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Home My WebLink AboutEHPR-11-09-2822.TIF s, v ~A C THIS IS NOT A PERMIT Case # EHPR-I 1-09-2822 CATAWBA COUNTY HEALTH DEPARTMENT Plan Review Application for Environmental Services Ig 42 sM Environmental Health Plan Review - OSWP IMPROVEMENT - AUTFI CONST APPLICANT OWNER* CONTRACTOR R A JOYCE CONSTRUCTION CO INC R A JOYCE CONSTRUCTION CO INC RON A JOYCE' PO BOX 716 PO BOX 716 HICKORY NC 28603-0716 HICKORY NC 28603-0716 828-381-2520 NAME TO APPEAR ON PERMIT R A JOYCE CONSTRUCTION CO INC Pin#: 370005099404 SITE ADDRESS: 1676 BUFFETT CIR, Hickory, NC DIRECTIONS: BERSHIRE PLACE/ LOT 14/ HWY 127 S/ LFT ON BETHEL CH RD/ GO 2 MILES/ LFT INTO BERKSHIRE/ 2ND RT/ ON RT NAME of SUBDIVISION: BERKSHIRE PLACE PH 1 Lot# 14 Section/Block/Phase PROPERTY SIZE: Square Feet Acres 0.409 Date Platted/Recorded TYPE OF FACILITY: House X Mobile Home Dimension of Structure Bedrooms 3 Basement: Yes 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 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 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 pr y. An epresent ton by you of house or structure location should confor to applicable setbacks. / Date: OC Signature of Applicant or Agent v An Environmental Health Specialist will contact you withi 2 wor ing days o ap ication date. If you need further information or assistance p ease call 828-46 7 1 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 15 Authorization to Construct Fee (Newt 11/20/2009 $150.00 Rear 30 Improvement Pennit Fee 11/20/2009 $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 11 /20/09 11:00 ~ • J THIS IS NOT A PERMIT WLS #%f CATAWBA COUNTY HEALTH DEPARTMENT / Application for Environmental Services IP AC S. T. Rpr. Exist. S. T. Well Prmt. Replacement Well 1. Name to Appear on Permit m o5 2. Permit Requested By L Business Phone 2 591- 2S2 D Address -6 c2-x~-~ f ► Z loci Home Phone 3. Property Owner Business Phone- ~2 -3 (LSZ~ Address Home Phone 4. Name of Subdivision k-S IrLe- Lot Section/Block/Phase Property Address i r Direction to Prope y: - - e J 2L - (h f~ n ~c t= e N l-f N Lgof- 5. Property Size: Square Feet Acres Date Platted/Recorded 6. TYPE OF FACILITY: House Mobile Home Dimension of Structure X 3 Bedrooms* 1:111 LUi?lll thatwilh.hc Inicrdcd to ti~~ ~'~ICIC,:II lhC ',M)c o! ConstruClli?Il Or for lutll!'C hould-hc m,tcd as a lay, ll,,m line ~iiu ltc~l <,n di[ aq p li'.lii~itl. - he I-li h~' colthr111"d h, I•01M11 1~;~rit~lfI~~1 01I h~,u~,e hli'ns-„spa bed) tcSrtl-at the t ii ic vt rbuilulitg l76mj,-A iss,uance. his may prevent the need for system stzimncrease irr-the4uture. Basement: no Water Using Fixtures in Basement: yes/& No. in Family 3f S Whirlpool Tub yes/1W 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 / 19 If so, describe: 8. Has any grading, removal, or addition of soil been done to this property? Yes / If so, describe: 9. Are there easements/right-of-ways recorded on this property? Yes / Do 10. Is a public water supply available on or adjacent to the above property? / No Check type that is available: [ ] Community well [ ] Semi-public well [County/City/Township water line **If No, a Well Permit must be issu with the Septic Permit.** 11. Monitoring Well Request? Yes / # of wells Name of Site 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 1-04 he eligibltfor.a non-expiring kLaL . 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. **IF A PERMIT HAS TO BE REDESIGNED AND/OR RETRIPS MA 7~~7OPERT THERE IS AN ADDITIONAL $50 CHARGE" Date G l Z~ Signature of Owner or Agent (FOR OFFICE USE ONLY) Please Contact between 8 am and 9 am Phone I have confirmed that no municipal water line exists adjacent to the above property if well permit is being issued.** Signature Date Catawba County, North Carolina 77us map product was prepared f ont the Cotait-bet Countp, AIC, Geogrophic Information Svvenr. N Catawba Countr has made substantial efforts to ensure the occnroc'y ojloccnian caul labeling information container/ mt this mop. Cotou bo Counm promoter and reconmrends the indepenclent verification ofcrm_ dato contained on this map product by the user. The County of Cntau ba, its emplopees, agents oral personnel discloin , and sholl not be held /table for envy oncl al! clonrcrges, loss or liability, whether direct, indirect or consegr vhiclr rie'es or may arise f 'nm Ihis Wrap product or the ure thereajby anv person ar entity. Legend Selected Parcel Number: 3700-05-09-9404 1 inch = 60 feet Prepared for: v A"I 6'o I 16 J1 2A~ , - ,9623 w Plat 66-,174. CO 114.20 ( r~ C C_ C(~ fir` ~ ~ tr c N$ c(I N 14 f 404 co V o r29 f, ; 89 Nw Cap I , jt f t t ~ !Ov 8371 13' 1b ~ X60 J A0 THIS IS NOT A LEGAL 1)0CUNIENT Friday, November 20, 2009 10:41 AiNI CATAWBA COUNTY NC- Parcel Report Information Regarding Selected Parcel(s) Parcel ID: 3700-05-09-9404 Name: R A JOYCE CONSTRUCTION COMPANY INC Name2: Address: PO BOX 716 Address2: City: HICKORY State: NC Zip: 28603-0716 Account: 159750453 Calc Acreage: 0.41 Tax Map: LRK: 606176 Deed Book: 2959 Deed Page: 0846 Subdivision Name: BERKSHIRE PLACE PH 1 Subdivision Block: Lots: 14 Plat Book: 66 Plat Page: 174 Building Number: 1676 Street Name: BUFFETT CIR Site Zip: 28602 Township: HICKORY Fire Code: MOUNTAIN VIEW City Code: COUNTY State Road: Total Bldgs Value: Land Value: $30,800 Total Value: $30,800 Year Built: Year Remodeled: Last Sale Date: Last Sale Amount: Neighborhood: 88 Watershed: Watershed Split: Voter Precinct: P23 E911 District: COUNTY Zoning: R-20 Zoning2: Zoning3: Zoning Split: N Zoning Overlay: ED-O Zoning District: COUNTY Split Zoning Dist: N Split Zoning Dist(1): 0 Split Zoning Dist(2): 0 School District: COUNTY Elementary School: MOUNTAIN VIEW Middle School: JACOBS FORK High School: FRED T FOARD School Split: NO P&Z Case Number: Census Tract 2010: 011102 Census Block 2010: 2031 Small Area Plan: MOUNTAIN VIEW Agricultural District: Printed: Friday, November 20, 2009 10:33 AM A CMG CATAWBA COUNTY, NC I00-A South West Blvd PLAN INVOICE Newton, NC 28658- 0 (828)465-8399 Friday, November 20, 2009 4 sm www.catawbacountync.gov Plan Case: EHPR-11-09-2822 Invoice Number: I NV-1 1-09-257432 Environmental Health Plan Review Invoice Date: 11/20/2009 Fee Name Fee Amount Improvement Permit Fee Fixed $150.00 Authorization to Construct Fee Adjustable $150.00 (New/Expansion) Fee Total Fees Due: $300.00 PAYMENTS Date Pay Type Check Number Amount Paid Change 11/20/2009 Check 2415 $300.00 $0.00 Total Paid: $300.00 Total Due: $0.00 pkin in4oice ; 55=43'_icc-1 I t e-=18i1-~-p t=I1-~6ech~ I d?tilc,.ipt 11/20/2009 11:16 `i -ATAkWBA COIJNTY Public Health Department Case # WLS2007-01159 < Environmental Health Division Subdivision BERKSHIRE PO Box 389, 100-A Southwest Blvd, Newton, NC 28658 Sect/BUPh/Lot # 2T► I v (828) 465-8270 FAX (828) 465-8276 TDD (828) 465-8200 PIN# 911370005095275-21?' ! Applicant/Owner JEON REAL ESTATE INC. kx4 Site Address: 1676 BUFFETT CIR QS $'C Property Size: 22,000 SF ACRES < Directions: HWY 321/ EXIT 42 (127 S) 127 S TO BETHEL CHURCH RD / LEFT 1 1/4 MILE ON LEFT IlC Improvement Permit 1 ~j 1 OC Permit Valid For: Five years -I- No Expiration Facility (Residential): House h House X Mobile Home Multi-Family Bedrooms 3 New? Addition? Projected Daily Flow Z(p~ g.p.d Water Supply Private Well? Public? )C Semi-Public? Basement: Y Basemennt Plumbing: N 1HotTub/Spa: Y i Special Fixtures (explain): Proposed Wastewater System: lu_ ~"P `l~ ZJ~ QC~ctfW~ Type: Proposed Repair: h Z55o Z,.~ Permit Conditions: t « aV lar~ YG 'o a S ti OCIt- t Owner or Legal Represe alive Si atur r~ Date: Z Authorized State Agent: Date: ip The issuance of this permit by the ealth Department does not guarantee the issuance of other permits. It is the responsibility of the applicant/property owner to insure that all Catawba County Planning/Zoning and Building Inspections requirements are met. This Improvement Permit is subject to revocation if the site plan, plat or the intended use changes, or if site conditions are altered. The Improvement Permit is not affected by a change in ownership of the property. This permit was issued in compliance with the provisions of the North Carolina 'Laws and Rules for Sewage Treatment and Disposal Systems' (15A NCAC 18A .1900). Neither Catawba County nor the Environmental Health Specialist warrants that the septic tank system will continue to function satisfactorily for any given period of time. Authorization to Construct Wastewater System (Required for Building Permit) * See site plan and additional attachments ( Proposed Wastewater System: Type: Wastewater Flow g.p.d New Repair Expansion Soil LTAR: g.p.d./ft2 Type of Facility: Basement: Y Basement Plumbing: N HotTub/Spa: Y Special Fixtures (explain): Wastewater System Requirements Tank Size: Septic Tank gal Pump Tank gal Grease Trap gal Drainfield: Total Area: sq ft Total Length: ft Maximum Trench Depth in Trench Width ft Minimum Soil Cover in Minimum Trench Seperation ft Distribution: Distribution Box Serial Distribution Pressure Manifold LPP Other Additional Specifications: Authorized State Agent: Date: Permit Expiration Date: 1 have read and accept the specifications and all conditions of this permit as indicated. Owner or Legal Representative Signature: Date: Form B r:Vide=rk\FomsVWLSnon.mi - - / I~ G A7 A WtBA COUNTY p--mac Public Health Department Case # WLS2007-01159 < Environmental Health Division Subdivision BERKSHIRE \J\ / PO Box 389, 100-A Southwest Blvd, Newton, NC 28658 Sect/BUPh/Lot # -L I Y (828) 465-8270 FAX (828) 465-8276 TDD (828) 465-8200 PIN# 911370005095275-2-?' Applicant/Owner JEON REAL ESTATE INC. Site Address: 1676 BUFFETT CIR Property Si 22,000 SF ACRES Directions: HWY 321/ EXIT 42 (127 S) 127 S TO BETHEL CHURCH RD / LEFT 1 1/4 MILE ON LEFT ® Improvement Permit E3Authorization To Construct Well Permit SITE PLAN r~5r fo' 11 Shlkco-t k (uQgiv Qvw~~ k~ ZSgv ..d` fo 15' sF~ ` 25' (o3t ~ ~l c~YOIL I "=fib' Scale System components represent approximate contours only. The contractor must flag the system prior to beginning the inst lation to ensut that proper grade is maintained. Do not install system under wet conditions. Thi$ permit is subject of rev ion if the sit Ian br conditions are altered. VZ 6 uthori State Agent ate Form C rAPdemnrkVn m.sVWLSnnn. mi