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HomeMy WebLinkAboutRBPR-04-2016-23738.TIF Catawba County Environmental Health (350) ia ;:' �2 N. .41111111%Itill%„. Ci\ik ..• ,1 (1flip , On cc N /79815 I -.."41/44..\\ (185) Parcel: 376301279838, 4942 ROCK BARN RD 1in=50ft CLAREMONT, 28610 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 04/27/2016 /it,_ ;; _/27. va E_- 544.50 / rota J v R ,- ,/ h _ - - 4� b /96. 29 .'. _��.. W ` N �--------___ • _/02.00 • �____ Q Q' N/R N O) '_— 0 ��ry; a o 4h � ' ! *omit ry ry p 40 to 4 HOME 3 o o jLOT Q-/ o O o ,*) ^ t. 0.620 ACRE � b 4 . /53./0 ' i y A. 0.53/Ac. h for N. ry e S20°5B 20 "W 2 - 0.53)AC.4 �� m /0154` Np /O/.55' b �-522.23'0"µ._ N/R A 203.09' p e 0 (0 4 h M rgg0r • •5 2 7 Acts N. C #40N0y. P, 0 of b• O 9. /782_ pD~Jo� MOSE q p\ •k ti CO ry N V q 4 4 --.------- S 26 • W • • b b K fp ZONING R-2 - RES• h 30 ' FRONT SETS. : 1111'' OFAO 0 Q „lyl3A •� THIS IS NOT A PERMIT Case # RBPR-04-2016-23738 CATAWBA COUNTY HEALTH DEPARTMENT fit L iko.:or % PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES \1842 -"sM Residential Building Plan Review - Manufactured Home o .r o c AUTH CO ST- NEW WELL 0 J Owner RANDY PHILLIP MOSER, 4061 CARLTON DR, CLAREMONT NC 28610 C:828-459-7720 NAME TO APPEAR ON PERMIT Randy Phillip Moser SITE ADDRESS: 4942 ROCK BARN RD, CLAREMONT NC 28610 PIN # 376301279838 NAME of SUBDIVISION: Lot# A-4 Section/Block PROPERTY SIZE: Square Feet Acres 0.41 DIRECTIONS: 1-40/Rock Barn Rd Ext/left on Rock Barn Rd/go past Golf Course/cross Bridge across from Community Rd/just above 3nd Mobile home on right/vacant lot PRIMARY CONTACT: Owner SEWER TYPE: Septic Tank GALLONS PER DAY: 360 WATER SUPPLY: Private Well DESCRIBE WORK: Revised 4/27/16- Received new Site Plan along w/ Original Survey. Property lines are different from how it is reflected on GIS. 1998 SW mobile home 14 x 66 Home must meet appearance criteria ---Screen or Remove Towing Tongue, Front Deck must be minimum of 36 sq ft, home must be masonry underpinned (can use vinyl if singlewide). Home must be parallel to road and must face front of property 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? APPLICATION FOR: New Structure STRUCTURE TYPE: PRIMARY RESIDENCE FACILITY TYPE: Mobile Home OTHER DESCRIPTION: DESCRIPTION OF vacant lot EXISTING STRUCTURES ON SITE(IF ANY) DIM EXISTING STRUCTURE: NUMBER OF EXISTING BEDROOMS: #OF OCCUPANTS: 2 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 14 x 66/w front deck 8x8& rear 4x4 #OF NEW BEDROOMS:: 3 Desired system types (Improvement Permit or Authorization to Construct): ACCEPTED: ALTERNATIVE: CONVENTIONAL: OTHER: INNOVATIVE: ANY: YES Other described: APPLICATION FOR WELL CONSTRUCTION PROPOSED WELL TYPE: Individual Well REPLACE WELL?: NO P9-ehapplieatinu 04/27/2016 10:29 Page 1 of 5 ssxA � CATAWBA COUNTY Case# RBPR-04-2016-23738 .� a Public Health Department Subdivision < , lie; �l Environmental Health Division PIN# 376301279838 PO Box 389, 100-A Southwest Blvd, Newton,NC 28658 /g,2 ,. NAME ON PERMIT: (RANDY PHILLIP MOSER),4061 CARLTON DR, CLAREMONT NC 28610 ( Randy Phillip Moser) Site Address: 4942 ROCK BARN RD, CLAREMONT NC 28610 Property Size: Square Feet Acres 0.41 Directions: 1-40/Rock Barn Rd ExU left on Rock Barn Rd/go past Golf Course/cross Bridge across from Community Rd/just above 3nd Mobile home on right/vacant lot 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 �FEENA;ME ilk�I1 P4 • • vim.,. h W. . ,i . T Fr ,W ,,ilE AMOUVT Authorization to Construct Fee (New/Expansion) 04/26/2016 $150.00 Fee Well Permit& Inspection Fee 04/26/2016 $300.00 �f ll'M�i!Il LTOTAL'F.EES ? , ,"tr s�I I�ili'+i'0, vtiila,/1iiiI111III.1�17II�ifi'. ;��+'II�IIIl1�Il+ -,'I'S450100 a. ld'f 4 .:lil'u1111111921#11r6.. • :.ydWdJL'Jild'ID+�,i Jh.uWW4iWWIIJLVIW6�:�Slli!I:,WL�uaCu�ll:uill,{i� FEES ARE NON-REFUNDABLE ONCE A SITE VISIT IS MADE OR WORK ON A PLAN REVIEW HAS COMMENCED SYSTEM REDESIGN AND/OR RETRIP WILL INCUR AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) E9-ehappl union 04/27/2016 10:29 Page 2 of 5 4.3yV3A Cc--- OG THIS IS NOTA PERMIT Case # RBPR-04-2016-23738 �� CATAWBA COUNTY HEALTH DEPARTMENT E p r10 ' f El \\' 4$ / :016:4.**. . v\' 1 PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES j 1842 sM Residential Building Plan Review - Manufactured Home D D l'o AUTH CONST - NEW WELL •� 1 -.I. Owner RANDY PHILLIP MOSER, 4061 CARLTON DR, CLAREMONT NC 28610 C:828-459-7720 NAME TO APPEAR ON PERMIT Randy Phillip Moser SITE ADDRESS: 4942 ROCK BARN RD,CLAREMONT NC 28610 PIN # 376301279838 NAME of SUBDIVISION: Lot A-q Section/Block PROPERTY SIZE: Square Feet Acres 0.41 DIRECTIONS: 1-40/Rock Barn Rd Ext/left on Rock Barn Rd/go past Golf Course/cross Bridge across from Community Rd/just above 3nd Mobile home on right/vacant lot PRIMARY CONTACT: Owner SEWER TYPE: Septic Tank GALLONS PER DAY: 360 WATER SUPPLY : Private Well DESCRIBE WORK: 1998 SW mobile home 14 x 66 Home must meet appearance criteria ---Screen or Remove Towing Tongue, Front Deck must be minimum of 36 sq ft, home must be masonry underpinned (can use vinyl if singlewide). Home must be parallel to road and must face front of property 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? APPLICATION FOR: New Structure STRUCTURE TYPE: PRIMARY RESIDENCE FACILITY TYPE: Mobile Home OTHER DESCRIPTION: DESCRIPTION OF vacant lot EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: NUMBER OF EXISTING BEDROOMS: #OF OCCUPANTS: 2 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 14 x 66/w front deck 8x8& rear 4x4 • #OF NEW BEDROOMS:: 3 Desired system types(Improvement Permit or Authorization to Construct): ACCEPTED: ALTERNATIVE: CONVENTIONAL: OTHER: INNOVATIVE: ANY: YES Other described: APPLICATION FOR WELL CONSTRUCTION PROPOSED WELL TYPE: Individual Well REPLACE WELL?: NO E9-ehapplication 04/26/2016 16:11 Page 1 of 5 syy,A CATAWBA COUNTY Case'f RBPR-04-20 1 6-23 73 8 F" G Public Health Department Subdivision Q —'--' a H Environmental Health Division PINd " ® K 376301279838 PO Box 389, 100-A Southwest Blvd,Newton,NC 28658 Ig 2 w NAME ON PERMIT: ( PHILLIP MOSER),4061 CARLTON DR, CLAREMONT NC 28610 • ( Phillip Moser) Site Address: 4942 ROCK BARN RD, CLAREMONT NC 28610 Property Size: Square.Feet Acres _ 0.41 Directions: 1-40/Rock Barn Rd Ext/left on Rock Barn Rd /go past Golf Course/cross Bridge across from Community Rd/just above 3nd Mobile home on right/vacant lot 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 acce ible so that a complete site evaluation can be performed. Date: 1-/-‘9Z4- - o/:‘ Signature of Applicant or Agent Ai • / . z a • _ An Environmental Health Specialist will contact you within 5 working days of a plication date. If you need further information or assistance please call 828-466-7291 AREA2 r sS°'t! -o^r t 'SG f„j - t r e FEENAMF a ` DATE FEE 7. AMOUNT,s; Authorization to Construct Fee (New/Expansion) 04/26/2016 $150.00 Fee Well Permit& Inspection Fee 04/26/2016 $300.00 a'r .y1 I .TOTAL FEES ,' $450 Ott ., L,.,. .. zDiK.t.i, t axn .J I,t i. : • 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-chapplication 04/26/2016 16:08 Page 2 of 5 CATAWBA TBA THIS IS NOT A PERMIT COUNTY a=,>ak CATAWBA COUNTY HEALTH DEPARTMENT No„w7. ,:- ` Application for Environmental Services Page 1 Improvement Permit ❑ Authorization to Construct Septic Repair ❑ Septic Malfunction U Septic Expansion n New Well Permit Replacement Well ❑ Well Abandonment❑ Well Repair Existing System Inspection (Pre-Approval Required) n Application is for New Construction Existing Facility n Property Address Li 7 �� 1 a,,,f e Tex .x ,1 Subdivision I . _ _ p` , - ( / a Lot# Acres p Section/Block/Phase *Driving Directions to Property I- it 0 ho G% /3 n4/1/I f, I tx< f I e AM/ o;2 ¢'e KC' zil✓7Qx1 T 6o P Snf 6, /�- caJ,e/�,F/- e nvnc,e, 5c //3t, dye n o5-/sfr/erc,9 C"�7Y/-i y.xj it g c r 4-t e-, e� e= Sv4 d M 6 d, /r. /t b e O''z /� S 4 I v�,/.�r, )'• h6 /4 NAME TO APPEAR ON PERMIT? Owner ❑ Applicant H Contractor Applicant Contact Information Name Address Phone Cell Phone k. Owner Contact Information Name k,,, Sy n ' esc Address U off/ CA1P /Ao•? /' C/4fe,, e .2t 46 5 / O Phone �',2 g _ 4 ,S ? — .1) ),_ d Cell Phone 0,9.,g_,. 63 — / 6 5 2 Contracto�r Contact Information / Name Y License# Address Phone Cell Phone • WHO WILL BE THE PRIMARY CONTACT? Owner ❑ Applicant H Contractor Description of Existing Structures on Site Vae j h ( Q3\- # of Bedrooms *I. it. Structure Dimensions in nt) # of Occupants Basement ❑ Yes le To Basement Fixtures ❑ Yes H No The Applicant shall notify the local health department upon submittal of this application if any of the following apply to the property in uestion. If the answer to any question is `yes", applicant must attach supporting documentation. ❑ Yes o Does the site contain any jurisdictional wetlands? ❑ Yes -Q���ff Does the site contain any existing wastewater systems? . ❑ Yes lit-No Is any wastewater going to be generated on the site other than domestic sewage? Yes ' No Is the site subject to approval by any other public agency? Ll Yes L3�Io Are there any easements or right of ways on this property? Describe Existing water supply in use ❑ 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 CrAny cA TA`s 7jZ A THIS IS NOT A PERMIT '^`1 \rM� I COUNTY VY L71 }� CATA WBA COUNTY HEALTH DEPARTMENT L\_,�+, E Application for Environmental Services Page 2 NoetM1 Corollna \�v B Facility Type By YLI n Primary Residence gNew Residence n Addition to Residence ft of New Bedrooms *1- P Project Description S , e y/.. w , /,. Structure Dimensions 1 Lf 2C 66 # of Occupants Basement ❑ Yes t.---7/No Basement Fixtures Yes No ❑ Accessory Structure(s) Describe # of New Bedrooms *t if applicable Structure Dimensions # of Occupants Accessory Dwelling ❑ Yes I No Plumbing Yes No Describe Plumbing Needed Multi-Family Residence#Units #Bedrooms per Unit*t Total # Bedrooms *t Structure Dimensions El Food Service Specify Type # Seats Floor Space-Entire Food Service Facility (Sq Ft) #Employees per Shift # of Shifts Dining Area(Sq. Ft.) n Business Specific Type of Business Retail Floor Space # of Employees per Shift # of Shifts n Other Facility Type Specify If Church# of Seats Kitchen n Yes ❑No If Daycare Specify Occupancy Application for Well Construction/Abandonment/Repair Proposed Well Type Individual Well ❑ Semi-Public Well n Community Well Abandonment Type 1-1 Drilled Bored ❑ Dug n 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. j 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 Pennits 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 e F•G ..N Date g 6 �d Printed Name of Owner or Agent ,/}/?c/✓ p.. -27 p 3 e- c • Catawba County Environmental Health (350) • • //' . p d 209 ott mgt' ., . • A' or I 3 2p) l A-4 h (102) ��`) iiiiir .00 a ny .,o A 91 • 77185---.4.-N\H (185) Parcel: 376301279838, 4942 ROCK BARN RD 1 in=50ft CLAREMONT, 28610 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 04/26/2016 Parcel Report ' Page 1 of 1 Parcel Report - Catawba County NC Parcel Information: Owner Information: Parcel 1D: 376301279838 Owner: MOSER RANDY PHILLIP Parcel Address: 4942 ROCK BARN RD Owner2: MOSER JANICE MARIE HOKE City: CLAREMONT, 28610 Address: 4061 CARLTON DR LRK(REID): 401055 Address2: null Deed Book/Page: 1782/0304 City: CLAREMONT Subdivision: null State/Zip: NC 28610-9649 Lots/Block: A-4/null School Information: Last Sale: Plat Book/Page: 40/14 School District: COUNTY Legal: LOT A-4 A-4 PL 40-14 PL 40-14 Elementary School: OXFORD Middle School: RIVER BEND Calculated Acreage: .410 Tax Map: null High School: BUNKER HILL Township: CLINES School Map State Road #: 1709 Tax/Value Information: Tax Rates(pdf) Zoning Information: City Tax District: All in County Zoning District: COUNTY County Fire District: OXFORD Zoningl: R-30 Building(s) Value: $0 Zoning2: null Land Value: $8,600 Zoning3: null Assessed Total Value: $8,600 Zoning Overlay: WP-O Year Built/Remodeled: null/null Small Area: ST STEPHENS/OXFORD 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 #: 3710376300J Building Details 2010 Census Block: 2012 WaterShed: WS-IV Protected Area 2010 Census Tract: 010101 Voter Precinct: P27 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. ©2016, Catawba County Government, North Carolina. All rights reserved. 21 3(o cI kit. http://gis.catawbacountync.gov/nomap/parcel_report.php?key=376301279838&typ=P 4/26/2016 ,c CATAWBA COUNTY Q ' o p Case# IMPV-04-2016-071584 T r- . Subdivision ./(r:2. Public Health Department t'ti C tiro.'j ;r Environmental Health Division tin11, r� r3 ' PMN# 376301279838 ,. PO Box 389. 100-A Southwest Blvd,New;on,NC 28658 i'o' i' , '� LOT, A-4 • CI gill NAME ON PERMIT: RANDY MOSER, 4061 CARLTON DR, CLAREMONT NC Site Address: 4942 ROCK BARN RD, CLAREMONT NC 28610 Property Size: Square Feet: 17,859.60 Acres:0.41 Directions: 140 Rock Barn Ext from Hickory. Left onto Rock Barn Rd, Go past the golf course, go across the bridge, Community Rd will be on the Left & right across is 3 mobile homes, vacant lot past the 3rd. Improvement Permit Facility: - Primary Residence - mobile home 3 Permit Category: New Septic Bedrooms WATER SUPPLY: Private Well Basement? No Basement Plumbing? No INITIAL SYSTEM SPECIFICATIONS Permit Valid: Expires In Five Years: _X_ No Expiration: Projected Daily Flow 360 g.p.d Proposed Wastewater System: 25% REDUCTION Type: 111G - OTHER NON-CONY TRENCH SYSTEMS Permit Conditions: REPAIR SYSTEM SPECIFICATIONS Repair System Required? Required Proposed Wastewater System: 50% REDUCTION Type: IVA-ANY SYSTEM WITH LPP DISTRIBUTION PUMP REQUIRED ***** OPERATOR REQUIRED Landscaping or other site alterations that potentially divert groundwater or surface water toward the septic system, or prevent proper drainage away from the septic system, including the direction of gutter flows or foundation drains, is not annroved, and may result in failure to approve the initial system installation,or the suspension/revocation of existing oermits. The issuance of this permit by the Health Depariracr.t does not guarantee the issuance slather permits. It is the responsibility,of the applicantiproperty 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 for Sewaee treatment and Disposal Systems' (ISA 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. ' Megen McBride 04/26/2016 All r HORIZED STATE AGENT APPROVAL DATE 04/26/2021 Permit Expiration Date: No grading or construction activity is allowed in areas designated for system and repair without approval of the Health Department. clmeimit 04/26/2016 09:11 Page 1 of 3 A \i`)Ell PIM-p11-)olb-)373% . ill 1 ROCF tfn R& CIarP.00n+ ...hS6ll I000noullon Se ;c-rrk- �.a 3o0-R, o{ D520 ReaucfiDn ; 9- 75Th *renclaes. -Irks-W-Irks-Wl dYaiv\-geld Oh ('or--our. * Serht, sls-1em Al IM be, a{ lean- 5b-fl_ -From. wells, 10-i fn,m prope(}7 lines, 5{4 -CiDA Sit OCk te5,inclvdini necks, ana ou} or rilk-I- o{- wa`!s couI ecsen,en-IS, k )7 H ariJe, grac2, C� of -pi 04er C�0-IC areoc. I - ¶ al orb Musk Shed Sur-F0„ veer o- 0,4 aWai -F'rar'n Se c sic+em. tni,S`' { Serif, Repair�ei We-1\ PNQss bet 5D?o Are l * �. - 50 1. -(rurn sey c 5/5-leo, L sox yo - 15q '&O r c Y 5, \ a''a\nq ae\c5 and. fox che5 J - 5{l. -(-orn IroPe47 lines N. tee() well aol of aIf Ilk+&v . { and easamer 5. ,„rn,g I. AroXimu E Areq 4 PrDpstd 342. Ivy S „ �II rI . bbxW o ( e�k 5 Seri( SyS�C M 1 /.5..mo n Eo �M` 75'45' I ° edad -!s' 4 ylCII 1g azia +/ RfeA j .` dock km PA . 'Lip t tm r v �y+ cy '' n A' t et zy P.i t R P .,- ,-,:,4,4.;:::v-,..,... >:7 a+ a '�' 4t ei,� x ,ry ' .a,Q be s'y Y. r+} , f.q,$c.",LS 7> ',44i�ua:«s�. ;." 1 ..:± .e ,,,". �..r...f?PqV rS .a vi m"+ath 5„1. mum}nsfi., .... r:ah.i k k..; _>. .. ...y ?�..,a ..a.., e . s" DEPARTMENT OFENVIRONMENt AND NATURAL RESOURCES Shed— DNISIDN OF ENVIRONMENTAL HEALTH PROPERTY Wit ,ON-SUE WASIEWATFRSECTION COUNTY: SOIL/SUE EVALUATION OWNER: t r AA t •r jn,ON-BYTE WASTEWATER SYSTEM •PLICATIONDATE N-t•!6 FNP .-c& 2416-13595 ADDRESS: DATE EVALUATED: 1!LO1M PRO POSED FACILITY: 3BP-M PROPQSEDDFSIQN FLOW(.1949): 360 . PROPERTY$IIE:Q41 ac r.5 LOCATION OF SITE; 4941 (!oc pc� S4, CIa((MA't PROPERTYRECORDEp: WATTIt sUPPLY: Ii Private 0 Public 0 well 0 sptwz 0 Other EVALUATION METHOD: 0 Auger Bering I Pit U Cut 7YPEOFwAS1'EWATER: CI Sewage 0 Industaalnoun 0 NLzc4 . n: r:nrs� m:... 1K jJ��. .v_.�.p.. :-2.LF rt�.L� . r ... _ : , a). c �:—:c.: :'__- _�MJ?1kK - � _. : ^::n :.r __ _ _ .S5TG . P38bGY _9 i av,k nrg.:L" xh H &L s s t z 'I mitmn,t � K e Rt mk .t F e � tss E312 iii rs1f tL } ttkrivov Abcx c ox :Dx Ei:0-11 5V-I- -fr:s5, scAp L )140 $ 0.- • {r.s5. (tic? — 03 • _ 0-7 . •Sb'1'I.. . .. • -fr,ss. SPXP PS 7- GO Ins (i 1 -1(:55, Serf 2 flyrv..14•of 901111 rasiho�h 0 — — O.as 0-5 5b� L • 11-r,s5, Srxp 3 5 50 I I56kG t.<s, srt _ 5D _ _ PS 0.3 .0-13 SbY-L r,s4, sexy _ 1 • .3-39 5hk1,t- fr:s5, cxxe PS 4 39- 50 usbk• LLf5Af fr.s5 _ 5" 0 — -- O•3 s °ESrT7OR pal'SY REPAIR SY STEAL OTHER FACTORS(.1946): _ A�ulrbls Spate(.1945) 1 p� SITE cL&ss cATIox(.1948): p S mlyle(i) '� –([l EVALUATE-D BY: ' `e�ct jI,p(\� . 9 Iq - OTHERS)PRESENT: . Site LIAR 0.3 0.3 COMM-RIM: ( -)0 No D' `t5' ,951 1701 pip 36t rte,{ Bock Born KA. 61c- 5c.alt) ..... .. ....