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Home My WebLink AboutEHPR-12-09-2992 (2).TIF A Cp THIS IS NOT A PERMIT Case # EHPR-12-09-2992 CATAWBA COUNTY HEALTH DEPARTMENT v ^C Plan Review Application for Environmental Services Ig~2 $M Environmental Health Plan Review - Accessory Structure EXS SYSTEM APPLICANT OWNER CONTRACTOR CARL HICKS CARL HICKS SAME AS OWNER NAME TO APPEAR ON PERMIT CARL HICKS Pin#: 378001294347 SITE ADDRESS: 1665 MAGGIE ST, Catawba, NC DIRECTIONS: HWY 10 E TO MURRAYS MILL RD/ LT ON TROY ST/ FOLLOW PAVED RD.8 MI/ LT ON MAGGIE ST/ LAST HOUSE ON LT NAME of SUBDIVISION: Lot # Section/Block/Phase PROPERTY SIZE: Square Feet Acres 5.07 Date Platted/Recorded TYPE OF FACILITY: I-louse X Mobile Home Dimension of Structure Bedrooms 2 Basement: Yes Water Using Fixtures in Basement:No No, in Family 2 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: 12 X 20' STORAGE 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? NA 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. n ~ Date: Signature of Applicant or Agent C1 An Environmental Health Specialist will contact you within 2 working d ys f application date. If you need further infonnation or assistance please call 828-466-7291 AREA I (FOR OFFICE USE ONLY) Zoning Approval: _Yes No "Zoning Approval UDO Zoning Form A Minimum Setbacks FEE NAME DATE AMOUNT 30 Front 15 Existing Tank Check Fee ` 12/03/2009 $80:00' Side l5 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 12/03/09 15:38 THIS IS NOTA PERMIT WLS CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services F IP AC r S.T. Rpr. S.T. Exp. I% Exist. S. T. Well Permit Replacement Well 1. Name to Appear on Permit: C I.C S 2. Permit Requested By: 1~ S Business Phone: i ` zs )).&o ct C , K Address: Home Phone: Z~(~ 2 g. f 3. Property Owner: R(~ Business Phone: lCg.G ~E----5 A(~.. __r 5h Home Phone: Address: - 1 4. Name of Subdivision: - - - Lot - Section/Block/Phase: Property Address: Directions to Property: S_ M.? CL 5. Property Size: Square Feet - Acres - ! Date Platted/Recorded 6. TYPE OF FACILITY: 4 House C' Mobile Home Dimension of Structure Bedrooms*i ~An .,r~m.tha~+~it 6e i~te~de~f $oFSl~e .in at tf~e Ei~ne:o~ ~on~ucxion ar 1^or futt~r~co~s~d,~ratcon_shacilc~ b~ ~v~ed?a~~ beefroan~a~~ounte€f d~.ail----_-.-_ :a... ki20°h~_.Tk~;~iGmb raf. :dtopmswillbeoflir~nec'fx.:tc~caressletetttiEiee)nth use kris..as.a.bedrt~tacthet~tileaitiielln ermi+s ~r °#z:;€ ::Th~s:ma.. re~ant:_th_-need::~a.~s stems3 eanc~ease~irtaE~e-future ......i _ r.. i ,o-,7.. Basement: 0 Yes (7 No Water Using Fixtures in Basement: Yes (to, No No. in Family: Whirlpool Tub: (7Yes 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 17, TYPE OF BUSINESS: No. of Employees 1 st F 2nd 3rd OTHER: (Specify) 7. Do you anticipate any additions to Facility? (',Yes (7,, No If so describe e 8. Flas any grading, rernoval, or addition of soil been done to this property? (-.Yes 4 No if so describe 9. Are there easements/right-of-ways recorded on this property? (-,Yes No 10. Is a public water supply available on or adjacent to the above property? (`!Yes. (3? No Check type that is available: f- Community Well F' Semi-public Well r County/City/Township waterline 11. Well Type Applying For: f- Individual Well l" Community Well F Semi-public Well Irrigation Well F Geothermal Well r 12. Monitoring Well Request:(" Yes {`-No # of Wells: 7_7 Name of Site: I understand that this 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 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 set backs. **IF A PERMIT HAS TO BE REDESIGNED AND/OR RETRIPS MADE TO THE PROPERTY, THERE IS AN ADDITIONAL CHARGE.** Date: 1 2_ Signature of Owner or Agent: Pnnt Foro~ - y G CATA.W A COUNTY a w' `C P O Box 389 - Newton, North Carolina 28658 - (828) 465-8270 - Fax (828) 465-8276 - TDD (828) 4654200 4v~~~~.~:aitt~~ ht,ec~unt~ nc.<,oe phealti,'ehnr,in,t{ Public Health - Environmental Health Division. 1842 w Application for a Waiver of Existing Wastewater System and Well Inspection For Properties of Two Acres and Greater 1 CA gL Ep,uPt rrKS (print'your name) certify that I am the owner or authorized agent (owner's signed authorization required') representing. the owner of the property described as (property address and PIN): I ~pLPS 1A~(,G)E i Ct-Ck~)t3A r~) C_~ 2_K(D0j PIN ~O 1 ` ZI - 4347 By signing this waiver application, I acknowledge and certify the following; • All proposed building and property line setbacks currently required by law or local zoning ordinance can be met, The minimum required building setbacks from any component of the wastewater system, designated repair area, or private water supply well can be met in accordance with the following applicable North Carolina Laws. and Administrative Codes: o Laws and Rules for Sewage Treatment and Disposal Systems (15A NCAC 18A.1900) Any building foundation 5 feet Any water line 10 feet Any swimming pool 15 feet Well Construction Standards (15A NCAC 020p • Any building foundation 25 feet • I, as the owner of the property described above, or as the owner's authorized agent accept full responsibility for n and l mage as a result of the proposed construction. Applicant Signature Date bL 2 /0 Required attachments: • Plat of property or site plan (drawn to scale) showing all proposed and existing structures • Copies of current applicable permits (septic system, well, zoning; etc.) 'Waiver Approved Denied Comments Signature Title Date Notice to the Applicant: Approval' of this waiver provides only an exemption for an existing wastewater system or well inspection, Any deviation from the submitted site plan voids this Nvaiver. All waiver applications shall be reviewed by the On-site Water Protection Program Supervisor, or the Environmental Reatth Administrator. Please allow three' business days for processing. c~iµ`r! l.iX•„ "Keeping the Spirit Alive Since 1842!" tc Ro A Catawba County, North Carolina 71Jrc nup pre i,cl true pt pnr"c/li'nnt llr C'.i1tr t hu C uririrt A`C. (r< r t Iir'r frdnt rnarrm; .I tl m, ("oraiu~h,I("'Inuchas In"lc•strlstutilia(el/fri iv,nurerheeeemue-t'nflueunnirru.tf/irlsrh';- form'H:nn . can aurrr, I,m MI., irrrrp. t 'nkrv2t<t (iiuhrt, pra ,I,,les urI'll et'anriIvIIds )heitidelrco o- /eat srr r; ie n ~n n) rnn: :huts cimi'llm"I..ir iismp prt hxi hr ih,- tae•r. !Ar (`wwrIv nJ t ',mm ha, N:c ra plarer_c. uyc•n!s'M.f p.r:coturrl rlr.cc form, emd .ahcdl not hr Licht huble Jar ctir_r and all rluut l'i•,c, lass sir lisihdi t. (sheik", 'Ov, r, utrL Crt ur ctuis, yu, mrul which arix,r, or nwi: unpr Irnm (his ma.p prnrlnci nv t/re' u.c• them njbt' crin•.p<rcr~u vrr Christ Legend Sclected Parcel (Number: r,80-01-29-4347 I inch = 60 feet Prepared for: i~J \ t 5 7A l t) f" - 1 hI IIS' L NOT A qOC l?liha~' Tuestiny, December 01, 2009 12:47 P.At CATAWBA COUNTY HEALTH DEPARTMENT NEWTON, NORTH CAROLINA COMPLETION PERMIT FOR SEPTIC TANKS PERMIT # C - 1:6 6 5 DATE : OWNER c~_ ADDRESS - 2 ee''~, - G BUILDING CONTRACTOR -SUBDIVISION A~ LOCATION P _e, LOT # LOT SIZE BLOCK OR SECTION HOUSE (1~ MOBILE HOME ( ) BUSINESS ( ) OTHER FHA- ( ) VA LOAN ( ) SEPTIC TANK: (SIZE C'aG Q'. GALS) WATER SUPPLY: NO. BEDROOMS__NO-FIXTURES Z NDIVIDUAL PUBLIC GARBAGE DISPOSAL UNIT:YES (-730, (I IF WELL, TYPE: BORED -/bRILLED DUG AUTO WASHING MACHINE: YES ('O ( ) DISTANCE FROM SEPTIC TANK OR NEAREST NITRIFICATION FIELD: 4160 SQ.FT. POLLUTION: 7-f- FT. 1) NUMBER OF LINES SEPTIC T MK IN ~E. B' 2) LENGTH AND WIDTH OF LINES `lh ( i .paY: PERMIT FEE a BED SYSTEM CERTIFICATE 0 COMPLETION BY: b) TRENCH'SYSTEM ( )hrl~s 3) DEPTH OF STONE IN LINES 1 & 4'-- REMARKS : ADEQUATE FALL (GRADE) ON':. 1) BUILDI (HOUSE) SEWER LINE: YES (v NO ( ) 2) NITRIFICATION LINES: DATE INSTALLED-- YE S (L NO ( ) SEPTIC TANK LAYOUT 75 o w pq H H 0 0 a 0 HEALTH -DEPARTMENT COPY N ~ OA 11KATAWBA COUNTY HEALTH DEPARTMENT IMPROVEMENT PERMIT FOR SEPTIC TANKS Permit No. 10.4.6 7 NAM 'OF OWNER V l l DATE ADDRESS OF OWNER PHONE NAME OF CONTRACTOR ADDRESS LOCATION - w SUBDIVISION LOT NO. SECTION OR BLOCK LOT SIZ41~OAILEHOME FHA, VA LOAN HOUSE ( ( ) BUSINESS ( ) OTHER ( ) SEPTIC TANK LAYOUT NO. BEDROOMS (3) NO. FIXTURES GARBAGE DISPOSAL UNIT: YES ( ) NO PLUMBING UNDER BASEMENT FLOOR: YES ( ) NO SIZE OF TANK _ 00 LIQUID GALLONS NITRIFICATION FIELD: 1. Number of lines 2. Length and width of lines: a. Bed System 7 2 12 % ft. b. Trench system ft. $'46 3. Total Depth of stone O inches GROUNDWATER INTERCEPTOR DRAIN: (IF REQUIRED) WATER SUPPLY: PRIVATE ( PUBLIC ( ) OWNER NOTIFIED TO CHECK ZONING: YES (1-Y'NO ( ) OWNER AGREES WITH LAYOUT: YES (►.~r- NO ( ) OWNER AGREES WITH SPECIAL INSTRUCTIONS: YES NO ( ) OWNER OR CONTRACTOR SIGNATURE PERMIT FEE $ , J PERMIT VOID AFTER 36 MONTHS IMPROVEMENT PERMIT ISSUED BY SEPTIC TANK CONTRACTOR MUST FOLLOW ALL SANITARIAN \ DETAILS OF THIS PERMIT (LAYOUT) HEALTH DEPARTMENT COPY SOIL CLASSIFICATION: SUITABLE ( ) PROVISIONALLY SUITABLE SUIT ABLE ( ) SITE FACTORS: 1. SLOPE - - U 7. SOIL PERMEABILITY 2. SOIL TEXTURE (12-48 IN.) S - t S - P - U UNDER 60 MIN. OVER 60 MIN. SANDY LOAMY CLAYEY 8. OTHER 3. SOIL STRUCTURE (12-48 IN.) S - U S - P t 4. SOIL DEPTH IN. (SPECIFY) 5. RESTRICTIVE HORIZONS (IN.) S - P U 9. SOIL SERIES: IMPERVIOUS STRATA ROCK A. CECIL ( ) B. HIWASSEE 6. SOIL DRAINAGE -GROUNDWATER C. MADISON ( ) D. APPLING ( ) S P - U E. PACOLET ( } F. FLOOD PLAIN ( ) (EXTERNAL - INTERNAL) G. 2-1 CLAY SOIL H. OTHER-SPECIFY Catawba County, North Carolina This map product was prepared from the Catawba County, NC, Geographic Information System. N Catawba County has made substantial efforts to ensure the accuracy of location and labeling information contained on this map. Catawba County promotes and recommends the independent verification of any data contained on this map product by the user. The Co my of Catawba, its employees, agents and personnel disclaim, and shall not be held liable for anti and all damages, loss or liability, whether direct, indirect or consequential which arises or may arise from this map product or the use thereof by any person or entity. Legend Selected Parcel Number: 3780-01-29-4347 1 inch = 177 feet Prepared for: z . ` " y~ ~ Jam/-'~•' ~ ~ , ,,d \ : _ r ' 9 6 00~ . ~ 19,9 % , a L~ r y' , i i~ c] It J ! 60 vV C 63A W X443 57P~o s . . 3'47 W r J r l r o r' 1 17 79 ;t(4 20 14 5.';9f. 02 s J I /1- 1 Q5 co A 5110] t , ' j _ Lr) i rn ~.43A I,1~f~ ^ v~ 5.7511 y~ _ 4 394,1 y / THIS IS NOT A LEGAL DOCUMENT Wednesday, December 02, 2009 10:44 AM t r 1\~ t CATAWBA COUNTY NC - Parcel Report Information Regarding Selected Parcel(s) Parcel,ID: 3780-01-29-4347 Narner HICKS CARL EDWARD Name2: Address: 1665 MAGGIE ST Address2: City: CATAWBA State: NC Zip: 28609-8249 Account: 30186990 Calc Acreage: 5.07 Tax Map: 018 Y 01089 LRK: 18977 Deed Book: 1500 Deed Page: 0624 Subdivision Name: Subdivision Block: Lots: Plat Book: Plat Page: Building Number: 1665 Street Name: MAGGIE ST Site Zip: 28609 Township: CATAWBA Fire Code: CATAWBA RURAL City Code: COUNTY State Road: Total Bldgs Value: $116,400 Land Value: $35,200 Total Value: $151,600 Year Built: 1979 Year Remodeled: 1998 Last Sale Date: 9/1/1977 Last Sale Amount: $6,500 Neighborhood: 126 Watershed: WS-IV Protected Area Watershed Split: NO Voter Precinct: P5 E911 District: COUNTY Zoning: R-40 Zoning2: Zoning3: Zoning Split: N Zoning Overlay: DWMH-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: 011501 Census Block 2010: 2007 Small Area Plan: SHERRILLS FORD Agricultural District: Printed: Wednesday, December 02, 2009 10:44 AM