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Home My WebLink AboutEHPR-11-09-2734.TIF THIS IS NOT A PERMIT Case # EHPR-11-09-2734 l io"r / CATAWBA COUNTY HEALTH DEPARTMENT Plan Review Application for Environmental Services 1842 sM Environmental Health Plan Review - Septic Malfunction EP_MALFUN APPLICANT OWNER . CONTRACTOR JAMES PENNELL JAMES PENNELL 2947 BETHANY CHURCH RD 2947 BETHANY CHURCH RD CLAREMONT NC 28610-9220 CLAREMONT NC 28610-9220 NAME TO APPEAR ON PERMIT JAMES PENNELL Pin#: 376009052013 SITE ADDRESS: 2947 BETHANY CHURCH RD, Claremont, NC DIRECTIONS: HWY 10 E - TURN RIGHT AT WITHERSPOON'S CROSS RDS ONTO BETHANY CHURCH RD - PROPERTY ON RIGHT ACROSS FROM BETHANY UNITED CHURCH NAME of SUBDIVISION: PEBBLE BAY PH 3 REVISION Lot # 124 Section/Block/Phase PROPERTY SIZE: Square Feet Acres 1.5 Date Platted/Recorded TYPE OF FACILITY: House Mobile Home X Dimension of Structure 24 X 60 Bedrooms 3 Basement: Yes Water Using Fixtures in Basement:Yes 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: NO Has any grading, removal, or addition of soil been done to this property? If so, describe NO 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: 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 AREA1 (FOR OFFICE USE ONLY) Zoning Approval: Yes No Zoning Approval UDO Zoning Form A Minimum Setbacks Front FEE NAME DATE AMOUNT Side Authorization to Construct (Repair) F, 11/16/2009 $300.00 Rear TOTAL FEES $300.00 Max Hght *If a permit has to be redesigned and / or RETRIPS made to the property, there is an additional $60 charge 11/17/09 15:42 ~A THIS IS NOT A PERMIT Case # EHPR-I 1-09-2734 CATAWBA COUNTY HEALTH DEPARTMENT Plan Review Application for Environmental Services 1842 SM Environmental Health Plan Review - Septic Malfunction EP_MALFUN APPLICANT OWNER CONTRACTOR JAMES PENNELL JAMES PENNELL 2947 BETHANY CHURCH RD 2947 BETHANY CHURCH RD CLAREMONT NC 28610-9220 CLAREMONT NC 28610-9220 NAME TO APPEAR ON PERMIT JAMES PENNELL Pin#: 376009052013 SITE ADDRESS: 2947 BETHANY CHURCH RD, Claremont, NC DIRECTIONS: HWY 10 E - TURN RIGHT AT WITHERSPOON'S CROSS RDS ONTO BETHANY CHURCH RD - PROPERTY ON RIGHT ACROSS FROM BETHANY UNITED CHURCH NAME of SUBDIVISION: WITHERSPOON ESTATE Lot # Section/Block/Phase PROPERTY SIZE: Square Feet Acres 1.83 Date Platted/Recorded TYPE OF FACILITY: House Mobile Home X Dimension of Structure 14 X 60 Bedrooms 3 Basement: No 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 Ist 2nd 3rd OTHER: (Specify) Do you aniticipate any additions to Facility? If so, describe: NO Has any grading, removal, or addition of soil been done to this property? If so, describe NO 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 b u of house or structure location should conform to applicable setbacks. Date: Signature of Applicant or Agent An Environmental Health Specialist will contact you t in 2 working s f application date. If you need further infonnation or assistance please call 828-466-7291 AREA1 (FOR OFFICE USE ONLY) Zoning Approval: _Yes No Zoning Approval UDO Zoning Form A Minimum Setbacks Front FEE NAME DATE AMOUNT n3~ Side Authorization 'to Construct (Repair) FiI 1716/2609 $300.00 Rear TOTAL FEES $300.00 Max Hght *If a permit has to be redesigned and / or RETRIPS made to the property, there is an additional S60 charge 11/16/09 16:22 THIS IS NOT A PERMIT WLS V CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services Improvement Permit El Authorization to construct F1 Septic Repair [Z Septic Expansion ❑ Existing Tank Check ❑ New Well Permit ❑ Replacement Well ❑ Well Abandonment ❑ 1. Name to Appear on Permit S . l~~h 2. Permit Requested By Business Phone Address Home Phone g,7- Q -!!X6 l0_3 3. Property Owner L., aid 8es , e ;T Business Phone Address Home Phone V 1,,i-24-64- -ld 3 4. Name of Subdivision Lot # Section/Block/Phase PropertyAddress S2r„ eq 29s Direction to Property: 11-iAIV / G' 2 /l~C?Lr1 0 e67 i!" m ' ~n ~ u e 'J Lc r c: n ~ r yt . ' - -G e wt h cam, o.► I/ s Y-v 6107 5. Property Size: Square Feet Acres Date Platted/Recorded 6. TYPE OF FACILITY: House Mobile Home_ Dimension of Structure /44,,P (ao 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.] he number ol'bedrooms will be confirmed by rooms Identified on house plans as a bedroom at the Time Of building pCrIlult issuance. 'phis may prevent the need for system size increase in the future. Basement: ,yes/no Water Using Fixtures in Basement: yga/no No. in Family v - Whirlpool Tub yes n 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 1st _ 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 / No 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 / No 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. r: [ ndividuaI 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 ~J -1 Signature of Owner or Agent Catawba County, North Carolina This map product was prepared from the Catawba County, NC, Geographic Information System. N Catawba Countv 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 ofanv data contained on this map product by the user. The Countv of Catawba, its employees, agents and personnel disclaim, and shall not be held liable for anv 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: 3760-09-05-2013 1 inch = 80 feet Prepared for: 60 BETHANY UNITED CHURCH OF CHRIST 2.47A 3241 Z u~ 7~ foss mss, o~ 1.83A 2013 60 l . 1160 0938 f 10 1.07A BETHANY L '/'0863 r THIS IS NOT A LEGAL DOCUMENT Mon, November 16, 2009 03:50 PM i ` \ Cam' V7/ \ i % 'CATAWBA COUNTY NC - Parcel Report Information Regarding Selected Parcel(s) Parcel ID: 3760-09-05-2013 Name: PENNELL JAMES LYNN Name2: PENNELL BESSIE JANE Address: 2947 BETHANY CHURCH RD Address2: City: CLAREMONT State: NC Zip: 28610-9220 Account: 51265500 Calc Acreage: 1.83 Tax Map: 062N 02016C LRK: 34816 Deed Book: 1628 \ Deed Page: 0132 Subdivision Name: WITHERSPOON ESTATE Subdivision Block: Lots: Plat Book: 13 Plat Page: 28 Building Number: 2947 Street Name: BETHANY CHURCH RD Site Zip: 28610 Township: NEWTON Fire Code: CLAREMONT RURAL City Code: COUNTY State Road: 1801 Total Bldgs Value: $64,800 Land Value: $19,400 Total Value: $84,200 Year Built: 1978 Year Remodeled: Last Sale Date: Last Sale Amount: Neighborhood: 117 Watershed: WS-IV Protected Area Watershed Split: NO Voter Precinct: P22 E911 District: COUNTY Zoning: R-30 Zoning2: Zoning3: Zoning Split: N Zoning Overlay: WP-0 Zoning District: COUNTY Split Zoning Dist: N Split Zoning Dist(1): 0 Split Zoning Dist(2): 0 School District: COUNTY Elementary School: CATAWBA Middle School: RIVER BEND High School: BUNKER HILL School Split: NO P&Z Case Number: Census Tract 2010: 011300 Census Block 2010: 3002 Small Area Plan: BALLS CREEK Agricultural District: Printed: Mon, November 16, 2009 03:50 PM CATAWBA COUNTY, NC ti~ r 100-A South West Blvd PLAN RECEIPT F ? Newton, NC 28658- V (828)165-8399 Monday, November 16, 2009 84 2 SM www.catawbacountync.sov Plan Case: EHPR-11-09-2734 Invoice Number: I NV-1 1-09-257288 Environmental Health Plan Review Invoice Date: 11/16/2009 Fee Name Fee Amount Authorization to Construct (Repair) Fee Adjustable $300.00 Total Fees Due: $300.00 PAYMENTS Date Pay Type Check Number Amount Paid Change 11/16/2009 Credit Card -1 $300.00 $0.00 Total Paid: $300.00 Total Due: $0.00 planreceipt (50207c1Oe-b! fa-=14)95-8992-3dcOa63-4b30a;.rpr 11/16/2009 16:21