Loading...
HomeMy WebLinkAboutEHPR-2-10-3762.TIF ~~A C THIS IS NOT A PERMIT Case # EHPR-2-10-3762 CATAWBA COUNTY HEALTH DEPARTMENT Plan Review Application for Environmental Services Environmental Health Plan Review - OSWP 1 4 sn+ SEPTIC MALFUNCTION APPLICANT OWNER CONTRACTOR RICHARD WITHERSPOON RICHARD WITHERSPOON 1138 GRAHAM ST 1138 GRAHAM ST ' CLAREMONT NC 28610 CLAREMONT NC 28610 828-612-5374 828-612-5374 NAME TO APPEAR ON PERMIT RICHARD WITHERSPOON Pin#: 377003149009 SITE ADDRESS: 1138 GRAHAM ST, Claremont, NC DIRECTIONS: HWY 10 E - TURN RIGHT ONTO BALLS CREEK RD - TURN RIGHT INTO WOODLAND OAKS (1ST ENTRANCE) TAKE FIRST LEFT GRAHAM ST - 3RD HOUSE ON LEFT NAME of SUBDIVISION: WOODLAND OAKS Lot # 24-27 Section/Block/Phase PROPERTY SIZE: Square Feet Acres 0.469 Date Platted/Recorded TYPE OF FACILITY: House X Mobile Home Dimension of Structure 40 X 68 Bedrooms 3 Basement: No Water Using Fixtures in Basement:No No. in Family 3 Whirlpool Tub : Gal. Capacity: MULTIPLE FAMILY RESIDENCE: Units 0.00 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: 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 Community Well X 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 property. Any representation by you of house or structure location should conform to applicable setbacks. Date: C j u 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 AREA1 (FOR OFFICE USE ONLY) Zoning Approval: _Yes No Zoning Approval UDO Zoning Form A Minimum Setbacks AMOUNT Front 30 FEE NAME DATE Side 15 1ULhurizalion to 'Cunsu uut (Repair) F,02/08%2010 5300.00 Rear 30- 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 02/08/10 11:31 THIS IS NOT A PERMIT WLS # CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services o Improvement Permit ❑ Authorization to Construct ❑ Septic Repair l~ Septic Expansion ❑ Existing Tank Check ❑ ~Ne New Well Permit ❑ Replacement Well ❑ Well Abandonment ❑ I. Name to Appear on Pe it ~C h,,crk a W ,-ekes` o.)rj 2. Permit Requested By W d meters o Business Phone i~a8 1 Z- 537 Address 1~3g Ci~H a.^t 5-14. 6 14 !C oNf NL 2F'C, t6 Home Phone ifzg 3a1nf 3. Property Owner Business Phone Address Home Phone 4. Name of Subdivision WoosIa" C) s Lot # Section/Block/Phase Property Address 3 Directions to ~Property: !r.^t ~rN~~.~ ; G uo~r f4w rb +o 6Rl is Cre>✓k R ~u f1ti /'i 1l fie- Tuf~ P! t iN 1 10 y I e-/I, 'f"L°~ri/vG f rS Jt -R 1-41 jno~S ©w le -FL 5. Property Size: Square Feet Acres t S7- Date Platted/Recorded 6. TYPE OF FACILITY: House ✓ Mobile Home Dimension of Structure tYQX Bedrooms* 3 '`Anv room thA will h,Illt~'Illl~ll I ~~C'~hlll~' ~Il lh~ 11111 ids 0,11,11 ucl1O11 01 l )l. lllttlre i~lltild~'fl1lI~~11 ~hotll&belwt~-'d ~1- ~I bedr00111.alld Co11111Cd 011-dil ahl)~I~:III~!Il~. I hL Iltill] l)Cl ll bC~~l'~~~Ill> wlil b~ ci,llll111-1~(j bV ll?~~Ill> ids 'I1I1110d 711 Ih~ll>C l ~~111 ~1>l~c~l bedroolll at:the tline Ul blllldino )tLl,q]1l l~>L<lI1Cl This s 11111! i ` ~lll the 11~Cd tt t ~~Cln SI/: I]1CIC.1~~ III 1~1 lUllllC. Basement: ye no Water Using Fixtures in Basement: yes/no No. in Family Whirlpool Tub yes/G) 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 additions to Facility? Yes / No 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 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 1'r6ommunity 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 T,H'ff P OPERT ! I -HERE IS AN ADDITIONAL CHARGE.** Date - ~a Signature of Owner or Agent 7 ~~;Z:~~ IEEE=,, 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 ofanv 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 am person or entity. Legend Selected Parcel Number: 3770-03-14-9009 1 inch = 60 feet Prepared for: [LO /I 9312 _ - t--._ ?o LO -j r.. 200 - 69 N 32: } 6 777~ - -1 - - - 0 30 0 _ 67 o _ - o 0_ 1_ - 66 29-- _ _ ` y 9200 6 28 5 =200 27 64 2 C~ ® 21. CD go ng 26 C) 63 --r_ - 25, , 62 20 24 61~---- LO 23 60 - 22 59 --'-----21 0 58 LO _ _ 209.2 20 57 907 - r CD _1.9 56 _0 200 18 55 THIS IS NOT A LEGAL DOCUMENT Mon, February 08, 2010 11:00 AM CATAWBA COUNTY NC - Parcel Report Information Regarding Selected Parcel(s) Parcel ID: 3770-03-14-9009 Name: WITHERSPOON RICHARD D Name2: WITHERSPOON JESSICA H Address: 1138 GRAHAM ST Address2: City: CLAREMONT State: NC Zip: 28610-8223 Account: 204840 Calc Acreage: 0.47 Tax Map: 022BY 02007 LRK: 22609 Deed Book: 2744 Deed Page: 1641 Subdivision Name: WOODLAND OAKS Subdivision Block: Lots: 24-27 Plat Book: 14 Plat Page: 152 Building Number: 1138 Street Name: GRAHAM ST Site Zip: 28610 Township: CATAWBA Fire Code: BANDY'S City Code: COUNTY State Road: Total Bldgs Value: $116,200 Land Value: $14,400 Total Value: $130,600 Year Built: 1974 Year Remodeled: Last Sale Date: 4/21/2006 Last Sale Amount: $138,500 Neighborhood: 123 Watershed: WS-IV Protected Area Watershed Split: NO Voter Precinct: P1 E911 District: COUNTY Zoning: R-20 Zoning2: Zoning3: Zoning Split: N Zoning Overlay: WP-0 Zoning District: COUNTY Split Zoning Dist: N Split Zoning Dist(1): 0 Split Zoning Dist(2): 0 School District: COUNTY Elementary School: BALLS CREEK Middle School: MILL CREEK High School: BANDYS School Split: NO P&Z Case Number: Census Tract 2010: 011400 Census Block 2010: 3011 Small Area Plan: BALLS CREEK Agricultural District: Printed: Mon, February 08, 2010 11:00 AM ~,A Cp CATAWBA COUNTY, NC / N® CEIPr 100-A South West Blvd PL/"1 Newton, NC 28658- (828)465-8399 Monday, February 8, 2010 42 sM ww. c atawbac ountync. gov j$ w Plan Case: EHPR-2-10-3762 Invoice Number: INV-2-10-259376 Environmental Health Plan Review Invoice Date: 02/08/2010 Fee Name Fee Amount Authorizaticn to Construct (Repair Fee Adjustable $300.00_ Total Fees Due: $300.00 PAYMENTS Date Pay Type Check Number Amount Paid Change 62108/2010 Cash 1 5300.00 $0.30 Total Paid: $300.00 Total Due: $0.00 planreceipt 114ct81c6-4cdb-4b2 4-bcc3-5a3670d~8b7e:.rpt 02/08/2010 11:30 4 CATAWBA COUNTY HEALTH DEPARTMENT COMPLETION PERMIT FOR SEPTIC TANKS (Ground Absorption Sewage Disposal System - G.S. 130-13C) OWNER OR CONTRACTOR &anj G r ` -Q-5 RATE 3, PERMIT NO. . Lf l LOCATION c~ ~t /(0 ~~/.L ~~l ~~l ~i• %z 47 L S.R. SUBDIVISION NAq LOT NO. "ECTION OR BLOCK NO. HOUSE /tL MOBILE HOME BUSINESS LOT AREA &OD NO. BEDROOMS /,I/ NO. BATHROOMS / r GARBAGE DISPOSAL UNITS NO SITE SUITABLE: YES NO SIZE OF TANK gals. NITRIFICATION FIELD ! _ sq. ft. WATER SUPPLY: INDIVIDUAL / / PUBLIC IN TALLED BY CERTIFICATE OF COMPLETION BY D TE