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Home My WebLink AboutEHPR-12-09-3024.TIF THIS IS NOT A PERMIT Case # EHPR-12-09-3024 CATAWBA COUNTY HEALTH DEPARTMENT ti Plan Review Application for Environmental Services 1842 Environmental Health Plan Review - OSWP SM AUTH CONST APPLICANT OWNER CONTRACTOR MILDRED MOORE BILLY HARLAN A & D RESIDENTIAL BUILDERS PO BOX 672 PO BOX 522 CLAREMONT NC 28610 HILDEBRAN NC 28673- CONOVER NC 28613-0522 828-459-2564 NAME TO APPEAR ON PERMIT MILDRED MOORE Pin#: 376107770724 SITE ADDRESS: 2485 GENELIA DR, Claremont, NC DIRECTIONS: NAME of SUBDIVISION: CHARLOTTES CROSSING Lot # 5 Section/Block/Phase PROPERTY SIZE: Square Feet Acres 2 Date Platted/Recorded TYPE OF FACILITY: House X 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 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 property. ny represen ' n by you of house or structure location should conform to applicable setbacks. _ Date: 7o~ • D 7- D 9 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 FEE NAME DATE AMOUNT Front Side Authorization to Construct Fee(New/12/07/2009 Rear TOTAL FEES $150.00 Max Hght *If a permit has to be redesigned and / or RETRIPS made to the property, there is an additional $60 charge 12/07/09 11:11 THIS IS NOT A PERMIT WLS CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services Improvement Permit ❑ Authorization to Construct LJ Septic Repair ❑ Septic Expansion ❑ Existing Tank Check ❑ New Well Permit E] Replacement Well E] Well Abandonment E] 1. Name to Appear on Permit M I l d r ed g , 16 o h le_ 2. Permit Requested B~ G e ' u'. (alo La-- Business Phone t c Home Phone Address FS2- lf~• lC 3. Property Owner dP C 5 7T Business Phone Address Home Phone 4. Name of Subdivision N y- c, 5 1 1/---( Lot Section/BlockfPhase Property Address e - (f ° / Directions to Property: 5. Property Size: Square Feet Acres Date Platted/Recorded 6. TYPE OF FACILITY: House Mobile Home Dimension of Structure 4~- X 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 identifiedon houszplans as 'a bedroom at the time of building permit issuanee. This may prevent the need for system size increase in the future. Basement: yeCnoo Water Using Fixtures in Basement: yes/1(07) No. in Family Whirlpool Tub yes/ C10) 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 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 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?(-Yel 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. 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 PROP , THERE IS AN ADDITIONAL CHARGE.** Date /c~ - 7 D Signature of Owner or Agent 'Z - ~if - Catawba County, North Carolina This map product was prepared from 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 any 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 arty person or entity. Legend Selected Parcel Number: 3761-07-77-0724 1 inch = 60 feet Prepared for: 12 1,985 J ~ X30 i t n f_ r 1)724 ~c S < r c i ' \ y A I 1 f t co THIS IS NOT A LEGAL DOCUMENT Monday, November 23, 2009 11:38 AM CATAWBA COUNTY NC - Parcel Report Inforinafor, Regarding Selected Parcel(s) Parcel ID: 3761-07-77-0724 Name: LOVE BILLY HARLAN Name2: Address: PO BOX 522 Address2: City: CONOVER State: NC Zip: 28613-0522 Account: 42722840 Calc Acreage: 2 Tax Map: LRK: 402390 Deed Book: 2342 Deed Page: 1893 Subdivision Name: CHARLOTTES CROSSING Subdivision Block: Lots: 5 Plat Book: 47 Plat Page: 137 Building Number: 2485 Street Name: GENELIA DR Site Zip: 28610 Township: CLINES Fire Code: City Code: CLAREMONT State Road: Total Bldgs Value: Land Value: $29,200 Total Value: $29,200 Year Built: Year Remodeled: Last Sale Date: Last Sale Amount: Neighborhood: 117 Watershed: WS-IV Protected Area Watershed Split: NO Voter Precinct: P6 E911 District: COUNTY Zoning: R-1 Zoning2: Zoning3: Zoning Split: N Zoning Overlay: Zoning District: CLAREMONT Split Zoning Dist: N Split Zoning Dist(1): 0 Split Zoning Dist(2): 0 School District: COUNTY Elementary School: CLAREMONT Middle School: RIVER BEND High School: BUNKER HILL School Split: NO P&Z Case Number: Census Tract 2010: 011400 Census Block 2010: 2019 Small Area Plan: Agricultural District: Printed: Monday, November 23, 2009 11:39 AM IMPROVEMENT PERMIT For Office UseOnly •CDP File Number 3 6 3 0 6 Catawba County Public Health Department Environmental Health Division County ID Number: EHPR-11-09-2850 t~ P.0 Box 389, 100-A Southwest Blvd Evaluated For: NEW ,J Newton NC 28658 Townsh Phone: (828)-465-8270 Fax: (828) 465-8276 PERMIT VALID UNTIL 12/1/2014 `NOTE TO INSPECTIONS DIVISION: Building Permits cannot be issued with this Improvement Permit. Applicant: Mildred Moore Property Owner: Address: P.O. Box 672 Address: City: Hildebran 7 Cily: State/Zip: NC 28673 State/Zip: Phone Phone Pro ertLocation & Site Information Address/Road Subdivision: Charlottes Crossing Phase: Lot: 5 2485 Genelia Dr. Claremont NC 28610 Directions Structure: SINGLE FAMILY # of Bedrooms: 3 # of People: "Water Supply: PUBLIC System Specifications Initial System rDesign te Classification: PS Minimum Trench Depth: a 4 Inches Flow: 3 6 6 Maximum Trench Depth: 3 0 Inches Soil Application Rate: 0 3 Septic Tank: 1 0 0 Gallons 1-Piece: QYes QNo `System Classification/Description: TYPE III G. OTHER NON-CONY. TRENCH SYSTEMS Pump Required: QYes Q No O May Be Required Pump Tank: Gallons 'Proposed System: 25% REDUCTION 1-Piece: QYes QNo Repair System Required:@Yes ONO ()No, but has Available Space Repair System -Site Classification: PS Minimum Trench Depth: a 4 Inches Soil Application Rate: 0 7 5 Maximum Trench Depth: 3 0 Inches `System Classification/Description: Pump Required: QYes *No QMay be Required TYPE III G. OTHER NON-CONV. TRENCH SYSTEMS Pump Tank: Gallons `Proposed System : 25% REDUCTION Pagel of 3 CDP File Number 36706 County ID Number: EHPR-1 1-09-2850 *Site Modifications ❑ Open Fill Sheet No grading or construction activity is allowed in areas designated for system and repair without approval of Health Department. *Permit Conditions The issuance of this permit by the Health Department in no way guarantees the issuance of other permits. The permit holder is responsible for checking with appropriate governing bodies in meeting their requirements. Site Plan The Improvement Permit shall be valid for 5 years from dateof issue with a site plan (means a drawing not necessarily drawn to O scale that shows the existing and proposed property lines with dimensions, the location of thefacility and appurtenances, the site for the proposed Wastewater system, and the location of water supplies and surfacewaters). Plat The Improvement Permit shall be wild without expiration with plat (means a property surveyed prepared by a registered land surveyor, drawn to a scale of one inch equals no morethan Go feet, that includes: the specific location of the proposed facility O and appurtenances, the site for the proposed Wastewater system, and the location of water supplies and surface waters. Plat also means, for subdivision lots approved by the local planning authority and recorded with the county register of deeds, a copy of the recorded subdivisions platthat is accompanied by a site plan that is drawn to scale). The Department and Local Health Department may impose conditions on the issuance and may revoke the permits for failure of the system to satisfy the conditions, the rules, or this article This permit is subject to revocation if the site plan, plat or intended use charges (NCGS 130A335(f)). The person owning or controlling the system shall be responsible for assuring compliance with the laws, rules, and permit conditions regarding system location, installation, operation, maintenance, monitoring, reporting, and repair (1938(b)} Applicant/Legal Reps. Signature Required? Oyes ONO ApplicanttLegal Reps. Signature. -Pe 0~' Date: ,Issued By: Date of Issue: 1 a/ 0 1/ a 0 0 9 Authorized State Agent: OValid without Expiration? OHand Drawing @Import Drawing **Site Plan/Drawing attached.** Total Time:(HH MIJ) Hours 1.4 inutes Page 2 of 3 CDP File Number: 36706 County File Number: EHPR-11-09-2a50 Drawing Type: Improvement Permit Date: l a/ 0 1/ a 0 0 9 Click below to import an image from an external location: Z15 r 52 r C v N ` y e5 ~ ~ 3 -~1Q 1 'r A P gyn. U 1 6A 49 Page 3 of 3