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Home My WebLink AboutEHPR-3-10-4376.TIF ~A C THIS IS NOT A PERMIT Case # EHPR-3-10-4376 CATAWBA COUNTY HEALTH DEPARTMENT v ~i►~ Plan Review Application for Environmental Services I89'42 sM Environmental Health Plan Review - OSWP EXS_SYSTEM APPLICANT OWNER CONTRACTOR JOHN GRIGGS JOHN GRIGGS CHARLES H IVEY 1538 VICTORIAN HILLS CIR 1538 VICTORIAN HILLS CIR 4131 CONOVER NC 28613 CONOVER NC 28613 4TH ST 828-464-4362 828-464-4362 HICKORY NC 28601 828-781-4173 NAME TO APPEAR ON PERMIT JOHN GRIGGS in#: 374410369373 SITE ADDRESS: 1538 VICTORIAN HILLS CIR, Conover, NC DIRECTIONS: N ON LEE CLINE RD/ LT ON VICTORIAN CIR/ HOME ON LT NAME of SUBDIVISION: VICTORIAN HILLS Lot # 20-21 Section/Block/Phase PROPERTY SIZE: Square Feet Acres 1.11 Date Platted/Recorded TYPE OF FACILITY: House X Mobile Home Dimension of Structure 14 X 16 ADDITION 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: Scats 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: BATHROOM AND WALK-IN CLOSET ADDITION-, 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 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 prV.,A,,-ny epresentat'on by you of house or structure location should conform to applicable setbacks. JDate: Signature of Applicant or Agent An Environmental Health Specialist will contact you within 2 w king days of a 'cation date. 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 30 FEE NAME DATE AMOUNT Side 15 Existing Tank Check Fee 03/15/2010 $80.00 Rear 30 TOTAL FEES $80.00 Max Hght *If a permit has to be redesigned and / or RETRIPS made to the property, there is an additional $60 charge 03/15/10 16:53 Catawba County, North Carolina N This map prodvci was prepared from the Calmvba County, NC, Geographic brformalior Srstem. Catan•ba Coanty hos made substantial efforts to ensure the occnracy of location and lobe/tug ii j,rmation c•ontnined on this map. Catawba Count y promotes and rec•ommencls the independent verification of ag dales contained or thin map product by the user. The Comp of Catawba, iis• emphnres, agents and personnel disclaim, and shall not be held liable for ai v and all damages, loss or liability, Whether chrec•t, indirect or consequential which arises or nrcrn arise from this map p1 oduc7 or the use thereof kv a» y persaa or e,ui{v. Legend Selected Parcel Number: 3744-10-36-9373 1 inch = 60 feet Prepared for: x/10 90.28 $9 16 100.07 VIC~r o, RIAN 7.8 6 100.07 -i J 00 ,J t' fir: • I O o 1;45 fit; } CV O a, 1.11A 19 c~ I l: f 9373 21 ,........100.01 O x ' , O 220 36 -71 23 22 m -n 00 -0211 1230, TH ISIS NOT A LEGAL DOCUIIMENT Monday, March 15, 2010 04:28 Pn4 CATAWBA COUNTY NC - Parcel Report Information Regarding Selected Parcel(s) Parcel ID: 3744-10-36-9373 Name: GRIGGS JOHN T Name2: GRIGGS PATRICIA A Address: 1538 VICTORIAN HILLS CIR Address2: City: CONOVER State: NC Zip: 28613-7774 Account: 25211000 Calc Acreage: 1.11 Tax Map: 1601 01012 LRK: 54735 Deed Book: 1914 Deed Page: 0797 Subdivision Name: VICTORIAN HILLS Subdivision Block: Lots: 20-21 Plat Book: 23 Plat Page: 247 Building Number: 1538 Street Name: VICTORIAN HILLS CIR Site Zip: 28613 Township: CLINES Fire Code: ST. STEPHENS City Code: COUNTY State Road: Total Bldgs Value: $310,500 Land Value: $23,900 Total Value: $334,400 Year Built: 1995 Year Remodeled: 2003 Last Sale Date: Last Sale Amount: Neighborhood: 74 Watershed: Watershed Split: Voter Precinct: P33 E911 District: COUNTY Zoning: R-20 Zoning2: Zoning3: Zoning Split: N Zoning Overlay: Zoning District: COUNTY Split Zoning Dist: N Split Zoning Dist(1): 0 Split Zoning Dist(2): 0 School District: COUNTY Elementary School: LYLE CREEK Middle School: RIVER BEND High School: BUNKER HILL School Split: NO P&Z Case Number: R-401 Census Tract 2010: 010201 Census Block 2010: 1035 Small Area Plan: ST STEPHENS/OXFORD Agricultural District: Printed: Monday, March 15, 2010 04:28 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 n New Well Permit ❑ Replacement Well ❑ Well Abandonment ❑ 1. Name to Appear on Permit U- f~N i XgohelZ/;~ i S 2. Permit Requested By Chat? e.y T✓ ei- co ms fircac /SIJ.v Business Phone Pd f ' ~fl 7.3 Address 4 elt,,- ti. 4-, A4 d P60 / Home Phone 3. Property Owner TdbA) 5/ 1*,y'101L111 /z > S Business Phone Address /~3~ lC 0~//¢N //;//v CiTe- dNOUt2 C, Home Phone eJ.f` j :i~y - % 3(0,?,- 4. Name of Subdivision Lot # Section/Block/Phase Property Address 53 %2c e Directions to Property: Lt-e- 4fllA-e a!9 /1/D& ? N U C RIAf/v 11111-f C1 5. Property Size: Square Feet Acres 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/ to Water Using Fixtures in Basement: yes/no No. in Family Whirlpool Tub yes/ o 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 Faci ity? es No If so, describe: fi& - 0<✓ Rwv\ 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? De / No 10. Is a public water supply available on or adjacent to the above property? (Ye 3)/ 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 [ ] 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 MA AN ADDITIONAL CHARGE.** Date 3 1 5 Signature of Owner or Agent =F?7'S i . ..0-.91 llO-Z 3~ru~ld a~13dw~. 9/ib X O/ts TGAO d01310?~ 10 ;aA-m- S 4oom 39431 .9 Duo-~~ nS-iC.1_ X r 9flC~ m :1510 N ~ ~ ~ rt 21015 0 ~ ~ (ry l~ ry OD X O o o z N m O LLB lJ Q INVA 9,, < Z I %Z Q • z~Q~ z O _ z v w I i a y Q Q I I v ~I w a 4 k {MJ i < F- - (Ynn Q W L---J II~ ~W V I N - z Ilz V I I N in LU J d ~~I z O w III = w0N - Ix V 13X0Od Q/Z w F- O ~ z Lu Z~w w w Z Ow to ZpLu v; w OC QWd 7 -1 ***,Op. Permit and/or Cert. Op. Required ~.u~t st be completed prior to final) N p % 92 1 CATAWBA COUNTY HEALTH DEPArOper. NT (704) 465-8270 Lot Eval:~Improve. PermitX Repair Permit Cert. of Comp. Permit Permit Owner/Agent CAP--- 1:-L FLer~ f5 Phone Address Subdivision tt hl~ Sec io~/1 gck/=P ase Lot# 2 Z / L t Size Directions: ~ 2, = Facility: House Mobile Home Business Other: Tax Map # Multi-famiky Other Zoning Approval # Z O 7-99 G Bedrooms Seats Employees Application Ratef)7_ GPD Flow Hot Tub or Spa yes/no Special Fixtures 100* Repair Area no REPAIR NOTICE: Basement yes/(D Basement Plumbing yes/no REPAIRS MUST BE WITHIN 30 DAYS OR Water Supply: Private Public DAYS FROM DATE OF PERMIT. Type of System: Trench_~\ Bed Pump Pump/Panel Panel LPP Other Tank Size: Septic Tank 1000 Pump Tank Nitrification Field: Total Square Feet /ZOO Depth of Stone 17-01CI~- Bed Size Trench Width 3 Total Length of All Trenches 400 Number of Trenches Individual Trench Length (W//CC11J0~`G/(9d/_ Feet on Center Maximum Trench Depth.3T Distance of Nearest Well -t,56 Lot Evaluation: Approved yes/no (Void After 24 months) Topo Slope Sketch of lot Evaluation Site - System Design - Final Texture , DO NOT INSTALL Structure WHEN WET i Clay Min. Soil Wetness Soil Depth " Restric. Hoz at Available space yes not i overall Class S PS U i \ t Comments: ors ! t \ ~r~ r_C3 xr t 1 ' S' t.- cX Septic Tank Contractors MUST contact the , C -IL Sanitarian BEFORE changing permit. **NO GUARANTEE OR WARRANTY IS IMPLIED OR GIVEN THROUGH THE ISSUANCE OF THIS PERMIT** Permit Date Z 3' (Improvement P mi }toid a ter 60 months) Owner/Agent Sana, is Installed By ` Date Sanitarian/ ~Y~~ ( to any Chan es information in red or by sketch on ba *******IF A PERMIT HAS TO BE REDESIGNED AND/OR RETRIPS MADE TO THE PROPS Y, THERE******** IS AN ADDITIONAL $25 CHARGE. White - Office Blue - Building Inspection Completion Yellow - Owner/Agent Green - Building Inspection IP