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Home My WebLink AboutEHPR-12-09-3059.TIF $A C THIS IS NOT A PERMIT Case # EHPR-12-09-3059 CATAWBA COUNTY HEALTH DEPARTMENT v C„0 `C Plan Review Application for Environmental Services 1842 SM Environmental Health Plan Review - OSWP REPLACE WELL APPLICANT OWNER CONTRACTOR RICK ABERNETHY PLUMBING DAVID STEWART 2146 E MAIDEN RD 8018 VISTA VIEW DR MAIDEN NC 28650- SHERRILLS FORD NC 28673 (828)612-6923 NAME TO APPEAR ON PERMIT RICK ABERNETHY PLUMBING Pin#: 36690451 1953 SITE ADDRESS: 2717 BALLS CREEK RD, Newton, NC DIRECTIONS: HWY 16 S, LEFT ON BALLS CREEK RD, 1 MILE ON LEFT NAME of SUBDIVISION: Lot # Section/Block/Phase PROPERTY SIZE: Square Feet Acres 34.45 Date Platted/Recorded TYPE OF FACILITY: House X Mobile Home Dimension of Structure Bedrooms 2 Basement: Yes 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 prope . Any representation by you of house or structure location should conform to applicable setbacks. Date: /'141-09 Signature of Applicant or Agent ' An Environmental Health Specialist will contact you within orking days of application date. If you need further information or assistance ease call 828-466-7291 AREA 1 (FOR OFFICE USE ONLY) Zoning Approval: Yes No Zoning Approval UDO Zoning Form A Minimum Setbacks Front FEE NAME DATE AMOUNT Side Well Permit & Inspection Fee 12/08/2009 $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 12/08/09 15:59 i THIS IS NOT A PERMIT WLS # CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services Improvement Permit ❑ Authorization to Construct ❑ Septic Repair ❑ Septic Expansion ❑ Existing Tank Check ❑ New Well Permit ❑ Replacement Well Well Abandonment ❑ 1. Name to Appear on P rrnit v e-) Q-i- 2. Permit Requested By L e Business Phone S'j e -6'1 2--6 7 Z 3' Address eg- A4, et, Pr = -0 Home Phone .1~2S - Gi Z ~S' Z s 3. Property Owner S Business Phone Address .Z 7 7 a l'ls C~~ Home Phone 4. Name of Subdivision Lot # Section/Block/Phase Property Address 7 i 7 E /~s C k~,,{ e Q Directions to Property: S~ s C~~ L /.s~.l~ CIA 5. Property Size: Square Feet Acres Date Platted/Recorded 6. TYPE OF FACILITY: House ri Mobile Home Dimension of Structure 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 identified on house plans as a bedroom at the time of building pen .t issuance. This may prevent the need for system size increase in the future. Basement: ye /no Water Using Fixtures in Basement: ye .no No. in Family Z Whirlpool ub yeQ 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 /93) If so, describe: 8. Has any grading, removal, or addition of soil been done to this property? Yes 6LID If so, describe: 9. Are there easements/right-of-ways recorded on this property? Yes / N 1 10. Is a public water supply available on or adjacent to the above property? Yes 60 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: WIndividual 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 infornation, 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 THE PROP TY, THERE IS AN ADDITIONAL CHARGE" Date 12- - C Signature of Owner or Agent Y Catawba County, North Carolina This map product was prepared from the Catawba County, NC, Geographic Information Svstem. N Catawba County has made substantial efforts to ensure the accuracy of location and labeling information contained on this snap. Catawba County promoter and recommends the independent verification of any 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 a- 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: 3669-04-51-1953 1 inch = 100 feet Prepared for: 2$3 0~ U 1.37A 510'8 t LI) 9 0 J 3 38 0923 15291 1315 THIS IS NOT A LEGAL DOCUMENT Tuesday, December 08, 2009 03:56 PM A CATAWBA COUNTY NC - Parcel Report Information Regarding Selected Parcel(s) Parcel ID: 3669-04-51-1953 Name: STEWART DAVID LEE Name2: STEWART SYBIL B Address: 8018 VISTA VIEW DR Address2: City: SHERRILLS FORD State: NC Zip: 28673-9278 Account: 66972010 Calc Acreage: 34.45 Tax Map: 001 K 01041 LRK: 467 Deed Book: 1886 Deed Page: 0518 Subdivision Name: Subdivision Block: Lots: Plat Book: Plat Page: Building Number: 2717 Street Name: BALLS CREEK RD Site Zip: 28658 Township: CALDWELL Fire Code: BANDY'S City Code: COUNTY State Road: 1810 Total Bldgs Value: $73,100 Land Value: $136,600 Total Value: $209,700 Year Built: 1945 Year Remodeled: Last Sale Date: 5/1/1994 Last Sale Amount: $115,000 Neighborhood: 122 Watershed: WS-II Protected Area Watershed Split: YES Voter Precinct: P1 E911 District: COUNTY Zoning: R-40 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: BALLS CREEK Middle School: MILL CREEK High School: BANDYS School Split: NO P&Z Case Number: Census Tract 2010: 011400 Census Block 2010: 3014 Small Area Plan: BALLS CREEK Agricultural District: Printed: Tuesday, December 08, 2009 03:56 PM