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Home My WebLink AboutEHPR-3-10-4332.TIF THIS IS NOT A PERMIT Case # EHPR-3-10-4332 CATAWBA COUNTY HEALTH DEPARTMENT Plan Review Application for Environmental Services Ig~}2 SM Environmental Health Plan Review - OSWP NEW WELL -ABANDONMENT APPLICANT OWNER CONTRACTOR ASHELY MORETZ HARLAN RICE 6159 NC 10 HWY 769 AIKEN RD HICKORY NC 28602- ASHEVILLE NC 28804-9729 (828)244-1420 828-244-1420 NAME TO APPEAR ON PERMIT ASHELY MORETZ Pin#: 37630481 1419 SITE ADDRESS: 3844 FLOWING IVY LN, Claremont, NC DIRECTIONS: HWY 70 TO CLAREMTON - TURN LEFT ONTO N LOOKOUT ST - CROSS 1-40 AND CONTINUE ON BUNKER HILL SCHOOL RD - CROSS BRIDGE - TURN LEFT ONTO AVEENA DR - TURN LEFT ONTO FLOWING IVY LN - MOBILE HOME ft RT HILLS 21-29 NAME of SUBDIVISION: Lot # Section/Block/Phase PROPERTY SIZE: Square Feet Acres 1.159 Date Platted/Recorded TYPE OF FACILITY: House Mobile Home X Dimension of Structure 12 X 58 Bedrooms 2 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 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: 3-12-1 //V 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 AREA2 (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 03/12/2010 $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 03/12/10 09:32 THIS IS NOT A PERMIT 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 ❑ 1. Name to Appear on Permit ~s f- D d'e, z 2. Permit Requested By stia Business Phoned u- 6 ia~- f X60-,2- Home Phone Address 6/S 17 3. Property Owner J4,~Nrkti i' ' P Business Phone_ Address Home Phone 4. Name of Subdivision Lot # Section/Block/Phase Property Address Directions to Property: 0 L/ 6 5. Property Size: Square Feet Acres Date Platted/Recorded 6. TYPE OF FACILITY: House Mobile Home Dimension of Structure 1 2- XS Bedrooms* ;L, *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/Io Water Using Fixtures in Basement: yes/Q No. in Family Whirlpool Tub yes/ o Gallon Capacity MULTIPLE FAMILY RESIDENCES: Uni 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 1st 2nd 3rd OTHER: (Specify) 7. Do you anticipate any additions to Facility? Yes 610) If so, describe: 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 / o 10. Is a public water supply available on or adjacent to the above properly'? Yes / No Check type that is available: [ ] Community well [ ] Semi-public well [ ] County/City/Township water line **If No, a Well Permit must be Jssued 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 6 Signature of Owner or Agent Catawba County, North Carolina N This map product was prepared f-onu the Catawba County, NC, Geographic Information System. 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 at- entity. Legend Selected Parcel Number: 3763-04-81-1419 1 inch = 60 feet Prepared for: ® s 37,04 ® Cb _29 28 o L f i cS` O O C-1- ID 27 A6A 26 19-25 108.41 4_ 30 ---24 •31 cs _23 (232 a~ 22 33 2 3 ` g_ T 153 21 34 tTl THIS IS NOT A LEGAL DOCUMENT _ Fri, March 12, 2010 09:08 AM 7 1 i W CATAWBA COUNTY NC - Parcel Report Information Regarding Selected Parcel(s) Parcel ID.- 3763-04-81-1419 Name: RICE HARLAN G Name2: Address: 769 AIKEN RD Address2: City: ASHEVILLE State: NC Zip: 28804-9729 Account: 204993 Calc Acreage: 1.16 Tax Map: 3405 05006 LRK: 68306 Deed Book: 2749 Deed Page: 0191 Subdivision Name: SIGMONT HILLS Subdivision Block: F Lots: 21-29 Plat Book: 13 Plat Page: 84 Building Number: 3844 Street Name: FLOWING IVY LN Site Zip: 28610 Township: CLINES Fire Code: OXFORD City Code: COUNTY State Road: 2400 Total Bldgs Value: Land Value: $15,400 Total Value: $15,400 Year Built: Year Remodeled: Last Sale Date: Last Sale Amount: Neighborhood: 67 Watershed: WS-IV Protected Area Watershed Split: NO Voter Precinct: P27 E911 District: COUNTY Zoning: R-30 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: OXFORD Middle School: RIVER BEND High School: BUNKER HILL School Split: NO P&Z Case Number: Census Tract 2010: 010101 Census Block 2010: 3022 Small Area Plan: ST STEPHENS/OXFORD Agricultural District: Printed: Fri, March 12, 2010 09:08 AM A CATA"A COUNTY, NC 100-A South West Blvd PLAN RECEIPT Newton, NC 28658- 0 (828)465-8399 Friday, March 12, 2010 4 L sM www.catawbacountync.gov Plan Case: EHPR-3-10-4332 Invoice Number: INV-3-10-260391 Environmental Health Plan Review Invoice Date: 03/12/2010 Site Address: 3844 FLOWING IVY LN, Claremont, NC APPLICANT OWNER ASHELY MORETZ HARLAN RICE 6159 NC 10 HWY 769 AIKEN RD HICKORY NC 28602- ASHEVILLE NC 28804-9729 (828)244-1420 828-244-1420 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 03/12/2010 Check 6200 $300.00 $0.00 Total Paid: $300.00 Payer: ASHLEY MORETZ MORETZ WELL DRILLING & PUMP SERVICE Total Due: $0.00 pl:~nreceiOt;R~Ilcfi69-~ cl-..11~?-Rtl-01a)ecd>>ec2;.r~t 03/12/2010 09:32