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Home My WebLink AboutEHPR-10-10-7932.TIF �� C � THIS IS NOT A PERMIT Case # EHPR-10-10-7932 �'� � CATAWBA COUNTY HEALTH DEPARTMENT v ,;: '�' Plan Review Application for Environmental Services j842 Sh Environmental Health Plan Review - OSWP C�d15cCl 3� � � EXS SYSTEM ( ', ? NAME TO APPEAR ON PERMIT � JONATHAN WATERMAN SITE ADDRESS: S 1 O3 LEISURE LN Sherrills Ford, NC Pin#: 461603027922 NAME of SUBDIVISION:ASBURY PARK Lot # pT 29 & 3( Section/Block/Phase PROPERTY SIZE: Square Feet Acres 0.639 DIRECTIONS: // APPLICANT OWNER CONTRACTOR JONATHAN WATERMAN AUBREY ISAAC 5103 LEISURE LN 74 DANITA LN SHERRILLS FORD NC 28673- VIPER KY 41774 (704)975-7366 PRIMARY CONTACT: Contractor APPLICATION FOR: Existing Structure DIM EXISTING STRUCTURE: 38 X 47 EXISTING FACILITY TYPE: House NUMBER OF EXISTING BEDROOMS: 2 SEWER TYPE: Septic Tank NUMBER OF EXISTING OCCUPANTS: 3 EXISTING WATER SUPPLY IN USE: Private Well CALCULATED DESIGN FLOW: Public water is **NOT** available for this property. PUBLIC WATER TYPE AVAILABLE: N/A DESCRIBE WORK: ADDITION TO EXISTING HOME/ 2 CAR GARAGE/ DINING ROOM AND KITCHEN/ UNFINISHED BONUS ROOM ABOVE GARAGE/ ADD[NG COVERED PORCH revision 3f28l11 no longer adding 3rd bedroom � PROPERTY EASEMENTS: NO PROPOSED CONSTRUCTION PRIMARY RESIDENCE NEW RESIDENCE? Add/Alt to Residence # OF NEW BEDROOMS: 0 # OF STRUCTURE OCCUPANTS: 3 PROJECT DESC: 2 CAR GARAGE/ DINING ROOM AND KITCHEN/ UNFINISHED BONUS ROOM ABOVE GARAGE/ /AD ING VERED PORCH *revision 3/28/1 1 no onger adding 3rd bedroom PROJECT DIMENSION: 1758 SO FT BASEMENT? No BASEMENT FIXTURES? No 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 norrexpiring 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 pr�operty. Any representation by you f house or structure location should confonn to applicable setbacks. ��cS�Prl �• l..aM�NSc�'t ��R- Date: �- Z� -� � Signature of Applicant or Agen An Environmental Health Specialist will contact you rthin king days of application date. If you need further information or assistance please call 828-466-7291 AREA1 *************************�*****************************************�*�*************�*********�*�**********�*�********* 03(28/l I l 1:�2 ��A CATAWBACOUNTY Case# EHPR-10-]0-7932 Q . Public Health Department Q 2 Subdivision ASBURY PARK .: Environmental Health Division - Plan Revie�v � :� `�' PO Box 389, f00-A South�vest Blvd, Newton, NC 286�8 Lot# PT 29 & 30 tg 2 sM PIN# 461603027922 Applicant/Owner JONATHAN WATERMAN, 5103 LEISURE LN, SHERRILLS FORD NC 28673- Site Address: 5103 LEISURG LN, Sherrills Pord, NC Property Size: SF 0.639 ACRES Directions: // Minimum Setbacks Front: 30 Side: 15 Rear: 30 Side St: Max Height: FEE NAME DATE AMOUNT BALANCE DUE Authorization to Construct Fee (New/Expansion) Fee 10/22/2010 $150.00 $0.00 Improve.... ._ .. . _ � _ . _ . _ _ _ ,. _ .. . . ment Permit Fee (0/22/2010 $150.00 $0.00 TOTAL FEES $300.00 $0.00 CHANGE WORK ORDER REQUIRING REDESIGN AND/OR RETRIP WILL INCURE AN ADDfTIONAL CHARGE (SEE FEE SCHEDULE) 03/28/ 1 1 I I:52 .�$ �o� cATAwBa couNTY, Nc �,� �, 100-A South West Blvd pLAN RECE/PT � � Newton, NC 28658- U �� ' (828)465-8399 Monday, March 28, 2011 �► 1842 sM www.catawbacountync.gov P�an case: EHPR-10-10-7932 �nvoice Number: INV-10-10-268428 Environmental Health Plan Review Invoice Date: 10/22/2010 Site Address: 5103 LEISURE LN, Sherrills Ford, NC APPLICANT OWNER CONTRACTOR JONATHAN WATERMAN AUBREY ISAAC 5103 LEISURE LN 74 DANITA LN SHERRILLS FORD NC 2867:r VIPER KY 41774 (704)975-7366 Fee Name Fee Amount Authorization to Construct Fee Adjustable $150.00 (New/Expansion) Fee Improvement Permit Fee Fixed $150.00 Total Fees Due: $300.00 PAYMENTS PAYER: SUSAN LAMONICA LAMONICA CUSTOM BUILDING Date Pay Type Check Number Amount Paid ChangE 10/22/2010 Credit Card -1 $300.00 $0.00 03/28/2011 Refund -1 ($150.00) $0.00 Total Paid: $150.00 Total Due: $0.00 �ilan rcceipl 03/28/201 I 12:19 ��p r�,�,� � r �. rr` N � �9� '� �v ' {9� ,. . " - _ �. ._ .� IM��i ` � 1 IY'a a� �'## �d"'�u F u .-t I .- � . . ., i I �� :��;,,C�atawba' �C,ounty Carolina � Disbursement��oupcher � ;� �,, �, � s , .�. , . , , , , Vendor No. Date 03/28/11 � C O Voucher No Make Payment To: � � (s). Lamonica Builders H � � 'Z d� H 111 Fransher Dr U � � Mooresville, NC 28117 j$ 42 ATTACHMENT Description Amount EHPR-10-10-7932 Refund AC fee 3rd bedroom will not be added 150.00 Sub-Total $ 150.00 Food Tax Sales Tax Total $ 150.00 � � ry .,�. , � w,�,��' �$,� � � '�w d � � t �� , �,��ri� _ ,� � ,,� �� , � �� ,,� � ' �� ,� . � � ,� � � ��, For Account�ng � � �' �"`��; ccount��llti ;�"F,unii�� ' ��°�`�Organ '�� 4 � Project." � � k.�,,'� �,��..�,�.$.�.� � � � 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) �BA t��' �� CATAWBA COUNTY � � c.� _ ;� :;: ^C P O Box 389 - Newton, North Carolina 28658 -(828) 465-8270 - Fax (828) 465-8276 - TDD (828) 465-8200 1 842 SM Public Health — Environmental Health Division AUTHORIZATION OF REFUND Date � � I � � Case # �i �"I ��i " � �' 10 '�]�-3�- � e�-ihe� r� �G��{,�'IY .t � Applicant �Dn Refund Amount `� J J�(� ��d Refund Reason nD n i S ' o Gc��l i 3� le. Authorizing Signature . Received By Permit Center Staff Date � o�� l 1