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Home My WebLink AboutEHPR-3-10-4313.TIF ~~A C THIS IS NOT A PERMIT Case # EHPR-3-10-4313 H ' CATAWBA COUNTY HEALTH DEPARTMENT v Plan Review Application for Environmental Services 1842 sM Environmental Health Plan Review - OSWP EXPANSION APPLICANT OWNER CONTRACTOR CLAYTON HOMES TOM DAVIS CARL COOK FOR: ALBERTO DELOSSANTOS 1230 CO 1394 MAIDEN WOODS CIR 5131 GROSS RD WEST MAIDEN NC 28650 PO BOX 10106 CONOVER NC 28613 HICKORY NC 28603 8284653450 704-462-1419 NAWI,E-TO`Ar;PE-R-ON- t-Rvi'i' i - L-1-"TON HOMES i 8 SITE ADDRESS: 1394 MAIDEN WOOD CIR, Maiden, NC DIRECTIONS: 321 S TO MAIDEN / LT AT STOP LIGHT/ RT AT NEXT LIGHT/ S MAIN TO SALEM CH RD/ RT TO MAIDEN WOODS/ TURN LT/ PROPERTY ON RT/ VACANT LOT W/BLDG IN BACK CORNER NAME of SUBDIVISION: MAIDEN WOODS Lot # 42 Section/Block/Phase PROPERTY SIZE: Square Feet Acres 0.759 Date Platted/Recorded TYPE OF FACILITY: House Mobile Home X Dimension of Structure 28 X 76' Bedrooms 4 Basement: No Water Using Fixtures in Basement:No No. in Family 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: 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? NO Type of Water Supply: Individual Well X Community Well Municipal Semi-Public 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. AnylYepresentation by you of house or structure location should conform to applicable setbacks. Date: Signature of Applicant or Agent ~ . R An Environmental Health Specialist will contact you with i 2,workmg days 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 FEE NAME DATE AMOUNT Side Authorization to Construct Fee (New/Expansion) Fee 03/1 1/2010 $275.00 Rear Improvement Permit Fee 03/11/2010 $150.00 Max Hght TOTAL FEES $425.00 *If a permit has to be redesigned and / or RETRIPS made to the property, there is an additional $60 charge 03/11/10 14:18 CATAWBA COUNTY HEALTH DEPARTMENT Telephone: (704) 4650 70 TDD: (704) 465-8200 1 3 5 }.r1~ Improve.`Permit_AAuthorization to ConstructRepair Permit_Oper. Permit, System Type, r Owner/Agent l h✓a,' ~ 0c-~i tO~~,f~S,~ Phone -zl"3 ~ Address Subdivision M1 -/,6L-Ar "Idcly's 1~1~i 2e- Section/Block/Phase Lot# Lot Size %y Directions: 3,-;!l XZAj~rAJG•^ ;Te!! 12-1J~/6l dr tycrcrr✓S 7-0 car- ~z 13'~'q ~~!/JPu a as s c~rz Facility: House Mobile Home X Business Other: Tax Map #6 7V -.f - S~ Multi-family Other Zoning Approval # M147XeA-7 # Bedrooms_ 3 # Seats # Employees Application Rate GPD Flow' Hot Tub or Spa yes/& Special Fixtures 100% Repair Area rs/no Basement yes /0 Basement Plumbing yes/no Water Supply: Private Well X Public Type of System: Trench V' Bed Pump Pump/Panel Panel LPP Other Tank Size: Septic Tank Size jerZT j "-t Pump Tank Size Nitrification Field: Total Square Feet ~e-e Depth of Stone 12- Bed Size Trench width ..34- Total Length of All Trenches J'oz) Number of Trenches Individual Trench Length_&ZL//0_/`G2) / / Feet on Center-25_ Maximum Trench Depth Distance of Nearest Well /C'in *DO NOT INSTALL WHEN WET* r**,t,t,t***,r*,t**,t,t,t,t,t,tw,t,vvr~t**w**,t,t****,t,r*,t,t,t***,t*,t*,t***,t,t,t,t,t*,t,t,t**,t**,t,r,t****,t,t,t,r***w*,t,t,r+t*,t***,t,t* Topo 3.5 o Slope Texture C'/~~I I L ~O I Structure 1?4e e-X Clay Min. _ Soil Wetness 14-5 " Soil Depth >y " I ~+tiCth Restric. Hcz. at° Available space /nol Overall Class U I -V _ Comments: f4s I I Z ZCi 1 2zv I I I I ~5a (3,i y mmjy N woo as cot **NO GUARANTEE OR WARRANTY IS IMPLIED OR GIVEN AS TO THE PERFORMANCE OR LENGTH OF TIME THIS SYSTEM WILL FUNCTION** *Improventent 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. Permit Date Owner/Agent Sanitarian Installed By' r Date " Sanitar n White - Office Blue - Building Inspection Operation Permit Yel;ow - Owner/Agent Green - Building Inspection Authorization to Construct Catawba County, North Carolina N This mop product was prepared from the Catam ha County, NC, Geographic b forma/ion System. Catcrwha Comaty has mode subsicnuial efforts to emare the occuracy ojlocation and labeling it+formttion contained on this map. Catawba Counhvpromotes and recommends the independent verijicofion o/'mrn data contained on this mop product by the user. The County of Catawba, its employees, ogenls and personnel disclaim, and shall not he held liable for any mitt all damages, loss or liability, whether direct, indirect or consequential which arises or mcm arise from tlri.s map product or the use thereof by cnt v person or entim. Legend Selected Parcel Number: 3636-11-7--~-1362 1 inch = 60 feet Prepared for: _ ~-1~,1 X11 h om, 40 f' ► R .O } s cr l j r r` 0 002-0-- ; ryo~ 41 ~o p 00 1966 ,t t°; s 1f'3.0 ---80.36 1 220.00 42 a o di i~- C) 0 ;0 .r 9789 ~T j 54 220.00 0 CD - J c 43 0 cn ° 16561 w 47.E co THIS IS NOT A LEGAL DOCUNIENT Thursday, Nlarch 11, 2010 01:33 PNI 200.00 CATAWBA COUNTY NC - Parcel Report Information Regarding Selected Parcel(s) Parcel ID: 3636-11-75-1862 Name: DAVIS TOM I III Name2: Ad&ess: 2318 22ND AVE NE Address2: City: HICKORY State: NC Zip: 28601-7966 Account: 201928 Calc Acreage: 0.76 Tax Map: LRK: 900774 Deed Book: 2695 Deed Page: 0789 Subdivision Name: MAIDEN WOODS Subdivision Block: Lots: 42 Plat Book: 38 Plat Page: 33 Building Number: 1394 Street Name: MAIDEN WOOD CIR Site Zip: 28650 Township: NEWTON Fire Code: MAIDEN RURAL City Code: COUNTY State Road: Total Bldgs Value: $13,900 Land Value: $10,500 Total Value: $24,400 Year Built: Year Remodeled: Last Sale Date: 9/21/2005 Last Sale Amount: $50,000 Neighborhood: 113 Watershed: Watershed Split: Voter Precinct: P20 E911 District: MAIDEN Zoning: R-20 Zoning2: Zoning3: Zoning Split: N Zoning Overlay: Zoning District: MAIDEN Split Zoning Dist: N Split Zoning Dist(1): 0 ` Split Zoning Dist(2): 0 School District: COUNTY Elementary School: MAIDEN Middle School: MAIDEN High School: MAIDEN School Split: NO P&Z Case Number: Census Tract 2010: 011702 Census Block 2010: 4040 Small Area Plan: Agricultural District: Printed: Thursday, March 11, 2010 01:38 PM 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 E] Replacement Well E] Well Abandonment E] 1. Name to Appear on Permit A/ o0-ef 2. Permit Requested By 3w r - C-12.. Business Phone Address 4 wov c l' e'a G1 v.iav fi- d✓ L Home Phone 3. Property Owner arm 1, ~JaT v,' S Business Phone Address Home Phone 4. Name of Subdivision 11-z Cd e.J Gv'ovoi~7r Lot 1Z Section/Block/Phase PropertyAddress `I` a~'oQc.... oo C"' c 1-e t•'c~~ •r Directions to Property: 30.2 ws;r ~9-P $nw(-~ •f-o /'t a.'cQ y"/c- S ~-f ha "k co,cw r- 5. Property Size: Square Feet Acres Date Platted/Recorded 6. TYPE OF FACILITY: House Mobile Homed Dimension of Structure A '06 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 ne ease in the future. Basement: yes Water Using Fixtures in Basement: y no No. in Family Whirlpool Tub yes/no Gallon Capacity MULTIPLE FAMILY RESIDENCES: Units Total Number of Bedrooms 40 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 /(19) If so, describe: 8. Has any grading, removal, or addition of soil been done to this property? Yes 149 If so, describe: 9. Are there easements/right-of-ways recorded on this property? Yes 10. Is a public water supply available on or adjacent to the above property? Yes / 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: A Individual well [ ] Community well [ ] Semi-Public well '6c%s N 9 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 infonnation 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 infonnation, 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 TH OPERTY, THERE I AN ADDITIONAL CHARGE.- Date 3 /41 Signature of Owner or Agent