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HomeMy WebLinkAboutEHPR-06-2016-24124.TIF CATAWI3AEnvironmental Health - Division of Public Health COUNTY ,. PO Box 389—100-A South West Blvd.-Newton,North Carolina 28658 as (828)465-8270—Fax(828)465-8276 North q„ ww.catawbacountync.gov/environinentalhealthl AUTHORIZATION OF REFUND Date: 9/8/2016 Case#: EHPR-06-2016-24124 Applicant: Jeff Hartley Refund Amount: $300 Refund Reason: Septic issue was fixed. Repair permit not needed Authorizing Signature: :_ji� Received By Staff: ik. ' 46411 1 __ Date: Ohit "Leading the Way to a Healthier Community" " 7 �E .. elt ;o ti Public Health Prcveel.Prw .Ptu legit. Catawba County, North Carolina - Disbursement Voucher Vendor No. Date 09/08/16 A Make Payment To: s1�,/IlbCO� Voucher No(s). Jeff Hartley f/��.'Z 3798 Mt Pleasant Rd t� ii ";gi Sherrills Ford, NC 28673 g 2 ATTACHMENT Prepared by Julia English Description Amount Septic problem was fixed. Repair permit not needed. 300.00 Sub-Total $ 300.00 Food Tax Sales Tax Total $ 300.00 For Accounting Fund Cost Center Object Project Amount Use Only 110 580200 663000 Total - The undersigned hereby certifies that the goods or services specified above have been received or performed. Payment has not been previously authorized and this expenditure is a proper charge to the appropriation indicated. The above charge is certified to you for payment. (SIGNATURE-APPROPRIATE OFFICIAL) • A Cp CATAWBA COUNTY �." �� 100A SOUTHWEST BLVD NEWTON,NORTH CAROLINA 28658 RECEIPT PHONE: 828.465.8399 V s, ��� Thursday, September 8, 2016 78 42 sM www.catawbacountync.gov PAYOR: Hartley,Jeff PAYMENTS TRANSACTION NUMBER: TRC-823822-08-09-2016 PAYMENT DATE : 09/08/2016 PAYMENT TYPE: DV INVOICE NUMBER FEE NAME FEE AMOUNT 06-16-329574 Authorization to Construct (Repair) ($300.00) Fee TOTAL PAYMENTS : ($300.00) EHPR-06-2016-24124 CASE TYPE: Environmental Health Plan Review WORK CLASS: Septic Malfunction SITE ADDRESS: 3798 MT PLEASANT RD, SHERRILLS FORD NC 28673 Owner JEFF HARTLEY, 3798 MT PLEASANT RD, SHERRILLS FORD NC 28673 C:8289947655 **NO PEOPLESOFT ACCOUNT ASSIGNED ** receipt 09/08/2016 16:19 Page 1 of 1 �qA • THIS IS NOT A PERMIT Case # EI-IPR-06-2016-24124• � � CATAWBA COUNTY HEALTH DEPARTMENT 0 :o-�'�� Q, ,mm-ay-Vll .- -w °O� PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES �' ti i842 s^4 Environmental Health Plan Review - Septic Malfunction • .'a o. I. AUTH_CONST- SEPTIC_MALFUNCTION ' sCI f ' Owner JEFF HARTLEY, 3798 MT PLEASANT RD, SHERRILLS FORD NC 28673 C:8289947655 NAME TO APPEAR ON PERMIT Jeff Hartley SITE ADDRESS: 3798 MT PLEASANT RD, SHERRILLS FORD NC 28673 PIN # 369702954328 NAME of SUBDIVISION: HOLIDAY PARK Lot# 2 Section/Block B PROPERTY SIZE: Square Feet 23,086.80 Acres 0.53 DIRECTIONS: Hwy 150 to Little Mtn Rd, Left onto Mt. Pleasant Rd PRIMARY CONTACT: Owner SEWER TYPE: Septic Tank GALLONS PER DAY: 360 WATER SUPPLY: Private Well DESCRIBE WORK: Drain field is slowly draining. Large tree has grown through drain field. 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 EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: 56x35 NUMBER OF EXISTING BEDROOMS: 3 #OF OCCUPANTS: 3 PROPOSED CONSTRUCTION BASEMENT? No BASEMENT FIXTURES? No PLUMBING REQUIRED? Desired system types (Improvement Permit or Authorization to Construct): ACCEPTED: ALTERNATIVE: CONVENTIONAL: OTHER: INNOVATIVE: ANY: YES Other described: 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 r.l-- I understand that I am solely responsible for the proper identification and labeling of all property lines and corners and making the site accessible at a plete sit-_r aluation cjarrbe performed. Date: %u / 7 2l/( Signature of Applicant or Agent X / • C� An Environmental Health Specialist will contact you; , .war ing days of app�cati n .ate. If you need further information or assi ante please call 828-466-729c," AREA1 09-ehapplicati,n 06/17/2016 13:16 Page 1 of7 p ,A CATAWBA COUNTY Case# EHPR-06-2016-24124 .Q' y Public Health Department Subdivision HOLIDAY PARK < 1,--e Environmental Health Division PIN# 369702954328 PO Box 389. 100-A Southwest Blvd,Newton,NC 28658 7842 ,. NAME ON PERMIT: (JEFF HARTLEY), 3798 MT PLEASANT RD, SHERRILLS FORD NC 28673 ( Jeff Hartley) Site Address: 3798 MT PLEASANT RD, SHERRILLS FORD NC 28673 Property Size: Square Feet 23,086.80 Acres 0.53 Directions: Hwy 150 to Little Mtn Rd, Left onto Mtt``. Pleasant Rd B F 71917 li i� ���111111 ' 1, 1� ! � 1 :1111 i Jilt I'1111DAA �_ I � ‘Lill�11�� �. I i� u l r I X111 i l� �L1� Authorization to Construct (Repair) Fee 06/17/2016 $300.00 711r fil teat TOTAL RE01111ll111y�g11111,1 Y9�� 1111���°11 flinil�«, 1111111111011 ' I�SI�� r ��1�15300)00". � I ti II >' � I �9 �d��in II lltl ��d.hV l�_ 111'11: il11, -, imatr uilimilizstu..t14'12atI,t111Lisuitimmmmnp,Mlp 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 icatLm 06/17/2016 13:16 Page 2 of 7 C ATAW e .THIS IS NOT A PERMIT couNty CATAWBA COUNTY HEALTH DEPARTMENT „off Application for;Environmental Services Page I Improveine'nt'Permit❑ Authorization to Construct❑ Septic RepairQ-Septic Malfunction❑ Septic Expansion ❑ New Well Permit ❑ Replacement Well ❑ Well Abandonment❑ Well Repair ❑ Existing System Inspection (Pre-Approval Required) ❑ Application is for New Construction El Existing Facility Property Address 3 7 9 B M°%-1-1-1- Aec.ia-I 1C Subdivision 5hnr.r'b/ 5 Ford NC OB W07 Lot# Acres Section/Block/Phase Driving Directions to Property /co L,a'f% M741 React /e/* (mit /ver /0/ea Savii 2c1 NAME TO APPEAR ON PERMIT? 6'ner ❑ Applicant ❑ Contractor Applicant Contact Information Name 1-e�4 /-10 rt ` Address 311ca out 44- ftec.5o"-4- / Jlw.ritis FO rot AID. C-8to_7a Phone Cell Phone �%�- j — - 7(053 Owner Contact Information Name 37e F( FEt Address 3-75 rylo :f / o S .t..� S{ -"tar/41S lard At '9 6 Va. ,. Phone Cell Phone cyJ-p, _ 9 5 C(_ 7(0,� "� Contractor Contact Information Name Address Phone Cell Phone WHO WILL BE THE PRIMARY CONTACT? Vwner ❑ Applicant ❑ Contractor Description of Existing Structures on Site # of Bedrooms *''i 3 Structure Dimensions # of Occupants 3 Basement ❑ Yes /2"-No Basement Fixtures ® Yes ® No The Applicant shall notify the local health department upon submittal of this application if any of the following apply to the property in question. If the answer to any question is "yes", applicant must attach supporting documentation. Yes ipso Does the site contain any jurisdictional wetlands? Yes ® No Does the site contain any existing wastewater systems? ❑ Yes O No Is any wastewater going to be generated on the site other than domestic sewage? D Yes s No Is the site subject to approval by any other public agency? ® Yes eNo Are there any easements or right of ways on this property? Describe Existing water supply in use [kCndividual Well U Community Well U Semi-Public Well ❑ 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): (systems can be ranked in order of your preference) ❑ Accepted ID Alternative El Conventional ❑ Innovative El Other Any C ATA ]B A THIS IS NOT A PERMIT COUNF - CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services Page 2 Proposed Facility Z:Virrimary Residence ❑ New Residence ❑ Addition to Residence #of New Bedrooms *'i Project Description Structure Dimensions # of Occupants Basement ❑ Yes ❑ No Basement Fixtures ® Yes ® No H Accessory Structure(s) Describe #of New Bedrooms *t if applicable Structure Dimensions # of Occupants Accessory Dwelling ❑ Yes In No Plumbing ❑ Yes ❑ No Describe Plumbing Needed ❑ Multi-Family Residence# Units #Bedrooms per Unit*t Total# Bedrooms *t Structure Dimensions U Food Service Specify Type # Seats Floor Space-Entire Food Service Facility (Sq Ft) it Employees per Shift #of Shifts Dining Area(Sq. Ft.) Lf Business Specific Type of Business Retail Floor Space # of Employees per Shift # of Shifts ❑ 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 12' Drilled ❑ Bored ❑ Dug ❑ Unknown Well Repair Requested ❑ Yes 12-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. t 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 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 comers and making the site accessible so that a complete site evaluation can be performed. Signature of Owner or Agent — Date J t l °l co / / v Printed Name of Owner or Agent_;J4-i4 At,/ (cc Catawba County Environmental Health P) 58.207 '9 N (118) N ti� N ^' iO P ki 111, S 25.0 w (105) • 0 00 *- S Ilip 106; R lr�/jf O .' J' •e �� .. rho tr & ��.00 i Iii , ragi" nt Ca Go_. Arlibilb.' 0 it. . . a. ..O 4 o°� 34s Parcel: 369702954328, 3798 MT PLEASANT RD tin=50ft SHERRILLS FORD, 28673 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 06/17/2016 Parcel Report Page 1 of 1 Parcel Report - Catawba County NC Parcel Information: Owner Information: Parcel ID: 369702954328 Owner: HARTLEY JEFFREY L Parcel Address: 3798 MT PLEASANT RD Owner2: null City: SHERRILLS FORD, 28673 Address: 3798 MT PLEASANT RD LRK(REID): 11770 Address2: null Deed Book/Page: 3277/1195 City: SHERRILLS FORD Subdivision: HOLIDAY PARK State/Zip: NC 28673-7805 Lots/Block: 2/ B School Information: Last Sale: School District: COUNTY Plat Book/Page: 13/80 Legal: LOT 2 PLAT 13-80 Elementary School: SHERRILLS FORD Middle School: MILL CREEK Calculated Acreage: .530 High School: BANDYS Tax Map: 011AX 03013 Township: MOUNTAIN CREEK School Map State Road #: 1849 Tax/Value 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: $33,300 Zoning2: Land Value: $9,900 Zoning3: Assessed Total Value: $43,200 Zoning Overlay: CRC-O,WP-O Year Built/Remodeled: 1994/null Small Area: SHERRILLS FORD 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 #: 3710369700J Building Details 2010 Census Block: 3029 WaterShed: WS-IV Critical Area 2010 Census Tract: 011504 Voter Precinct: P31 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=369702954328&typ=P 6/17/2016 OPERATIONS PERMIT FOR TYPE III WASTEWATER SYSTEM PERMIT NUMBER 7021 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 Matthew Hatfield CATAWBA COUNTY FOR THE operation of a wastewater collection, treatment, and disposal system, to serve tax map # 11AX-3-13 pursuant to 15 A NCAC 18A 1900 et seq and in conformity with the application, improvement permit , and other supporting data. subsequently filed and approved by the 'Catawba County Health Department and considered a part of this permit Facilities to be served. y; (Address and specific type of facility) - -,Mat•,thew Hatfield --3.7:9 VMt.. Pleasant Road Dewier, 4`N.C P` "-2 8,037 `Typ e: 3 B The' approved wastewater collection, treatment, and disposal system consists,of z r (1) 10001,gal . septic" tank (2) 1000' gal.', pump tank (Zoeller PN 53-00.02) Md. 53 (3.) 3 inch pressure manifold (4) 4 trenches (75 ft. x 3 ft. ) 12 inches of stone (5) 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 (31) , 1937 (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 1 This permit is effective only with respect to the number and type of proposed facilities and volume and nature of wastes specified 2 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 3 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 4 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 5 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 6 Adequate measures shall be taken to divert stormwater from the disposal field area and to prevent wastewater runoff 7 Diversion or bypassing of the untreated wastewater from the treatment facilities is prohibited 8 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 . 9 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 , .j 10 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 11 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 , 130A-22C, 130A-23 , and/or 130A-25 12 In the event that the facilities fail to perform satisfactorily, including the creation of nuisance conditions, the Owner/Operator shall contact the Catawba County Environmental Health Section of the Health Dept within 48 hrs of discovering this failure or problem 13 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 14 Non-biodegradable products (plastics, metals, etc ) chemicals (disinfectants, drain cleaners, acids, alkalies, pesticides, petroleum products, etc ) or grease shall not be discharged into the septic system 15 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 PERMIT ISSUED THIS THE // DAY OF A a.sr" , l97 CATAWBA CO HEALTH DEPT Owner Signature ENVIRONMENT HEALTH SECT 67vL�J. R S tax map # 11AX-3-13 V/ `3 '? / O 0-) ./:9 L3 L (; —t!�Op Permit and/or Cert Op Required,', (Must be completed prior to finale ,704 I t' C A T A W B A COUNTY' HEALTH DEPARTMENT Kt': (704) 465-8270 �' �O� Lot. Evah,.0/Improve Permit C./Repair Permit Cert. of Comp Permits/ Oper Permit.- Owner/Agent "9-7717516-(4.) /3/f-7/C'/CC!) . Phone 4$3 - 6g9 V Addc ss 379' ? Yr1T Pt c H f' £{N-_4) . Subdivision J/ouony •PACt' ., `A4 C C . _,..r_ ....� t�lc i C a. .. 2 . 0.- Lion/Block/Phase Lot# 02. Lot Size //,2 /}c2E Directions IS-0 C _ 04177D 1177- PCE15S/Mir/L•.D o ii-Pteox ten.[.E--s cb7 0_,A) iCLr/B-7- 13 e7 ./E-C/V 739-6C/4Ni CT' 134W L7' /7/7--: e D . Facility: House Mobile Home 6�Business Other: Tax'Map # . %/fl '...3 —/3 tlulti=family_ .Other Zoning Approval # a94 /R9/ Bedrooms 3 .Seats Employees Application Rate GPD Flow ,3.60. Hot. Tub or Spa yes(g6pecial Fixtures 100% Repair Area° o REPAIR NOTICE Basement yes Basement plumbing ye-I/'fl- REPAIRS MUST BE WITHIN 30 DAYS •OR Water Supply Private �PUblic_ DAYS FROM DATE OF PERMIT *'*********.*****************************************************************************.*** Type of System Trench d_Pump✓ump/Panel Panel^LPP Other Tank Size: Septic Tank .1000 Pump Tank /Ofh •Nitrification Field Total Square Feet "Oh Depth of Stone /02 Bed Size . Trench Width -3 ' Total Length of All Trenches 200 Number of Trenches Cf Individual Trench Length 9S/757 7575/ Feet on Center 2 / Maximum Trench Depth _ Distance of Nearest. Well SO /-/.' Lot Evaluation Approve. o (Void After 24 months) ***************** * *- . . . . . . **. .**************** Topo t % Slope Sketch of lot Evaluation Site - System Deign Texture cc/9-yCy `' DO NOT INSTALL Structure .attic, - I WHEN WET Clay Min / 1/ TQ/i/LE2 Soil Wetness . 5" Soil Depth 9.2 4a ic2onir Restric Hoz at " 1 /�,_jj Available space .o ' Lou' �q/Lc Overall Class Sis - •Comments �sri; rl CL SE E H7-T/-cm '� b q r_g7�yq ,y, 0 P- C _ _ _ l/Le NGif tom. C/t-Oc, �j.61=02-E i :T�cc/ - _ - _ __ _ ` 77- / X3 /Septic Tank Contractor•. \ .. � MUST contact the j" - „ Sanitarian BEFORE P'II'v'r°`•n changing permi. . **NO GUARANTEE OR WARRANTY IS IMPLIED OR GIVEN THROUGH THE ISSUANCE OF THIS PERMIT** Permit Date '',,are_ a3. /99 . (Improvement Permit void after 60 months) Owner/Agent 'sy Sanitarianc I i/u . vi :.- �u .•..- / Installed By appey M/mil, • Data 7-'7- 9.� Sanitarian $ (Note any changes/information in red or by sketch on back) *******IF A PERMIT HAS- TO BE REDESIGNED AND/OR RETRIPS MADE TO THE PROPERTY, THERE**"***** IS AN ADDITIONAL $25 •CHARGE. Dy S3 -000 a. 0- i. DE� t✓, I White Office Blue Bldg Insp.Comm Yellow-Owner/Agent Green Bldg.Inip.I.P If 1j• ov Eck --0ROOF•EMa. 4 X Co..fir.toL . .or- W/ LIGHT 4•.+D/o¢_ BE1. 1 • IscP IS SEaLE:h AT TAuK .se ccz,A"TE LI¢_cut-r5 slur, A'r E%,LT 'TOI.+rrs Foe Fog ALARM -N, 'I"ur-.■P Zktf SUPPLY LI/.I,E• Rut) WI Wc.,. NO E1._ECTR1C ■C. SuNtQ1LO S 1,4 'TuMt'CFtiJK • 1 f.-L" , agent" 1I Fa.ADE •. • 6"N3ovE CrgADE i' N. . r uJO E LCieu•J3 ELEC Tien. CGE E4, / .4 ..•• z. . 7.suitCD' CBECC c. UuoLI vALVE ' . • SUPPLY LWE EXITS s'.o. .. I . T44z,0oGN "RISE R. A ,•^:u„ I ('J`•. -ZELOw CLE{ADE lN/E PUMP TANK ST 70PE coE • F'D.+, DFC quq CUTAI.A2M F LoAt3 AWAY VI I I I E z" pvc 7 suDPLY • C.c.ECO1 eeLL Y�G$IS TgNT _ LI.IQ . 1aDF e2 Cwa.... I • Fact- ?uMD "RE/ADV at- i • I I • 44LR(J.A 3'..st-cr .. ti 3 — — — ALARM sw'TCu /ru" SIPrt, 3tEAksfi. noLi ta...A P o u • 'la •I A3ove "-t u.•..P au" Fl.op-r com-rg.o SyJ1—rCh GouLLs Avea3 73 SIP — -- — r — - HOC LU'a2 IS3 ' . 3 )74,P • N - ` D9,aw 1)0(..34 / LEVeLS Fog rho PCS S—y W/o /�'9 ;AP, — C1 M _7J Fu.." our.ar tUMP Ucfn C4LL_Om 17 wmn LE cc()pr e,e4O•crE� CIMTCPL • l AT TD.H_/ U L LISTED /// • •I/ STAUD PIPE • • 8" n'+=¢e-re CE.? MTEO I UTO • 'gLoc..c �a �. l r CO+I C"."3ux+c.• . .i I C-J # I • . a/5o CM [ , ' L d , m /I . 0 d ; W n n (J) n .r i. c fTt tl L LJ ,„ 1 p GY Y , ,�/ n N F co ellefin 0 r ITI VI T ll — O " c ri ma d W n x n N Z • VI H — a • = aC .0 ^�pd �-! ' = Q Mr ° r" mT 0 y • r N f D D n G+ i ca. 9 U i E 31=.O o L m �N III C On u m t TC ,n 4 v A4. t r /7 OL Zm - > n x t __ to a .° r L p 7) aN • e , m m al ° a1° A pi, O m a m . m gip ? z C 2 =N,�. - � c m C JO m V 'r ATF z A 0 A- _,-. 3d 4 z Z .. ... M E m (� o m \ n m A .cmY 0 CA en o 1:0 m � •. < • 'C NI r0 -I L 0 m iJ ja m ° m m �n � 3 c F MI 9r (17 (j7 O F P� t 1.1 f 0 i 4 m 7 5+ u r 03 v 0 dz •y Ga « �r 7 m .. x C Q o N C m d tl • 4 O i L i, m N I f ti c C P o a a. N 111 d m c rN 9 c f 33 mU 1 { n L ti k I F l?'A CEO, CATAWBA COUNTY 100A SOUTHWEST BLVD as NEWTON, NORTH CAROLINA 28658 RECEIPT 11 sm PHONE: 828.465.8399 Friday, June 17, 2016 1842 ml www.catawbacountync.gov PAYOR: Hartley,Jeff PAYMENTS TRANSACTION NUMBER: TRC-693803-17-06-2016 PAYMENT DATE : 06/17/2016 PAYMENT TYPE: Credit Card INVOICE NUMBER FEE NAME FEE AMOUNT 06-16-329574 Authorization to Construct (Repair) $300.00 Fee TOTAL PAYMENTS : $300.00 • E1-1P R-06-2016-24124 CASE TYPE: Environmental Health Plan Review WORK CLASS: Septic Malfunction SITE ADDRESS: 3798 MT PLEASANT RD, SHERRILLS FORD NC 28673 Owner JEFF 1-IARTLEY, 3798 MT PLEASANT RD, SHERRILLS FORD NC 28673 C:8289947655 ** NO PEOPLESOFT ACCOUNT ASSIGNED ** receipt 06/1712016 13:16 Page I of