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Home My WebLink AboutEHPR-2-10-3737.TIF ~~A C THIS IS NOT A PERMIT Case # EHPR-2-10-3737 CATAWBA COUNTY HEALTH DEPARTMENT Plan Review Application for Environmental Services 1842 sM Environmental Health Plan Review - OSWP EXS_SYSTEM APPLICANT OWNER CONTRACTOR RICHARD TAN HO TRONG LE 3496 SAVANNAH LN 3496 SAVANNAH LN CLAREMONT NC 28610- CLAREMONT NC 28610 (828)695-1195 NAME TO APPEAR ON PERMIT RICHARD TAN HO Pin#: 375207780552 SITE ADDRESS: 3496 SAVANNAH LN, Claremont, NC DIRECTIONS: ROCK BARN RD/ RT OLD SAVANNAH LN/ I ST LEFT / CORNER OF OLD SAVANNAH & CHARLESTON CT NAME of SUBDIVISION: OLDE SAVANNAH Lot # 4 Section/Block/Phase PROPERTY SIZE: Square Feet Acres 0.519 Date Platted/Recorded TYPE OF FACILITY: House X Mobile Home Dimension of Structure 60 X 60 Bedrooms 4 Basement: No Water Using Fixtures in Basement:No No. in Family 4 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 1 st 2nd 3rd OTHER: (Specify) Do you aniticipate any additions to Facility? If so, describe: ADDING SUNROOM ON REAR OF DWELLING & ADD ROOF OVER FRONT PORCH 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? NONE 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. Any representation by you of house or structure location should conform to applicable setbacks. Hate: --0 LIC - -go /0 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 Front FEE NAME DATE AMOUNT - Side Existina Tank Check Fee 02/04/2010 $80.00 Rear 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 02/04/10 17:24 THIS IS NOT A PERMIT WLS # CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services Improvement Permit ❑ Authorization to Construct El Septic Repair El Septic Expansion El Existing Tank Check ~ New Well Permit ❑ Replacement Well ❑ Well Abandonment ❑ 1. Name to Appear on Permit lC ~~YC~ if D _ 2. Permit Requested By Q 1 C k', d Business Phone L2 6" Address ~I y, Home Phone y.2Y ? / ,Z ~J Business Phone fT 6 f i/ y 3. Property Owner 1 G ~tc,v 140 Address I e/ y ( r A hi Home Phone v, 2 4. Name of Subdivision 1,-4- k) Lot Section/Block/Phase 4SMWM7q eL Property Address ti 1, -1,? A Directions to Property: J 5. Property Size: Square Feet J'/00 -Acres d, Z Date Platted/Recorded 6. TYPE OF FACILITY: House 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 permit issuance. This may prevent the need for system size increase in the future, Basement: yes/no Water Using Fixtures in Basement: yes/no No. in Family Whirlpool Tub yes/no 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 1 st 2nd 3rd OTHER: (Specify) 7. Do you anticipate any addition/s~ to Facility? P/ No r If so, describe: (J'1 1( v u A v1 het t= r ~ /1//t- t 8. Has any grading, removal, or addition of soil been done to this property? Yes / o 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? 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. 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 ,2 - - ZQ Signature of Owner or Agent Catawba County, North Carolina This map product was prepared f "om the Catawba County, NC, Geographic Information System. N Catawba County has made substantial efforts to ensure the accuracy of location and labeling information contained att this map. Catawba County promotes and recommends the independent verification ofanv data contained on this map product by the user. The County of Catawba, its emplovees, agents and pet-sonnet disclaim, and shall not be held liable for any and all damages, loss or liability, whether direct, indirect or consequential which arises or mqv arise from this map product or the use thereof by anv person or entity. Legend Selected Parcel Number: 3752-07-78-0552 1 inch = 60 feet Prepared for: 9785 _ 42109 t ' 24.381 ~Y >>6-- 32.22-- 30.61 iJ COT ICY 2631 r ° R 24.38 30.61 4 ' 39.18 o 32.22 0552-_ V 8456 ~j 2443 5 a2 rn W - 0396 ~ ~70 THIS IS NOT A LEGAL DOCUMENT C'~ Thursday, February 04, 2010 05:03 PM O~j~ 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 Countv promotes and recommends the independent verification of arty 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: 3752-07-78-0552 1 inch = 60 feet Prepared for: 3Z'22~ ` f . 30.61 r` r',` ` a• C"T 24.38 30.61 18 32:22 7.7 g J r ,t. N51 . f 244:3 % ;Ik 1&7 3A Hill' II \0'1''\ I 'I V DM INIENf Thursday, February 04, 2010 05:03 PM CATAWBA COUNTY NC - Parcel Report Information Regarding Selected Parcel(s) Parcel ID: 3752-07-78-0552 Name: LE TRONG HOANG PHAN Name2: HO PHU THI Address: 3496 SAVANNAH LN Address2: City: CLAREMONT State: NC Zip: 28610-8654 Account: 159757866 Calc Acreage: 0.52 Tax Map: LRK: 300226 Deed Book: 3002 Deed Page: 1130 Subdivision Name: OLDE SAVANNAH Subdivision Block: Lots: 4 Plat Book: 37 Plat Page: 205 Building Number: 3496 Street Name: SAVANNAH LN Site Zip: 28610 Township: CLINES Fire Code: - City Code: CLAREMONT State Road: Total Bldgs Value: $343,600 Land Value: $46,600 Total Value: $390,200 Year Built: 2000 Year Remodeled: Last Sale Date: 11/20/2009 Last Sale Amount: $300,000 Neighborhood: 73 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: 010102 Census Block 2010: 3012 Small Area Plan: ST STEPHENS/OXFORD Agricultural District: PROXIMITY Printed: Thursday, February 04, 2010 05:03 PM CATAWBA COUNTY HEALTH DEPARTMENT ~7 k f .s, tM ` _ •dfi. ?T .il ~-'i'[Il lv_,ii Rpi. Pmll - Owner/Agc.nc_ - 1"m ! L f f1 ~?`l the:°tt'fE i Phone Address Subdivision Sectl-'n/Block/P se Lot# LOt Size ' -Directions: t: ~.>GLcL~ to~<^?~ -1 y ~ - :.<C lllyf t- /P'1.. 4/ LI/ .c,P.c~°.,U?~i....`1-:1w'x:41%' F.=•f- ill i- -2`G'%'~" ~if~.r~' - ~~`9~ ,r'i~ .~•yZ ifacility: House' Mobile Home Business Multi-familv . Other: Tax Map or Pin Number 3 /`j 7 Other . Zoning Approval l_' j~ • Bedrooms # Seats # Employees . Application Rate 6-. 3.5 GPD Flow Hot Tub or Spa yes o pecial Fixtures Basement yes/oTi, . 100% Repair Areafsl ? no (il C%<,u - - - . , ` f !Basement Plumbing yes/no Water Supply: Private Wl Public f-\ Semi/Public ~3=:i::is~:i:*ic,t::r;:*~k~:W:k*yF**~~k,k*acXc:YN-~>X:Kak*:k~k:Ic;R:kSA::k *:K+R %M ~E*:k*:K,kRW l'~X~rK A~>kY.-;;#~%~~k*~+k:k*~*~k k*,k,k:k:k ~;c x:#xc#,k#N;,;:*a'cis:k,ic~:,*~!c*:h~k,KW=k**:;ci:-k ~k:k S: ~,h:k,k~k ~k k*h ~k*:k Type of System: Trench Bed Pump Pump/Panel Panel LPP Other = * r'' Septic Taulc Size Pivnp Tank Size Nitrification Field: Total Square Feet C} : Depth of Stone Bed Size Trench Width :3 't'otal Length of All Trenches .3 2 2- Number of Trenches Trench Length 101415)" / Feet on Center lx Maximum Trench Depth f Distance of Neard§t Well 'v/X11 "teE I 7, iHti°I N T,. " i[':d G f n •a E1 ';i"} k' -rr` II Tq m d* ;•:!.,c.k.k k.. -r~*x,k-.x.k yc,k:k ~e ch,h ...->k ~>kzex,§,k,k:k Ye ~e ~:#:k:f::%:kk:c&,k:k*~#,k k k ~k*~:r'c*W:F#Ac~##,'s=f:§~~k~Ne'*~k K ~k,F ~e Ye*=k cf~-k ~k ~:e~a*ge~at;kK?k ak~fc,k_,k,~c-~'.c~~:kck:k:k#:k,k:k&,k#**,k:k,k,k*:kk: Topo e_' % Slope ;=k Texture Structure Clay Mh,, Soil Wetness I f t Soit Depth ci. I l pct 9~' JF 1 r y Restric. I Ioz. at E-< 4a { f s,, , 1K Available space yes.no f • 4\r ~v ^,f . ~r r Overall Class S PS !.l Comments: j td~- ca , A I f F .1 1i. 5~4 Lt'i~~ Y LJ`i X~ ' -Av mv4e,P A tltltl 888 , t ~l i l NO GUr1RANTEF OR WARRANTS' IS IMPLIED OR GIVEN AS TO THE PERFORMANOR LENGTH OF TIME THIS SYSTEM WILL FUNCTION * - - :S::k.:,i:,Fak:R=k :k9:8:=k=,~~+k:r%I:a:,kS%F:,k,1:J::k>kii::k>k#~::kA:d::k~k>k$~Sc 1=:k,k>[C~~R h=%i=:k ~k ~k+M:B ck 3::k:k~k>Rde:<:k,K+k+k,k,k,$4c%kb:!c>♦c,[:aK:k:k#ge%k%k~#~k3,k%k>'fa4%:ksc,k`k%k+k,k%k:k$$kea!t>t>k%#::k~sk:k~ck:k$:k~akak"?'- . no tmr)iral c'n d:and !`4 ir2nsri_e 2I i 3 t a _ )lc t) !l y , 1-8~ 4 be vt±£'C. S38 i?1i3.[-is ¢"l i' fir ii~i!., €:l1 i!3a CIi-i E;.. E:ef 111' ..oastruct is vaa zd foi five vcnns E'?-om _nue is:;is<<'ts and €1 uut ts3a2.`,'fci:il) ":•"!~CII _,_-TD_ 'V11lie f0l- c VELM-S 2f 6 SiS€ ,da €a p4'l.`, Elks um c.h'angc. '"ell location, installation, alkd Iprotea tion mu,'( tiled state aild Local 8';-gulcat 8i31i5. 3FIC3 a7i 6 t l?Fc :i:;• -5- Ie„ -b;,sl by oi-he t:7.'r•b' Fltinty Aeal 'a Dep ;rw-,wat spc:tore, anv vor€ion Cal' i e hilt pt :c,t.Cai2 is plO il'te ust,'. ttl stJl is io TJ-roS'id ~ r•' z ` e i3I'r?LtC'ii u1~T aaptti t"2?Q;t i.'fl t;5`>;blE S~aFi,'+_es faz ~E..e-stiLE3 1.?~t< ..~i J:t'ri2 ~kt LL Ri3 Elc by Fal? k'nt:?]tit D zli. rtmed~t. Permit Date EFIS,_ Owner/Aoentf Septic Tank hutalled By . Date EHS Well Installed By, ` Well Grout Approval Date Welt Head4npproval bate Date Sample Collected Date of Results Results EHS ;i:. .l~iu, asl . !r :pe_., .a c_),,,raiiun P"'m iE Ow„_: Az e , Green - rtuIl :n 3jx ;te - v, < a, cru t CATAWBA COUNTY, NC 100-A South West Blvd PLAN INVOICE a, Newton, NC 28658- 0 (828)465-8399 Thursday, February 4, 2010 184 'L sM www.catawbacountync.gov Plan Case: EHPR-2-10-3737 Invoice Number: INV-2-10-259330 Environmental Health Plan Review Invoice Date: 02/0412010 Fee Name Fee Amount Existing Tank Check Fee Fixed $80.00 Total Fees Due: $80.00 PAYMENTS Date Pay Type Check Number Amount Paid Change 02/04/2010 Check 1077 $80.00 $0.00 Total Paid: $80.00 Total Due: $0.00 1:I;inmoic~;c23hU{''6?~1-'ld-8ta-<r_',4~1It1Rk7f,;.rp~ 02/04/2010 17:23