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Home My WebLink AboutEHPR-2-10-4008.TIF A THIS IS NOT A PERMIT Case # EHPR-2-10-4008 CATAWBA COUNTY HEALTH DEPARTMENT Plan Review Application for Environmental Services 1842 sM Environmental Health Plan Review - OSWP NEW WELL APPLICANT V OWNER CONTRACTOR KATHIE RHONEY VIRGIL DEAN RHONEY 8352 JC RD 8352 JC RD VALE NC 28168-8932 VALE NC 28168 IA-Dilf V64 NAME TO APPEAR ON PERMIT KATHIE RHONEY Pin#: 266702682979 SITE ADDRESS: , , NC DIRECTIONS: HWY 10 WEST, RIGHT ON OLD SHELBY RD, PAST COOKSVILLE GRILL CONTINUE ON OLD SHELBY, RIGHT ON JC RD, UNDEVELOPED PROPERTY JUST PAST 5TH HOUSE ON LEFT. NAME of SUBDIVISION: Lot # Section/Block/Phase PROPERTY SIZE: Square Feet Acres 1.309 Date Platted/Recorded TYPE OF FACILITY: House X Mobile Home Dimension of Structure Bedrooms 0 Basement: No Water Using Fixtures in Basement:No No. in Family 0 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: 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 norrexpiring 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: o2 jo Signature of Applicant or Agent An Environmental Health Specialist will contact you within working days of application d e. 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 Well Permit & Inspection Fee 02/23/2010 $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 02/23/10 16:00 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 F-1 Well Abandonment ❑ 1. Name to Appear on Permit a " 2. Permit Requested By q c siness Phone Address ~J 3 _8 I ~O Home Phone '70 q -Y& 2 -g-3y 8 3. Property Owner G Business Phone Address '~Q Me, Home Phone 70(ILI<od ~~zf 17 4. Name of Subdivision Lot # Section/Block/Phase Property Address Directions to Property: 5. Property Size: Square Feet Acres -31 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 lst 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? 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: K 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." J Dated oZ3- /0 Signature of Owner or Agent 6J~~ Y/ I&" 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 Catmvba, 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 frmn this map product or the use thereof by any person or entity. Legend Selected Parcel Number: 2667-02-68-2979 1 inch = 60 feet Prepared for: 2.70A r==~ 3205 434 (288) 146.03 --~-~-_1 1141 Co. ~ o~ 40) ° 1.31 A o ,`o (343) 2979 THIS IS NOT A LEGAL DOCUMENT Tuesday, February 23, 2010 04:02 PM l CATAWBA•COUNTY NC - Parcel Report Information Regarding Selected Parcel(s) Parcel ID: 2667-02-68-2979 Name: RHONEY VIRGIL DEAN Name2: RHONEY KATHIE WRIGHT Address: 8352 JC RD Address2: City: VALE State: NC Zip: 28168-8932 Account: 202082 Calc Acreage: 1.31 Tax Map: LRK: 101014 Deed Book: 2695 Deed Page: 1961 Subdivision Name: Subdivision Block: Lots: Plat Book: Plat Page: Building Number: Street Name: JC RD Site Zip: 28168 Township: BANDY'S Fire Code: COOKSVILLE City Code: COUNTY State Road: Total Bldgs Value: Land Value: $8,900 Total Value: $8,900 Year Built: Year Remodeled: Last Sale Date: Last Sale Amount: Neighborhood: 89 Watershed: WS-III Protected Area Watershed Split: Voter Precinct: P2 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: BANOAK Middle School: JACOBS FORK High School: FRED T FOARD School Split: NO P&Z Case Number: Census Tract 2010: 011802 Census Block 2010: 1006 Small Area Plan: PLATEAU Agricultural District: Printed: Tuesday, February 23, 2010 04:02 PM ~A p CATAWBA COUNTY, NC 100-A South West Blvd PLAN RECEIPT Newton, NC 28658- 0 (828)465-8399 Tuesday, February 23, 2010 18 4 Z sM www.catawbacountync.gov Plan Case: EHPR-2-10-4008 Invoice Number: INV-2-10-259819 Environmental Health Plan Review Invoice Date: 02/23/2010 Site Address: , NC APPLICANT OWNER KATHIE RHONEY VIRGIL DEAN RHONEY 8352 JC RD 8352 JC RD VALE NC 28168-8932 VALE NC 28168 Fee Name Fee Amount Well Permit & Inspection Fee Fixed $300.00 Total Fees Due: $300.00 PAYMENTS Date Pay Type Check Number Amount Paid Change 02/23/2010 Credit Card -1 $300.00 $0.00 Total Paid: $300.00 Payer: KATHIE RHONEY Total Due: $0.00 plan receipt ; 51 Od",171-3854 We-a000-W59a6fi 108; rpt 02/23/2010 15:59 V-POS - Transaction Receipt Page 1 of 1 Transaction Receipt Catawba County, NC Catawba County Permit Center 100 A SW Blvd Newton, NC 28658 828-4658404 02/23/2010 03:58PM Catawba022310155759534Eng 28754148 EHPR-2-10-4008 KATHIE W RHONEY 2 NA KATHIE W RHONEY / null null ************8797 Authorization and Capture Amount: $300.00 Cardmember acknowledges receipt of goods and/or services in the amount of the total shown hereon and agrees to perform the obligations set forth by the cardmember's agreement with the issuer. Signature 4,41~- /J Z414 click here to continue. https://www.ve locitypayment. com/admin/catawbacountync/vpos/942/transactions/receipt/?... 2/23/2010