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Home My WebLink AboutEHPR-11-09-2887 (2).TIF THIS IS NOT A PERMIT WLS # CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services Improvement Permit ❑ Authorization to Construct ❑ Septic Repair I °'I Septic Expansion ❑ Existing Tank Check ❑ New Well Permit ❑ Replacement Well ❑ Well Abandonment ❑ 1. Name to Appear on Permit -:~74- C) f /I 2. Permit Requested By j5i'-'1-L 'o Business Phone Address ~67 Home Phone 11: QV-rB 3 /t 3. Property Owner Business Phone _ g(e1j Address /pG 4i ~ Ali , Ar C, tc~j Home Phone 4. Name of Subdivision Lot # Section/Block/Phase Property Address G Directions to Property: V,~ r' ~✓a 27 5. Property Size: Square Feet Acres l Date Platted/Recorded 6. TYPE OF FACILITY: House i.- Mobile Home Dimension of Structure 2y V i 5 Bedrooms* _ *Any room that will be intended for sleej)ing 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 perm, issuance. This may prevent the need for system siz eicrease in the future. Basement: , e /no Water Using Fixtures in Basement: \(e /no 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 1 st 2nd 3rd OTHER: (Specify) _ 7. Do you anticipate any additions to Facility? Yes If so, describe: 8. Has any grading, removal, or addition of soil been done to this property? e o If so, describe: ~t-rte 8' ~r 9. Are there easements/right-of-ways recorded on this property? Yes / 0 10. Is a public water supply available on or adjacent to the above property? Yes /LO 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 - Signature of Owner or Agent Catawba County, North Carolina This map product was prepared from the Catawba County, NC, Geographic Information System. N Catmvba County has made substantial efforts to ensure the accuracy of location and labeling information contained on this map. Catawba County promotes and reconunends the independent verification of any data contained on this map product by the user. The County of Catmvba, 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 o- may arise from this map product or the use thereof by anv person or entity. Legend Selected Parcel Number: 4710-03-43-3773 1 inch = 60 feet Prepared for: 'A l Fj`iat t rl ~t t P112423 T/ F1 a ou E 1 7 - r o~ r" 01 c'o.S ZZ 5 O ti THIS IS NOT A LEGAL DOCUMENT X"/ Tuesdav, November 24, 2009 11:31 AM ~1 l 1 / t 1-1 11 Ll 1 ' rr \ 1 ! i CATAWBA COUNTY NC - Parcel Report Information Regarding Selected Parcel(s) Parcel ID: 4710-03-43-3773 Name: COCKERHAM JOHN F Name2: COCKERHAM KATHERINE H Address: 1066 WHISPERING WINDS DR Address2: City: CATAWBA State: NC Zip: 28609-8878 Account: 13421000 Calc Acreage: 1.21 Tax Map: 014 Y 02054A LRK: 15079 Deed Book: 1850 Deed Page: 1236 Subdivision Name: Subdivision Block: Lots: Plat Book: 20 Plat Page: 250 Building Number: 1066 Street Name: WHISPERING WINDS DR Site Zip: 28609 Township: CATAWBA Fire Code: SHERRILLS FORD City Code: COUNTY State Road: 1855 Total Bldgs Value: $105,700 Land Value: $154,600 Total Value: $260,300 Year Built: 1994 Year Remodeled: Last Sale Date: 9/1/1993 Last Sale Amount: $65,000 Neighborhood: 129 Watershed: WS-IV Critical Area Watershed Split: NO Voter Precinct: P21 E911 District: COUNTY Zoning: R-30 Zoning2: Zoning3: Zoning Split: N Zoning Overlay: CRC-O,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: 1012 Small Area Plan: SHERRILLS FORD Agricultural District: Printed: Tuesday, November 24, 2009 11:31 AM ti~~tl f' ' Case # WLS2009-00074 CATAWBA COUNTY Subdivision k l.s Public Health Department , Q Environmental Health Division S0ct1011/Bl/1 h/Lot# PIN# 4710-03-43-3773 - PO Box 389, 100A Southwest Blvd, Newton NC 28658 18 41 sM (828) 465-8270 Fax (828) 465-8276 TDD (828) 465-8200 Applicant/Owner John Cockerham Site Address: 1066 Whispering Winds Dr. Catawba, NC Property Size: 1.21 acres Directions: EXISTING SYSTEM INSPECTION REPORT Site/System Diagram m 0~ t, Yid I r j s e V rv~,-Hc~ q1 P , J eX~S~I n S S-} . CWCA1occ~ close r ell -T NaiJS W i;~s~ ,~~Wi S Dr }~L p ZXIS-lir~ YivPWa - Yudel~- U -T 10, CTO air ey, dr;vewa - aJed , Type of Facility : House ® Mobile Home ❑ #Bedrooms 3 Business F-1 Specify Other Specify Proposed Additions/Accessory Structure: Tearing down existinu 3 bedroom house... building new 3 bedroon house. Will connect to existing septic system. Approved ® Not Approved ❑ Reason Evidence of Sy:iiw NO System Type/Descripti on fVa LLP (permit 7307) Z TE AGENT AP OVAL DATE NOT FOR LOAN APPROVAL tF. `Permit and/or COp. :Required_C. us :be. c6mpjetp~d prior to final} ~i .A ;.CATA~WE3 A C'OIYNZ'Y, A~.TH flE_PAI2TMENT ! V (704) '4658270 ve. Permit air Permit Cert. of Como. Permit Lot.Eval. ~!Impro p _-Op Permit Owner/Agent: _TVHAJ. ~D-Gze, fr_ 4 _ Phone Address____ cciE i ` sv W/itl1Z 7~~P. Subdivision iV~ Section/Block/Phase . Lo.. r-- Lot Size 1 Z3 14_G zt :1 i. rections•: L -<A Zfl P2 e- C S_ EQ e__ D /1/7 GiIJ~ %O Faciiityl ,,kouse_.i%, -ff6ftle .Home Aus ness_. Other.. Tax-A2ap # /Y,~~--a- S A Multi=famrl.y_ .Other'. Zoning Approval. # "Z9~G0;L2' V' Bedrooms Seats Employees. Application Rate GPD Flow<,3,CQ Hot Tub or, S a es/ o S ecial F.ix-tures 100%"Repair Area. e no REPAIR NOTICE: . P y Pe , Basement yes Basement Flumbn:g yes~c REPAIRS MUST'BE WITHIN 30 DAYS OR' Water Supply:. Private c%Pii6lic DAYS-.FROH<pATE ;OF PERMIT. Type of 'System: ;Trench . Bed ' - :`Pump° :Pump/Panel.. Panel LPP t:-@t'fier .Tank Size:' Septic Tank /Q:D O Pump Tank /006 Nitrification`Field:. Total- Square,Feet./?,07?--`-D`epth of Stone S Bed Size Trench Width / TotalLerigth of, All Trenches~3.6 Number of Trenches C i. i. Individual Trench Length~~~t on.Center~ Maximum Trench Depth_ Distance of .Neaest:Well /f Lot Evaluation: Approved esZ o, (Void After.24•.months) ,Topo_71.,C)-.~o Slope { Sk o . va uation Site System Design - Final Texture Rr.r~. f So07T/G'=h+NK Go%vT.ei9Gl. a2, NOV { ^ IVNSTA41 Structure COpE EN WET Clay Min. Cre; JAS fs:o~Y=`y Soil Wetness 5~:,`~ /t'`'C a F' Ees,N Li4T `w. Soil Depth_ Restric. Hoz. at. .Available space- no r M Overall Class PS Comments:. w. v I 5P :.~r• - - J-, Sept'. Tank Contractors MUS contact the" O S/ Dl: F S itarian BEFORE - changing permit. ~~7C~vr~//UG- D2. *NO'GUARANTEE OR ,W S ,IMPLIED. OR• GIVEN. THROUGH, THE:'ISSUANCE OF T S._PERLTST* Permit Date leg 5f. (Improvement PeYmi-t void after 60 months ) Owner./Agent Sanitarian S Installed' B- 4&4?,64, %4ne - Date 9 'Sanitarian (Note;' ` changes/information in_.red'`or by sketch 0-11 back) any, * * * * * * * IF. A7 PERMIT , HAS -TO; BE' REDESIGNED' ;AND %OR RETRIPS HARE TO THE PROPERTY. THERE*,* IS AN' ADD ITIONAL , $ 2 S„ CHARGE White - Office a Blue „Bldg, Insp. Comp. ' Yellow - Own #Agem, Green - Bldg. Insp. I.P. fj V-POS - Transaction Receipt Page 1 of 1 Transaction Receipt Catawba County, NC Catawba County Permit Center 100ASWBlvd Newton, NC 28658 828-4658404 11/24/2009 11:49AM Catawbal12409114814761Eng 25261826 EHPR-11-09-2887 JOHN COCKERHAM 1 NA COCKERHAM/JOHN null null ************6352 Authorization and Capture Amount: $300.00 Cardmember acknowledges receipt of goods and/or services in the amount of the total shown hereon and agrees to perform the obligations set forth by the cardmember's agreement with the issuer. Signature L - click , click here to continue. https://www.velocitypayment.com/admin/catawbacountync/vpos/942/transactions/receipt... 11/24/2009 CATAWBA COUNTY, NC I00-A South West Blvd PLAN RECEIPT Newton, NC 28658- 0 (828)465-8399 Tuesday, November 24, 2009 184 sm www.catawbacountync.gov Plan Case: EHPR-11-09-2887 Invoice Number: INV-11-09-257524 Environmental Health Plan Review Invoice Date: 11/24/2009 Fee Name Fee Amount Authorization to Construct (Repair) Fee Adjustable $300.00 Total Fees Due: $300.00 PAYMENTS Date Pay Type Check Number Amount Paid Change 11/24/2009 Credit Card -1 $300.00 $0.00 Total Paid: $300.00 Total Due: $0.00 plan receipt ; b<)c73e4-ditch-4ziadr9bdt- I b~b~tt I abi)R ; _rpt 1 1 /24/2009 1 1:50