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Home My WebLink AboutEHPR-11-09-2696 (2).TIF p'A C THIS IS NOT A PERMIT Case # EHPR-11-09-2696 CATAWBA COUNTY HEALTH DEPARTMENT v 'C Plan Review Application for Environmental Services 1842 sM Environmental Health Plan Review - OSWP EP MALFUN AIPTILrf A'NJ ®,WNER. CONTRACTOR LEWIS E WMSO.% LEWIS E WILSON 1388 ASTORIA PKWY 1388 ASTORIA PKWY CATAWBA NC 28609-8884 CATAWBA NC 28609-8884 NAME TO APPEAR ON PERMIT LEWIS E WILSON Pin#: 460606286120 SITE ADDRESS: 7271 LYNBROOK CREEK RD, Denver, NC DIRECTIONS: HWY 16 S, LEFT CAMPGROUND RD, LEFT CATAWBA BURRIS RD, RIGHT BANKHEAD, LEFT WOODCHUCK TO STOP SIGN AND BEAR RIGHT. GRAY CABIN ON RIGHT NAME of SUBDIVISION: CRESCENT LAND AND TIMBER CORP Lot # 61 Section/Block/Phase PROPERTY SIZE: Square Feet Acres 0.87 Date Platted/Recorded TYPE OF FACILITY: House X Mobile Home Dimension of Structure Bedrooms 1 Basement: No Water Using Fixtures in Basement:No No. in Family 2 Whirlpool Tub : Gal. Capacity: MULTIPLE FAMILY 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: NO Has any grading, removal, or addition of soil been done to this property? If so, describe NO Are there easements/right-of-ways recorded on this property? NO 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 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 setbacks. Date: Signature of Applicant or Agent nabk An Environmental Health Specialist will contact you within 2 working days of application date. pllm-&f -fi rng_ If you need further information or assistance please call 828-466-7291 ~r el AREA 1 Ut I (FOR OFFICE USE ONLY) Zoning Approval: Yes No Zoning Approval UDO Zoning Form A Minimum Setbacks AMOUNT Front FEE NAME DATE Side Authorization to Construct (Repair) F, 11/12/2009 $300.00 Rear TOTAL FEES $300.00 Max Hght I __j *If a permit has to be redesigned and / or RETRIPS made to the property, there is an additional $60 charge 11/13/09 08:46 THIS IS NOT A PERMIT WLS CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services Improvement Permit ❑ Authorization to Construct ❑ Septic Repair Septic Expansion ❑ Existing Tank Check ❑ New Well Permit J❑ Replacement Well ❑ Well Abandonment ❑ 1. Name to Appear on Permit ~ee, , s (,t) i I s ot.-- 2. Permit Requested By v Business PhoneW-(2~~' COs Address S r- t c>-, ABU) La L 1 ' &Crl Home Phone {~~f-if7~ -52~ 7S 3. Property Owner .rat J i5 2~ r ~SU~J Business Phone Address rr'G+ U4 t (l~ Home Phone S -q78 cIP-0s 4. Name of Subdivision N Ck Lot # ( / Section/Block/Phase Property Address rl."L11 1 n broo4 Qreee_ 41d E? V~►~ C f '37 Direc •ons to Property: f w 4 (!o ~ 0(;t n Qe, found Pgt _ 4ukn. lle f J_e0n u auk n.- ~~is ~ f Ult 6 Naid L 'ton W ooalc Yr tx~ cv ~ 5. Property Size: Square Feet Acres Date Platted/Recorded I 1 4 k8 6. TYPE OF FACILITY: House Mobile Home Dimension of Structure Bedrooms* *Any room that will be intended or 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 system size increase in the future. Basement: yes/0) Water Using Fixtures in Basement: yes No. in Family Whirlpool Tub yes/(5 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? Yes N If so, describe: 8. Has any grading, removal, or addition of soil been done to this property? Yes /Q° If so, describe: 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? Yes /0 Check type that is available: [ ] Community well [ ] Serni-public well [ ] 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 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 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. r **IF A PERMIT HAS TO BE REDESIGNED AND/OR RETRIPS MADE Td THE PROPERTY, THERE IS AN ADDITIONAL CHARGE" 0 Date / Signature of Owner or Agent Catawba County, North Carolina This map product was prepared from the Catawba County, NC, Geographic Information System. N Catawba Countv has made substantial efforts to ensure the accuracy of location and labeling information 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 fron this map product or the use thereof by any person or entity. Legend Selected Parcel Number: 4606-06-28-6120 1 inch = 40 feet Prepared for: 10.00 s° s 3 1 0 17.00 ~ co 4280 c-~ ~s ~ 61 ~ 61/20 M ~ Cpry p 269.35 0 THIS IS NOT A LEGAL DOCUMENT Thursday, November 12, 2009 02:08 PM i~v CATAWBA COUNTY NC - Parcel Report Informatiorr Regarding Selected Parcel(s) Parcel ID: 4606-06-28-6120 Name: WILSON LEWIS E Name2: WILSON PATRICIA T Address: 1388 ASTORIA PKWY Address2: City: CATAWBA State: NC Zip: 28609-8884 Account: 75706700 Calc Acreage: 0.87 Tax Map: 017 X 34061 LRK: 17899 Deed Book: 1543 Deed Page: 0260 Subdivision Name: CRESCENT LAND AND TIMBER CORP Subdivision Block: Lots: 61 Plat Book: 16 Plat Page: 16 Building Number: 7271 Street Name: LYNBROOK CREEK RD Site Zip: 28037 Township: MOUNTAIN CREEK Fire Code: SHERRILLS FORD City Code: COUNTY State Road: Total Bldgs Value: $150,500 Land Value: $159,200 Total Value: $309,700 Year Built: 1974 Year Remodeled: Last Sale Date: 1/1/1988 Last Sale Amount: $115,000 Neighborhood: 129 Watershed: WS-IV Critical Area Watershed Split: NO Voter Precinct: P41 E911 District: COUNTY Zoning: R-30 Zoning2: Zoning3: Zoning Split: N Zoning Overlay: CRC-O,WP-O,FPM-O Zoning District: COUNTY Split Zoning Dist: N Split Zoning Dist(1): 0 Split Zoning Dist(2): 0 School District: COUNTY Elementary School: SHERRILLS FORD Middle School: MILL CREEK High School: BANDYS School Split: NO P&Z Case Number: Census Tract 2010: 011502 Census Block 2010: 4012 Small Area Plan: SHERRILLS FORD Agricultural District: Printed: Thursday, November 12, 2009 02:08 PM CATA"A COUNTY, NC 100-A South West Blvd PLAN RECEIPT a Newton, NC 28658- 0 (828)465-8399 Thursday, November 12, 2009 O j$ 42 sM www.catawbacountync.gov Plan Case: EHPR-11-09-2696 Invoice Number: INV-11-09-257215 Environmental Health Plan Review Invoice Date: 11/12/2009 Fee Name Fee Amount Authorization to Construct (Repair) Fee Adjustable $300.00 Total Fees Due: $300.00 PAYMENTS Date Pay Type Check Number Amount Paid Change 11/12/2009 Check 7433 $300.00 $0.00 Total Paid: $300.00 Total Due: $0.00 plan receipt ; ca39516t -d26f-d ! 19-a fd8-f4 ~a6ac)fte2 }.rpt 11/12/2009 14:09