The URL can be used to link to this page

Home My WebLink AboutEHPR-11-09-2604.TIF $P C THIS IS NOT A PERMIT Case # EHPR-1 1-09-2604 r~ CATAWBA COUNTY HEALTH DEPARTMENT Plan Review Application for Environmental Services 1842 SM Environmental Health Pl Review - OSWP _ 411 TwOnrilent 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 HARVEL 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 2 Basement: No Water Using Fixtures in Basement:No No. in Family 0 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: 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 X 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 PC An Environmental Health Specialist will contact you within 2 workin days of application date. If you need further information or assistance please call 828-466-7291 AREA I (FOR OFFICE USE ONLY) Zoning Approval: Yes No Zoning Approval UDO Zoning Form A Minimum Setbacks FEE NAME DATE AMOUNT Front Side Rear TOTAL FEES Max Hght *If a permit has to be redesigned and / or RETRIPS made to the property, there is an additional $60 charge 11/09/09 15:05 i j~ X THIS IS NOT A PERMIT wLS # CATAWBA COUNTY HEALTH DEPARTMENT M Application for Environmental Services [-i IP r AC S.T. Rpr. rl S.T. Exp. ri Exist. S. T. Well Permit h Replacement Well 1. Name to Appear on Permit: Duke Energy Carolinas, LLC 2. Permit Requested By: Elena Massiminr Business Phone: $28-478-7605 8320 East NC Hwy 150 ! N/A Address: Home Phone: Duke Energy Carolinas, LL. 828 478-7605 3. Property Owner: Business Phone: S. Church Street I N/A Address: Home Phone: F 4. Name of Subdivision: Lot Section/Block/Phase: ` 3275 Harvel Road Terrell, NC 28682 Property Address: 77 north.to exit 36. Head west on Hwy 150 for 6 miles, Harvel Road on right Directions to Property: < i 5. Property Size: Square Feet L_.-...-'._._......_-..' Acres 2'83__.._._....__.__....._ Date Platted/Recorded CC; House Mobile Home 6. TYPE OF FACILITY: Dimension of Structure 38'x24' J. Bedrooms*F - d. Basement; )Yes C No Water Using Fixtures in Basement: Yes ( No No. in Family: i Whirlpool Tub: CYes C.;No Gallon Capacity: MULTIPLE FAMILY RESIDENCES: Units Total Number of Bedrooms DAY CARE: Number of Children i RESTAURANT: Seats Square Feet Dining Area 17,11' Square Feet Food Stand/Meat Market Floor Space TYPE OF BUSINESS: No. of Employees 1st rI 2nd F77 3rd F OTHER: (Specify) ()Yes (,No If so describe Current house to be demolished and 7. Do you anticipate any additions to Facility. property to be vacant from use 8. Has an removal, or addition of sail been done to this . Y grading, property? (`Yes No If so describe 9. Are there easements/right-of-ways recorded on this property? (,)Yes No 10. Is a public water supply available on or adjacent to the above property? Yes C• No Check type that is available: r' Community Well r; Semi-public Well CX County/City/Township water line 11. Well Type Applying For. IX Individual Well r Community Welli Semi-public Well r Irrigation Well Geothermal Well ,Yes (:)No # of Wells:- Name of Site: 12. Monitoring Well Request: I understand that this a formal application fora well permit, Improvement Permit or Authorization to Construct aground 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. 1 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 (S) five years from th date issued and is not transferable. Note: You must obtain Zoning Approval prior to locating a home or structure on this property. Any represent on byyou of house or structure location should conform to applicable set backs. "CIF A PERMIT HAS TO BE REDESIGNED AND/OR RETRIPS MADE TO THE PROPER E IS AN ADDITIONAL CHARGE.' Date: 11/09/09 Signature of Owner or Agent: _ i i I i i I ..--------------._.i..... r i i I i ji NOV-18-2009 WED 12:6 PM McCall Brothers FAX NO. 7043982605 P. 02 WELL. ABANDONMENT RECORD Noah Carolina Department of Environmcut and Natural Resources- Division of Water Quality WELL CONTRACTOR CERTIVICATION N i 1. WELL CONTRACTOR: 5. WELL DETAILS(: 711,^r, Sj lase-- PL. Total Qettib:_ t & Diamctcr.---io- Well contractor ividual) Name b. Water Level (Below Measuring Point): = ft. An Mescaring pain) is • Q A, above land surFacc. cH Coatraclot Company Name _sj STRfi$ f ADDRESS t3 / 1 6. CASING: Length Diastteter 1 6 R, Ming Dapth (if known). fl- i1L j City or Town State Zip Code b. Casing Removed• _ IL to. .i Area code - opc number 7. DISINFEC`[ ION t ,r2. WELL INFORMATION. (Amount of 5° -759L calcium hypoahloritc used) SITE WELL ID # (ifapplicabic) 6 SF.ALINC MATERIAL. STATE WELL PU MIT # Gfapplicable) ~ Sand CemtstlL i Cement -3-LA- lb. Cement -_lb, COUNTY WIU L PL VMT ff (ifapplicabic) S 7 I Water gaL weler gaL . DWQ or OTHER PER14T 9 (if applicable) $ to WELL USE (Circle applicable use) Monitoring eabde to HaAitc lb. Mualelpal/Publlc lndustrialIComMerclal Agricultural Type` Shm Pcllcls- Recovery Injection Irt•lgatt" Wares Other (lid use) other & W EI.L LOCATION: Typo material COUNTY t` ,A-4 QUADRANGLE NAME NEAREST TOWN;-1 a.r-} I Amount (Strmt/Rood Name. Number, Coaaaunity, Subdivision. Lot No., Aatcel. Zip Code) 9. EXPLAIN Mmj()D OF EMPLACEMENT OF_MATERIAU TOPOGRAPHIC/LANDSE7TfNG: ~MS ,rr txt.`L (5 1) fi~'n-`t . Slope Valley t Ridge Otb®r (Circle approlodulo setting) May be in degrees. LATr=.R: ] s minute% it=da, or ni a o ~ dccimnl fomtat LONGiTUD.>S D 1_ 4 7 10. WELL DIACL~AIN: Dtnw a detailed sketch of the well on lftc bank of this Latitudellongitude source; GYPS Topograpilic.map form showing total depth, doplh attd diameter of scrc=(if any) remaining (Loemlon of well mrrs/ be shown on a USGS topo map and in tbrc well, gravel interval, inbavals of casing perforatloas, and dcplhs and arroohed to rhlr font. 1(nol using GPS.) types of fill materials used. 4a. FACitL1TY-1ln naum orihe b:ainet! where the weu is )oared. Complete 4a and4b i (Ifs mWentewdl, stcip4a; oompiota4b, wdl owner information ugly.) 11. DATE WM. LABANDONED O .09 FACILITY 10 N(ifapplicable) 6\1p, 64w) 1% I DOH11013i M&TC"rTHAT MIS WELL WASABANDONaa IN ACCORDANCE NAME OFFACILrry (nA / SF WITH 15ANCAC2C.WELL CoNSTRUCtiot4 stANnARDs,ANDTHATACOPY Of STREET AD13RESS 32 iue ( THIS RECORD HAS BEEN PROVIDED TOTO& WaL OWNER. 2-: 1147-9 PVT - City or Town State Coda SIGNATUP"F CERTtFtEQ WELLCONT"CTQB PATE 4b. CONTACT PERSON/WELL O~Wr4ER: NAME 1:1 Q w!I SIGNATUREOFPRIVATCWC'MOWNER AHANAONIN¢THEWELL- -DATE (w ptivate wd1 owner mast bean inn idual who MON abandons his/her nosldeatial wag STREET ADDRESS O Za ~.a J-y J ~V . In aceordan i 5 C 2C .0 t t 3. 1. GSr~ o~t.nx ~1~✓ KAM a' PERSON All"DON1NG.THE WF,I:L _ _ _ FOFM-