawbacountync.gov/nomap/parcel_report.php?key=267801458497&typ=P 2/25/2016 CATAWBA COUNTY HEALTH DEP I ,2o- (70446Repair No- 0 5 Lot Evaluation Improvement Permit `/ Repair Permit Completion Permit Owner/Agent g CV' . Phone -// Address tentrIP'0 U. afirill Subdivision (,� Section/Bloc ot? Lot Size 1177 Directions: - 101211lSZc'7 .n h . L. Ati IKITTI W411 131_ IPNifilDUFWi a, ai_1!!fl :.cr, - Facility: House_ Mobile Hose V Business . Other: Zoning Approval e;i no # 1 14 23 Multi-family Other ' - 1002 Repair Area yes/no Bedrooms 2 Seats Employees . CPD Flow Application Rate Hot Tub or Spa yes/no Special Fixtures REPAIR NOTICE: REPAIRS MUST BE WITHIN Basement ves no esent Plumbing yes/ 'o . 30 DAYS OR DAYS FROM DATE OF Water Supply: Private Ba P.hlic . PERMIT. Type of System: Trench L Bed System) Other (Specify) Tank Size: Septic Tank MOO 9o_ Pump Tank // ' t Nitrification Field: Total Square Feet (ACS Depth of Stone c� Bed Size Trench Width 31 na Total Leygth of All Trenches Wcoi Number of Trenches 3 r+ rr Individual Trench Lengthen/ b 2/ 67/ / _ Feet on Center (7/ Maximum Trench Depth/if Distance of Nearest We 155-/0 Lot Evaluation: Approved t4t' no (Void After 24 months) Topo 'C/D 2 Slope Sketch of lot Evaluation Site - System Design - Final Texture C.o. r /54,C7 l Structure ,( 1pc4 4' ! _ Clay Min. P + >~ i" Repair Soil Wetness " � S` � Qie°. Soil Depth (( `} Restric. Hoz. at " QJI Available Class S( Uno (1 I Overall Class S U —^ \ Comments: Tl a'i l� ► Sn�i+ � � o JO . e /� ' . At* M J } t / o mo , r , d ' V) ' r�� �;" � Q I aa 7d r hi ' .�.,�,.,.�,�*...... 'C ..em ..,� Permit Date 'J • 10 r(Improvement Permit void after 60 months) AYOwner/Agent aw1i .' r . .,/�� - Sanitarian . i• {' ':J. Installed 1���%��� �... Date I. Z_ Sanitarian st"e��tf �. IIL (Note any / 4n.es/informatidn' in 'red or by sketch on .. ck) / Z�Oo CATAWBA COUNTY HEALTH DEPARTMENT. A A Telephone: (704) 465-8270 TDD: (704/)) •465-8200 �� N° 0 1 `t `f Improve. Permit Authorization+ to Construct K Repair Permit Oper. Permit !R System Type J owner/Agent L MYr� C, ( no IC ` Phone 4 2 - '� CJ/ Address cr q (-YNtJ &'Lj (2CJ Subdivision V R( F N C Section/Block/Phase Lot# Lot Size Directions: /0 w ep 0A, Cv,V/U i-1'r/,v 2� Ley- rT/ 2r6iFr 7a.S t l6 f- w/lc' /,.W..c ' PNe1eMCC Facility: House Mobile Home X Business . Other: Tax Map # ?8 - Z - el Multi-family Other . Zoning Approval # .2- ...10 4/0.41 # Bedrooms # Seats # Employees . Application Rate GPD Flow Hot Tub or Spa yes/no Special Fixtures . 100% Repair Area yes/no Basement yes/no Basement Plumbing yes/no Water Supply: Private Well Public Type of System: Trench y Bed Pump Pump/Panel Panel LPP Other r Tank Size: Septic Tank Size �1^-S ,v\ Pump Tank Size Nitrification Field: Total Square Feet 806 Depth of Stone J Z. Bed Size Trench Width 36 Total Length of All Trenches /O d Number of Trenches Individual Trench Length_/_/ / / Feet on Center Maximum Trench Depth Z y Distance of Nearest Well *DO NOT INSTALL WHEN WET* Topo % Slope Texture Structure Clay Min. Soil Wetness " Soil Depth " P ��l Restric. Hoz. at " (PR,,fik I &Yf /tiF1'I Available space yes/no Y V■Overall Class S PS U Comments: 1 P1�i55 acid_ p Lief...) d G - - — LOE- _ j D v i3X //, lk.PJ billi **NO GUARANTEE OR WARRANTY IS IMPLIED OR GIVEN AS TO THE PERFORMANCE OR LENGTH OF TIME THIS SYSTEM WILL FUNCTION** *Improvement Permit has no expiration date and is transferable, but may be revoked if site plans or intended use changes for the proposed facility. An Authorization to Construct is valid for (5) five years from date issued and is not transferable. Permit Date //- 20- 9S Owner/Agent yyr �/ Sanitarian t/ / /� �, _ • Installed By je'i » `j��/� Date/7-07-55. ate//07 55. Sanitar -nad� to rA if II White-Office Blue-Building Inspection Operation Permit Yellow-owner/Agent Green-Building Inspection Authorization to Construct .CATAWBA COUNTY HEALTH DEPARTMENT i"°51 • Telephone: (828)465-8270 TDD: (828)465-82 WLS#v/— Cc' IP . -AC Ape Pr t O�prr..,Prmt. Sys. Type Well Prmt. replacement Well Well Rpr. Prmt. Owner/Agent / . Phone ' Address _ - _`� ' /r Subdivision Se tion/Block/Phase Lot# Lot Size Directions: / Ina. Blif t:I--� • S a - - rrwi �rfr n a / — Property Address ow, _ ,.....4 Facility: House Mobile Home Lusiness Multi-family . Other: Pin Number tQgt 7�3--cry iir . g e/92 Other . Zoning Approval# Y # Bedrooms #Seats # Employees . Application Rate GPD Flow Hot Tub or Spa yes/no Special Fixtures Basement yes/no . 100% Repair yes/no Basement Plumbing yes/no Water Supply: Private Well/ Public Semi-Public *4*4***4********4*4*4*****4*******4****4*******4*4***************4******i#****4***4444***44*4*4**4************************4* Type of System: Trench Bed Pump Pump//•anel Panel LPP Other t Septic Tank Size ' - p Tank S' a =� Aetrificalion Fiel oral Square Feet iepth of Stone -�. Bed Size 'rent Wi•. C _ A - -th of A I-ren • `u •ber of Trenches Trench Length_/ / / / / Feet on Center Maximum Trench Depth Distance of Nearest Well *DO NOT INSTALL SEPTIC WHEN WET* *WELL RECORD REQUIRED AT COMPLETION* *********4*4*4*4*******4*4*4*4*4******4***4**4******4*********4*******4****4****4*****4***4***44*4************4****4*****#* Topo • % Slope • Textu S ture — . ay Mi Soil W i ness e" '� . Soil t:ept . Re- ric 'oz. at I / Available vac: y n Overall Clan; PS ` Elill . Comments: 54 /.‘ if' I: , Y V Filter Required - I rt, Riser required when �n✓j tank is more than 6 inches deep. **NO GUARANTEE OR WARRANTY IS IMPLIED OR GIVEN AS TO THE PERFORMANCE OR LENGTH OF TIME THIS SYSTEM WILL FUNCTION** 44*444***************4*****4********4444*******4****4*************4444*****44******4***4******4444******4************4***** *Improvement Permit has no expiration date and is transferable, but may be revoked if site plans or intended use changes for the proposed facility. An Authorization to Construct is valid for (5) five years from date issued and is not transferable. Well Permit valid for 5 years provided site conditions do not change. Well location, installation, and protection must meet state and local regulations, and must be inspected and approved by a representative of the Catawba County Health Department before any portion of the installation is put into use. ' The siting of the well by the Health Department staff is to provide protection from known possible sources of contamination. No volume of water is guarante-d at any site by the Health Department. /!����^ 2 Permit Date — EHS -r_._Qi 21). `-1--1_i Owner/Agent r-i—ti a�i/�e__e - Septic Tank Installed By Date EHS Well Installed By Well Grout Approval Date Well Head Approval Date Date Sample Collected Date of Results Results EHS White-Office Blue-Building Inspection Operation Permit Yellow-Owner/Agent Green-Building Inspection Authorization to Construct