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Home My WebLink AboutEHPR-11-09-2539.TIF Off. THIS IS NOT A PERMIT Case # EHPR-1 1-09-2539 CATAWBA COUNTY HEALTH DEPARTMENT V Cp: Plan Review Application for Environmental Services 1842 sM Environmental Health Plan Review - OSWP APPLICANT OWNER CONTRACTOR' DONALD BILL RHONEY DONALD BILL RHONEY 9051 JACOB FORK RD 9051 JACOB FORK RD VALE NC 28168-8943 VALE NC 28168-8943 828-302-2741 828-302-2741 NAME TO APPEAR ON PERMIT DONALD BILL RHONEY Pin#: 265802963429 SITE ADDRESS: 9051 JACOB FORK RIVER RD, Vale, NC DIRECTIONS: HWY 10 W/ RT ON PROVIDENCE CHURCH RD/ GO TO END/ TURN LFT/ GO TO 1 ST RD/ PAST LANE FLORIST/ GO ABOUT 2-1/2 MILES/ WHITE HOUSE ON LFT NAME of SUBDIVISION: Lot # Section/Block/Phase PROPERTY SIZE: Square Feet Acres 127.76 Date Platted/Recorded TYPE OF FACILITY: House X Mobile Home Dimension of Structure Bedrooms 1 Basement: Yes Water Using Fixtures in Basement:No No. in Family 2 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 1st 2nd 3rd OTHER: (Specify) Do you aniticipate any additions to Facility? If so, describe: CARPORT ALREADY BUILT 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 X 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: ' 1 - 05- 09 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 2 (FOR OFFICE USE ONLY) Zoning Approval _Yes No Zoning Approval UDO Zoning Form A Minimum Setbacks Front 30 FEE NAME DATE AMOUNT Side 10 Existing Tank Check Fee 11/05/2009 $80.00 Rear 5 TOTAL FEES $80.00 Max Hght *If a permit has to be redesigned and / or RETRIPS made to the property, there is an additional $60 charge 1 1 /05/09 11:50 THIS IS NOT A PERMIT W LS CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services Improvement Permit ❑ Authorization to Construct ❑ Septic Repair ❑ Septic Expansion ❑ Existing Tank Check New Well Permit ❑ Replacement Well ❑ Well Abandonment ❑ I . Name to Appear on Permit 7U A)A ~ ~ '13 1~ VIDE / 2. Permit Requested By 5 yr., Business Phone 2P a Address C~d 5) l+c Q.b -urK a'Ver kc4. Home Phone Vh P 3. Property Owner S A ✓r 2 Business Phone Address 5 J2 o Home Phone 4. Name of Subdivision .1)) - N 6 yn e Lot # Section/Block/Phase Property Address Directions to Property: u 'd n/ L ChIA Y' L U Y' N 5. Property Size: Square Feet Acres l Io Date Platted/Recorded 6. TYPE OF FACILITY: House ✓ Mobile Home Dimension of Structure Bedrooms* *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 system size increase in the future. Basement: Le)/no Water Using Fixtures in Basement: yes/0 No. in Family Whirlpool Tub yes no Gallon Capacity MULTIPLE FAMILY RESIDENCES: Units Total Number of Bedrooms DAY CARE: Number of Children RESTAURANT: Seats Square Feet Dining Area -Square Feet Food stand/Meat Market Floor Space TYPE OF BUSINESS: Number of Employees 1 st 2nd 3rd OTHER: (Specify) 7. Do you anticipate any additions to Facility? Yes If so, describe: r^ o k 8. Has any grading, removal, o addition of soil been done to this property? Yes If so, describe: 9. Are there easements/right-of-ways recorded on this property? Yes / 10. Is a public water supply available on or adjacent to the above property? Yes / Flo Check type that is available: [ ] Community well [ ] Semi-public well [ ] County/City/Township water line **If No, a Well Permit must be issued with the Septic Permit.** 11. Well Type Applying For: [ ] Individual well [ ] Community well [ ] Semi-Public well 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 valid for 5 years or may be non-expiring under certain specified conditions. Improvement Permits and Well Permits are transferable, but may be revoked if this information, site plans or intended use changes for the proposed facility. An 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. **IF A PERMIT HAS TO BE REDESIGNED AND/OR RETRIPS MAD TO THE PR ERTY, THER IS AN AD TIONAL CHARGE" Date Signature of Owner or Agent Catawba County, North Carolina This map procluci u•as prepared fi om the Cmmwha CowitY, NC, Geographic h joi niation Si slem. N Catawba Couch- has made substantial efforts to ensure the accuracy of locmion and labeling it formation co rained oil this map. Catmwbct County promotes mid recommends the independent verification of anv data contained on this map product by the user. The Comtty ofCatmwba, its emplo'vees, agents and personnel disclaim, and shall not he held (fable for any and al/ domages, loss or liobilit, iwheiher direct, indirect or consequential which arises or may cirise j om this mop product or the use thereof by ant person or entity. Legend ) A elected Pared/ umber: 2653-02-96-3429 I inch - 60 feet Prepared for: t O ` ~ t / ~-{I { ffr R-40 ! r c k=.'....... J~~ J . . R-40 , . . . / . . r IS NOT A LEGAL DOCUMENT Thursday, November 05, 2009 11:30 AIM _ CATAWB'A CONTY NC - Parcel Report Information Regarding Selected Parcel(s) Parcel ID: 2658-02-96-3429 Name: RHONEY DONALD BILL Name2: RHONEY CAROLEEN C Address: 9051 JACOB FORK RIVER RD Address2: City: VALE State: NC Zip: 28168-8943 Account: 55726010 Calc Acreage: 127.76 Tax Map: 006 B 02003 LRK: 5683 Deed Book: 1846 Deed Page: 0745 Subdivision Name: Subdivision Block: Lots: Plat Book: Plat Page: Building Number: 9051 Street Name: JACOB FORK RIVER RD Site Zip: 28168 Township: BANDY'S Fire Code: COOKSVILLE City Code: COUNTY State Road: 1111 Total Bldgs Value: $1,300 Land Value: $306,000 Total Value: $307,300 Year Built: Year Remodeled: Last Sale Date: Last Sale Amount: Neighborhood: 89 Watershed: WS-III Protected Area Watershed Split: NO Voter Precinct: P2 E911 District: COUNTY Zoning: R-40 Zoning2: Zoning3: Zoning Split: N Zoning Overlay: 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: BANOAK Middle School: JACOBS FORK High School: FRED T FOARD School Split: NO P&Z Case Number: Census Tract 2010: 011802 Census Block 2010: 1004 Small Area Plan: PLATEAU Agricultural District: Printed: Thursday, November 05, 2009 11:30 AM A- CATAWBA COUNTY, NC 100-A South West Blvd PLAN INVOICE F-] Newton, NC 28658- 0 (828)465-8399 Thursday, November 5, 2009 84 2 sM www.catawbacountyiic.gov Plan Case: EHPR-11-09-2539 Invoice Number: INV-11-09-257032 Environmental Health Plan Review Invoice Date: 11/05/2009 Fee Name Fee Amount Existing Tank Check Fee Fixed $80.00 Total Fees Due: $80.00 PAYMENTS _ Date Pay Type Check Number Amount Paid Change 11/05/2009 Check 1520 $80.00 $0.00 Total Paid: $80.00 Total Due: $0.00 ~;ni n<<i~ ;2•t i i>? ,'',o-13~a1-!~2J'i w~~~uJ5h4; i~u 11/05/2009 12:04