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HomeMy WebLinkAboutEHPR-08-2016-24535.TIF - , ..1'°'"A '• THIS IS NOT A PERMIT Case# EI-IPR-08-2016-24535 : :i4vii..:3-I., 1'1 ii'lAr'Alrli .`" CATAWBA COUNTY HEALTH DEPARTMENT ,crj ii... .,s,,:_c a PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES 784 sm Environmental-Health Plan Re -* SWP _.., ,: ■MMOININI■ ignfra 1117'' - , ,:$71. IMPROVEMENT NEW_WELL 0 mw.iits-57 PA,11 Ye) 0/7htp Applicant STEPHEN KFNEHARDT,2057 WOODSTONE DR,NEWTON NC 28658- C:7045163834 Contractor CLAYTON HOMES (13OBB1 *LASAGE), PO BOX 132,TAYLORSV1LLE NC 28681 C:8282173168 JWI-101,DER@HOTMAIL.COM Land MOSER BROTHERS ENTERPRISES INC,2828 ROHRER RD, WADSWORTH.OH 44281 . , NAME TO APPEAR ON PERMIT STEPHEN, RINEHARDT SITE ADDRESS: 3549 MELDON,NA DR,MAIDEN NC 28650 PIN-# 366703322514 ' K 18,2 NAME or SUBDIVISION GEORGIA PAR : Lot* Section/Block . — PROPERTY SIZE: Square Feet 36,285.48 Acres DIRECTIONS: Hwy 16,Right onto Buffalo Shoals Rd, Left onto Meldonna Dr.,Property is the 1st 2 lots on the Left. PRIMARY CONTACT: Contractor SEWER TYPE: Septic Tank GALLONS PER DAY: 360 I WATER SUPPLY; Private Well 1, DESCRIBE WORK: IP Only at this time*Proposing to combine'2 lots. Each lot has an existing septic. Looking to be able to use 1 of the existing systems on the property. 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: New Structure 'STRUCTURE TYPE: PRIMARY RESIDENCE FACILITY TYPE: Mobile Home OTHER DESCRIPTION: DESCRIPTION OF Vacant Lots EXISTING STRUCTURES ON.SITE(IF ANY) DIM,EXISTING STRUCTURE: NUMBER OF EXISTING BEDROOMS: #OF OCCUPANTS: 2 PROPOSED CONSTRUCTION NEW STRUCTUREDIM:: Modular 30x66'built in front porch, Back:6x6 #OF NEW BEDROOMS:: 3 BASEMENT? No BASEMENT FIXTURES? No PLUMBING REQUIRED? Desired system types(Improvement Permit or Authorizationto Construct): ACCEPTED: ALTERNATIVE: CONVENTIONAL: OTHER: INNOVATIVE: ANY: YES Other described: APPLICATION<FOR WELL CONSTRUCTION PROPOSED WELL TYPE: Individual Well REPLACE WELL?: NO • 1;,9-chappiicatioa 09/0712016 16:01 Page 1 of 4 • CATAWBA COUNTY Case .EHPR-08-2016=24535 . ita Public Health Department Subdivision GEORGIA PARK < Environmental Health Division PIN# • iitilmrgi • • 366703322614. PO/fox,389, 100-A StiuthWest:BlVd,Newton,NC 28658: . NAME ON PERMIT: (STEPHEN RINEHARDT),2057 woopsToNF.DR.NEWTON,NC28658- (STEPHEN RINEHARDT) Site Address: 3549,MELDQNNA DR,MAIDEN NC 28650 Property Size: Square Feet 38844 Acres, '833 Directions: Hwy 16,Right onto Buffalo Shoals Rd.Left onto Meldonna Dr.,;Property is theist 2 lots on the,,Left. Improvement Permits issued as a result of this information are valid for 5 years or may pe non-expiring under certain,specified,conditions.An Authorization to Construct issued by this department:isAialid for(5)tivelears froMthe date issued,and is not transferable;IrtiOrovernent Permits and Well Permits are transferrable. Permits may be:revoked if the information on this application,site Plant,orintended Use'changes forthe 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(Wet. 1,Understind that I am solely responsible for the proper identification and lab-iing of all property tine. and corners and making the tite:aeces-silesptkat a complete site evaluation can be performed. Date: 4,9° , Signature of Applicant Or Agent . •, n Environmental Health Specialist will cOntattyouFiVitliiii A,:voriciog clayS of application date. If you need,further infonnation or assistance.pteak enlI828A66-7291 AREA1 EWATir-mo- FEEN'AM,Er4-2&' . O.0 N4151 ImprOverriera Permit Fee 08/1 /2016 $1500 Well permit UnSpeCtien Fee 09/07/201.0 $300:09 7,i-tiy--Fg„°aw§z.w4.:s:- .KwfvtqiH:.P.vjkqA,_,qftswr4p-4,%k,pass'iftjroq •rrii,,R.rortr...--,-;.;.:4404...ri3m..4'. tr..1rtr: , '1',.2-44,(4V4'14% 651AVMPREF:MallgMallMials, . . . 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) • -chapplitltion 09/07/2016 16:01 Page 2 of 4 - c-__,--- � CATAWBA COUNTY � 100A SOUTHWEST BLVD F"'� a NEWTON,NORTH CAROLINA 2865E RECEIPT -679 .� PHONE: 828.465.8399 .t✓►ty 4 Wednesday, September 7, 2016 18.42 sM www.catawbacountync.gov PAYOR: Clayton Homes Clayton Homes(*Lasage,Bobbi) PAYMENTS TRANSACTION NUMBER: TRC-822099-07-09-2016 PAYMENT DATE : 09/07/2016 PAYMENT TYPE: Credit Card 171900280 INVOICE NUMBER FEE NAME FEE AMOUNT 09-16-332430 Well Permit& Inspection Fee $300.00 TOTAL PAYMENTS : $300.00 EHPR-08-2016-24535 CASE TYPE: Environmental Health Plan Review WORK CLASS: OSWP SITE ADDRESS: 3549 MELDONNA DR,MAIDEN NC 28650 Applicant STEPHEN RINEHARDT,2057 WOODSTONE DR,NEWTON NC 28658- C:7045163834 Land Owner MOSER BROTHERS ENTERPRISES INC,2828 ROHRER RD, WADSWORTH OH 44281 Contractor CLAYTON HOMES,PO BOX 132,TAYLORSVILLE NC 28681 C:8282173168 JWHOLDER @HOTMAIL.COM **NO PEOPLESOFT ACCOUNT ASSIGNED ** receipt 09/07/2016 16:01 Page 1 of 1 qA • THIS IS NOTA PERMIT Case # EHPR-08-2016-24535 „ BGG • CATAWBA COUNTY HEALTH DEPARTMENT baa _o t� 4 "'"Purl �C") C•, 7 ���«!' PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES 842 m Environmental Health Plan Review - OSWP : o o ti o t �•�r • 1 • r IMPROVEMENT Applicant STEPHEN RINEHARDT, 2057 WOODSTONE DR, NEWTON NC 28658- C:7045163834 Contractor CLAYTON HOMES (BOBBI *LASAGE), PO BOX 132, TAYLORSVILLE NC 28681 C:8282173168 JWHOLDER@HOTMAIL.COM Land Owner MOSER BROTHERS ENTERPRISES INC, 2828 ROHRER RD, WADS WORTH OH 44281 NAME TO APPEAR ON PERMIT STEPHEN RINEHARDT SITE ADDRESS: 3549 MELDONNA DR, MAIDEN NC 28650 PIN # 366703322514 NAME of SUBDIVISION: GEORGIA PARK Lot# 18`2 Section/Block PROPERTY SIZE: Square Feet 36,285.48 Acres .833 DIRECTIONS: Hwy 16, Right onto Buffalo Shoals Rd, Left onto Meldonna Dr., Property is the 1st 2 lots on the Left. PRIMARY CONTACT: Contractor SEWER TYPE: Septic Tank GALLONS PER DAY: 360 WATER SUPPLY: Private Well DESCRIBE WORK: IP Only at this time* Proposing to combine 2 lots. Each lot has an existing septic. Looking to be able to use 1 of the existing systems on the property. 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: New Structure STRUCTURE TYPE: PRIMARY RESIDENCE FACILITY TYPE: Mobile Home OTHER DESCRIPTION: DESCRIPTION OF Vacant Lots EXISTING STRUCTURES ON SITE(IF ANY) DIM EXISTING STRUCTURE: NUMBER OF EXISTING BEDROOMS: #OF OCCUPANTS: 2 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: Modular 30x66 built in front porch, Back: 6x6 #OF NEW BEDROOMS:: 3 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: 139-ehapplical ion 08/18/2016 16:47 Page I of4 x« • CATAWBA COUNTY Case# EHPR-08-2016-24535 .7C2 Department Subdivision GEORGIA PARK Public Health �Q 4 rkr Y Environmental Health Division PIN# 366703322514 Wsr PO Box 389, 100-A Southwest Blvd,Newton-NC 28658 IR.2 ss NAME ON PERMIT: ( STEPHEN RINEHARDT), 2057 WOODSTONE DR, NEWTON NC 28658- ( STEPHEN RINEHARDT) Site Address: 3549 MELDONNA DR, MAIDEN NC 28650 Property Size: Square Feet 36,285.48 Acres .833 Directions: Hwy 16, Right onto Buffalo Shoals Rd, Left onto Meldonna Dr., Property is the 1st 2 lots 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 �aa d lab ling of all property lines and corners and making the site accb a so that a complete site evaluation can be performed. Date: x (81((n Signature of Applicant or Agent , v An Environmentaln( 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 ,1Fb7"Iiii1Ip5PIIIlr " l • }a ' ` mi1� Mil fl :DATE `�%iliFEEAMOUN Improvement Permit Fee 08/18/2016 8150.00 11i �g :TOTAL FEES ' a. �l'Pr'illigililIIIIIli�li�iii ' liirPt. 'ulI�IN? ..I ij'si50100H i 1111ii1 ;Iltwll�p.�� _{u(I�l�lal�ul I Ill�eIf4i'1(INi>9tia � LULN4u»lllulaUs rl i„I> id°IIIa11ti1:19dISfdrs>Vlllt'.tIIdWm.• E111mi.n_ 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-ehapplicatiou 08/18/2016 16:47 Page 2 o14 • C„ 1 k fl " THIS IS NOT A PERMIT `ouNinL „...----e.-.--.,11.ti ,� CATAWBA COUNTY HEALTH DEPARTMENT Wiz „ Application for Environmental Services Page 1 Improvement Permit Authorization to Construct❑ Septic Repair❑ Septic Malfunction Septic Expansion ❑ New Well Permit❑Replacement Well ❑ Well Abandonment❑ Well Repair : Existing System Inspection (Pre-Approval Required) ❑ Application is for New Construction ❑ Existing Facility ❑ TEN? Property Address MEj #J'v4 eon 1 +a- Subdivision C2(eeI 1A' Febei_- fYla cteN .art" Lot# 1 d'„,).. Acres t 8 3 3 i, Section/Block/Phase Driving Directions to Property I( r •':. . at,LIs9&),MS_-e,CQ D--i,Q n D k10'V _. 1A,I L'L..4. S J e. • _._.1' IS. NAME TO APPEAR ON PERMIT? 0Owner H Applicant E. Contractor Applicant Contact Information ;< t Name C.layite..1 t✓1r s4,pgi - eiIrvjl 4a Sam Address taoo (��/1dvcc Rjt rD !.o cc '1O4-e'z Nr arty 1 3 Phone ng.• ytoS,3uest> Cell Phone 8;g _al 7-3)6,8 Owner Contact Information Name SEEPhen/ gin ei,acted r Address Phone ---70/4 - 5/te ... 31 I Cell Phone 70e/-* 57(D - 7533 Y Contractor Contact Information Name Address Phone j Cell Phone WHO WILL BE Tint PRIMARY CONTACT? ❑ Owner Applicant ❑ Contractor Description of Existing Structures on Site LV'J 4 # of Bedrooms *'r Structure Dimensions #of Occupants Basement ❑ Yes ❑ No- Basement Fixtures 0 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 question. If the answer to any question is"yes", applicant must attach supporting documentation. pYes %No Docs the site contain any jurisdictional wetlands? Yes Olio Does the site contain any existing wastewater systems? p Yes Pi;No Is any wastewater going to be generated on the site other than domestic sewage? ® Yes ,Y]No Is the site subject to approval by any other public agency? 17 Yes 16 No Are there any easements or right of ways on this property? Describe Existing water supply in use ❑ Individual Well ❑ Community Well 0 Semi-Public Well ❑ County/City/Township Water Line Is a public water supply available? ** Li 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) 0 Accepted 0 Alternative 0 Conventional 0 Innovative 0 Other %Any A TANNTBLk THIS IS NOT A PERMIT C COL]n I NCATAWBA COUNTY HEALTH DEPARTMENT •, „k' Application for Environmental Services Page 2, p Proposed Facility Type lig 't l .04 ❑ Primary Residence !t' New Residence [ Addition to Residence # of New Bedrooms .1- Project Description licALC elt —L YYIGIDaJtb2 Structure Dimensions 3OX talo #of Occupants Basement ❑ Yes No Basement Fixtures ® Yes t, No • [ Accessory Structure(s) Describe # of New Bedrooms *j' if applicable Structure Dimensions # of Occupants Accessory Dwelling ❑ Yes ❑ No Plumbing ❑ Yes ❑ No Describe Plumbing Needed Multi-Family Residence#Units #Bedrooms per Unif*j' Total#Bedrooms *I- Structure Dimensions H 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 ❑ Other Facility Type Specify If Church# of Seats Kitchen ❑ Yes X❑No If Daycare Specify Occupancy Application for Well Construction/Abandonment/Repair • Proposed Well Type ❑ Individual Well E. Semi-Public Well ❑ Community Well Abandonment Type ❑ Drilled ❑ Bored ❑ Dug ❑ Unknown Well Repair Requested n Yes ❑ 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. • *Airy room that will he 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 eonfirmed 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 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 deportment 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 _t Date "q 1I] 1(, Printed Name of Owner or Agent !. iv 4 .1 hba 8/ g,i WAk;f41 I r: 44 0 I ILII sft>q 11111:d .1:: # F? c iYI�R kii 's baa L,. . #3� . - 3Prr .+ 9 I Sl'::, tRi N i :5 sKBe� ;JI F B'!3 I vE zxt q • ' '; i t'2 f v §is i / 1, ifit 5 z I z v s 3 1.1111 ; f i s~z ` a£ i / P :r =• " a„. 1::-/ r` C f a` _ 1we . __ o.a / N 3 Ile _- - O 5 if , 4J :lit '45. N45 °'.%nm.°•` Com. r o / _ -.- 3 Pi, • Ty 00 i A e: I/ / <:,;® �:4� II i it El ' • o:� i+ El �,� `Q j; / �'� .�Ian�1G�_I 51 11i. :,;3p s,s 343E ' 5- `;14..):;',,,/` IA 4 p i / V;./ I t. i / ra ):N / / I ! 1l f n ov 4 7 ? j1 >maea • VIVyl . rm o : N. " •+ ; b 0 %'i Yl 1l ` 9' f"4 444.I. 1,1 V i o 7 v 4 't .I. c o O a // ,mss ?a1} _ '_,�.�_ M I. O •n ` o•Boo.>:-Pi 65 . „::2.7 8 7 % o- �� F \ : o0 o tylii /\; mo 1i w S; (ry '� Ait .7t JrI:uS mr ice"s'k ' tv Parcel Report Page 1 of 1 Parcel Report - Catawba County NC Parcel Information: Owner Information: Parcel ID: 366703322514 Owner: MOSER BROTHERS ENTERPRISES Parcel Address: 3549 MELDONNA DR INC City: MAIDEN, 28650 Owner2: STONE REAL ESTATE COMPANY LRK(REID): 8171 LTD Deed Book/Page: 2915/0175 Address: 2828 ROHRER RD Subdivision: GEORGIA PARK Address2: Lots/Block: 2/ City: WADSWORTH Last Sale: State/Zip: OH 44281-9533 Plat Book/Page: 52/65 Legal: LOT 2 2 PL 52-65 GEORGIA PARK PL School Information: School District: COUNTY 52-65 Calculated Acreage: .460 Elementary School: TUTTLE Middle School: MAIDEN Tax Map: 008AK 01002 Township: CALDWELL High School: MAIDEN School Map State Road #: TaxNalue Information: Tax Rates(pdf) Zoning Information: City Tax District: All in County Zoning District: COUNTY County Fire District: BANDYS Zoning1: R-40 Building(s) Value: $0 Zoning2: Land Value: $9,100 Zoning3: Assessed Total Value: $9,100 Zoning Overlay: Year Built/Remodeled: / Small Area: BALLS CREEK Current Tax Bill Split Zoning Districts: / Zoning Agency Phone Numbers Miscellaneous: Firm Panel Date: 2007-09-05 Building Permits for this parcel. Firm Panel #: 3710366600J Building Details 2010 Census Block: 4001 WaterShed: 2010 Census Tract: 011602 Voter Precinct: P9 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 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=366703322514&typ=P 8/18/2016 -- CATAWBA COUNTY /:;:-/..e 4-- pf��'(6Poblic Health Department Case# WLS2008-00354 l Ir\ Environmental Health Division Subdivision GEORGIA PARK V A\W�/ PO Box 389, 100-A Southwest Blvd,Newton,NC 28658 Sect/BUN/Lot/4 I •-2.4 (828)465-8270 FAX(828)465-8276 TDD(828)465-8200 PIN# 366703323434 Applicant/Owner: GEORGE MOSER Site Address: 3563 MELDONNA DR MAIDEN NC Property size: SF 370 ACRES Directions: HWY 16 S/ FIT BUFFALO SHOALS RD/ON RT @ CORNER OF MELDONNA DR& BUFFALO SHOALS RD/GEORGIA PARK, til EXISTING SEPTIC SYSTEM INSPECTION REPORT Site/System Diagram 4 Do no-} tc II ix- rpt, c.J r �lcldraw.Dr sys+t-tin or nc, ' I 156, 190.� �1E s4 S1tt. ( Slrr�n nn I a0 Q.pi- c.-Inn k t ccp-i c syshrv,1 �' .I �°� \�cq rt'cr to / g ttp�`'+'r etA(uti wS:, horse *dicks c _1� \�. r o 9CThts ss no4a gy&aYctn�ec o i- Lc c1 4 4A/VN-A-1 SA stem w II �i&.nJu,— ho Siblt Sint`s cc firi:4i , WI-1-11 P.val ua'-cd • Type of Facility: House Mobile Home X #Bedrooms 3 Business Specify Other Specify Proposed Additions/Accessory Structures: Approved ✓ Not Approved Reason �" J Evidence of system malfunction: YES - NOO)n✓ System Type/Description [.}owt( heA 9 Q� Authorized State Agent SSC 'ak v i \i/OL , `I DATE: 5-/3 yo b NOT FOR LOAN APPROVAL Form E diidrnv,OVa Mt LSnnn nn CATAWBA COUNTY HEALTH DEPARTMENT PERMIT # 9.; 235 ,.1 1 COMPLETION PERMIT OWNER OR CONTRACTOR: eec.e.t 0-1�. r DATE: c%4[ .2 ‘ /7f' ADDRESS : PHONE: LOCATION: ! it ! 3 .� ra - _7,..-4, /Z-,- /-c--L 4-14 c-- 2rntIY.A,n,-,, ' LD SUBDIVISION: 4/'Q,li j G_da Ary ; / SECTION OR BLOCK: LOT SIZE: House ( ) Mobile Home (c____4—Business ( ) Other ( ) Flow Rate : gpd Bedrooms : 3 Bathrooms : — Special Fixtures : Other: Basement —Yes ( ) No ( ) Fixture in basement-Yes ( ) No ( ) Garbage Disposal, Unit: Yes ( ) No ( ) Water Supply: Private ( ) Public ( L—_) . TANK SIZE: ,P,,� ,_ gallons Distance from septic tank or nearest source of NITRIFICATION FIELD:C' pollution: Number of lines: FINAL APPROVAL OF THIS SEPTIC TANK SYSTEM SHALL IN Length and width of lines NO WAY BE TAKEN AS-A QUARANTEE THAT THE SYSTEM WILL (a) Bed System %.40—:,.. .„.---_7-4,„, FUNCTION SATISFACTORILY FOR ANY GIVEN PERIOD OF (b) Trench System 36" x vTIME. or Trench Sys. 30" x DATE INSTALLED: Total Sq. Ft. Depth of Stone INSTALLED BY:.-__"-___ REMARKS: SANITARIAN: (-- C�, ,,..,,,,,, �a SITE AND SEPTIC TANK LAYOUT ' J, LUKN ,-.12-0-4 -a pe , - i ,1 i,• , f 1 . , 0---1r sly< � �ri - - HEALTH DEPARTMENT COPY CATAWBA COUNTY HEALTH DEPARTMENT NEWTON, NORTH CAROLINA COMPLETION PERMIT FOR SEPTIC TANKS PERMIT ' ' N° 0 .1167 DATE : ( /6 /I6', OWNER £wcjf' Lf/2c� ADDRESS BUILDING CONTRALTO . , U WN ) fJ/ / ay , /C5 . 6 ----.46,7----.46,74.,,„.„2„, . - M LOCATION s� %1 - `t__2.,:, ,,,, ,,, ,,_„4„.„0„, r/ �-, o is �� ,_1_, LOT �� LOT SIZE B OCR OR SECTION HOUSE ( ) MOBILE HOME (_)- BUSINESS ( ) OTHER ( ) FHA-VA LOAN ( ) SEPTIC TANK: (SIZE GALS) WATER SUPPLY: NO. BEDROOMS—ANO IX S ---- INDIVIDUAL PUBLIC c___-- GARBAGE .rGARBAGE DISPOSAL UNIT:YES (77M)-4— ) IF WELL, TYPE : BORED DRILLED DUGc/ AUTO WASHING MACHINE : YES (" ) NO ( ) DISTANCE FROM SEPTIC TANK OR NEAREST NITRIFICATION FIELD: .zy SQ.FT. POLLUTION: FT. 1) NUMBER OF LINES SEPTIC TANK INSTALLED BY: 2) LENGTH AND WIDTH OF LINES PERMIT FEE S a) BED SYSTEM—) CERTIFICATE OF COMPLETION BY : b) TRENCH SYSTEM_(__) Sw,,.,,,,,4c 3) DEPTH OF STONE IN LINES— REMARKS : 7-0,,.r .. _ y,�,g ADEQUATE FALL (GRADE) ON: 1) BUILDING (HOUSE) SEWER LINE : YES .1.:1;:::!..g.:N 2) NITRI -NES : DATE INSTALLED:' YES 0 ( ) SEPTIC TANK LAYOUT i 1 -.2-twc.: —/-1'74- F U F O I - HEALTH DEPARTMENT COPY CATAWBA COUNTY /Set 1}it`a, Public Health Department Case# V.`LS2008-00355 Subdivision GEORGIA PARK F, / I Environmental Health Division PO Box 389, 100-A Southwest Blvd,Newton,NC 28658 Seet/BL/Ph/Lot# 2 (828)465-8270 FAX(828)465-8276 TDD(828)465-820(1 PIN# 366703322514 Applicant/Owner: GEORGE MOSER Site Address: 3549 MELDONNA DR MAIDEN NC • Property size: SF .46 ACRES Directions: HWY 16 S/RT BUFFALO SHOALS RD/ON RT @ CORNER OF MELDONNA DR& BUFFALO SHOALS RD/GEORGIA PARK, EXISTING SEPTIC SYSTEM INSPECTION REPORT • Site/System Diagramr� U (+ '7f o no'r C) tit q rl4c 7Or do Vc outs o'- rpcv r area, SkcH S t 6r..i r\ Fronk, ce-p-i c. drain F'tic( w I c Ron(c ctec,lrs. ,1e Po F a 5i etrasa Et (� SHS-lent. tti.; it Canc., fr. — AD D Nitta. Dr Vis He- SI jn 5 ' oh et,-IF t I t.L rG Whart c cTe& . 3o I c . 2Vv-t-c' 53 ' 3 Scifr, ,-` npr,a r O5 NI Rcldi E — — — _ ( rcpew r t„7.44 Type of Facility: House Mobile I-tome X 4 Bedrooms 3 Business Specify Other Specify Proposed Additions/Accessory Structures: Approved rriNot Approved Reason I Evidence of system malfunction: YES NO System Type/Description u Authorized State Agent: , /O i l 132e.„._ DATE: C 13' O V Form E NOT FOR LOAN APPROVAL r\TiAnmd'Jnr,11NWWLSuov.rw CATAWBA COUNTY HEALTH DEPARTMENT NEWTON, NORTH CAROLINA COMPLETION PERMIT FOR SEPTIC TANKS PERMIT G/—HZN2 u 0 3 7 L �� /6/1-Z1-to/At / DATE : ,- n OWNER �`GC 1 6/ ' t ADDRESS BUILDING CONTRACTOR SUBDIVISION �a� « /"?/-2/k— LOCATION c 5.-e.e.- If 6 LOT 11 1 LOT SIZE BLOCK OR SECTION HOUSE ( ) MOBILE HOME BUSINESS ( ) OTHER ( ) FHA-VA LOAN ( ) SEPTIC TANK: (SIZE 0(7-G. GALS) WATER SUPPLY: / NO. BEDROOMS NO FIXTURES INDIVIDUAL PUBLIC (/ GARBAGE DISPOSAL UNIT:YES ( ) NO ( ) IF WELL, TYPE : BORED DRILLED DUG AUTO WASHING MACHINE : Y S ( ) NO ( ) DISTANCE FROM S ;T TANK OR NEAREST NITRIFICATION FIELD: SQ.FT. POLLUTION : 0rlal>? FT. 1) NUMBER OF LINES SEPTIC TAN I '� tD BY: �/ 2) LENGT1j D WIAT` 0 - / N�' La�-� ( '2j -5( X 70 PERMIT F $ co a) BE S STEM ( ) CERTIF . ' . E i'" co r i^- i '' " : b) TRENCH SYSTEM ( Z)........-<-- > /4i1 F! 3) DEPTH OF STONE IN LINES (7 REMARK . ADEQUATE FALL (GRADE) ON: '' 1) BUILD NGAHOUSE) SEWER LINE: YES (LI' NO ( ) 2) NITRIFICATION LINES : BATE INSTALLED: LI _ 4" 7.—P--- YES (/) NO ( ) SEPTIC ANK AYIITf. I (l (CGr H ( ( x M0 d / m H let 0 ( (( HEALTH DEPARTMENT COPY CATAWBA COUNTY HEALTH DEPARTMENT AA pp „ ,� bgb 111 . '�� IMPROVEMENT PERMIT FOR SEPTIC TANKS P rmit No Js d c N ".E OF OWNER 4..Q�L/ [,r LE({:?�I(�l. DATE.1111 /—rJ S AD KESS OF OWNER 1111 /T PHONE NAME OF CONTRACTOR �`� 1 ADDRESS '� y� LOCATION /1 ,y221 t er2L- M•C7�s4yr-ee �'-- 7,1 it�� ,/ZZ ,4„,),S PLar-A SUBDIVISION /,.,,„h,r2.�J�ct, / LOT NO. 7"--- SECTION OR BLOCK _ LOT SIZE l'I ;FHA, V /AN Septic Tank Contractor must follow all HOUSE ( ) MOBILE HOME ( USINESS ( ) OTHER ( ) Details of this permit (layout) NO. BEDROOMS (3) NO. FIXTURES (1)_, SEPTIC TANK LAYOUT GARBAGE DISPOSAL UNIT: YES ( ) NO ( ) PLUMBING UNDER BASEMENT FLOOR: YES ( ) NO ( ) SIZE OF TANK /c9l7,IQUID GALLONS ( NITRIFICATION FIELD: 1. Number of lines 1 S 2. Length and width ,of lines: a. Bed System /f ��( r" -_ ,„ b. Trench system ' f . i$j' - n ', (- 3. Total Depth of stone (4 hes �Fr ^� GROUNDWATER INTERCEPTOR DRAIN: (IF REQUIRED) i 1 / 'iii --'� RATER SUPPLY: PRIVATE (..1 PUBLIC ( .- ( -� / OWNER NOTIFIED TO CHECK 'NING: YES ( ) OWNER AGREES WITH LAYOUT: YES ( NO ( ) ( J ' ' OWNER AGREES WITH SPECIAL INSTRUCTIONS: YES (Lk M: ( ) r! 76Ths OWNER OR CONTRACTOR SIGNATURE - - Cat PERMIT FEE $ I/10 ca e.2 . __-____-- PERMIT VOID AFTER 36 MONTHS FINAL APPROVAL of THIS SEPTIC TANK SYSTEM BY IMPROVEMENT ' " IIT I .UED `j THE HEALTH DEPARTMENT SHALL INDICATE THAT THE t SYSTEM HAS SEEN CONSTRUCTED TO SANITARIAN \ , � THE STANDARDS SET FORTH N THECATWBA CODUNTY / SEWAGE DISPOSAL REGULATIONS, BUT IN NO WAY HEALTH DEPT. COPY SHALL BE TAKEN ASA GUARANTEE THAT THE SYSTEM WILL FUN I5N SATISFACTORILY FOR ANY GIVEN SOIL CLASSIFICATION: SUITABLE ( ) PROVISIONALLY SUITABLE ( 'UNSUITABLE ( ) SITE FACTORS: 1. SLOPE (%) S - PS - U 7. SOIL PERMEABILITY S - PS - U 2. SOIL TEXTURE (12-48 IN.) S - PS - U UNDER 60 MIN. - OVER 60 MIN. SANDY, LOAMY, CLAYEY 8. OTHER S - PS - U 3. SOIL STRUCTURE (12-48 IN.) S - PS - U (SPECIFY) 4. SOIL DEPTH (IN.) S• - PS - U 9. SOIL SERIES: 5. RESTRICTIVE HORIZONS (IN.) S - PS - U A. CECIL ( ) B. HIWASSEE ( ) (IMPERVIOUS STRATA, ROCK) C. MADISON ( ) D. APPLING ( ) 6. SOIL DRAINAGE - GROUNDWATER S - PS - U E. PACOLET ( ) F. FLOOD PLAIN ( ) (EXTERNAL - INTERNAL) G. 2-1 CLAY SOIL H. OTHER-SPECIFY � CATAWBA COUNTY IOOA SOUTHWEST BLVD .71 NEWTON, NORTH CAROLINA 28658 RECEIPT err PHONE: 828.465.8399 C vr5 `C Thursday, August 18, 2016 1842 sm www.catawbacountync.gov PAYOR: Clayton Homes Clayton Homes(*Lasage, Bobbi) PAYMENTS TRANSACTION NUMBER: TRC-789160-18-08-2016 PAYMENT DATE : 08/18/2016 PAYMENT TYPE: Credit Card INVOICE NUMBER FEE NAME FEE AMOUNT 08-16-331775 Improvement Permit Fee $150.00 TOTAL PAYMENTS : $150.00 EHPR-08-2016-24535 CASE TYPE: Environmental Health Plan Review WORK CLASS: OSWP SITE ADDRESS: 3549 MELDONNA DR, MAIDEN NC 28650 Applicant STEPHEN RINEHARDT,2057 WOODSTONE DR,NEWTON NC 28658- C:7045163834 Land Owner MOSER BROTHERS ENTERPRISES INC, 2828 ROHRER RD, WADSWORTH OH 44281 Contractor CLAYTON HOMES, PO BOX 132, TAYLORSVILLE NC 28681 C:8282173168 JWHOLDERaHOTMAIL.COM ** NO PEOPLESOFTACCOUNTASSIGNED ** receipt 08/18/2016 16:46 Page 1 of 1