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HomeMy WebLinkAboutEHPR-11-09-2776 (2).TIF A c~G _ THIS IS NOT A PERMIT Case # EHPR-11-09-2776 CATAWBA COUNTY HEALTH DEPARTMENT v ^C Plan Review Application for Environmental Services 1842 5M Environmental Health Plan Review - OSWP/FLI EXS_SYSTEM APPLICANT OWNER CONTRACTOR JUMPSTART ACADEMY LISA CORPENRDANIEL HUENE SAME AS OWNER 2615 W NC 10 HWY NEWTON NC 28658- (828)465-5412 NAME TO APPEAR ON PERMIT JUMPSTART ACADEMY LISA CORPENING Pin#: 362910463232 SITE ADDRESS: 2615 W NC 10 HWY, Newton, NC DIRECTIONS: STARTOWN RD/ I OW/ ON LEFT APPROX 1/4 MILE ON/ JUMPSTART ACADEMY NAME of SUBDIVISION: Lot # 1 SectionBlock/Phase PROPERTY SIZE: Square Feet Acres 1.07 Date Platted/Recorded TYPE OF FACILITY: House Mobile Home Dimension of Structure Bedrooms 0 Basement: No Water Using Fixtures in Basement:No No. in Family 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 12.00 1st 2nd 3rd OTHER: (Specify) Do you aniticipate any additions to Facility? If so, describe: 10 X 12 ACCESSORY BUILDING 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? No Type of Water Supply: Individual Well Community Well Municipal X 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: g - Signature of Applicant or Agent Q es~N 001 An Environmental Health Specialist will contact you within 2 working days of applicatio date. If you need further information or assistance please call 828-466-7291 AREA 2 (FOR OFFICE USE ONLY) Zoning Approval: Yes No Zoning Approval UDO Zoning Form A Minimum Setbacks FEE NAME DATE AMOUNT Side Front 5 0 Exisiin Tank Check Fee 11/18/2009 $80.00 Rear 5 TOTAL FEES 580.00 Max Hght *If a permit has to be redesigned and / or RETRIPS made to the property, there is an additional $60 charge 11/18/09 16:22 THIS IS NOT A PERMIT WI.S # CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services Improvement Permit ❑ Authorization to Construct ❑ Septic Repair El Septic Expansion ❑ Existing Tank Check 0~ New Well Permit ❑ Replacement Well ❑ Well Abandonment F] 1. Name to Appear on Permit 2. Permit Requested By 77o c~ f Cu r--,-e c,- Business Phone 974 465 -5 y t I Address C104 Iq~4S't P\ acs lk,~k,r , , hl G ~$b a t Home Phone 823 3a e L A o 3. Property Owner -Ferg , A- 7~ r` 4ck a- a Business Phone Address 2, 5 S5 w C. r, : 3 n1~~ Fem., a k h5~ Home Phone 4. Name of Subdivision M 14 Lot # Section/Block/Phase Property Address Q b Ios `x r,~ G l u tt Directions to Property: 1 ay 4{~ av \V i u.J r.~ Ski r t-o" n LcaSs \P-e ~bo~ k Sac, yG. d C C,c~ N lr,e- t' A- 5. Property Size: Square Feet Acres k, 01 Date Platted/Recorded 6. TYPE OF FACILITY: House Mobile Home Dimension of Structure Bedrooms* *Anv 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 system size increase in the future. Basement: yes/6 Water Using Fixtures in Basement: yes/rrJ No. in Family Whirlpool Tub yes/159 Gallon Capacity MULTIPLE FAMILY RESIDENCES: Units Total Number of Bedrooms DAY CARE :umber of Children f~.1 4'o: i 7 a 4e-A-- k 1` 1z e_ s 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 /o If so, describe: 8. Has any grading, removal, or addition of soil been done to this property? Yes / 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? I(T% / No Check type that is available: [ ] Community well [ ] Semi-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. **IF A PERMIT HAS TO BE REDESIGNED AND/OR RETRIPS MADE TO THE PROPERTY, THERE IS AN ADDITIONAL CHARGE.- Date lO - k E aS Signature of Owner or Agent Co ZONING CLEARANCE PERMIT r CITY OF NEWTON PLANNING DEPARTMENT P.O. BOX 550 (828)695-4305 Fax (828)465-7412 THIS PERMIT EXPIRES IN SIX MONTHS OR AFTER A ONE YEAR LAPSE IN WORK Project Address Pin:,) Z " 10 ° y 3232 Project Descriptions B( (©XI Z Area Estimated Disturbed: ~ Cost: $ ~ Oo c~ Applicant: Owner: ' -~c,,cv~o tsr-! ~c~cler~~t 9 T2cc, ~~~.e~Q Address: Address: a~ l~ t,.~ N C ~p Hwy ~5 `ss !J C l-l..~y X0 ~J City: M -17 o r~ State: Nom- Zip Code: ~~GS City: ~wT o -State: NC . Zip Code: JUS_% Phone: Fax: Phone: Fax: 8a8 ~b5 -sy t2. Email: Email: ' I do hereby certify that the foregoing statements are accurate and correct to the best of my understanding and knowledge and that I agree to conform to all. City Ordinances and Laws of the State of North Carolina regulating such work and any plans or specifications submitted. With my signature below 1 assume responsibility for all errors and omissions of the Information provided on this application together with any plans and/or other documents associated with the issuance of this Permit by the City of Newton. Signature of Applicant: Date: Type of Permit Needed: < F7 New Construction r Sign r Mobile Home r Remodel f-L- ccessory r. Addition/alteration 17, Service Change r Structure Moving F Demolition Change of Use Type of User F'i Single-Family Residential FLI__~Ommercial r Assembly. r Multi-Family Residential F-, Industrial r-Non-Profit/Governmental Zoning District: Required Setbacks: Utilities Services: Overlay District: Front: Electricity: f7, City of Newton r7 Duke/ REMO (-SPI -Highway Corridor + Rear: Water: rCitYof Newton -,Well (-"SPI -Watershed Side: Sewer: City of Newton Septic Tank r: Flood Plain Overlay s ~ f7, r St Pauls Overlay Side Street: Other Requirements: Buffers & Screening Re quired Stormwater Permit Required Grading-permit Required . g . F-. Watershed: WS-IV- P /WS-111 - C /WS-111 - BW r Soil Erosion Permit Required Driveway Permit Required: City / NCDOT F Flood Plain - As Built Survey.Required : Plan Review Required Vested Rights _ ' Approval: Complete Application Received: ttha t Fee: $ ~J Receipt , / Ja1-1 Signature of Approving Authority: Date: ~~~d(d9 NOTES: Inspection Approval: Setback -Date: By: Final - Date: By: Catawba County, North Carolina This map product was prepared fij onr the Calms-ba Counh{ A'C, Geogroplac h forniniau Svshmr. N Coiawbo Counrv has mode substamial efforts 1o ensure the acctnocr of locution mil labeling information emnamed on this mop. Cmcnrba Comanfi promotes and recommends the independent verrf colion of mmv (1(71a contoured wr this map product by the user. The Comrrv of Catawba, its emplovee.s, agents cmd personnel disclaim, and shall not be held liable for am' and all damages, loss or hobilin" a hedrer direct, indirect or amsegrrewml which arises or moy arise from this prop product or the use 1hercof by am person or enim . Legend Selected Parcel Number: 3629-10-46-3232 1 inch = 60 feet Prepared for: - 0o NAP z5° DNS 0 _ NSN ,w o 0 0 cP- O V w 1.97A rA _ _.r W 3232 00 CQ 4. _ _ ~s ~ ~tyr6yi ,I m4. _ r. - - 4.69A THIS IS NOT A LEGAL DOCUNIENT Wednesday, November 13, 2009 04:11 PiNI CATAWBA COUNTY NC,- Parcel Report Information Regarding Selected Parcel(s) Parcel ID: 3629-10-46-3232 Name: HUENE DANIEL EDWARD Name2: HUENE TERRI W Address: 2555 NC HWY 10 W Address2: City: NEWTON State: NC Zip: 28658-9712 Account: 33081550 Calc Acreage: 1.07 Tax Map: 004 J 01004A LRK: 3453 Deed Book: 2354 Deed Page: 1346 Subdivision Name: Subdivision Block: Lots: 1 Plat Book: 44 Plat Page: 129 Building Number: 2615 Street Name: W NC 10 HWY Site Zip: 28658 Township: JACOBS FORK Fire Code: City Code: NEWTON State Road: Total Bldgs Value: $214,900 Land Value: $37,300 Total Value: $252,200 Year Built: 1985 Year Remodeled: Last Sale Date: 4/11/2002 Last Sale Amount: $250,000 Neighborhood: 92 Watershed: Watershed Split: Voter Precinct: P34 E911 District: NEWTON Zoning: R-20 Zoning2: Zoning3: Zoning Split: N Zoning Overlay: Zoning District: NEWTON Split Zoning Dist: N Split Zoning Dist(1):0 Split Zoning Dist(2): 0 School District: COUNTY Elementary School: STARTOWN Middle School: MAIDEN High School: MAIDEN School Split: NO P&Z Case Number: Census Tract 2010: 011702 Census Block 2010: 1000 Small Area Plan: Agricultural District: Printed: Wednesday, November 18, 2009 04:11 PM A C~ CATAWBA COUNTY, NC 100-A South West Blvd PLAN INVOICE Newton, NC 28658- 0 (828)465-8399 Wednesday, November 18, 2009 184 sm www.catawbacountync.gov Plan Case: EHPR-11-09-2776 Invoice Number: INV-11-09-257370 Environmental Health Plan Review Invoice Date: 11/18/2009 Fee Name Fee Amount Existing Tank Check Fee Fixed $80.00 Total Fees Due: $80.00 PAYMENTS Date Pay Type Check Number Amount Paid Change 11/18/2009 Check 1056 $80.00 $0.00 Total Paid: $80.00 Total Due: $0.00 pianinvwcc;cGl~f 186.1-;t~t_;~- G?a-`)do-?-~SL>>h5r)r,?~~G~ ipt 11/18/2009 16:22