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HomeMy WebLinkAboutEHPR-06-2016-24108.TIF y��A �C THIS IS NOT A PERMIT Case# EHPR-06-2016-24108 :, CATAWBA COUNTY HEALTH DEPARTMENT 0 • - . • t 0 0 An try' PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES �. 1842 5M Environmental Health Plan Review - OSWP f o U D•IMPROVEMENT •0:.{ D Contact Person REALTY EXECUTIVES (ANNE BARRIER), 785 HWY 70 SW 100, HICKORY NC 28602 C:8282343133 ABARRIER@ABARRIER.COM Owner WANDA SUAREZ, 2455 FIRE DEPARTMENT ST,NEWTON NC 28658 C:828449093I NAME TO APPEAR ON PERMIT Wanda Suarez SITE ADDRESS: 2455 FIRE DEPARTMENT ST, NEWTON NC 28658 PIN # 362915545352 NAME of SUBDIVISION: STARTOWN WOODLANDS Lot# 16& 17 Section/Block B PROPERTY SIZE: Square Feet 32,234.40 Acres 0.74 DIRECTIONS: Hwy 10 West, Left onto Startown Rd, Right onto Fire Dept St, House is the A frame on the LEft. PRIMARY CONTACT: Contact Person SEWER TYPE: Septic Tank GALLONS PER DAY: 360 WATER SUPPLY: Private Well DESCRIBE WORK: IP Only at this time to determine possibility of expanding septic from 2 to 3 BdRms for sale of home. The existing home has a permit for 2 BdRms & potentially has a 3rd BdRm existing in the home. 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? Yes 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? No Are there any easements or right-of-ways on this property? No APPLICATION FOR: Existing Structure STRUCTURE TYPE: PRIMARY RESIDENCE FACILITY TYPE: House OTHER DESCRIPTION: DESCRIPTION OF House, Metal Carport, Bldg EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: House 36x31, Bldg 12x14 NUMBER OF EXISTING BEDROOMS: 2 #OF OCCUPANTS: 1 PROPOSED CONSTRUCTION #OF NEW BEDROOMS:: 1 BASEMENT? Yes BASEMENT FIXTURES? Yes PLUMBING REQUIRED? Desired system types(Improvement Permit or Authorization to Construct): ACCEPTED: ALTERNATIVE: CONVENTIONAL: OTHER: INNOVATIVE: ANY: YES Other described: E9-elutppl teat ion 06/15/2016 10:57 Page 1 of4 .4yv,• • CATAWBA COUNTY Case# EHPR-06-2016-24108 `Q' 2 Public Health Department Subdivision STARTOWN WOODLANDS d, — � k Environmental Health Division PIN# 362915545352 \ N0 PO Box 389, 100-A Southwest Blvd,Newton.NC 28658 yg42/ NAME ON PERMIT: ( WANDA SUAREZ), 2455 FIRE DEPARTMENT ST,NEWTON NC 28658 ( Wanda Suarez) Site Address: 2455 FIRE DEPARTMENT ST,NEWTON NC 28658 Property Size: Square Feet 32,234.40 Acres 0.74 Directions: Hwy 10 West, Left onto Startown Rd, Right onto Fire Dept St, House is the A frame on the LEft. 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 s61 - .: plete site evaluation can be performed. L2-Date: u2- \ S— \ `,J Signature of Applicant or Agent tan. 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 AREA2 ************************************************************************************************************ I��IEEENAIMEj Nih ^� 3:� �i�a�� ��� � 1� 1 � f '>1�DATE 'i y�i 11511%14%.,•EIAMOUNT j Improvement Permit Fee 06/15/2016 $150.00 II a ;; 't' a OTALFEES{ IIIIIOIkIPV tsNIl IVF tii'nJ00IIi:: l�fI�tktJlZ IiiEllp$�.,�$1?owooI if 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 icat ion 06/15/2016 10:57 Page 2 o14 CATAU713 THIS IS NOT A PERMIT sound' ��� I--- CATAWBA COUNTY HEALTH DEPARTMENT north —� Application for Environmental Services Page 1 Curol� Improvement Permit Authorization to Construct❑ Septic Repair❑ Septic Malfunction ❑ Septic Expansion n New Well Permit[ Replacement Well ❑ Well Abandonment❑ Well Repair ❑ Existing System Inspection (Pre-Approval Required) n Application is for New Construction ❑ Existing Facility Address , ` SS .rn ,'t- Subdivision «< ��� \-„„-. (\L a\VC,SR Lot# Acres Section/Block/Phase Driving Directions to Property _, . _ D _ a a �\ tTho LA 0. \ — ems__ .� _° NAME TO APPEAR ON PERMIT? 'Owner ❑ Applicant ❑ Contractor Applicant Contact Information ..4. Name 0,..e pi,,s�'\_e S yf Address ----1 0'u,• "\ C-? .S , .�.) 4-, 4,1e.o a�i..96 �- Phone 5 -a - 7, _7yt -- ell Phone R.,, J Owner Contact Information Name C7. )(,, a N ctiv-e Address ure.)c - :, S.P^h.o\ 4 f `r\Q.u)S` r--- (C— `;... S(_ts%) Phone Cell Phone '3 .% - 1._\44q- o°l3\ Contractor Contact Information Name Address Phone Cell Phone WHO WILL BE THE PRIMARY CONTACT? I Owner [Applicant ❑ Contractor Description of Existing Strictures on Site n - -4vci.,r�.e_. \r-Q11 (1)( y ft of Bedrooms 0 Structure Dimensio of Occupants `1 Basement 'Yes ❑ No Basement Fixtures a Yes 0 No —' The Applicant shall notify the local health department upon submittal of this application if any of the following apply to the property in�n``question. If the answer to any question is "yes", applicant must attach supporting documentation. 0 Yes irk() Does the site contain any jurisdictional wetlands? YesTO Does the site contain any existing wastewater systems? © Vivo o Is any wastewater going to be generated on the site other than domestic sewage? gli Yes � �No_ Is the site subject to approval by any other public agency? a Yes `IB No Are there any cements or right of ways on this property? Describe Existing water supply in use Individual Well ❑ Community Well I I Semi-Public Well n County/City/Township Water Line Is a public water supply available? ** ❑ Yes ❑ No If applying for an Improvement Permit or Authorization to Construct,Please Indicate Desired System Type(s): V (systems can be ranked in order of your preference) ❑ Accepted ❑ Alternative ❑ Conventional ❑ Innovative ❑ Other Any e C ATM TU A THIS IS NOT A PERMIT u u, 1 �9' 1L� CATAWBA COUNTY HEALTH DEPARTMENT ..J • • a No hC,7q,` Application for Environmental Services Page 2 VProyosed Facility Type Primary Residence ❑ New Residence n Addition to Residence # of New Bedrooms *j Project Description Structure Dimensions # of Occupants Basement ❑ Yes ❑ No Basement Fixtures ® Yes DI No n Accessory Structure(s) Describe # of New Bedrooms *j if applicable Structure Dimensions # of Occupants Accessory Dwelling n Yes n No Plumbing ❑ Yes ❑ No Describe Plumbing Needed 1 I Multi-Family Residence# Units #Bedrooms per Unit*j Total# Bedrooms *j Structure Dimensions n 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 #of Employees per Shift # of Shifts n Other Facility Type Specify If Church # of Seats Kitchen ❑ Yes ❑ No If Daycare Specify Occupancy Application for Well Construction/Abandonment/Repair Proposed Well Type n Individual Well n Semi-Public Well ❑ Community Well Abandonment Type n Drilled n Bored ❑ Dug n Unknown Well Repair Requested ❑ Yes C 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 AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) Improvement Peewits 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. Signature of Owner or Agent _ �����j_ . Date c� Printed Name of Owner or Agent k'�fj1. � dam' A r ! a_ } Catawba County Environmental Health i--- 103.00 • r\s} 101.50 \ \IIIIhib- 102.75 F1Re 4EPARTMENT ST (1.8) 3 ` 1 -1 1 1 I! 1 s 1 :11 1 . .0. 1 i 0 1 it IS t y ca 1 (95) �—.4 1 —.000110111.1r cc (9B) gli , W • • Parcel: 362915545352, 2455 FIRE tin=50ft DEPARTMENT ST NEWTON, 28658 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 06/15/2016 Parcel Report Page 1 of 1 Parcel Report - Catawba County NC Parcel Information: Owner Information: Parcel ID: 362915545352 Owner: SUAREZ WANDA HUFFMAN Parcel Address: 2455 FIRE DEPARTMENT ST Owner2: null City: NEWTON, 28658 Address: 2455 FIRE DEPARTMENT ST LRK(REID): 4091 Address2: null Deed Book/Page: 3329/1898 City: NEWTON Subdivision: STARTOWN WOODLANDS State/Zip: NC 28658-8600 Lots/Block: 16 & 17/ B Last Sale: $131,000 on 2016-02-25 School Information: School District: COUNTY Plat Book/Page: 10/35 Elementary School: STARTOWN Legal: LOT 16 & 17 16-17B PL10-35 Middle School: MAIDEN STARTOWN PL 10-35 High School: MAIDEN Calculated Acreage: .740 School Map Tax Map: 004BJ 08004 Township: JACOBS FORK State Road #: 2057 TaxNalue Information: Tax Rates(pdf) Zoning Information: City Tax District: All in County Zoning District: COUNTY County Fire District: NEWTON RURAL Zoningl: R-20 Building(s) Value: $95,000 Zoning2: null Land Value: $13,100 Zoning3: null Assessed Total Value: $108,100 Zoning Overlay: ED-O Year Built/Remodeled: 1999/null Small Area: STARTOWN 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 #: 3710362900J Building Details 2010 Census Block: 1001 WaterShed: null 2010 Census Tract: 011702 Voter Precinct: P34 Agricultural District: Proximity 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. ©2016, Catawba County Government, North Carolina. All rights reserved. http://gis.catawbacountync.gov/nomap/parcel_report.php?key=362915545352&typ=P 6/15/2016 CATAWA COUNTY HEALTH DEPARTMENT Telephone: (704) 46 -- 270 TDD: (704) 465-8200 N° V 8 J /4/1. Improve. Permits Authorization to Construc Repair Permit_Oper. Permit System Type r Owner/Agent 41)-1 i r�/ ,'/(1'l� Phone L,ly'5 Address s u 17 iza 1 Subdivision A e J I c941_ A." Section/Block/Phas Lot# Lot Size Directip s: /QnJ ii ,Si:rY N ee'',O-4-� /' - &tf " 5 Q -1-- - Facility: House X Mobile Home Business . Other: Tax Map # '3.J- F�`—'/ Multi-family Other . Zoning Approval # a' 6j It 3 # Bedrooms # is # Employees . Application Rate o y GPD Flow puff) Hot Tub or pa yes/ Special Fixtures . 100% Repair Area yes/no Basement 110/no Basement Plumbing 62/no Water Supply: Private Well )( Public - Type of System: Trench Bed Pump Pump/Panel Panel LPP Other Tank Size: Septic Tank Size /OIJU / Pump Tank Size / ali ` ^ i Nitrification Field: Total Square Feet GO/) Depth of Stone XJ/i4 Bed Size Trench Width 036 Total Length of All Trenches d Number of Trenches Z Individual Trench Length 57)/ 5/ / -/ Feet on Center Maximum Trench Depth. Distance of Nearest Well !QE) *DO NOT INSTALL WHEN WET* J Topo p2 J % Slope Texture (/,ay / SPNO 4-0 b PC,N l l 'p N1 d} Structure /Vartef A-5 r►'• e 33 Clay Min. / 2 / 1361-- 0-f-C 0 + Soil Wetness / 5 " � Soil Depth ,741r- " Side r4Ja 1- Restric. Hoz. at ----w Available space /no IV 19nrPe-•f 1-f '. Overall Class + I Comments: / t 3/.�r t^O(f s �r 4 51. ,,,,„,e - l Pr y I_S I'"-gal pe-r- ( r•"..e Ci I a 5P 5 Pis g tAlf C-U"tics 4#1 -Q; (&)60 ;11L I **NO GUARANTEE OR WARRANTY IS IMPLIED OR GIVEN AS TO THE PERFORMANCE OR LENGTH OF TIME THIS SYSTEM WILL FUNCTION** *Improvement Permit has no expiration date and is transferable, but may be revoked if site plans or intended use changes for the proposed facility. An Authorization to Construct is valid for (5) five years fr.m •ate issued and is not transferable. , Permit Date 2 �Owner/A Owner/Agent •� .4� ��• • Sa y i ian . �/ //,,,A,,. i //�, Installed By 1 aI £4" to . 2 anitar' .. L—• r/igffi%fird7 02 White-Office Blue-Building Inspection Operation Permit ' Yellow-Owner/Agent Green-Building c Audi. ' ..on to Construct V a. OPERATIONS PERMIT FOR TYPE IV WASTEWATER SYSTEM PERMIT NUMBER 0852 In accordance with the provisions of Article 11 of Chapter 130A, General Statutes of North Carolina as amended, and other applicable Laws and Rules PERMISSION IS HEREBY GRANTED TO Hugh F :Shillito CATAWBA COUNTY FOR THE Operation of a wastewater collection, treatment, and disposal system to serve Tax map pin# 4BJ-8-4 pursuant to 15 A NCAC 18A 1'90q et seq and in conformity with the application, improvement permit, and- other supporting data subsequently filed and approved by the Catawba' County Heat'�,Depa-r-tment and--considered a- part Of -- -- -- this permit Facilities to be served (Address and specific type of facility) 2455 Fire Department St Newton, NC 28658 Type 4A The approved wastewater collection, treatment and disposal system consists of (1) 1000 gallon septic tank (2)1000 gallon pump tank (3) (.1) Gould' s WE0-311L 1/3 HP Effluent pump (4) 100ft of T&J Panel Block System (5) 2" supply line (6) 1 1/4" line in drainfield (7) (2) Adjustment valves The Owner shall be subject to all applicable provisions of Article 11 of Chapter 130A of the General Statutes and 15A NCAC 18A 1900 et seq The Owner is especially referred to Rules 1935 (29, 31) , 1937 (d, e) , 1938 (g) , 1945 (a, b) , 1950 (a through i) , 1961(a through d) , 1965, 1967 and 1968 The Owner shall also be subject to the following specified conditions and limitations as they apply I GENERAL 'CONDITIONS This'permit is effective only with respect to the number and type of proposed facilities and volume and nature of wastes specified In the event that the facilities fail to perform satisfactorily, including the creation of 'nuisance conditions, the Owner/Operator shall take immediate corrective actions to correct the problem, including actions as may be required by ;the Catawba County Health Dept , such as the construction of or replacement of wastewater treatment or disposal facilities, upon receipt of a repair permit The septage generated from this system shall be disposed -of in accordance with Article 9 of Chapter 130A of the General Statutes and 15A NCAC 13B 0100 et seq and in a manner approved by the North Carolina Division Of Solid Waste Management The issuance of this permit shall not relieve the Owner of the responsibility for damages to surface or groundwaters resulting from the operation of this system Neither does the issuance of this permit exempt the Owner from complying with any and all statutes, rules, regulations, or ordinances which may be imposed by other government agencies (local, state, and federal) Which have jurisdiction This permit may become suspended Or revoked if the soils fail to adequately absorb and treat the wastes or if the facilities. are not maintained and operated as designed The system must be operated and maintained in a manner which will not create a public health hazard or nuisance by surfacing of effluent or discharge directly into ground water or surface water any time during the operation of the system Adequate measures shall 'be taken to divert stormwater from the disposal, field area and to prevent wastewater runoff Diversion or bypassing of the ' untreated wastewater from the treatment facilities is prohibited Prior to the transfer of this land to a new owner, a notice shall be given to the new owner that gives full details about the system and the materials applied or incorporated at this site At the time of the sale of the property a new 'Operations Permit will have to be issued Operations permits are nontransferable .. The designated repair area Shall be reserved for the installation of additional nitrification fields and is not to be covered with structures or impervious materials No addition, expansion, alteration or other repairs shall be made to the wastewater system without first obtaining an' improvement permit from the Catawba County Health .Dept in accordance with GS 130A-336 Failure to abide by the conditions and limitations contained in this permit may subject the Owner to an enforcement action in accordance with North Carolina General Statute 130A-18 , 138A-22C, 130A-23, and/or 138A-25 In the event that the facilities fail to perform satibfactorily, including the creation of ,nuisance conditions , the Owner/Operator shall contact the Catawba County Environmental Health Section of the Health Dept within 4-8'^hrs`= of°'diSbovering- Chia failure or problem A suitable cover, preferably fescue, shall be maintained over the drainfields Grassed areas shall be kept mowed and the clippings and other debris removed as needed to prevent thatch build-up No traffic (including parking of RV' s, boats, trailers as well as other vehicles) or other, equipment shall be allowed on the drainfields,with the exception of mowing equipment Non-biodegradable products (plastics, metals, etc ) chemicals (disinfectants, drain cleaners, acid?, alkalies, , pesticides, ,petroleum products, etc ) or grease shall not be discharged into the septic system The owner shall keep the plumbing system in the facility in good repair and eliminate leaks, drips, or excess flows as they are found Use of ultra low fixtures and conservative water use practices are recommened II OPERATION AND MAINTENANCE REQUIREMENT, • The Owner shall maintain a contract With a subsurface sewage system operator who is currently certified by the Water Pollution Control System Operators Certification Commission to maintain this system Verification of any changes' to the contract currently on file shall be submitted in writing to the Catawba County Health Dept This system is required to be inspected by the certified operator at- a minimum frequency of two times per yeas or as otherwise specified by the Catawba County Health Dept The distribution device should be inspected during each maintenance visit for proper operation ,If needed the pressure should be inspected and set properly at each maintenance visit Low pressure lateral lines shall be purged of solids at least once a year Using potable water directly or added into the dosing tank If the operator and the health dept determine purging is needed more or less frequently, then a new schedule shall be implemented Pressure on the distribution lines shall be checked and adjusted in accordance to design.'"pressure's`sa'ffe'r'e`ach -piliging and at least - semi-annually Pump drawdown level (between the on-float and the off-float) , approximate dosing volume, and pump delivery rate shall be measured after each purging and .at least semi-annually The°-owner and operator shall be responsible for assuring any broken pipe, lateral end caps or cleanouts are repaired within 48,, .hrs of. becoming aware of such a problem The 'condition of all pipework -shall be evaluated during each inspection Surface and subsurface water shall be diverted away from the tanks and drainfield Outlets on diversion ditches and tile drainage tubes shall be kept open and free flowing The. septic tank shall be inspected at least, annually for leakage, blockage of influent/effluent lines, structural integrity, condition of baffle and tee, condition of risers if present, scum and solids level , and effluent clarity Solids shall be removed from the entire tank before the solids depth exceeds 1/3 of the liquid depth in the inlet compartment, and is otherwise determined to be needed by the operator or the Health Dept^ The dosing tank shall be inspected semi-annually for leakage, structural integrity, condition of risers, solids level and effluent clarity Solids shall be removed from the dosing tank when solids are removed from the septic tank or when the solid level is up to the pump or siphon intake level Solids accumulating on the pump ,or siphon and floats shall be removed by hosing Pumps and electrical controls shall be inspected at least semi- annually for pump presence and proper automatic functioning The floats / pipe / control valves / union / anti-siphon hole are in proper working condition The control panel / electrical connections are. properly maintained and operational The highwater alarm is present and operating .properly Siphons, when present, shall 6e inspected at least semi-annually to verify proper automatic functioning, and the highwater alarm is present and properly operating III MONITORING -AND REPORTING—REOUIREMENTS- ------ -" Any 'monitoring deemed necessary bytthe Catawba Co Health Dept to insure the proper performance of the system shall be performed A record shall also be maintained documenting each site visit by the operator, including visual observations of all system components, -and, all maintenance activities It is recommended that the owner be offered a copy of each document for each visit A monitoring report, including all required records, signed by the operator, shall be submitted on or before the last day of the month following each 12 month period after permit issuance to the , following address Catawba County Environmental Health Attn. George Pendergrass PO Box 389 Newton, NC 28638 Non-compliance notification The owner/operator shall report by telephone to the Catawba Co Health Dept , Phone No 465-8270 , as soon as possible, but in no case more than 48 hrs upon finding the System is malfunctioning by the surfacing or backing up of effluent, discharge directly into the ground water or surface water, or when repairs are needed Ti Dep., PERMIT ISSUED -_THE Sr DAY OF �) r9" tom- — j,1//,�" CATAWBA CO. HEALTH DEPT. /u/ �-- Ad s'O7 r Signature E 'O r ALII/' TH SECT. if I AA \ CATAWBA COUNTY IOOA SOUTHWEST BLVD /' ' NEWTON, NORTH CAROLINA 28658 RECEIPT d Jm re PHONE: 828.465.8399 it Wednesday, June 15, 2016 1842 sM www.catawbacountync.gov PAYOR: Realty Executives Realty Executives(Barrier,Anne) PAYMENTS TRANSACTION NUMBER: TRC-692343-15-06-2016 PAYMENT DATE : 06/15/2016 PAYMENT TYPE: Check 3694 INVOICE NUMBER FEE NAME FEE AMOUNT 06-16-329465 Improvement Permit Fee $150.00 TOTAL PAYMENTS : $150.00 EHPR-06-2016-24108 CASE TYPE: Environmental Health Plan Review WORK CLASS: OSWP SITE ADDRESS: 2455 FIRE DEPARTMENT ST,NEWTON NC 28658 Contact Person REALTY EXECUTIVES, 785 HWY 70 SW 100, HICKORY NC 28602 C:8282343133 ABARRIER @ABARRIER.COM **NO PEOPLESOFT ACCOUNT ASSIGNED ** Owner WANDA SUAREZ, 2455 FIRE DEPARTMENT ST,NEWTON NC 28658 C:828449093I receipt 06/15/2016 10:57 Page 1 of 1