Loading...
HomeMy WebLinkAboutRBPR-08-2016-24436.TIF vS4A THIS IS NOT APERMIT Case # RBPR-08-2016-24436 � G , CATAWBA COUNTY HEALTH DEPARTMENT , PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES • �� �' . /842 SM Residential Building Plan Review - Building New 13 �. •D . `o IMPROVEMENT - AUTH CONST Applicant * FISHER CONSTR CO., CARROL (DANNY FISHER), 614 N MAIN ST. SALISBURY NC 28144 B:7046336124 C:70420251 1 0F:7046337898 DANNY@CARROLFISHER.COM Contractor * FISHER CONSTR CO., CARROL (DANNY FISHER), 614 N MAIN ST.SALISBURY NC 28144 B:7046336124 C:7042025110F:7046337898 DANNY@CARROLFISHER.COM Owner PEBBLE BAY OF CATAWBA LLC. 614 N MAIN ST, SALISBURY NC 28144 B:0 NAME TO APPEAR ON PERMIT * FISHER CONSTR CO., CARROL (Danny Fisher) SITE ADDRESS: 7361 BAY COVE CT, DENVER NC 28037 PIN # 460603238664 NAME of SUBDIVISION: PEBBLE BAY PH 5 Lot# 240 Section/Block PROPERTY SIZE: Square Feet Acres 1.04 DIRECTIONS: NORTH CATAWBA BURRIS RD TO BANKHEAD RIGHT ON SALLY BROOK RIGHT ON BAY COVE GATE CODE 1379 PRIMARY CONTACT: Contractor SEWER TYPE: Septic Tank GALLONS PER DAY: 480 WATER SUPPLY: Community Well DESCRIBE WORK: BUILDING 4 BEDROOM HOUSE • 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: 0 NUMBER OF EXISTING BEDROOMS: #OF OCCUPANTS: PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 77X47 #OF NEW BEDROOMS:: 4 BASEMENT? No BASEMENT FIXTURES? No PLUMBING REQUIRED?Yes Desired system types (Improvement Permit or Authorization to Construct): ACCEPTED: ALTERNATIVE: CONVENTIONAL: OTHER: INNOVATIVE: ANY: YES Other described: E9-chapplication 08/03/2016 16:15 Page 1 of4 $A CATAWBA COUNTY case n RBPR-08-2016-24436 /1..._t '�"�® Public Health Department PEBBLE BAY PH 5 TSubdivision ?I -3/4t-t---Th}y-Environmental Health Division 460603238664 PO Box 389, 100-A Southwest Blvd,Newton.NC 28658 PINK /8 2 w NAME ON PERMIT: * FISHER CONSTR CO., CARROL (DANNY FISHER), 614 N MAIN ST, SALISBURY NC 28144 # FISHER CONSTR CO., CA Site Address: 7361 BAY COVE CT, DENVER NC 28037 Property Size: Square Feet Acres 1.04 Directions: NORTH CATAWBA BURRIS RD TO BANKHEAD RIGHT ON SALLY BROOK RIGHT ON BAY COVE GATE CODE 1379 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 FEENAME., =;`- DATEN; `;r FEE'.AMOUNT Authorization to Construct Fee (New/Expansion) 08/03/2016 5300.00 Fee Improvement Permit Fee 08/03/2016 5150.00 TOTAL FEES jr a- 5450.00 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 08/03/2016 16:15 Page 2 014 ��T rills as NOT A PERMIT -'`'c S C� 1>_G. C �� f C�.��Vb At Ce C.000 . counrx �, ••• ` CATAWBA COUNTY 1TL'ALTII DEPARTMENT aryw._c.:6w*�'u° —' . Application for Environmental ServicesI Page I —i /' Improvement Permit ❑ Authorization to Construct l�' Septic Repair.❑ Septic Malfunction ❑ Septic Expansion ❑ ,NewWell Permit❑.Replacement;Well ❑. Wcll°Abandoriment:0 ' Well Repair ❑ Existing System Inspection,(Pre-Approval Required) ❑' PI ❑ r6dE fisting Facility ❑ �7A lliltc Application for New Existing ,�` ` ('� Property Address 7; �\ ., L- 7`-9:.. l., St �C'�b� J 4-y �- -AI\ 1Cf.. 2-2C-l3/ Lot if -7 4t ` Acres V1039) Sectio n/Block/Pliase t\ ` . zir Driving Directions to Property - NAME TO APPEAR ON PERMIT? �,...Awncr — pplicant X ntractor Applicant Contact Information Name •t`r,A'C`te C k S'ker CieziAt CLJ t4)lee CS, �ovrrri ', 'YThAc-ci v 1 5Ci.. ch `\I- , r. " yo _ .` Address 1..47 9O3 '7 Phone .. Cell Phone Oi{ ZflZ,;-SLSO Own • ontactInft ,cation c� 'vw,� ^ tsk rn . Name A , • _ . 41ULfiiOn\isiLeQi • n r '/ Address ' f rl IA 7 14-'Phone 11 Phone • Contractor Contact.Information (� . . Name cDC_NNY\\,c : -t•CLai( `to 4-- 702_ - kly Address Phone • ' - 'Cell--Phone • WHO WILL BE I`Iit,PRIMARY CONTAC;I'? mer, 61ieant ► ontractor' • Descriptionbf Existing Structures on Site "'• "�- em ' #of Bedrooins9j' 4• •StructureiDensions'T� K ,1-. .,. #.of Occupants Basement ❑ Yes Rmi o.. Basement rsnturus ®;Yes ® No pp ' y p i n ent iipon submittal of tans application if any of the following apply:to The A licant shall hoof the locab'liealth do art n the property in uestion. If the answer to any question is "yes", app 'cant;must attachisupport ng documentation! 0 Yes Does the site contain any jurisdictional wetlands? • 0 YesDoes the site contain any eisting wastewater,systems9, w ID Yes' i _1 /o Is.any wastewater going to be generated on the site other than domestic sewa e? r� )(Yes 1 is the site subject to approval by any{other publrcagency7 ' ' c'Q- US N. CYes water supplyui Are ire tli'c,re any easements or right of ways on thss;property?„ D ,, , Existing ❑ Individual Well [J'Commundy!WeW ' Senn Publid Well ` ' ' ( (:A ❑ County/Cit}It shi Watei•Line Is'a public water supply available? ** 'Yes. ❑No Ifapplyisig for an lmproscnient'Peiimit orl4utlioriz:ition to•Consti'u Please Indicate:Desired System Type(s): (systems can be ranked in order of your preference) ❑ Accepted 'D Alternative " Conventional ❑'Innovanvc El,Other Any ` is ,,b,r • -Ay?' . :IIiOtll:Jc 1 , :.. nri xr. �u: ✓.> ,. . .. -.. a .... i ... t;i ,...[ .._. blirv- • CATH« B.q THIS IS NOT A PERMIT coot:r . A�CD CATAWBA COUNTY ITEALTI DEPARTMENT Application.for Environmental Services Page 2 Proposed Facility Type ❑ Primary.Residence 12 New Residence ddition to Resid�n`ce^ # of New Bedrooms *t 2-1 Project Description n�le `y t� �` NE, Structure Dimensions `7 K # of Occupants Basement Yes`g Basement Fixtures i� Yes *No Li Accessory Structure(s) ,Describe # of New Bedrooms *1. ifapplicable Structure Dimensions # of Occupants Accessory' Dwelling ❑ Yes ❑ No Plumbing ❑ Yes ❑ No Describe Plumbing Needed (J Multi Family Re'sideuce#`Units #Bedrooms per Unit'f Total# Bedrooms *t Structure Dimensions ❑ Food Service Specify Type # Seats Floor Space-Entire Food Service Facility (Sq Ft) # Employees per Shift, #of Shifts Dining Area(Sq. Ft.) Business Specific Type of Business Retail Floor Space 4 of Employees per Shift # of Shills ❑ Other Facility Type'Specify If Church#.of Seats Kitchen ❑ Yes ❑ No If Daycare Specify Occupancy. Application for Well Construction/Abandonment/Repair Proposed Well Type ❑ Individual Well ❑ Semi-Public Well ❑ Community Well Abandonment Type ❑ Drilled ❑ Bored ❑ Dug ❑ Unknown WellRepair Requested ❑ Yes ❑ No. ,, Describe Calculated Design Flow, Commercial t Additional information may be required'to determine design flow from certain:facilities I his value will;be determined during consultation with on-site staff. *Any room that will be intended for'sleeping at thetime of construction or for'future consideratioir should be.noted'as,abedroom and counted on all applications.The number of bedrooms will be confirmed by rooms.identified on house,plans as a'bedroomat the tune of building permit issuance. This may prevent the need'for septic system size increase in the future. t If structure isplumbed but no bedrooms, calculated design flow is required. "* If No,a well permitmust be issued with,the Authorization to Construct SYSTEM REDESIGN AND/OR RETRIP WILL INCUR AN ADDITIONAL CITARGE:(SEE FEE SCHEDULE) Improvement Permits issued as a result of this',informationarevalid for yearsormay benon-expiring raider certain specified conditions.An Authorization to Constrict issued by this department is valid for:(5)1$ve years from the date issued and is not transferrable,Improvement Permits and Well Permits are transferrable. Permits may be revoked if the'information on this application, site p use changes for the proposed facility. I have read this application and certify that the information;provided herein is true,complete and correct. Authorizedcounty 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 solelyresponsible‘forthe proper identification and labeling of all property lines and comers and making the site accessible so that a complete site evaluation can be performed. Signature of Owner or Agent / 1• Date e -3- 'e) Printed Name ofOwner'orAgent c`)&'\k r O N � —cFm� -- c_9,5,_____ — co \\, \ r— \ \ I\\\\\ 11 � 0 n 1 m«/ ,‘i L, 11 O CFC/. P 1 . 1 N L4 O 1 � � 1 O 1 ov,x .po — 2 ` 5 1 m 1 ,,—'-1111111-- —: � �L vv DJ O m 1 1�� ,rr x mo N COo A D . ➢ O Z r ci O N ill anw INc ♦ =ewecr coN eeec:oe ♦ I/ SITE PLAN LOT 240 PEBBLE BAY CARROL FISHER CONSTRUCTION I it.01.701 Cli ♦ ♦ 1 ♦ , L i Catawba County Environmental Health 100?0 75.19 • BAY COVE CZ • .1 , 132.38 -Naas32.38 • • • • • • • 1111 • 171.00 -Ad • •• Parcel: 460603238664, 7361 BAY COVE CT 1in=50ft DENVER, 28037 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 08/03/2016 Parcel Report Page 1 of 1 Parcel Report - Catawba County NC Parcel Information: Owner Information: Parcel ID: 460603238664 Owner: PEBBLE BAY OF CATAWBA LLC Parcel Address: 7361 BAY COVE CT Owner2: City: DENVER, 28037 Address: 614 N MAIN ST LRK(REID): 803091 Address2: Deed Book/Page: 2725/1727 City: SALISBURY Subdivision: PEBBLE BAY PH 5 State/Zip: NC 28144-3644 Lots/Block: 240/ Last Sale: School Information: Hat Book Page: 65/145 School District: COUNTY Legal: LOT 240 PEBBLE BAY PHASE 5 PL 65- Elementary School: SHERRILLS FORD Middle School: MILL CREEK 145 Calculated Acreage: 1.040 High School: BANDYS Tax Map: School Map Township: MOUNTAIN CREEK State Road #: TaxNalue Information: Tax Rates(pdf) Zoning Information: City Tax District: All in County Zoning District: COUNTY County Fire District: SHERRILLS FORD Zoningl: R-30 Building(s) Value: $0 Zoning2: Land Value: $35,000 Zoning3: Assessed Total Value: $35,000 Zoning Overlay: CRC-O,WP-O Year Built/Remodeled: / Small Area: SHERRILLS FORD Current Tax Bill Split Zoning Districts: / Zoning Agency Phone Numbers Miscellaneous: Firm Panel Date: 2007-09-05 Building Permits for this parcel. Firm Panel #: 3710460600J Building Details 2010 Census Block: 4017 WaterShed: WS-IV Critical Area 2010 Census Tract: 011504 Voter Precinct: P41 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 veritication 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,tawba County Government, North Carolina. All rights reserved. / /,aa http://gis.catawbacountync.gov/nomap/parcel_report.php?key=460603238664&typ=P 8/3/2016 ' \ Catawba County Public Health � .C 4W a www.catawbacounCv nc. ov/environmentalhealth • COUNTY Environmental Health h � P.O. Box 389, 100-Fl South West Blvd., Newton, NC 28658 North Carolina Phone (828) 465-8270. Fax (828) 465-8276 Memorandum To: Pebble Bay of Catawba. LLC From: Michael Cash, Environmental Health Supervisor Date: August 11, 2014 Subject: Permit Extension Addendum for Expiring Septic Permit at 7361 Bay Cove Ct. Denver, NC; Catawba County Permit WLS2006-01523 In accordance with State Law 2010-177, effective August 5, 2010, your Improvement Permit referenced above, expiring October 12, 2011 is granted an extended expiration date. Your new expiration date will be October 12, 2015. This Addendum will remain with your existing permits on file. Please note that only the Improvement Permit is transferable to any future owners of the property and that the permit is valid only so long as the property boundaries, site plan, site conditions, and wastewater flow remain unchanged. "Leading the Way to a Healthier Community" '68Health q 1 A\YBA COUNTY s Public Health Department Case k VVLS2006-0023 •S t t mrromuemnl Health Division Subdivision PEBBLE BAY PHASES / PO Box 389,100-A Southwest Blvd,Newton,NC 28658 Sect/BL/Ph/Lot N 240 04281465-8270 FAX(82S)465-8276 TDD( —.825i465-8200 �t� PINn 911460601164071-240 • Applicant/OwnerPEBBLE BAY OFCATA\VBA LLC Site Address: ROAD B (PEBBLE BAY PH 5) DENVER NC Property Size: SF 1.03 ACRES Directions: CATAWBA-BURRIS RD/ RT BANKHEAD/ RT SALLY BROOK Improvement Permit Permit Valid For: Five years No Expiration tIN Facility(Residential): House House X Mobile Home Multi-Family Bedrooms 4 New? • Addition? Projected Daily Flow Int g.p.d Water SupplyPrivate Well? Public? ,t( Semi-Public? Basement: N Basement lumbine: llN�� t[Holub/Spa:_ SpecialrrFixturr-- (explain): Proposed Wastewater System: ^ -p ii 015% Si E-e 2e�lt.e 1va�- Type: 3 8/6 Proposed Repair: ?ctw`n �D a 5 sl�-C '2e uzL- '. 3 B/6- Permit Conditions: Owner or Legal Representat/ atuye� ��-"s� _82 ',cam.-� Date: Authorized State Agent: /C ✓ Date: /0—/,2— to The issuance of this permit by the Health Department does not;guarantee the issuance of other permits. It is the responsibility of the applicant/property owner to insure that all Catawba County Plannina/Zonine and Building Inspections requirements are mel. 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 Di.tpa.sal Systems' (ISA NCAC ISA .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. Authorization to Construct Wastewater System (Required for Building Permit) * See.rite plan and additional attachments t Proposed Wastewater System: Type: Wastewater Flow g.p.d New Repair Expansion - Soil LTAR: g.p.d./tt2 Type of Facility: Basement: N Basement Plumbing: N HotTub/Spa: N Special Fixtures(explain): Wastewater System Requirements Tank Size: Septic Tank _gal Pump Tank gal Grease Trap gal Drainfield: Total Area: sq ft Total Length: ft Maximum Trench Depth ._ in Trench Width ft Minimum Soil Cover Minimum Trench Separation ft Distribution: Distribution Box SeridhDistribution Pressure Manifold LPP Other Additional Specifications: Authorized State Agent: Date: Permit Expiration Date: I have read and accept the specifications and all conditions of this permit as indicated. Owner or Legal Representative Signature: Date: Form l3 r,\Tide,mrk'FormMtLeovv.m: nitt ,,T-Th=,, cAT,LwBAcot;NTY /i i i Public Health Dep nment Case# RtLS2006-01523 (T; E v ronvienud lie.kalif]Division Subdivision PEBBLE BAY PHASE 6 \� PO Box 389,100-A Southwest Blued.Seaton.NC 28658 Sect/BUP}i/Lot# 240 . \,,_i/ 181,465-8270 FAX(828T 465-8276 TDD(828)465-8200 PIN# 911460601164071-240 Applicant/Owner PEBBLE BAY OF CATAWBA Site Address: ROAD B (PEBBLE BAY PH 5) DENVER NC Property S SF 1.03 ACRES Directions: CATAWBA-BURRIS RD/ RT BANKHEAD/RT SALLY BROOK © Improvement Permit El Authorization To Construct CI Well Permit SITE PLAN til Io pvrVs- l-cur as% 5 t b C Q e cl lne 1'"M ss 5ysi.ew. 4- (0 22pat K ?OVA to t . OS t LOY 60 f_ * - 3.16 340 1 .14,E /// A. Its /32 Scale 'Zen p System components represent approximate contours only. The contractor must flag the system prior to beginning the installation to ensure that proper grade is maintained. Do not install system under wet conditions. This permit is subject of revocation if the plan or site conditions are altered. Ant rized State gent Date Form C r9Tid',orHpenmViILauv.ra DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES Sheet i of I DIVISION OF ENVIRONMENTAL HEALTH PROPERTY ID#:96-d/52.3 ON-SITE WASTEWATER SECTION COUNTY: -% • SOIL/SITE EVALUATION �) (�I,,I for/ LON-S1_ITE IWr'ASTEWATER SYSTEM lh OWNER: rP rU V If fl`/ oC. CO 1 C(W �1 t} Lr�APPLICATION DATE _' - oc 1_ p ADDRESS: (011-1 13 11/0°}0L1 S i s/4C-«Bug DATE EVALUATED:/0-//- PROPOSED FACILITY: (gyp U. PROPOSED DESIGN FLOW(.1949): 14 _ PROPERTY SIZE: LOCATION OF SITE: >e lnbl.e _13 ray p�sc S c..0c..0-1-.Ua Y/O PROPERTY RECORDED: WATER SUPPLY: ❑Private blic (]Well ❑Spring ❑Other EVALUATION METHOD: ❑Auger Boring ("it ❑Cut TYPE OF WASTEWATER: Sewage ❑Industrial Process ❑Mixed R SOH,MORPHOLOGY OTHER F , I (:1941) PROFILE FACTORS 1 L .1940 = _. .. I E • `.LAND Holli- I - I .1942 .. SCAPE ' ZON .1941 .1941 SOIL 1 .1943 : .1956 . .19441 ' PROFILE # POSITION/ DEPTH STRUCTURE/ • CONSISTENCE/MWETNESS/ ' ..SOIL . SAPRO RESTR CLASS . . SLOPE% . d TEXTURE, !MINERALOGY • ICOLOR H 'DEPTH , CLASS ORIZ Si. LTAR V / P I LOS& SCL y� F-5. S� -.3Z iSBk 5C L Pr J{11 _ /� 1 g 32-111 ]aJ k S61_ Fir' �SGAy�e - jSJ I P'5 1 0-0 1 vst3(1 5rt /T' G-a0 z is sic.. n 11 Sdd 12 2-- S 2 5,ti 'L�- LJsRIe- . -i_ F..�' - 3s` o -m I,.6{bit- sct C a • ' i 2- lSR C1 I- , Liz-- 3s- 3 S,� I I T 4 ' -- • DESCRIPTION INITIAL SYSTEM REPAIR SYSTEM OTHER FACTORS(.1946): C SITE CLASSIFICATION(.1948): P Available Space(.1945) 5 /' D System Type(s) p;550 I �j`_J j EVALUATED BY: C{ _ 2( OTHER(S)PRESENT: Site LTAR ,35 I -35 COMMENTS: P � 4 \ ki' rZ,4)�Pot..? vk • LEGEND • use the following standard abbreviations SOIL CONVENTIONAL LPP MINERALOGY/ LANDSCAPE POSITION GROUP TEXTURE .1955 LTAR` .1957 LTAR* CONSISTENCE STRUCTURE ' CC(Concave Slope) I S(Sand) 1.2-0.8 0.6-0.4 NEXP(Non-expansive) G(Single Grain) CV(Convex Slope) LS(Loamy Sand) SEXP(Slightly Expansive) M(Massive) D(Drainage Way) EXP(Expansive) CR(Crumb) DS(Debris Slump) II SL(Sandy Loam) 0.8-0.6 0.4-0.3 GR(Granular) FP(Flood Plain) L(Loam) 513K(Subangular Blocky) FS(Foot Slope) ASK(Angular Blocky) H(Head Slope) III Si(Silt) 0.6-0.3 0.3-0.15 PL(Platy) L(Linear Slope) SiCL(Silty Clay Loam) PR(Prismatic) N(Nose Slope) CL(Clay Loam) R(Ridge) SCL(Sandy Clay Loam) MOIST WET S(Shoulder Slope) SLC(Silt Loam Clay) T(Terrace) VFR(Very Friable) NS Mon-such) IV SC(Sandy Clay) 0.4-0.1 0.2-0.05 FR(Friable) 5S(Slightly Sticky) SiC(Silty Clay) Fl(Fiat) S(Sticky) VF1(Very Firm V.Very Sticky) VS(Very Sticky) 0(Organic) None EFI(Extremely Firm) NP(Nm-plastic) SP(Slightly Plastic) *Adjust LIAR due to depth,consistence,swetwq soil wetness,landscape,position,wastewater(low and quality. P(Plastic) NOTES VP(Vey Plastic) HORIZON DEPTH In inches below natural soil surface DEPTH OF FILL In inches from land surface RESTRICTIVE HORIZON Thickness and depth from land surface SAPROLITE S(suitable)or U(unsuitable) • . SOIL{i'ETA'ESS Inches from land surface to free water or inches from land surface to soil colors with.chroma 2 or less-record Munsell color chip designation ' CLASSIFICATION S(Suitable),PS(Provisionally Suitable),or U(Unsuitable) I Evaluation of saprolite shall be by pits. Long-term Acceptance Rate(LTAR):gal/day/IP Show profile locations and rther site features(dimensions,reference or benchmark,and rrth). i ( - - E, I • • ..........__ .._. .._ C ... ._ E r �. _. , i I • I. I l • ! Ir) 1 - - - - --: 1-1---;S------ --:-..---;-____4__________4______;____ i i I t_. ' DEIINR(kki:=-) Review(#'T.'.)) SOIL/SITE EVALUATION Sheet of_ (Continuarion Sheet) ��- THIS IS NOT A PERMIT Case # WLS2006-01523 CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services Improvement Permit? IMPROVEMENT lit Septic Service Type: N/A Well Service Type: N/A APPLICANT OWNER CONTRACTOR PEBBLE BAY OF CATAWBA LLC PEBBLE BAY OF CATAWBA, LLC 614 N MAIN ST 614 N MAIN ST SALISBURY NC 28144-3644 SALISBURY NC 28144 NAME TO APPEAR ON PERMIT PEBBLE BAY OF CATAWBA LLC Pint 911460601164071-240 SITE ADDRESS: ROAD B (PEBBLE BAY PH 5) DENVER NC DIRECTIONS: CATAWBA-BURRIS RD/ RT BANKHEAD/ RT SALLY BROOK NAAIE or SUBDIVISION: __EEBB[F HAY PHASE 5 Lot# 240 Section/Block/Phase PROPERTY SIZE: Square Feet_ Acres 10"3 Date Platted/Recorded TYPE OF FACILI'T'Y: House Mouse X Mobile Home _ Dimension of Structure 60 X 60 Bedrooms 4 Basement: N_ Water Wine Fixtures in Basement: N No. in Family ° Whirlpool Tub : N Gal. Capacity: MULTIPLE FAMILY RES DAYCARE: Number of Children RESTAURANT: Seats Square Feet Dining Area Square Feet Foodstand/Meat Market Floor Space TYPE OF BUSINESS: Number of Employees 1st 2nd 3rd OTHER: (Specify) Do you:anticipate any additions to Facility? N If so, describe: _ Has any grading,removal,or addition of soil been done to this property? N U so,describe Are there easements/right-of-ways recorded on this properly? N Type of Water Supply: Individual Well Community Well X Municipal Semi-Public Monitoring Well Request: N #of wells Name or Site 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 properly and authorize Catawba County Health Department employees to go on this property for evaluation purposes. I certify the above information to be correct and understandthat an Improvement Permit issued as a result of this information is transferable and has no expiration 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. gg, Date: o�� Signature of Applicant or Agent # f�� �� • 7 t i CeeSl• �� * **- **.* (FOR OFFICE USE ONLY) Please Contact GEORfF PFNI]FRRR ASS between 8 am and 9 am Phone _828,465-8772 Zoning Approval: _Yes No Zoning Approval#. Form A FEES Type Description Date Heceived Amount By ADMN Improvement Permit 09/27/2006 P50 $140.00 Total: $140.00 *If a permit has to be redesigned and/or RETRIPS made to the property,there is an additional$60 charge