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HomeMy WebLinkAboutRBPR-04-2016-23668.TIF .4.1\3A co THIS IS NOT A PERMIT Case # RBPR-04-2016-23668 Q i CATAWBA COUNTY HEALTH DEPARTMENT U " t PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES rt 1842 sM Residential Building Plan Review - Modular .11- o t 0 r. . .� ti y• IMPROVEMENT ▪ t' o ¢to U •• • Applicant *OAKWOOD HOMES#712 (ELIOBERTO ALFONSO), 1265 70 HWY W,NEWTON NC 28658 B:(828)217-1862 C:(828)464-2662F:828-464-4301 R712 @CLAYTONHOMES.COM Land Owner WEAVER BILLY A HEIRS, 5509 W NC 10 HWY, HICKORY NC 28602 Owner DAVID QUEEN, 3846 W NC 10 HWY, NEWTON NC 28658 C:8283028603 Paid By RONALD BAKER II„ 8:8284642662 NAME TO APPEAR ON PERMIT David Queen SITE ADDRESS: 3846 W NC 10 HWY, NEWTON NC 28658 PIN # 361903115375 NAME of SUBDIVISION: Lot tl Section/Block PROPERTY SIZE: Square Feet Acres DIRECTIONS: 70 toward Startown Rd/left Startown Rd/right 10 W/pass under 321/about 1 mile down/lot on left PRIMARY CONTACT: Applicant SEWER TYPE: Septic Tank GALLONS PER DAY: 360 WATER SUPPLY: Public Water DESCRIBE WORK: new modular dwelling 28 x 60 /front deck 6 x 6 / rear deck 6 x 6 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? No APPLICATION FOR: New Structure STRUCTURE TYPE: PRIMARY RESIDENCE FACILITY TYPE: Single Family Residence OTHER DESCRIPTION: DESCRIPTION OF SW mobile home EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: 14 x 70 NUMBER OF EXISTING BEDROOMS: #OF OCCUPANTS: 3 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 28 x 60 #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: INNOVATIVE: ANY: YES Other described: NY-dmpplication 04/18/2016 08:22 Pagel of 4 „tYs CATAWBA COUNTY Case a RBPR-04-2016-23668 .C' Public Health Department Subdivision ,,, Environmental Health Division PIN# 361903115375 - / PO Box 389. 100-A Southwest Blvd.Newton.NC 28658 Ia.2 w NAME ON PERMIT: ( DAVID QUEEN), 3846 W NC 10 HWY, NEWTON NC 28658 ( David Queen) Site Address: 3846 W NC 10 HWY, NEWTON NC 28658 Property Size: Square Feel Acres Directions: 70 toward Startown Rd/left Startown Rd/right 10 W/pass under 321/about 1 mile down/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. 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 1-Iealth Specialist will contact you within 5 working days of application date. If you need further information or assistance please call 828-466-7291 AREA2 1 1 IFEENAMEtjlIJ tt i'Jh�el �hIi i 7 1t'11j'({II��iTIATE I�i��liattt FEE,AMOUNrF it u�.l.-Jt ,�.,:.____�...�.....�a� —_,-E.��Id, t.6oa �..�t� ,_ Improvement Permit Fee 04/15/2016 $150.00 t t I t �gptr _t ii It I'Illt�'1 I fl�b� i ,;'1 ' 77. j�Illt . TOTAL FEES tl1t tp t a� �� y�� i�h h hill'”' n$150.00 .� I1 It.lt9 -.V1I 6ttutlt 1i.i nr � lit .Liu - i�r .• Ll.htt tll dii1I iPiJN I„. t' !!l.�a.Li"W;OlfutklCw!ItW!wuL i ,/ 411111 tut. a,. t 111 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) P9-ehappl i cation 04/18/2016 08:22 Page 2 or • 4•I'qA ®G THIS IS NOTA PERMIT Case # RBPR-04-2016-23668 H� f ' CATAWBA COUNTY HEALTH DEPARTMENT 0 .. .1- CI II y\, ®y PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES 1F{ 1 842 :M Residential Building Plan Review - Modular o ro 0 IMPROVEMENT '0•�"PAPA_ : Applicant *OAKWOOD HOMES #712 (ELIOBERTO ALFONSO), 1265 70 HWY W,NEWTON NC 28658 B:(828)217-1862 C:(828)464-2662F:828-464-4301 R712 @CLAYTONHOMES.COM Land Owner WEAVER BILLY A HEIRS, 5509 W NC 10 HWY, HICKORY NC 28602 Owner DAVID QUEEN, 3846 W NC 10 HWY,NEWTON NC 28658 C:8283028603 Paid By RONALD BAKER II, , B:8284642662 NAME TO APPEAR ON PERMIT David Queen • SITE ADDRESS: 3846 W NC 10 HWY,NEWTON NC 28658 PIN # 361903115375 NAME of SUBDIVISION: Lot# Section/I31ock PROPERTY SIZE: Square Feet Acres DIRECTIONS: 70 toward Startown Rd/left Startown Rd/right 10 W/pass under 321/about 1 mile down/lot on left PRIMARY CONTACT: Applicant SEWER TYPE: Septic Tank GALLONS PER DAY: 360 WATER SUPPLY: Public Water DESCRIBE WORK: new modular dwelling 28 x 60 /front deck 6 x 6 / rear deck 6 x 6 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? No APPLICATION FOR: New Structure STRUCTURE TYPE: PRIMARY RESIDENCE FACILITY TYPE: Single Family Residence OTHER DESCRIPTION: DESCRIPTION OF SW mobile home EXISTING STRUCTURES ON SITE(IF ANY) DIM EXISTING STRUCTURE: 14 x 70 NUMBER OF EXISTING BEDROOMS: #OF OCCUPANTS: 3 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 28 x 60 #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: INNOVATIVE: ANY: YES Other described: E9-ehapplication 04/15/2016 17 04 Page 1 of 4 • v,A CATAWBA COUNTY - Case# RBPR-04-2016-23668 Public Health Department Subdivision Q "I Environmental Health Division PIN# t F 361903115375 }li__ PO Box 389, 100-A Southwest Blvd,Newton,NC 28658 NAME ON PERMIT: ( DAVID QUEEN), 3846 W NC 10 HWY, NEWTON NC 28658 ( David Queen) Site Address: 3846 W NC 10 HWY,NEWTON NC 28658 Property Size: Square Feet Acres Directions: 70 toward Startown Rd/left Startown Rd/right 10 W/pass under 321/about 1 mile down/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. 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 3rp ys R: f" a } ? r"' -�— ; FEENAME v s ) 'DATE FEE AMOUNTS. Improvement Permit Fee 04/15/2016 $150.00 w TOTAL FEFS , '"' sir s , " .5150 00'1 i. 1 FEES ARE NON—REFUNDABLE ONCE A SITE VISIT IS MADE OR WORK ON A PLAN REVIEW HAS COMMENCED SYSTEM REDESIGN AND/OR RETRIP WILL INCUR AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) E9-ehapplication 04/15/2016 17:04 Page 2 uf4 CATAWBA THIS IS NOT A PERMIT COUNTY CATAWBA COUNTY Y HEALTH DEPARTMENT w „h .Z.�. Application for Environmental Services Page 1 Improvement Permit Authorization to Construct El Septic Repair ❑ Septic Malfunction❑ Septic Expansion New Well Permit ❑ Replacement Well ❑ Well Abandonment❑ Well Repair ❑ Existing System Inspection (Pre-Approval Required) Application is fo r New Construction ❑ Existing Facility ID !Property Address 3NU? (,Jell' 4-6,1LI /tC 10 Subdivision Id ac C,,t. Lif riDcc& Lot# Acres Section/Block/Phase Driving Directions to Property rip k Lc d{C . )--Gr-(-n,I n / ri --Ft_ n if) <c/-cr-(n(A)rl (Pc-i. fZ yr\ ( J IU L I (. - (pc-S S t ti nrte✓ ,R,- 4$hoc.,--4 inn( Le C cx.., \ 1 04 ocN 1-e -c- ,- NAME TO APPEAR ON PERMIT? v3 Owner ❑ Applicant ❑ Contractor Applicant Contact Information > `' 1��x�41�12 C\c1 11rxvei.NY Name Cc V is \-`ccn e�` H r >P i ` cil\ `vr , ` Address 1 L L o R 1-I t ..� { 0 —t. e t VU C- ,— ?(o s Phone C 2j -�t9 y -n(l Cell Phone Owner Contact Information Name Qc v\ A (Th ,„, e e n Address Zcc • 'S — Y bU( t ll -4�1e �ltiev- IN.Y.1 r�._K t o S� Phone .. T"-- -5 , I Cell Phone Contractor Contact Information Name ,5C---,,-r• P c S V e 11 CC./.rtr- Address Phone Cell Phone WHO WILL BE Lilt PRIMARY CONTACT? ❑ Owner niApplicant ❑ Contractor Description of Existing Structures on Site . a b i ' r0 u " - 'n .AS - - -k) ElnUV2O #of Bedrooms *j' Structure Dimensions 14 41 t] #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 proper in question. If the answer to any question is"yes", applicant must attach supporting documentation. ti Yes Does the site contain any jurisdictional wetlands? 'tYes ' 4o Does the site contain any existing wastewater systems? b Yes 'loo Is any wastewater going to be generated on the site other than domestic sewage? )4,Yes o Is the site subject to approval by any other public agency? ®Yes o Are there any easements or right of ways on this property? Describe Existi water supply in use U Individual Well U Community Well U Semi-Public ell ounty/City/Township Water Line Is a public water supply available? ** Yes ❑ No If a plying 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 N.4.Any ■ E/ l 9WOe-IL-VO w d Z£:VV.ZO ?LLJHA L0Ebb91 U ■ CATAWBA THIS IS NOT A PERMIT COUNTY === CATAWBA COUNTY HEALTH DEPARTMENTS i• ,b,,,,,„�,;, Application for Environmental Services Page' r ^ Proposed Facility Type / LVD Primary Residence ❑ New Residence ❑ Addition to Residence #of New Bedrooms *t ,k lJ/` Project Description In es-0 rY1 l.0 JLJar Imp in,- C Structure Dimensions ��'If (o #of Occupants Basement ❑ Yes No Basement Fixtures ® Yes)EiNo U Accessory Structure(s) Describe #of New Bedrooms *t if applicable Structure Dimensions #of Occupants Accessory Dwelling ❑ Yes ❑No Plumbing ❑ Yes ❑No Describe Plumbing Needed U Multi-Family Residence#Units #Bedrooms per Unit*t Total# Bedrooms *t Structure Dimensions U Food Service Specify Type #Seats Floor Space-Entire Food Service Facility (Sq Ft) #Employees per Shift #of Shifts Dining Area (Sq. Ft.) U Business Specific Type of Business Retail Floor Space 14 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 ❑ Unlmown 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. yy j�( �� �J /�/ Signature of Owner or Agen hP /1 I / � �1�a e Io (_ (� Printed Name of Owner or Agent "\ t s -} c `�A £/Z gLOZ-LL-170 'ui'd 05:b17:ZO ZLLDHW LOEbb9178Z8 644301 MHC712 09:20 40 a.m. 04-14-2016 1 '/1 """I /��� ,;. ' - -DB. 2108;-PG: 41 /(� ,yy,. P8: 40, PG. 141 d��OR OFil ��� I'Iy' DIRECTOR OF F• IKEVIN T.Ai CAROLS / \ 11 V v` p 1 W_ � iZ 08. 2223, PG.693 / • � 0 ``� 3O� [I o� IIRZ I PB. 40, PG. 141 1421 141 l\ Q I - is'-f„... GO • ess \ kS st� e \ \ VONG YANG XE VANG 110 , \\ \ DB. 2211, PG. 567 c ck \ ( . PB, 36, PG, 1 \ �\ \ J1�\ N1ONOON \ ALTEGRA CAE* w \\Q'yC y DO. 2 5 COMPANY 25 \$ b \ � �S\�' o. PB. 38, PG. 1 7 •% \�� vn�I efri\94" HOBME � ,�‘. \ A 0\da. O IF \t1/2 ROD • 9��' \ y (COUND) \\ >��\ I m m BILLY A. WEAVER \ ;" 1 1 1710D m DO.-x1899, PG. 71 \ 1 Lr, -er ic a / I L� E BUCHANAN !n� � I �l 1 fi98 BPG;H 318 b '. i � �� NSB 29�]36,0T \ I 26 PG 131 _ 2 56809 15'V • ' 9475 58823.4a'1V , _� • R Ir . WE \- ' c ou•N D CONTF BEeAR 5/BPIPE � •, \ ( OUND) T". . (FVUNO) (FDURO)6( UN L1 (FOUND) 559'2948'W 25844• �� L6 �1, CORNS z. oo/ dn� < I sa ' ®ME L N N VC I,/ 'Oa` I N 1f.> I NN°� I 5' V' ci r I O /J • DB. 2 Pi 9 m $n a in �4a` I daa N'F 2 PB. b VN� 3�n J[0'Vml.( Srnj,j core) fir.in n ( I O I,' Sma $moa i �1�mm I � m ¢ma 2. m • ` I g ° m1 °md I °O (F/OUND) . N OPl I E I�.:,/(FOUND) SUBDIVISION (30 + (30.00') (30.71') Jp — ' — • P LS cv' L4; cP ]F CATAWB•4-ED �'��U.\ N.C. WEST (paved) • THIS.PLAT SUCH (c-6A �� (APPARENT 60 R/W) ■fS, EXCEPT elli MAINTAIN ALL HE PLAT,. AS • 'ED FOR ANY I, TEDDY E. SHARPE CERTIFY THAT THIS PLAT WAS DRAWN UNDER MY SUPERVISION ROVED BY FROM AN ACTUAL HELD SURVEY UNDER MY SUPERVISION (DEED DESCRIPTION RECORDED IN BOOK 1899 PAGE 7t BOOK— - PAGE— );FROM AN ACTUAL FIELD UNDER MY SUPERVISION: THAT THE BOUNDARIES NOT SURVEYED ARE_SHOWN AS Catawba County Environmental Health /\ J \ 6`'��0 \ illr \ 03,8.9 bo .41. \ l `\Air. \ xi'tq;e#1\ ,s • \. �2 95' N\ --- .... e / i g61�' •3856 i d Parcel: 361903115375, 3846 W NC 10 HWY 1in=60ft NEWTON, 28658 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 verroatlon of any data contained on this map/report product by the user.The County of Catawba,its employees,agents,and personnel,disclaim,and shalt not be held liable for any and al damages,toss ar liability,whether direct,Indirect or consequential which arises or may arise ham this map/report product or the use thereof by any person or entity. Copyright 2014 Catawba County NC • 04/11/2016 E/£ 9L0Z—ll-170 'wit LI:SV:E0 ZlLDHW LOEbb968Z8 Catawba County Environmental Health / .' \ / .6 \ T 3A / 3 i \ 0383t \ �G.> \ A. \ 3B h \ ti 1B (3� e 3Q46 Cif or i PT ` 03850 �� s�o� 560 1 \ ilk g5 (7,>,., 111\\Firoo. LQ-4 _— .% r Ill .10.0 v •3858 _ _ _fr. ...., ' o \ :mss I" Ar 1 n 1 )41. ' 1 00� 10 t 1 2 44.. tips ." V _. a 03908 03888 0 aG \ i„...”...- / Parcel: 361 9031 1 5375, 3846 W NC 10 HWY ��� 1 in=100ft NEWTON, 28658 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 04/11/2016 Ir Parcel.Report Page 1 of 1 Parcel Report - Catawba County NC Parcel Information: Owner Information: Parcel ID: 361903115375 Owner: WEAVER BILLY A HEIRS Parcel Address: 3846 W NC 10 HWY Owner2: null City: NEWTON, 28658 Address: 5509 W NC 10 HWY LRK(REID): 700036 Address2: null Deed Book/Page: 1899/0071 City: HICKORY Subdivision: null State/Zip: NC 28602-7136 Lots/Block: B/null School Information: Last Sale: $23,000 on 1994-08-01 Plat Book/Page: 36/197 School District: COUNTY Legal: LOT B PLAT 36-197 Elementary School: BLACKBURN Middle School: JACOBS FORK Calculated Acreage: 2.930 Tax Map: 002 J 04012E High School: FRED T FOARD Township: JACOBS FORK School Map State Road #: 10 TaxNalue Information: Tax Rates(pdf) Zoning Information: City Tax District: All in County Zoning District: COUNTY County Fire District: PROPST Zoning1: R-20 Building(s) Value: $0 Zoning2: null Land Value: $25,700 Zoning3: null Assessed Total Value: $25,700 Zoning Overlay: ED-O,WP-O Year Built/Remodeled: null/null Small Area: STARTOWN Current Tax Bill Split Zoning Districts: null/null Zoning Agency Phone Numbers Miscellaneous: Firm Panel Date: 2007-09-05 Building Permits for this parcel. Firm Panel #: 3710361900J Building Details 2010 Census Block: 1014 WaterShed: WS-111 Protected Area 2010 Census Tract: 011702 Voter Precinct: P3 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. ©2016, Catawba County Government, North Carolina. All rights reserved. JhCnY (dui • to. Cy(-0 3 rEd rn 3at ,S°4°161/(1 http://gis.catawbacountync.gov/nomap/parcel_report.php?key=361903 1 1 5375&typ=P 4/14/2016 Katherine Harris From: Jonathan Greer Sent: Monday, April 11, 2016 3:40 PM To: Katherine Harris Subject: Re: 3846 W NC 10 Hwy Newton They can continue to use the septic system. Thanks. Jonathan Greer Utilities & Landfill Project Manager On Apr 11, 2016, at 2:36 PM, Katherine Harris<KHarris @CatawbaCountyNC.gov>wrote: Jonathan, Oakwood Homes is applying for a mobile home change out at the address 3846 W NC 10 Hwy, Newton. There is an existing septic system on the property. There is a sewer line showing on GIS on W NC 10 Hwy. The property is back off the road on the other side of a 45 foot ROW. I just want to make sure that they are okay to continue on with their Improvement Permit and to continue using the septic system on the property. Thank you, Katherine Harris Administrative Assistant I Environmental Health Catawba County Public Health 100A Southwest Blvd Newton NC 28658 828-465-8270 828-465-8276 fax The information contained in electronic transmissions is confidential and may be subject to protection under the law,including the Health Insurance Portability and Accountability Act(HIPAA).An electronic transmission is intended for the sole use of the individual or entity to whom it is addressed. If you are not the intended recipient,you are notified that any use,distribution or copying of the message is strictly prohibited.If you received a message in error,please contact the sender immediately by replying to the email and delete the material from any computer. 1 **"9p. Permit and/or Cert. Op. Required_ (Must be completed prior to final) 7 d [ 1?- C A T AM] A COUNTY FIE A L T H D EPA R M E N'I' / d P (704) 465-82e0 Lot Eval. KImprove. Permit. PC Repair Permit Cert. of Comp. Permi Oper. Permit Ocmer/Agent BI Iiv! tA.JCA t Phone `/' 2 - ZSC 7 Address 2r 80Y /S//I Subdivision / �/ r��� /I�� Sectio /B10 k/Phase Lot#_ Lot Size 5,70/ Directions: /i e,.J vai )' a,r.�P /e/ente /227 Ok.) /e&&az 7 •` J 6 w Mcie%, y Facility: House Mobile Home Business_ . Other: Tax-Map # 2'7 - Wi fi-- 1/2,-- Multi-family_ Other . Zoning Approval # 99O z3 v Z Bedrooms 602- S Employees . Application Rate .3 GPD Flowe2eEd Hot Tub di Sp es/ Special Fixtures . 100% Repair Area yes/no REPAIR NOTICE: Basement yes Basement Plumbing yes/no . REPAIRS MUST BE WITHIN 30 DAYS OR Water Supply: Private }C7 Public_ . DAYS FROM DATE OF PERMIT. ***********************, ****************************************************************** Type of System: Trench )c Bed_Pump_Pump/Panel_Panel_LPP_Other Tank Size: Septic Tank /Mz9d • Pump Tank Nitrification Field: Total Square Feet 44) Depth of Stone z Bed Size Trench Width c_36 Total Length of All Trenches 2_6(.) Number of Trenches •3 Individual Trench Length( // 1(7 7/ /_ Feet on Center , Maximum Trench Depth 2 e/ , Distance of Nearest Well SJ Lot Evaluation: Approve../no (Void After 24 months) ****************************************************************************************** Topoc2 el % Slope Sketch of lot Evaluation Site - System Design - Final Texture 47/47J-7 P • I DO NOT rn rs" !"''a r m *-"2 NSTALL . Structuregare j' WHEN WET Clay Min. / ) / � . 6 ri Soil Wetness �\ Soil Depth 7 C ../-166 ,(01 Restric. Hoz " Available space -77.7-- 'no Overall Class . U . 'mob4 ( 9 Comments: • v Septic Tank Contractors A� MUST contact the Sanitarian BEFORE I . changing permit. I **NO GUARANTEE OR WARRANTY IS IMPLIED OR GIVEN THROUGH THE ISSUANCE OF THIS PERMIT** ***************** v//p ************* Permit Date T (Improvement 'ermit o •r .0 months) Owner/Agent �P •1 I f .y,` . v .a 't.. ian 41(-La !�/ /AL�i Installed By _,,a.r ,t. _ Date it a. Sanitaria' .ar/��,/�I&�t* (Nile any changes/informati. i red or by sketch on (pack) /`\ IF A PERMIT HAS TO BE REDESIGNED AND/OR RETRIPS MADE TO THE PROPERTY. THERE******** t IS AN ADDITIONAL $25 CHARGE. ,ti �� White-Office Blue-Bldg Insp.Comp. • • Yellow-Owner/Agent Green-Bldg.Insp. P i? t 4 •