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HomeMy WebLinkAboutRBPR-05-2016-23801.TIF �qA THIS IS NOTA PERMIT Case # RBPR-05-2016-23801 e' QL a' d ripiI" CATAWBA COUNTY HEALTH DEPARTMENT D ; IE U °"" '' PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES :1% ti 1842 SM Residential Building Plan Review - Building New ,1:1 • ; , ‘78A CATAWBA COUNTY Case a RBPR-05-2016-23801 EtaPublic Health De trtment 2, PF Subdivision < IRww I,�; Environmental Health Division PRJP, 367603336865 PO Box 389, 100-A Southwest Blvd,Newton,NC 28658 /8.2 s. NAME ON PERMIT: ( DAVID ELLIS), 6716 LOVE POINT RD, DENVER NC 28037 ( David Ellis) Site Address: 4945 ANDERSON MOUNTAIN RD, MAIDEN NC 28650 Property Size: Square Feet Acres 16.39 Directions: Hwy 321 to East Maiden Rd, turn right on Anderson Mtn Rd, property 1/2 mi on right 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 : i ended use changes for the proposed facility. I have read this application and certify that the information provided herein is true, complete an. corre . Authorized cou y and state officials are granted right of entry to conduct necessary inspections to determine compliance with applicable laws a d rul- nderst7 t I am solely responsible for the proper identification a d f Ebeling�f II property lines and corners and making the site accessib #�.I- -valuat.r .mbe-performed. Date: es- / (7h/ �r, Signature of Applicant or Agent �__ . —_s�.a GGG An E vironmental Health Specialist will contact you wi r orking days if app•ication date. If you need further information or assistance ple..e call 828-41..-7291 AREA1 �1 nl ill�j'SiiL s '11117,171117;57i7714 ii jell l{11111��I i m fil i nri" nm(l�ijy i� rn ,y i5 ntFEENAM E, 'tIt —111::.ttJ..�lialilir iiN;���110 FFEAMOUNT: Improvement Permit Fee 05/05/2016 $150.00 Well Permit& Inspection Fee 05/05/2016 $300.00 Authorization to Construct Fee (New/Expansion) 05/05/2016 $300.00 Fee Improvement Permit Fee 08/17/2016 $150.00 Authorization to Construct Fee (New/Expansion) 08/17/2016 $300.00 Fee 1� ' tt1.10TOTA1 FEES IG.1 I INN i� i t �c' t I�jr ' ilP .11 in •51,2-00.9110 �.,fct h1< I,i,dllliur BIiN�t,, , I Ilill,� ..olid cal. . ✓y_ui11u.INl»WVt ,sitsd,ONNF.KtivAr - u.rt: imiauflPJiV' .71.2811.1811a.....--2--11. ,1111, 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-ehapplicatinn 08/17/2016 09:39 Page 2 of /IPA • Permit if RBPR-5-1623801 CATAWBA COUNTYc17G Public Health Department Name David Bilis c 49-0 Environmental Health Division Address 4945 Anderson bon Rd Maiden • Southwest BlvdNe too 658 NC i 2 )u (52S)465-8'370 Fm (928)465-8276 TDD(828)465-8200 PINii 367603336865 _ —1 Lit ` 4,- e ---it A ria Ion ' As-i.Q..) Site Plan Authorization to Construct ` / l L' i tS p0 r s 0: ,,.�0�•� 5,..... . S - ( 0of ca io4,O ')aIn rr,_... � ,-,c -1-o .r S. •-• OP CN F3Et.,0 if• ood'S4 S° S 1?vile NARA P •� �6®�J ` • ti, t u --SEPTPC TANK L 1 __ • \ lis ' S rr- I `I r -Co prat . ' WALLS b6 I ' y6e_ 1.1••.� P 1 I S cr.ot... n ��b t�ccL 0 C -4 =ale 0 )0(c pro:, ,d.. a' b L)L.+.t'-r Pa r a d 41 V--11.-LLL c. � Co CATAWBA COUNTY `�" ,, A ]OOASOUTHWEST BLVD Y NEWTON,NORTH CAROLINA 28658 INVOICE/RECEIPT L-,43 " 44 PHONE: 828.465.8399 I,.J 7417/4. 4.11:,:p4 1, j �a>v/' . Wednesday, August 17, 2016 1847, sm t+ww.catawbacountync.gov Invoice Number: 08-16-331700 Invoice Date: 08/17/2016 RBPR-05-2016-23801 CASE TYPE: Residential Building Plan Review WORK CLASS: Building New SITE ADDRESS: 4945 ANDERSON MOUNTAIN RD, MAIDEN NC 28650 Owner DAVID ELLIS, 6716 LOVE POINT RD, DENVER NC 28037 H:7042768990C:7043082822 Contractor *JCM CUSTOM HOMES, LLC, 1998 KIRSTEN ST, NEWTON NC 28658 C:828-217-3862F:8289707475 JCMCUSTOMHOMES a GMAIL.COM ACCOUNT: 6725 PAYOR: *JCM CUSTOM HOMES, LLC FEES RBPR-05-2016-23801 FEE AMT DUE AMT Authorization to Construct Fee(New/Expansion) 08/17/2016 $300.00 $300.00 Fee la" 'Impio e3. Peinirt Fee...j,u?,p -,`11, �I11'1 11608/17/2016 +iu a , 1 °"i 111 1' ` -F" - 1 �:rt.Ili.�..lwl�,. .., . gin.. S150.00 .��„r,.1F: $15000uirl FEES: $450.00 $450.00 TOTAL FEES : $450.00 $450.00 inroicercceipt 08/17/2016 09:38 Page I of 1 THIS IS NOT A PERMIT Case# RBPR-05-2016-23801 C r' CATAWBA COUNTY HEALTH DEPARTMENT CI f 0 p# PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES '�f+.x 1842 5M Residential Building Plan Review - Building New tali,. yU 1 h IMPROVEMENT- AUTH_CONST- NEW WELL U Pp\i\NA 7 D t i Contractor * CUSTOM HOMES, LLC (JUSTIN MORRISON), 1998 KIRSTEN ST,NEWTON NC 28658 C:828-217-3862F:8289707475 JCMCUSTOMHOMES@GMAIL.COM Owner DAVID ELLIS, 6716 LOVE POINT RD, DENVER NC 28037 H:7042768990 C:7043082822 HOME:7042768990 NAME TO APPEAR ON PERMIT David Ellis SITE ADDRESS: 4945 ANDERSON MOUNTAIN RD, MAIDEN NC 28650 PIN # 367603336865 NAME of SUBDIVISION: Lot# TR B Section/Block PROPERTY SIZE: Square Feet Acres 16.39 DIRECTIONS: Hwy 321 to East Maiden Rd, turn right on Anderson Mtn Rd, property 1/2 mi on right PRIMARY CONTACT: Contractor SEWER TYPE: Septic Tank GALLONS PER DAY: 480 WATER SUPPLY: Private Well DESCRIBE WORK: New 4 bedroom house 66x65 with basement, attached garage no bonus room. 60x40 future in-ground pool w/ concrete 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? No APPLICATION FOR: New Structure STRUCTURE TYPE: PRIMARY RESIDENCE FACILITY TYPE: Single Family Residence OTHER DESCRIPTION: DESCRIPTION OF Vacant Lot EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: NUMBER OF EXISTING BEDROOMS: #OF OCCUPANTS: 5 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 66x55 House, Future Inground Pool 60x40 w/Concrete #OF NEW BEDROOMS:: 4 BASEMENT? Yes BASEMENT FIXTURES? Yes PLUMBING REQUIRED?Yes 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 05/05/2016 13:14 Page 1 of 4 `,�A • CATAWBA COUNTY Case# RBPR-05-2016)-2.3801 !'.E:;a Public Health Department Subdivision 4 i Environmental Health Division PIN# 367603336865 ''.o- PO Box 389, 100-A Southwest Blvd,Newton,NC 28658 1842 ,w NAME ON PERMIT: ( DAVID ELLIS),6716 LOVE POINT RD, DENVER NC 28037 ( David Ellis) Site Address: 4945 ANDERSON MOUNTAIN RD, MAIDEN NC 28650 Property Size: Square Feet Acres 16.39 Directions: Hwy 321 to East Maiden Rd, turn right on Anderson Mtn Rd, property 1/2 mi on right 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 AREA1 lir IIr ` I "p EJI ' u EUI,IFEENAME }(i' i.l !i i� ;1# ' DATE v�dli FE^AMONTj Improvement Permit Fee 05/05/2016 $150.00 Well Permit& Inspection Fee 05/05/2016 $300.00 Authorization to Construct Fee (New/Expansion) 05/05/2016 $300.00 Fee n 3 TOLF_ Im a IIi IIII ;a� {Ill.l : �; „ , 1 17 ......... b , - 7s (a ::r. " t';' L14PtIitllPi 111W�Ir tsllNU d'a u'ilINUu 7!pI hII{plllLyl'dP T�_ FEES ARE NON-REFUNDABLE ONCE A SITE VISIT IS MADE OR WORK ON A PLAN REVIEW HAS COMMENCED SYSTEM REDESIGN AND/OR RETRIP WILL INCUR AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) h9-ehappli cation 05/05/2016 13:14 Page 2 of 4 vJ$ - • . THIS IS NOT A PERMIT Case # RBPR-05-2016-23801 e, 1. CATAWBA COUNTY HEALTH DEPARTMENT 0 nVo--y 0 ►ia: PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES r ' ' 1842 sa Residential Building Plan Review - Building New �1 •o o IMPROVEMENT - AUTH CONST - NEW WELL .o it o. x o •a Contractor *JCM CUSTOM HOMES, LLC (JUSTIN MORRISON), 1998 KIRSTEN ST,NEWTON NC 28658 C:828-217-3862F:8289707475 JCMCUSTOMHOMES @GMAIL.COM • Owner DAVID ELLIS, 6716 LOVE POINT RD, DENVER NC 28037 H:7042768990 C:7043082822 HOME:7042768990 NAME TO APPEAR ON PERMIT David Ellis SITE ADDRESS: 4945 ANDERSON MOUNTAIN RD, MAIDEN NC 28650 PIN # 367603336865 NAME of SUBDIVISION: Lot# TR B Section/Block PROPERTY SIZE: Square Feet Acres 16.39 DIRECTIONS: Hwy 321 to East Maiden Rd, turn right on Anderson Mtn Rd, property 1/2 mi on right PRIMARY CONTACT: Contractor SEWER TYPE: Septic Tank GALLONS PER DAY: 480 WATER SUPPLY: Private Well DESCRIBE WORK: New 4 bedroom house, 480 gpd, 66x65 with basement, attached garage no bonus room. 60x40 future in-groun pool / IP attached only for 3 bedrooms 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? No APPLICATION FOR: New Structure STRUCTURE TYPE: PRIMARY RESIDENCE FACILITY TYPE: Single Family Residence OTHER DESCRIPTION: DESCRIPTION OF EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: NUMBER OF EXISTING BEDROOMS: #OF OCCUPANTS: PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 66x55 House #OF NEW BEDROOMS:: 4 BASEMENT? Yes BASEMENT FIXTURES? Yes PLUMBING REQUIRED?Yes 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 05/05/2016 11:44 Page I.of4 eA CATAWBA COUNTY Case# RBPR-05-2016-23801 70 mi 2 Public Health Department Subdivision < " Environmental Health Division ® PO Box 389.100-A Southwest Blvd,Newton.NC 28658 PIN# 367603336865 g. . NAME ON PERMIT: ( DAVID ELLIS), 6716 LOVE POINT RD, DENVER NC 28037 ( David Ellis) Site Address: 4945 ANDERSON MOUNTAIN RD, MAIDEN NC 28650 Property Size: Square Feet Acres 16.39 Directions: Hwy 321 to East Maiden Rd, turn right on Anderson Mtn Rd, property 1/2 mi on right 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 • ect. Authorized county and state officials are granted right of entry to conduct necessary inspections to determine compliance with applicable laws an-, rules understand t .t I am solely responsible for the proper identification and la elin of all property lines and corners and making the site accessibl- so th-J- com-dete':;,e evaluation can be performed. Date: 6/ / -, Signature of Applicant or Agent An nvironmental Health Specialist will contact you with working dr s ofppplication date. If you need further information or assistance please call 828-466-7291 AREA1 FEENAME s DATE ' I •'FEE AMOUNT Improvement Permit Fee 05/05/2016 $150.00 Well Permit & Inspection Fee 05/05/2016 $300.00 Authorization to Construct Fee (New/Expansion) 05/05/2016 $300.00 Fee TOTAL FEES ',.µ $750.00 FEES ARE NON-REFUNDABLE ONCE A SITE VISIT IS MADE OR WORK ON A PLAN REVIEW HAS COMMENCED SYSTEM REDESIGN AND/OR RETRIP WILL INCUR AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) E9-ehappl ication '05/05/2016 11:44 Page 2 of 4 CATAWBA THIS IS NOT A PERMIT cou Tr a Y � CATAWBA COUNTY HEALTH DEPARTMENT „-�, Application for Environmental Services Page 1 Improvement Permit Authorization to Construct K Septic Repair n Septic Malfunction ❑ Septic Expansion ❑ New Well Permit V4teplacement Well ❑ Well Abandonment❑ Well Repair Existing System Inspection (Pre-Approval Required) H Application is for New Construction Existing Facility ❑ Property Address �l��.1/45 Kt„Aebc ol: No,I- a A Subdivision l I GY.A�'6(3 / ti C. A O 650 Lot# Acres rte:, nn Section/Block/Phase Driving Directions to Property 6')-1 .o Ea,4 r A e,1,..) Qo�IaA . I-- u, r P P- s k - 00 k h.&trfi n 4 ) 1 l b vc.-1-al r,) Pna Q pre) Q�r--`y Y2 i--k i l& c F-J F-i V 0, n+ ' NAME TO APPEAR ON PERMIT?X Owner ❑ Applicant 0 Contractor Applicant Contact Information Name Address Phone Cell Phone Owner Contact Information Name D•4 V16, atis Address d,7 i G..., I.-C>oa> p©S p4- fGaa / .De,N De I- Ni C- .QM 03`7 Phone Cell Phone 70 q - 3 Ds .- ,Q� 02 Contractor Contact Information - / t• * Name __ .. ' I n - i, . —On I F o License # 6 `.(0r7 (/N/ 1 (l Address ! q Q,g k , ca-\-e50 <'j-i- {.,- i i..>k-a N j G 2-$ 5 Phone Cell Phone gg S -,2/ 7- 3 a-- WHO WILL BE THE PRIMARY CONTACT? n Owner ❑ Applicant [y'Crontractor Description of Existing Structures on Site \J - L04- # of Bedrooms *.j Structure Dimensions # of Occupants Basement ❑ Yes ❑ No Basement Fixtures ❑ Yes n No T 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 12-No Does the site contain any jurisdictional wetlands? ❑ Yes ' Eno Does the site contain any existing wastewater systems? ❑ Yes lilYSIo Is any wastewater going to be generated on the site other than domestic sewage? '*Yes Et No Is the site subject to approval by any other public agency? ❑ Yes !;d'Ab 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 1K1 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) \IC Accepted ❑ Alternative ❑ Conventional ❑ Innovative ❑ Other PIC cAr(''A B A THIS IS NOT A PERMIT counry Yr� Lam) CATAWBA COUNTY 'HEALTH DEPARTMENT Nor;„—c7;;;,7---,,a Application for Environmental Services Page 2 Proposed Facility Type 1 H Primary Residence [qt.:New Residence n Addition to Residence # of New Bedrooms **I c-1- Project Description l� Structure Dimensions 66/Del /6,5 LaSh of Occupants 5 Basement [U4'es n No Basement Fixtures es n No ❑ Accessory Structure(s) Describe ))('1n\ (AI ( teen ]' #of New Bedrooms `j if applicable (*j Structure Dimension! (GO 1` # of Occupants Accessory Dwelling ❑ Yes To - 01/4-200A Plumbing ❑ Yes No Describe Plumbing Needed Multi-Family Residence#Units #Bedrooms per Unit*t Total #Bedrooms *j' Structure Dimensions Li 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 n Semi-Public Well ❑ Community Well Abandonment Type n Drilled n Bored n Dug n Unknown Well Repair Requested I 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 ANN 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 depaw tment 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 'roper identification and labeling of all property lines and corners and making the site accessible so that a complete site evaluation I be performed. Signature of Owner or Agent 4 __ i " • •• Date J/ 5//6 Printed Name of Owner or Agent 0 r'nl N Catawba County Environmental Health ,I . 7/ 2 Q • ili"A' er $411 / IP 2 /4 w ,__. 0 \ 0 • •. r 1 0 eV O 1 x- • P \ oJ� / /Or 11fre v- \ / 390. },,,,,, 1 / / Parcel: 367603336865, 4945 ANDERSON 1 in=100ft MOUNTAIN RD MAIDEN, 28650 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 05/05/2016 Catawba County Environmental Health `y �r"� f i •,& r r r s3 \H. \ dia„„i,a4u - - IllAk 0111111/4 ■ nit. 711114SIMCII?11/4:\it _ -. _ ..S . rill A i ( x 111 1101:p �� 21 M + ' ' O7 tilk i 4/1 / /41'49 J/J 386.E 185.57 / �tl. � �, igi J� 14. N. \ il• ? \ \ \ 05031 \ 015 ` 1' 04924 I I ---A\ ' _ ist---Tai, Parcel: 367603336865, 4945 ANDERSON • 1 in=200ft MOUNTAIN RD MAIDEN, 28650 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 mapheport 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 05/05/2016 Parcel Report Page 1 of l Parcel-Report=Catawba-County-NC Parcel Information: Owner Information: Parcel ID: 367603336865 Owner: ELLIS DAVID M Parcel Address: 4945 ANDERSON MOUNTAIN Owner2: ELLIS LYDIA A RD Address: 4945 ANDERSON MOUNTAIN RD City: MAIDEN, 28650 Address2: null LRK(REID): 12589 City: MAIDEN Deed Book/Page: 3297/1460 State/Zip: NC 28650-0000 Subdivision: School Information: Lots/Block: TR B/ Last Sale: $135,500 on 2015-07-07 School District: COUNTY Plat Book/Page: 44/81 Elementary School: TUTTLE Middle School: MAIDEN Legal: LOT B PLAT 44-81 Calculated Acreage: 16.390 High School: MAIDEN Tax Map: 012 K 01023 School Map Township: CALDWELL State Road #: 1857 TaxNalue Information: Tax Rates(pdf) Zoning Information: City Tax District: All in County Zoning District: COUNTY County Fire District: BANDYS Zoningl: R-40 • Building(s) Value: $0 Zoning2: Land Value: $90,300 Zoning3: Assessed Total Value: $90,300 Zoning Overlay: • Year Built/Remodeled: null/null Small Area: BALLS CREEK 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 #: 3710366600J Building Details 2010 Census Block: 4007 WaterShed: null 2010 Census Tract: 011602 Voter Precinct: P9 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. 2(8 y ©2016, Catawba County Government, North Carolina. All rights reserved. ,� U Ecii3ti '1 L. CjG11C(�• http://gis.catawbacountync.gov/nomap/parcel_report.php7key=367603336865&typ=P 5/5/2016 a CATAWBA COUNTY �0p �r�, b Case 1\AVV-O6-2015-061663 i 2. Public Health Department l•�,.aL -Qs Subdivision *r H) Environmental Health Division tit- 731.1 I'INlr 367603336865 ''aM� PO Box 389. 100-A Southwest Blvd, Newton.NC 28658 e- �i, A'` LOl'll TR B 1841 -: .tu NAME ON PERMIT: DAVID ELLIS, 6716 LOVE POINT RD, DENVER NC 28037 Site Address: 4945 ANDERSON MOUNTAIN RD, MAIDEN NC 28650 Property Size: Square Feet 713,948.40 Acres 16.39 Directions: E Maiden Rd, Anderson Mountain Rd, property 1/2 ile on right Improvement Permit Facility: Primary Residence Permit Category: New Septic Bedrooms 3 WATER SUPPLY: Private Well Basement? Yes Basement Plumbing? Yes INITIAL SYSTEM SPECIF[CNTIONS Permit Valid: Expires In Five Years: X_ No Expiration: Projected Daily Flow 360 g.p.d Proposed Wastewater System: 25% REDUCTION Type: IIIG -OTHER NON-CONY TRENCH SYSTEMS Permit Conditions: Keep all parts of septic system and repair system minimum: 50' from any creek or well, 10'from property lines, 5' from home at day lighted side of basement, 15' from basement at ares of 2' or greater cut on side slope. Lines to be installed on contour. Do not grade drive or fill over system or repair area. Outlet plumbing from home will require specific placement or a pump may be required. REPAIR SYSTEM SPECIFICATIONS Repair System Required? Required Proposed Wastewater System: 25% REDUCTION Type: IIIB- SYSTEM W/SINGLE EFFLUENT PUMP PUMP 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 approved, and may resuit in failure to approve the initial system installation, or the suspension/revocation of existing permits. The issuance of this permit by the Health Department does not guarantee the issuance ol'other permits. It is the responsibility of the applicanUproperty owner 10 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 Sewage Treatment and Disposal Systems' (15A NCAC ISA .1900). Neither Catawba County nor the Environmental Ifenith Specialist warrants that the septic tank system will continue to function satisfactorily for any given period of time. Jason Boyd 06/12/2015 AUTHORIZED STATE AGENT APPROVAL DATE 06/11/2020 Permit Expiration Date: No grading or construction activity is allowed in areas designated for system and repair mithad approval of the Health Department. elipcnuit 061122013 13:18 Page 1 of3 A Pennit4 EHPR-5-15-21590 '` ini G CATAWBA COUNTY y 'Z Name David Ellis 'Public Health Department d w°I'orr°$ s Environmental Health Division Address 4945 Anderson Mm Rd Maiden I �!! PO Box 339, IOOA Southwest Blvd, Newton NC 28658 NC is 41, 9, (828)465-8270 Fa: (828)45.8276 •DD(828)465-8200 PIN# 367603336865 Site Plan Improvement Permit (c...j"L T �� L' "3 4, c_..1-•-3L A tom A AL f ‘,4 , P.- I I a ra-c ZS k • I Imo., k 24 ti 4:4 ) Sys t�� �— 3 (� Q APPr4 2,85 2 -a . / Z d' ` l x MIL '� y t e t r • .'D t iordet r 7 H, ' - q is 1 ao_pc .1, (nrt.'- 1 J I ° 01 \\-6,< Pr ' '‘ 0 /3 aN F. ti CL 's PP 0 tO ° 0 w� ,pra- s Pil+ 2 � 0 p N AFT F L.10 V Scale Department of Epvironmenl,Health,and Natural Resources Sheet: Division of Environmental Health Property ID: On-site Wastewater Section Lot#: SOIL/SITE EVALUATION File#: • for ON-SITE WASTEWATER SYSTEM AppID: EHPR-5-15-21590 Owner: L-yid Ellis Applicant: Address: 4945 Anderson Mtn Rd Dale Evaluated: 6/1112015 Proposed Facility: 3 BR home Design Flow(.1949) 360 and Property Size: Location of Site: Properly Recorded: Water Supply: pit well ( )Spring [ J Other Evaluation Method: hand dug by David Ellis [ J Cut Type of Wastewater: , X Sewage b I ( J Industrial Process I I Mixed 'i` it � Itit 1 . : 1 t u pRr,p r?t� r�- p G � ,r �� � I� ) S a i - iprP .1 , a i� J 9 P` 4 ' ,G?I4 eco t � �� MORpOt ,G,Ns ' LEORS � � k �ry .. y. { � 4 1t �IN1194 , ' r v3 f , L ra , 14 ; RROFI IFACTtgis r: � a ' v , t F t e La U F I 'Iv � $ -` � ";1942 I " ary my �n�,��t e J a v l r & , jI f s4a: iII �i "'� M i " h p 9 ^� �1.� ; d9 )1 ) 1556 ~ 1eed ) �P a ? (Iit1[E1kh) Lad e -(IDe Ili ? ,ut _ P1Cnisece L GJ1 ir ,:1Nee Ia— ) J3 So pv.Szprfl , • + iCl ga �S;'II yy ''+'' r� 1 Pusi;w.✓i 4 St ce ¢ tJ hit, ; =L#�, o p a/'M L (IN!)i Bll I�lasTexturW) 1Ihw"Mmeralocy . Pe y_. ,6 11G. , Deri li,(Ni1 �p§ 1ass S;dHorizG, he 1 LL 6-8% 0-6" topsoil 6-30" SCL 30-48" SC SS SP SEXP FR 48'• PS.3 2 same as 1 48" PS.3 3 same as 1,2 48" PS.3 4 5 a 7 Description Initial System Repair System Other Factors(.1946): Available Space(.1945) PS PS Soil Evaluation By: Jason Boyd System Type(s) IIIG IIIB Others Present: Site LTAR .3 .3 Site Classification(.1948): Pa Site Evaluation By: Others Present: Sheet: COMMENTS: FILE p. }.anfscape Position Group Texture 1455 LTAR Structure R-Ridge I S-Sand 1.2-0.8 SG-Single Grain SS-Shoulder Slope LS-Loamy Sand M-Massive LS-Linear Slope CR-Crumb FS-Foot Slope II SL-Sandy Loam 0.8-0.6 GR-Granular NS-Nose Slope L-Loam SBK-Suhangular Blocky HS-Head Slope ABK-Angular Blocky CC-Concave Slope III SI-Silt 0.6-0.3 PL-Platy CV-Convex Slope SICL-Silty Clay PR-Prismatic T-Terrace Loam FP-Flood Plain CL-Clay Loam SCL-Sandy Clay Loam IV SC-Sandy Clay 0.4-0.1 SIC-Silly Clay C-Clay Consistence Consistonco Mineralogy Moist Wet SEXP-Slightly Expansive VFR-Very Friable NS-Non-Sticky EXP-Expansive FR-Friable SS-Slightly Sticky FI-Firm S-Sticky VFI-Very Firm VS-Very Sticky EFI•Extremely Firm NP-Non-Plastic SP-Slightly Plastic P-Plastic VP-Very Plastic Sketch of Soil Evaluation Locations v�n kSCL t-S6 9 �. Julia English From:Jason Boyd Sent:Friday, May 27, 2016 7:57 AM To:Katherine Harris; Julia English Subject:FW: 4945 Anderson Mountain Rd From: David Ellis \[mailto:david.m.ellis@me.com\] Sent: Thursday, May 19, 2016 11:06 AM To: Jason Boyd Subject: 4945 Anderson Mountain Rd Jason, I hope you are doing well. Justin Morrison told me that you called him asking about the new home site. I drew up a sketch on Google Earth to show you the new home site and driveway location. You can see the three holes I dug last summer for you in the image just to the left of where the address is written. We basically just pulled the home site up a bit from where it was. The tree line that divides the two pastures will be cleared out. -David 1