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Home My WebLink AboutEHPR-11-09-2600.TIF A COQ THIS IS NOT A PERMIT Case # EHPR-1 1-09-2600 ` CATAWBA COUNTY HEALTH DEPARTMENT Plan Review Application for Environmental Services 1842 SM Environmental Health Plan Review - OSWP APPLICANT OWNER CONTRACTOR JACKIE WILSON JACKIE WILSON 337 SW 39TH ST PL 337 SW 39TH ST PL NC 28602 NC 28602 828-324-6384 828-324-6384 NAME TO APPEAR ON PERMIT JACKIE WILSON Pin#: 363920728069 SITE ADDRESS: 2210 LITTLE COULTERS CHURCH RD, Newton, NC DIRECTIONS: 321 S/ RT MCKAY FARM RD/ RT LITTLE COULTER FARM RD (BEFORE BRIDGE) AT END OF ROAD NAME of SUBDIVISION: Lot # Section/Block/Phase PROPERTY SIZE: Square Feet Acres 14.159 Date Platted/Recorded TYPE OF FACILITY: House Mobile Home Dimension of Structure Bedrooms 3 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? NONE 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: (I 9 Signature of Applicant or Agent An Environmental Health Specialist will contact you withi 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 #:&eJ6P 24U UDO Zoning Form A Minimum Setbacks Front 40 FEE NAME DATE AMOUNT Side 10 Authorization to Construct Fee (New/. 11/09/2009 $150.00 Rear 40 Improvement Permit Fee 1 1 /09/2009 $150.00 Max Hght $300.00 TOTAL FEES *If a permit has to be redesigned and / or RETRIPS made to the property, there is an additional $60 charge 1 1 /09/09 13:56 THIS IS NOT A PERMIT WLS # CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services Improvement Permit ❑ Authorization to Construct El Septic Repair ❑ Septic Expansion Existing Tank Check ❑ New Well Permit E] Replacement Well ❑ Well Abandonment E] 1. Name to Appear on Permit 2. Permit Requested By _ / L 67 Business Phone Address / l r 'l,7LO.Home Phone 3. Property Owner C 1 5 Business Phone Address Home Phone 4. Name of Subdivision Lot # Section/Block/Phase Property Address Directions to Pro erty: o~ C. 5. Property Size: Square Feet Acres /U- Date Platted/Recorded 6. TYPE OF FACILITY: House Mobile Home Dimension of Structure a k'SD, Bedrooms* *Aay 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 wil l be confinned by rooms identified on house plans as a bedroom al the time of building permit issuance. This may prevent the need for system size increase in the future. Basement: yes/0 Water Using Fixtures in Basement: yes/np No. in Family o~- Whirlpool Tub yes/r ~allon 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 Ist 2nd 3rd OTHER: (Specify) 7. Do you anticipate any additions to Facility? Yes/(No If so, describe: 8. Has any grading, removal, or addition of soil been done to this property? Yes 160 If so, describe: 9. Are there easements/right-of-ways recorded on this property? Yes / o 10. Is a public water supply available on or adjacent to the above property? Yes / No Check type that is available: [ ] Community well [ ] Semi-public well [ ] County/City/Township water line **If No, a Well Pen-nit must be issued with the Septic Permit.** H. 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 MADE TO THE PROPERTY, THERE IS AN ADDITIONAL CHARGE.- Date Signature of Owner or Agent = t r Catawba County, North Carolina This map product was prepared from the Catawba County, NC, Geographic Information System. 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 airy 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 fh•om this map product or the use thereof by any person or entity. Legend Selected Parcel Number: 3639-20-72-8069 1 inch = 100 feet Prepared for: 52 er v 3532 - - - y~ 'yy \ VI V esF" _ \ V]8 ~f 13000r\7~~% 40.00 0,9 . f I y f N r sue' ~ ~ i r ' 7l t j f~/ : - t ~ i : A - Plat 35-195 . 8.57A - Etc) '9 t t ' s/ 7 .s 6 .......a: ; t r' b, . f 1 t t ~ i _ THIS IS NOT A LEGAL DOCUMENT / noonday, November 09, 2009 01:34 PM CATAWBA COUNTY NC - Parcel Report Information Regarding Selected Parcel(s) Parcel ID: 3639-20-72-8069 Name: WILSON JACKIE H Name2: WILSON SANDRA H Address: 337 39TH ST PL SW Address2: City: HICKORY State: NC Zip: 28602-1506 Account: 113179 Calc Acreage: 14.16 Tax Map: 047N 04006D LRK: 30619 Deed Book: 2137 Deed Page: 0941 Subdivision Name: Subdivision Block: Lots: Plat Book: Plat Page: Building Number: 2210 Street Name: LITTLE COULTERS CHURCH RD Site Zip: 28658 Township: NEWTON Fire Code: NEWTON RURAL City Code: COUNTY State Road: Total Bldgs Value: Land Value: $51,600 Total Value: $51,600 Year Built: Year Remodeled: Last Sale Date: 3/1/1999 Last Sale Amount: $40,000 Neighborhood: 117 Watershed: Watershed Split: Voter Precinct: P32 E911 District: NEWTON Zoning: R-20 Zoning2: Zoning3: Zoning Split: N Zoning Overlay: Zoning District: NEWTON Split Zoning Dist: N Split Zoning Dist(1): 0 Split Zoning Dist(2): 0 School District: COUNTY Elementary School: CONTACT SCHOOL DISTRICT Middle School: MAIDEN High School: MAIDEN School Split: YES P&Z Case Number: Census Tract 2010: 011701 Census Block 2010: 2061 Small Area Plan: Agricultural District: Printed: Monday, November 09, 2009 01:27 PM Catawba County, North Carolina This map product was prepared firont 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 amr J4 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 any person or entity. Legend Selected Parcel Number: 3639-20-72-8069 1 inch = 100 feet Prepared for: 7 ~ i~ . IK 9. THIS [S NOT A LEGAL DOCUMENT Monday, November 09, 2009 01:33 PM ilt ~ , Catawba County, North Carolina This map product was prepared front the Catawba Counw, NC, Geographic h7fortnation System. N Catawba County has made substantial efforts to ensure the accuracv of location and labeling information contained on this map. Catawba County promotes and recommends the independent verification of anv 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 uuav arise front this map product at, the use thereof by anv person or entity. Legend Selected Parcel Number: 3639-20-72-8069 1 inch = 200 feet Prepared for: 9751 . I. 1 4.J . .1532 d 'i't~~~'►yy / / ~y r~ 2. 15-1 95 /,AEFIN J i e r r ~ t r ll , Cal F f f •r7 . / ' SR 2067 ±Kt . j / t / ~ \I\ ! } ! PIZt3-`rr, 4 ~11.-'_ -a t 437 - , / 0 , I z d.... t x / / 3372 N . + . - . _ ~ ~ ~r., 300 r _ . ~ ~ THIS IS NOT A LEGAL DOCUMENT Monday, November 09, 2009 01:27 PM ZONING CLEARANCE PERMIT F~o CITY OF NEWTON PLANNING DEPARTMENT P.O. BOX 550 (828)695-4305 Fax (828)465.7412 THIS PERMIT EXPIRES IN SIX MONTHS OR AFTER A ONE YEAR LAPSE IN WORK Project Address: 2 -zt-o _i ale Coc) 1 ~ev C 1rlt 3~ 3C1 ZO 7Z- &0 Ct Project Description: Area Estimated 'I? X S 2 A10 J 01 alr Disturbed: C 2fj Xj Cost- Applicant: Owner: :a C_ e- - Vill e Address: Q,/Address: City: Ale,) h, State: 71L Zip Code: Zg s sA City: State: Zip Code: Phone: ~f 63g Fax: Phone: Fax: Email: Email: - I do hereby certify that the foregoing statements are accurate and correct to the best of my understanding and knowledge and that t agree to conform to all City Ordinances and Laws of the Ste of North Carolina regulating such work and any plans or specifications submitted. With my signature below I assume responsibility for all errors and omissions of the Information provided i this application together with any plans and/or other documents associated with the issuance of this Permit by the City of Newton. Signature of Applicant: Date: Type of Permit Needed: lew Construction r Sign F7 Mobile Home F7 Remodel Accessory Addition/aiteration Service Change r Structure Moving F Demolition r Change of Use Type of Use: ingle-Family Residential r Commercial Assembly, Multi-Family Residential r Industrial j Non-Profit/Governmental Zoning District: -ZO Required Setbacks: Utilities Services: Overlay District: Front: go Electricity: ;r City of Newton Duke REW rSPI - Highway Corridor Rear: C~a Water: r City of Newton ~<Well (-SPI - Watershed Side: j~ Sewer: r". City of Newton KSeptic Tank r Flood Plain Overlay St Pauls Overlay Side Street: 2O Other Requirements: F- Buffers,& Screening Required r Stormwater Permit Required r Grading Permit Required- f- Watershed: WS-1V - P / WS-III - C / WS-III - BW r Soil Erosion Permit Required Driveway Permit Required: City / NCDO' Flood Plain - As Built Survey Required f' Plan Review Required F- Vested Rights Approval: Complete Application Received: W101 Fee: $ 3 Receipt 7f 3 Signature of Approving Authority: Date: ha2 C/ NOTES: Net~ D~coo~ n~ M Inspection Approval: Setback - Date: By: Final - Date: By: A C~~.. CATAWBA COUNTY, NC 100-A South West Blvd PLAN INVOICE 1- j Newton, NC 28658- 0 (828)465-8399 Monday, November 9, 2009 1► 184 sm+ www.catawbacountync.gov Plan Case: EHPR-11-09-2600 Invoice Number: I NV-1 1-09-257106 Environmental Health Plan Review Invoice Date: 11/09/2009 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 Date Pay Type Check Number Amount Paid Change 11/09/2009 Check 749 $300.00 $0.00 Total Paid: $300.00 Total Due: $0.00 Ilan mvncr ;97kl1LId1-cS?c--Io?s-h(y1 -i„•,,U 1 12122; 1ri 11/09/2009 14:04