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Home My WebLink AboutEHPR-2-10-4094.TIF gA Cp ` , t THIS IS NOT A PERMIT Case # EHPR-2-10-4094 ` CATAWBA COUNTY HEALTH DEPARTMENT - oC Pe V ^C Plan Review Application for Environmental Services 1842 SM Environmental Health Plan Review - OSWP EXS_SYSTEM APPLICANT OWNER CONTRACTOR LAURA GARGIULO LAURA GARGIULO 6095 JUPITER CT 6095 JUPITER CT DENVER NC 28037-8184 DENVER NC 28037-8184 704-273-6781 704-273-6781 NAME TO APPEAR ON PERMIT LAURA.GARGIULO Pin#: 368616935333 SITE ADDRESS: 6095 JUPITER CT, Denver, NC DIRECTIONS: GRASSY CREEK RD/ SAGITTARIUS CIR/ LFT ON JUPITER/ ON LFT NAME of SUBDIVISION: STONECROFT PH 5 Lot # 34 Section/Block/Phase PROPERTY SIZE: Square Feet Acres 0.639 Date Platted/Recorded TYPE OF FACILITY: House X Mobile Home Dimension of Structure 54 X 52 Bedrooms 3 Basement: No Water Using Fixtures in Basement:No No. in Family 3 c, Whirlpool Tub : Gal'. QdPacity: 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: POSSIBLE FRONT- EXTENDED. GARAGE T EXISTING GARAGE.. 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 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. representat' y ou f house or structure location should conform to applicable setbacks. j ' Date: 67(_O~ td' C/ Signature of Applicant or Agent An Environmental Health Specialist will contact you within 2 working da of application 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 Existing Tank Check Fee 02/26/2010 $80.00 Rear 5 TOTAL FEES $80.00 Max Hght 1 -1 *If a permit has to be redesigned and / or RETRIPS made to the property, there is an additional $60 charge 02/26/10 17:21 THIS IS NOT A PERMIT W L S #1J 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 ❑ I. Name to Appear on Permit Lau o (7ac ul o 2. Permit Requested By ~Ci 0,e- Business Phone Address G)qy L,/) I' -Lr ('ajr fi Home Phone -70y-Q:23-679 I 3. Property Owner Lai kb C-62(n~'(,~l Business Phone Address ji P _79C.~1~1 fP.r C u),-4- Home Phone 4. Name of Subdivision Lot # Section/Block/Phase Property Address Directions to Property: /(o 5&4A 4-V 61-6aSSTcez/c 120od lej t a;n h~~' Scar 4- of -rn 1 le?Lf cv~a--o i , r - 6x/s-C, 4-~Faay ) 5. Property Size: Square Feet 3D Acres • -72- Date Platted/Recorded 6. TYPE OF FACILITY: House Mobile Home_ Dimension of Structure- K Be_drooms*_ _ An that %~ill be;intended for Slecpinc:lt lhetin~ d~onstl n 'or futir~ :k111,idcratio11 shoiild,be n"oi.d as 'a bedroom.and counted On all applications. "The number ot;bedrooms,will he con-firmed i- roomy-identitied on liou,c hlai~ say bedroumat the time of!building permitiSSLIMICC This ma, prevent the need Ioi sjstc n i c increa e in the tutlue:, Basement: ye no Water Using Fixtures in Basement: yes/no No. in Family Whirlpool Tub yes no allon 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?CYe / No If so, describe: ~C~Ss i h~C' !Ym f t~ ~1/~P/1j C ; C2C( -px"56 /n Q-qn2~~ff 8. Has any grading, removal, or addition of soil been done to this property? Yes / o 'YO - 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? es / No Check type that is available: [ ] Community well [ ] Semi-public wel ~ ounty/City/Township water line **If No, a Well Permit must be issued with the Septic Permit.** J 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 PROPE T T ReIS' AN ADDITIONAL CHARGE" Date - 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 of any 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 J4 Selected Parcel Number: 3686-16-93-5333 1 inch = 60 feet Prepared for: q 9 u- - X39 09 >b G co w 1 O 10 33 i 07 363 s~ ~6~3 ; - 6458 35 4401® 32" DSO ,-(0 l o M!P .34 00 o0 6397 e 5333 31 flu 00 120 o. o_ 0 7227- do 2pp 4212 0 -121 0 do -3C o l 7"168 - o ° r)1Qn6 THIS IS NOT A LEGAL DOCUMENT Friday, February 26, 2010 04:46 PM S CATAWBA COUNTY NC - Parcel Report Information Regarding Selected Parcel(s) Parcel ID: 3686-16-93-5333 Name: GARGIULO MICHAEL L Name2: GARGIULO LAURA A Address: 6095 JUPITER CT Address2: City: DENVER State: NC Zip: 28037-8184 Account: 197169 Calc Acreage: 0.64 Tax Map: LRK: 801609 Deed Book: 2604 Deed Page: 1744 Subdivision Name: STONECROFT PH 5 Subdivision Block: Lots: 34 Plat Book: 50 Plat Page: 10 Building Number: 6095 Street Name: JUPITER CT Site Zip: 28037 Township: MOUNTAIN CREEK Fire Code: SHERRILLS FORD City Code: COUNTY State Road: Total Bldgs Value: $216,700 Land Value: $25,400 Total Value: $242,100 Year Built: 2002 Year Remodeled: Last Sale Date: 8/31/2004 Last Sale Amount: $195,000 Neighborhood: 129 Watershed: WS-IV Protected Area Watershed Split: NO Voter Precinct: P41 E911 District: COUNTY Zoning: R-40 Zoning2: Zoning3: Zoning Split: N Zoning Overlay: WP-O 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: 011502 Census Block 2010: 4051 Small Area Plan: SHERRILLS FORD Agricultural District: Printed: Friday, February 26, 2010 04:46 PM ~A CATAWBA COUNTY Case # WLS2009-00440 Subdivision Stonecroft 2 ' Public Health Department Section/Bl/Ph/L ot# 34 Environmental Health Division pIN# 368616935333 PO Box 389, 100A Southwest Blvd, Newton NC 28658 18 2 sM (828) 465-8270 Fax (828) 465-8276 TDD (828) 465-8200 Applicant/Owner Laura Gargiulo Site Address: 6095 Jupiter Ct Denver Property Size: .64 Directions: EXISTING SYSTEM INSPECTION REPORT Site/System Diagram < C~D S ~ -S• c1' S~ "d Type of Facility : House Mobile Home #Bedrooms Business Specify Other Specify Proposed Additions/Accessory Structure: 10'X20' deck Approved I!fl Not Approved ❑ Reason Evidence of System Malfunction : YES ❑ NO fl,] Sysem Type/Description ow " 7-7-09 AUTHORIZED STAT AGENT APPROVAL DATE NOT FOR ]LOAN APPROVAL Cc\DocumentsandSenings\jenglish\LocalSenings\Temporarylnternet Files\Content.Outlook\C9H5VVQQ\EXISTING TANK CHECK (2).docx WLS ~QO5 -60 Health Department/ Building ]inspection '**Inner- Office Farm Only*** EXISTING SEPTIC SYSTEM Type of Facility: House Mobile Home Church Business Other Name: Address: Location: [1~ 6r Cj S Sg- 1)/k vY ✓ Sabdivisim: Lot # O-G'd SL/41 . SaDitazian• Zoning: Date: CATAWBA COUNTY HEALTH DEPARTMENT PoS~d Telephone: (828) 465-8270 TDD: (828) 465-8200 WLS a&1:;Z - IP V AC Rpr. Prmt._ _ Opr. mt. Sys. Type Well Prmt. Replacement Well Well Rpr. Prmt. Owner N enI r Phone Address Subdivision 1•n,Q Y~ Segtion/Block/Phase Lot'! -3 y Lot Size L Directions: L m L Property Address D _ Facility: House Mobile Home Business Multi-family . Other: Pin Number(of- j~ 'Cfy~S 333 Other . Zoning Approval # - Z (o N Bedrooms - # Seats it Employees . Application Rate , .3 S GPD Flow (g Hot Tub or Spa yes/no Special Fixtures Basement yes . 100% Repair Area yes/0 Basement Plumbing yes/no Water Supply: Private Well Publics Semi-Public Type of System: Trench Bed Pump Pump/Panel Panel LPP Other Septic Tank Size " Pump Tank Size Nitrification Field: Total Square Feet [ C Depth of Stone 1 Z Bed Size Trench Width Total Length of All Trenches 3 Number of Trenches Trench Length /4 //8-2/_/_ Feet on Center - Maximum Trench DepthJ_ Distance of Nearest Well 0//d* *DO NOT INSTALL SEPTIC WHEN WET* *WELL RECORD REQUIRED AT COMPLETION* Topo,3, fo % Slope Texture Z Structure/ titj" (T Clay Min. I j / Soil Wetness P5 " Soil Depth > Restric. Hoz, at Available space /no Overall Class S U / Comments: j S i i 3 Filter Required v CA- Riser required when tank is more than 6 inches deep. **NO GUARANTEE OR WARRANTY IS IMPLIED OR GIVEN AS TO THE PERFORMANCE OR LENGTH OF TIME THIS SYSTEM WILL FUNCTION** *Improvement Permit has no expiration date and is transferable, but may be revoked if site plans or intended use changes for the proposed facility. An Authorization to Construct is valid for (5) five years from date issued and is not transferable. Well Permit valid for 5 years provided site conditions do not change. Well location, installation, and protection must meet state and local regulations, and must be inspected and approved by a representative of the Catawba County Health Department before an , orti n of the installation is put into use. The siting of the well by the Health Department staff is to provide protection from known os le so ces of contamination. No volume of water is guarant d at anv site by the Health Department. i Permit Date EHS Owner/A t Septic Tan nstalled IWIL- Date$-Z2 EHS Well Installed By Well Grout Approval Date Well Head App oval Date Date Sample Collected Date of Results Results EHS White - Office Yellow - Owner/Agent Pink - Building Inspection Authorization to Construct CATAWBA COUNTY, NC 100-A South West Blvd PLAN INVOICE Newton, NC 28658- (828)465-8 0 399 Friday, February 26, 2010 y, rY 1$ 42 sM www.catawbacountync.gov Plan Case: EHPR-2-10-4094 Invoice Number: INV-2-10-259938 Environmental Health Plan Review Invoice Date: 02/26/2010 Fee Name Fee Amount Lx,isting Talk (fheck Fee Fixed $3,0.00 Total Fees Due: $80.00 PAYMENTS Date Pay Type Check Number Amount Paid Change 02/26/2010 Check 3948: $80.00 $0.001 Total Paid: $80.00 Total Due: $0.00 plan invpice ;6'919_61 3311-=la65-a~07-657,yt3~>'(ie3r.ipt 02/26/2010 17:25