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Home My WebLink AboutEHPR-11-09-2813 (2).TIF A THIS IS NOT A PERMIT Case # EHPR-11-09-2813 CATAWBA COUNTY HEALTH DEPARTMENT U ^C Plan Review Application for Environmental Services 1842 sM Environmental Health Plan Review - OSWP EXS SYSTEM APPLICANT OWNER CONTRACTOR SAME AS OWNER MARY PARKER SAME AS OWNER MARY PARKER NEIL D STEWART STATESVILLE NC 704-873-8926 NAME TO APPEAR ON PERMIT SAME AS OWNER MARY PARKER Pin#: 47100301 1209 SITE ADDRESS: 1 183 MOLLYS BACKBONE RD, Catawba. NC DIRECTIONS: MOLLYS BACKBONE RD NAME of SUBDIVISION: Lot # Section/Block/Phase PROPERTY SIZE: Square Feet Acres 2.519 Date Platted/Recorded TYPE OF FACILITY: House Mobile Home X Dimension of Structure Bedrooms 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 I st 2nd 3rd OTHER: (Specify) Do you aniticipate any additions to Facility? If so, describe: 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 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 An Environmental Health Specialist will contact you within 2 working days of application date. If you need further information or assistance please call 828-466-7291 AREA 1 (FOR OFFICE USE ONLY) Zoning Approval: _Yes No Zoning Approval UDO Zoning Form A Minimum Setbacks AMOUNT Front 30 FEE NAME DATE Side 15 Existing Tank Check Fee 11/23/2009 $80.00 Rear 30 TOTAL FEES $80.00 Max Hght *If a permit has to be redesigned and / or RETRIPS made to the property, there is an additional $60 charge 11/23/09 10:14 ' THIS IS NOT A PERMIT WLS # '44? 3 CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services Improvement Permit ❑ Authorization to Construct ❑ Septic Repair ❑ Septic Expansion ❑ Existing Tank Check New Well Permit ❑ Replacement Well ❑ Well Abandonment ❑ 1. Name to Appear on Permit 4b, 5a YI/` 677 2. Permit Requested By WA T Business Phone Address Q 6-11,44&-Af SC4®~ { L G Home Phone 1~- 8-13 $ Q ZG 3. Property Owner Business Phone Address /3 N6'-C4 L 6 , F Home Phoneg.N-V ?F .2.47~Y 4. Name of Subdivision Lot # Section/Block/Phase Property Address ~(a,! S 6,64 AR 46F JW, Directions to Property: 5. Property Size: Square Feet - Acres Date Platted/Recorded 6. TYPE OF FACILITY: House Mobile Home Dimension of Structure Bedrooms*__!~7 *Am- ioo►n that wilTbe intended for sleepin 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/no 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 1st _ 2nd 3rd OTHER: (Specify) 7. Do you anticipate any Xn'~_'Jons to Facility. Yes No If so, describe: ' 8. Has any grading, removal, or addition o soil been done to this property? Yes /I~Io If so, describe: 9. Are there easements/right-of-ways recorded on this property? Yes No 1 10. Is a public water supply available on or adjacent to the above property? Yes / o 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 [ ] Se►ni-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 1'Z, " 0 q Signature of Owner or Agent 1&_4 Catawba County, North Carolina This map product iros prepared fi om the Catawba Coinr. AT. Geogrophic htformalion system. N Calau ha Comm twos made suhcimmal efforts to ensure die aecurcrct of loccloon and lohe/nig information contained on this imp. Calarha Comiti promoics and reconuncods the indepenclew reI-l/iccuion n/ ctnr doer conloined mr /Ms mop produce bI the ricer. "lhc Comm mofCannncct, its employees. agents cold pel'.ronnel disclaim, once shall not he lick/ liahle for otn mid all dmnages, /oss or liahilih, irhether direct, nrrhrec't or cotssequenliol which arises or mmv arise front Ibis mop product or Ilse use Ihcreof hy oily person or elltlh•. Legend Selected Parcel Number 4710-03-01-1209 1 inch = 60 feet Prepared for 1 -T %.l V 2.52P, Cam. s 2 ~9 V C. v i l l Ir ~il- 61-7 C / tr 90 ~ . oo It THIS IS NOT A 1.,A:GA1, DOCU~'IEiNT Fradayr, November 20, 2009 08:12 AEI i x r CATAV'1BA COUNTY NC - Parcel Report Information Regarding Selected Parcel(s) Parcel ID: 4710-03-01-1209 Name: PARKER MARY KING Name2: Address: 1183 MOLLYS BACKBONE RD Address2: City: CATAWBA State: NC Zip: 28609-9210 Account: 50746000 C p.e S Calc Acreage: 2.52 2 v ' C Tax Map: 014 Y 03027 ( (I ' i LRK: 15117 L ~ C~- Deed Book: 1050 Deed Page: 0618 Subdivision Name: Subdivision Block: Lots: r Plat Book: r `i k Plat Page: Building Number: 1183 Street Name: MOLLYS BACKBONE RD C Site Zip: 28609 Township: CATAWBA Fire Code: SHERRILLS FORD City Code: COUNTY State Road: 1835 Total Bldgs Value: $64,000 Land Value: $24,100 Total Value: $88,100 Year Built: 1984 Year Remodeled: Last Sale Date: Last Sale Amount: Neighborhood: 128 Watershed: WS-IV Critical Area Watershed Split: NO Voter Precinct: P21 E911 District: COUNTY Zoning: R-40 Zoning2: Zoning3: Zoning Split: N Zoning Overlay: WP-O Zoning District: COUNTY Split Zoning Dist: N Split Zoning Dist(1): 0 Split Zoning Dist(2): 0 School District: COUNTY Elementary School: CATAWBA Middle School: MILL CREEK High School: BANDYS School Split: NO P&Z Case Number: Census Tract 2010: 011502 Census Block 2010: 1020 Small Area Plan: SHERRILLS FORD Agricultural District: Printed: Monday, November 23, 2009 08:43 AM ~~A C CATAWBA COUNTY, NC 100-A South West Blvd PLAN INVOICE Newton, NC 28658- 0 (828)465-8399 Monday, November 23, 2009 1► -184 Z sM www.catawbacountync.gov Plan Case: EHPR-11-09-2813 Invoice Number: INV-11-09-257474 Environmental Health Plan Review Invoice Date: 11/23/2009 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 11/23/2009 Check 930 $80.00 $0.00 Total Paid: $80.00 Total Due: $0.00 ~r7: r 11/23/2009 10:29