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Home My WebLink AboutEHPR-10-09-2420.TIF ~4'A C THIS IS NOT A PERMIT Case # ERPR-10-09-2420 Y CATAWBA COUNTY HEALTH DEPARTMENT Plan Review Application for Environmental Services I84 SM Environmental Health Plan Review - OSWP Ul~el► Abanoonme-Af APPLICANT OWNER CONTRACTOR DUKE ENERGY CAROLINAS LLC DUKE ENERGY CAROLINAS LLC PO BOX 1007 PO BOX 1007 CHARLOTTE NC 28201-1007 CHARLOTTE NC 28201-1007 NAME TO APPEAR ON PERMIT DUKE ENERGY CAROLINAS LLC Pin#: 461820905357 SITE ADDRESS: 3275 HARVEL RD, Terrell, NC DIRECTIONS: HWY 150, LEFT ON IIARVEL RD, PROPERTY ON LEFT NAME of SUBDIVISION: Lot # Section/Block/Phase PROPERTY SIZE: Square Feet Acres 2.829 Date Platted/Recorded TYPE OF FACILITY: House X Mobile Home Dimension of Structure Bedrooms 4 Basement: No Water Using Fixtures in Basement:No No. in Family Whirlpool Tub : Gal. Capacity: MULTIPLE FAMILY RESIDENCE: Units 1.00 Total Number of Bedrooms DAYCARE: Number of Children RESTAURANT: Seats Square Feet Dining Area Square Feet Foodstand/Meat Market Floor Space TYPE OF BUSINESS: Number of Employees 1 st 2nd 3rd OTHER: (Specify) Do you aniticipate any additions to Facility? If so, describe: Has any grading, removal, or addition of soil been done to this property? If so, describe Are there easements/right-of-ways recorded on this property? NO Type of Water Supply: Individual Well Community Well Municipal Semi-Public I understand that this is a formal application for a well permit, Improvement permit or Authorization to Construct a ground absorption sewage disposal system to serve the above described facility on this property and authorize Catawba County Health Department employees to go on this property for evaluation purposes. I certify the above information to be correct and understand that an Improvement Permit issued as a result of this information is transferable and may be eligible for a non-expiring date, but may be revoked if this information, site plans or intended use changes for the proposed facility. A Well Permit and Authorization to Construct issued by this department is valid for (5) five years from the date issued and is not transferable. Note: You must obtain Zoning Approval prior to locating a home or structure on this property. Any representation by you of house or structure location should conform to applicable setbacks. Date: Signature of Applicant or Agent An Environmental Health Specialist will contact you within 2 working days of application date. If you need further information or assistance please call 828-466-7291 AREA 1 (FOR OFFICE USE ONLY) Zoning Approval: _Yes No Zoning Approval UDO Zoning Form A Minimum Setbacks AMOUNT Front FEE NAME DATE Side Rear TOTAL FEES Max Hght *If a permit has to be redesigned and I or RETRIPS made to the property, there is an additional $60 charge 10/29/09 14:27 Julia English From: Massimini, Elena L [Elena.Massimini@duke-energy.com] Sent: Wednesday, October 28, 2009 1:28 PM To: Julia English Subject: Well Abandonment for 3323 and 3275 Harvel Road Attachments: 3323 Harvel Road Well Abandonment Form.pdf; 3275 Harvel Road - Well Abandonment Form.pdf Attached is the application for closing the wells located at 3275 and 3323 Harvel Road, Terrell, NC 28682. Please let me know if there is more information needed or if you have any questions and/or comments. Thanks £lP.4~ Ma4S-~~ Project Manager/Engineer Engineering & Technical Services Buck/Marshall Steam Stations 8320 East NC Highway 150 Terrell, NC 28682 Cellular: 704.310.0400 Office: 828.478.7605 duke Energy- 1 CSC' ~ ,Qp THIS 1 TA PERMIT wLS# ~~.~~-_►b.-:D~i-.'..`o~y~0 CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services f- IP F AC F S.T. Rpr. r S.T. Exp. F Exist. S. T. r Well Permit ( Replacement Well 1. Name to Appear on Permit: Duke Energy Carolinas, LLC ! 2. Permit Re uested B Elena Massimini Business Phone: 828-478-7605 8320 East NC Hwy 150 N/A Address _ Home Phone: . Duke Energy Carolinas, LLC 828 478-7605 3. Property Owner: _ . . Business Phone: 526 S Church Street N/A Address: - . Home Phone. - . 4. Name of Subdivision. . - ~ Lot - Section/Block/Phase: - Property Address: F77 3275 Harvel Road Terrell, NC 28682 i north to exit 36. Head west on Hwy 150 for 6 miles, Harvel Road on right Directions to Pro ert : . _ . 5. Property Size: Square Feet' Acres 2.83- Date Platted/Recorded - - - - House C Mobile Home 38x24 2 6. TYPE OF FACILITY: Dimension of Structure Bedrooms*. Basement: 0Yes No Water Using Fixtures in Basement: r Yes (7 No No, in Family: Whirlpool Tub: C`Yes No Gallon Capacity: of Bedrooms MULTIPLE FAMILY RESIDENCES: Units Total Number F . . . DAY CARE: Number of Children RESTAURANT: Seats I Square Feet Dining Area 17 Square Feet Food Stand/Meat Market Floor Space 17 TYPE OF BUSINESS: No. of Employees 1 st 2nd ~T 3rd OTHER : (Specify) 7. Do you anticipate any additions to Facility? Yes (-.,No If so describe Current house to be demolished and property to be vacant from use 8. Has any grading, removal, or addition of soil been done to this property? C Yes C; No i i ~ . If so describe 9. Are there easements/right-of-ways recorded on this property? 0Yes 0No 10. Is a public water supply available on or adjacent to the above property? (,;Yes { No Check type that is available: rl Community Well E Semi-public Well r County/City/Township water line 11. Well Type Applying For: r Individual Well I Community Well r Semi-public Well r Irrigation Well Geothermal Well 12, Monitoring Well Request:(',Yes No # of Wells: Name of Site: I understand that this a formal application for a well permit, Improvement Permit or Authorization to Construct a ground absorption sewage disposal system to serve the above described facility on this property and authorize Catawba County Health Department employees to go on this property for evaluation purposes. I certify the above information to be correct and understand that an Improvement Permit issued as a result of this information is transferable and may be eligible for non-expiring date, but may be revoked if this information site plans or intended use changes for the proposed facility. A Well permit and Authorization to Construct issued by this department is valid for (5) five years from the date issued and is not transferable. Note: You must obtain Zoning Approval prior to locating a home or structure on this property. Any representation by you of house or structure location should conform to applicable set backs. "IF A PERMIT HAS TO BE REDESIGNED AND/OR RETRIPS MADE TO THE PROPER E IS AN ADDITIONAL CHARGE.** I Date: 10/26/09 Signature of Owner or Agent: r i t i I l i i Catawba County, North Carolina This map product was prepared from the Catawba County, NC, Geographic Information System. N Catawba County has made substantial efforts to ensure the accuracy of location and labeling information contained on this map. Catawba County promotes and recommends the independent verification of arty data contained on this map 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 product or the use thereof by arty person or entity. Legend Selected Parcel Number: 4618-20-90-5357 1 inch =193 feet Prepared for: J . g 3 Q Du K° E;iE id" Q5:39 ~ 2 tsdi (J PI3e vatic <w-. ~ ~ 537 W Q ~ x Qa - C d1,P"w E9.49 E' _ ~a: c7-9 4 i 53 LAKE X50 NORMAN 5 PI&i 20-143 ~1y=' Q- O O JUKE EtiE 20' ~I C~/ 48 248 THIS IS NOT A LEGAL DOCUMENT Thursday, October 29, 2009 02:21 PM 1'" , / / \ \ CATAVYBA COUNTY NC - Parcel Report Information Regarding Selected Parcel(s) Parcel ID: 4618-20-90-5357 Name: DUKE ENERGY CAROLINAS LLC Name2: Address: PO BOX 1007 Address2: City: CHARLOTTE State: NC Zip: 28201-1007 Account: 159744446 Calc Acreage: 2.83 Tax Map: 009 X 01005 LRK: 9027 Deed Book: 2914 Deed Page: 0907 Subdivision Name: Subdivision Block: Lots: Plat Book: Plat Page: Building Number: 3275 Street Name: HARVEL RD Site Zip: 28682 Township: MOUNTAIN CREEK Fire Code: SHERRILLS FORD City Code: COUNTY State Road: 1902 Total Bldgs Value: $142,800 Land Value: $215,500 Total Value: $358,300 Year Built: 1951 Year Remodeled: Last Sale Date: Last Sale Amount: Neighborhood: 129 Watershed: WS-IV Critical Area Watershed Split: NO Voter Precinct: P31 E911 District: COUNTY Zoning: GI Zoning2: Zoning3: Zoning Split: N Zoning Overlay: CRC-O,MUC-O,WP-O,FPM-O Zoning District: COUNTY Split Zoning Dist: N Split Zoning Dist(1): 0 Split Zoning Dist(2): 0 School District: COUNTY Elementary School: SHERRILLS FORD Middle School: MILL CREEK High School: BANDYS School Split: NO P&Z Case Number: SU-90 Census Tract 2010: 011502 Census Block 2010: 2027 Small Area Plan: SHERRILLS FORD Agricultural District: Printed: Thursday, October 29, 2009 02:21 PM i j NOV-18-2009 WED 12:45 PM McCall Brothers FAX NO, 7043982605 P. 03 RA77 ~ °r WELL ABANDONMENT RECORD v Y North Carolina Department of Environment and Natural Resources- Division of Water Quality WELL CONTRACTOR CERTIFICATION # j 1. WELL CONTRACTOR: S, WELL DETAILS: ~tDs1~d1 C a. Total Dgth:~ 7 - IL Diameter Well Contractor (individual) Name b. Water Levcl (Below Measuring Point): Measuring point is _ 7. f!. A~aOVe land surface. Vol] Contractor Company Name STELL•BT ADDRESS CASING: Length Diameter _C 2 81&1 & a. Casing Depth (lfkn(3wn): City or Town State . Zip Code b. Casing Removed- fl• En. , 15bL Area dodo - ho= number 7. DISINFEty E7ON; - 1, WLsL41NTQRMATION: " (Amount a .65% 75% calcium hypochlorite used) SITY: WELL 1D # (if applicable) & SEALING MATERIAL: STATE WELL. PERMIT # (if applicabicL Neat Ccmrni d a9 Cement fit lb. Cement lb. gal. COUNTY WELL PERMIT # (if upplicablc) l" 9 -.L~2 _ Water„~_ (;nL Water DWQ or OTHER PERMIT p (if applicable) entnnilc WELL USE (Circle applicable use): Manitoring eldentht t3cmm~lta manlelpflypublic IndustriollCommerclal r c ral Type: Slurry_ pdjels_ Itecavory Injection Irrigation Water gal. Other (list use) OthCt• 3.WL:LI•Y TI{ON. Typematerial COUNTYG' QUADRANGLE NAME NEARESTTOWN: Amount (SocciMaad Namc, N mber, Community, S"vW-, Lot No., pa(cel, zip Code) 4. EXPL ON METHOD OF EM--PLACEMENT OF MATZRIAL.t I TOPOGRAPHIC / LA SETTINd: fad sA ~n Slope Valley lot Ridsz Other {Cir+clc app etc silting) ! May ba is degre", LATITUDE - b_ 3~ L_ minutes, secoude. or ht a LONCIlTuDG W- L° decimal format 10, WELL DIAGRAM- brow a detailed a$ctsh of the well an the back of this Ladru"Jongitude sou=: GPS Topographic map form showing total depth, depth and diameter ofscreens (ifany) Tcmaining (Locallon cjlwell inasr be showm on a IfSGS repo map a and in the well, grovel "tnterval, intervals of casing perforalions, and deplhs and aliadied (o thu jonn if rust uting GPs) types of ft ll materials vaed• 4z. FACILITY-Tito crone of thtrwnus where die well is located, Complete 4a oitM i r b 0179L residmid well, skip 4a; complete 4b, wilt ownq' ioforamtion only.) . 11. DATE WELL ABANDON FM ` r FACILITY ID #(if applicable) I DO HEREBY =TII Y THAT THIS WELL WAS ABANDONED IN ACCORDANCE NAME OF RACIL-PTY-Jp WITH 15A KCAC 1C, WELL CONST RUCnON STANDARDS, ANDTHATA COPY OF ST ~~((~I TH15 RECORD HAS BEEN PROVIDED TO TI-Is WELL OWNER. IiE13fADDR,ESS [LLO~ - 2 ~tby L City or Town State Zip Code SIGN R Ct: IrtED WELLCOM-R•CTOR DATi+ 4b. CONTACT PERSON/WEI.L OWNER: NAME C Ifu SIGNATURE OF PRIVATE WELL OWNER ABANMONIING THA WELL DATE (The pdvata wdl aWner mast bean individual who Gabandans r n sidantlal wall STREET ADDRESS 3 U E in accordaaao will 15A NCAC X .0 t 13,) dAl C 2 8l ~ /'/"r PRINTED NAME OF PERVON AIIArlptTl!IING THE WELL