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Home My WebLink AboutEHPR-12-09-3098.TIF A THIS IS NOT A PERMIT Case # EHPR-12-09-3098 CATAWBA COUNTY HEALTH DEPARTMENT v ®as0 Plan Review Application for Environmental Services 1842 SM Environmental Health Plan Review - OSWP EXS_SYSTEM APPLICANT - 17 ER " - CONTRACTOR" _ JEFFREY TEAUUE jJEFFREY TEAUUh j ;I 4966 LINEBERGER RD 4966'L[NEBERGER RD, ' DENVER NC 28037-7497 DENVER NC 28037-7497 NAME TO APPEAR ON PERMIT JEFFREY TEAGUE Pin#: 369604629991 SITE ADDRESS: 4966 LINEBERGER LOOP RD, Denver, NC DIRECTIONS: HWY 16 S/ LFT ON CAMPGROUND RD/ LFT ON CATAWBA BURRIS/ LFT ON LINEBERGER RD/ STAY STRAIGHT UNTIL PASS UNDER POWER "TOWER LINE/ 2ND DW MOH ON RT NAME of SUBDIVISION: MUNDY ACRES PHASE III Lot # 33 & PT 3: Seetion/Block/Phase PROPERTY SIZE: Square Feet Acres 1.639 Date Platted/Recorded TYPE OF FACILITY: House Mobile Home X Dimension of Structure Bedrooms 4 Basement: No Water Using Fixtures in Basement:"No No. in Family Whirlpool Tub : Q'. 'Capacity: ra 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?_~ . 1. ` N If so. describe Are there easements/right-of-ways recorded on th,is 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 iss 1 ued and is not transferable. Note: You must obtain Zoning Approval prior to locating a home or structure on this property. Any representatiori'by you of house or structure location should conform to applicable setbacks. Date: ~Z -I -~a Signature of Applicant or Agent An Environmental Health Specialist will contact you within W2ing ys of applicatio t date. If you need further information or assistance please call 828-466-7291 AREA 1 (FOR OFFICE USE ONLY) Zoning Approval: Yes No Zoning Approval UDO Zoning Form A Minimum Setbacks Front 30 FEE NAME DATE_ AMOUNT Side 10 Exisfing"Tark'Check'Fe8 P2/1`I/2009' r$ O ^ Rear 5 TOTAL FEES $80.00 Max Hght *If a permit has to be redesigned and / or RETRIPS made to the property, there is an additional $60 charge 12/11/09 15:36 G~ THIS IS NOT A PERMIT W LS # -3 CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services Improvement Permit ❑ Authorization to Construct El Septic Repair ❑ Septic Expansion El Existing Tank Check LJ New Well Permit ❑ Replacement Well E] Well Abandonment E] I . Name to Appear on Permit a 4'Ce_~~ 'P 2. Permit Requested By SCZw"e- Business Phone e cil Address i n z r t- a lU eJ v~ $U 1-444 Phone 10 Lt - 5 3v - t -7 3 a. 3. Property Owner g C1rnfh -L Business Phone •7.o `I - 4F3 --73 3 Address Q Vl 1 kQ e- C _ a_~_n,3:7 P "Phone 4. Name of Subdivision Lot # Section/Block/Phase Property Address _ Directions to Property: 1- ti 1 4 S - /S males c_112 RY I Y~ e~ l on ~[~v~~nrou.~'c - Turn I.cF~- c~ ~U-{-ra~~~- 13c, rr,'~ Turr L-~~f ovv i t Y ~x ; hp~~_~' \ GAS 5 U r 5. Property Size: Square Feet Acres 1.6-4 Date Platted/Recorded 6. TYPE OF FACILITY: House Mobile Home Dimension of Structure Qg -4 __4_ Bedrooms* 'nv 1-,jli tll,ll \,,!i 1be*iw.'IId,,'d for sleeplll'_'_ 'it I11e tlI11C ~'I ~nll~ll II~UOII ~'I col tlti_II~l ~01151~1~I;lU~'II ~~lOU1(1 h~' I1~~tC'~ ~I~ :1 bedroom and"counted On all application,. Th, Ililnlbei-''I he,11W' ms„wl11 h.: continmd by rooms_identihen on hou-2 plans asla bedroom`at the tiny e of_building_pzrniit ia. lei ~ntthe nQ, l lol_system size Increase in the future. no Water Using Fixtures in Basement: yes/""' No. in Family Basement: yes UJ Whirlpool Tub es/ o Gallon Capacity MULTIPLE FAMILY RESIDENCES: Unit Total Number of Bedrooms DAY CARE: Number of Children 1*;; 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 / o If so, describe: 8. Has any grading, removal, or addition of soil been done to this property? Yes(Lo) If so, describe: 9. Are there easements/right-of-ways recorded on this property. s No 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 [ ounty/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 PROPERTY, THERE IS AN ADDITIONAL CHARGE.- Date IZ- //l - 0 Signature of Owner or Agent 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 ofany 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 any person or entity. Legend Selected Parcel Number: 3696-04-62-9991 1 inch = 60 feet Prepared for: 1041.99 250000 MENU 167 l 11 30 tr 64A 1. 3P /I 1 19 t ` 1.51A 00844 `27 • 10, ✓ r// 01/%a r~-,:--- THIS IS NOT A LEGAL DOCUMENT rf o~,•'~ Friday, December 11, 2009 02:59 PM CATAWBA COUNTY NC - Parcel Report Infortnation Regarding Selected Parcel(s) Parcel ID: 3696-04-62-9991 Name: TEAGUE JEFFREY PAUL Name2: TEAGUE TAMMY Address: 4966 LINEBERGER RD Address2: City: DENVER State: NC Zip: 28037-7497 Account: 69238100 Calc Acreage: 1.64 Tax Map: 016BX 01025 LRK: 17210 Deed Book: 1869 Deed Page: 0362 Subdivision Name: MUNDY ACRES PHASE III Subdivision Block: Lots: 33 & PT 32 Plat Book: 17 Plat Page: 111 Building Number: 4966 Street Name: LINEBERGER LOOP RD Site Zip: 28037 Township: MOUNTAIN CREEK Fire Code: SHERRILLS FORD City Code: COUNTY State Road: Total Bldgs Value: $95, 100 Land Value: $16,900 Total Value: $112,000 Year Built: 1997 Year Remodeled: Last Sale Date: Last Sale Amount: Neighborhood: 129 Watershed: WS-IV Critical Area Watershed Split: NO Voter Precinct: P41 E911 District: COUNTY Zoning: R-30 Zoning2: Zoning3: Zoning Split: N Zoning Overlay: DWMH-O,WP-O Zoning District: COUNTY Split Zoning Dist: N Split Zoning Dist(1): 0 Split Zoning Dist(2): 0 School District: COUNTY Elementary School: SHERRILLS FORD Middle School: MILL CREEK High School: BANDYS School Split: NO P&Z Case Number: Census Tract 2010: 011502 Census Block 2010: 4012 Small Area Plan: SHERRILLS FORD Agricultural District: Printed: Friday, December 11, 2009 02:59 PM ~ -A` ~p CATAWBA COUNTY, NC 100-A South West Blvd PLAN INVOICE' ' . Newton, NC 28658- 0 (828)465-8399 Friday, December 11, 2009 .l?s~ 1$ 42 sM www.catawbacountync.gov Plan Case: EHPR-12-09-3098 Invoice Number: INV-12-09-257969 Environmental Health Plan Review Invoice Date: 12/11/2009 Fee Name Fee Amount 7-7 Existing Tank Check Fee Fixed 300.00; Total Fees Due: $80.00 PAYMENTS Date Pay Type Check Number Amount Paid Change 12/11;2009- Check 631 sbc'06 $0.00, Total Paid: $80.00 Total Due: $0.00 plan im°<?icr: ; alada_icS-RCC f =1>I'~l-9dL~- 3 % I f(i44a7 ; .rpt 12/11/2009 15:4 1 it . t„, N° 1 7 7 6 CATAWBA COUNTY AE'ALTH DEPARTMENT Telephone: (704) 465-8270 TDD: (704) 465-8200 Improve. Permit_L,,-Yruthorization to Construct impair Permit Oper. Permit System Type Owner/Agent 7 m /71!j a , ~r/4" L; Phone ;2-91 Address L - Subdivision 119U N.D y V~ -;Z Section/Block/Phase -10' L o t # Lot Size c/) 6tC,p,y-j irections : <--ALM~a G J Facility: House Mobile Home Business Other: --flax Map # Multi-family Other Zoning Approval # a9 ~h # Bedrooms__ # Seats # Employees Application Rate, 3 GPfD Flow Hot Tub or Spa yes no Special Fixtures 100% Repair Are es o Basement yes/C;a Basement Plumbing ye n ' Water Supply: Private Well Public ***************w,r****w****,r,r**,r,r,r*********,rw*w,rw**w**+.+r*,r*,r*,r**,r***********ww****************** Type of System: Trench_L _--15t!d Pump Pump/Panel Panel LPP Other Tank Size: Septic Tank Size /O cDo Pump Tank Size Nitrification Field: Total Square Feet fa.Q Depth of Stone Bed Size Trench Width Total Length of All Trenches !f0 d Number of Trenches Individual Trench Length> rf/ Feet on Center C_ Maximum Trench Depth !R~Ojl- Distance of Nearest Well ~t ~1- ***,r**********,w*w****w ,r*,rw,r**,r*,r,r*****************w************* *w*****************ww******** Topo S G % Slope Texture} r, Structure QLQc',ey Clay Min. / : / \ LO ( ~~C 3 Soil wetness \\J Soil Depth y _j Restric. Hoz. at Lam" Available space es nol x overall Class S - W Comments: u,~,F.~.t~s~'o 6 7 I - - /A) p 4 6' NHG6 1%4Z,09 i r - - - Gc✓S ~ ~ 1 ~ 0 ~(,iGi~iAG loo 'x 3 j! C- #t- L4 -5 e- p2o/9 raa)t E-4 I I ~ **NO GUARANTEE OR WARRANTY IS I PLIED OR GIVEN AS TO TIE PERFO CE OR LENGTH OF TIME THIS SYSTEM WILL FUNCTION** *Improvement Permit has no, piration date and is transferable, but may be revoked if site plans or intended use anges for the proposed facility. An Authorization to Construct is valid for (5) fiv ears from date issued and is not transferable. Permit Date S l Owner/Agent Gs A Sanitarian f - Installed By Date y--23 Sanitarian _Oi White - Office Blue - Building Inspection Operation Permit Yellow! Owner/Agent Green - Building Inspection Authorization to Construct