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Home My WebLink AboutEHPR-3-10-4393.TIF ~A c ~ THIS IS NOT A PERMIT Case # EHPR-3-10-4393 CATAWBA COUNTY HEALTH DEPARTMENT Plan Review Application for Environmental Services Ig~2 SM Environmental Health Plan Review - OSWP IMPROVEMENT APPLICANT OWNER CONTRACTOR JASON POTTER William Slaughter 1929 KINGS GRANT DR 1914 Kings Gant DR NEWTON NC 28658- Newton NC 28658 (828)695-9986 (828)850-5145 NAME TO APPEAR ON PERMIT JASON POTTER Pin#: 363809150171 SITE ADDRESS: S KINGS GRANT DR, Newton, NC DIRECTIONS: HWY 10 W - TURN LEFT ONTO STARTOWN RD - TURN LEFT ONTO KINGS GRANT DR - TURN LEFT AT POND ONTO DIRT ROAD - AT END OF ROAD NAME of SUBDIVISION: Lot # 2 Section/Block/Phase PROPERTY SIZE: Square Feet Acres 13.6781 Date Platted/Recorded TYPE OF FACILITY: House X Mobile Home Dimension of Structure 40 X 90 Bedrooms 4 Basement: No Water Using Fixtures in Basement:No No. in Family 3 Whirlpool Tub : Gal. Capacity: MULTIPLE FAMILY RESIDENCE: Units 0.00 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 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 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 pr erty. Any representation by you of house or structure location should conform to applicable setbacks. r' II Date: l~ - Signature of Applicant or Age t An Environmental Health Specialist will contact you within working days of application date. If you need further information or assistance please call 828-466-7291 AREA1 (FOR OFFICE USE ONLY) Zoning Approval: _Yes No Zoning Approval UDO Zoning Form A Minimum Setbacks Front 30 FEE NAME DATE AMOUNT Side 15 Improvement Permit Fee 03/16/2010 $150.00 Rear 30 TOTAL FEES Max Hght $150.00 *If a permit has to be redesigned and / or RETRIPS made to the property, there is an additional $60 charge 03/16/10 15:10 THIS IS NOT A PERMIT "A~* EI y ~7,J CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services Improvement Permit 1~ Authorization to Construct ❑ Septic Repair ❑ Septic Expansion ❑ Existing Tank Check ❑ New Well Permit ❑ Replacement Well ❑ Well Abandonment ❑ I. Name to Appear on Permit - LA LV4 6 2. Permit Requested By Business Phone g a Address kR2., Gtr 4 1Y. - e G ~4 Home Phone T2-T -1-,a5 -9981e 3. Property Owner l Business Phone 62-1-L(W -5C61 Address t ylHome Phone S21- 5~ ( J 4. Name of Subdivision of # -2- Section/Block/Phase Property Address Directions to Property: `,1 -rte I Yoa 5. Property Size: Square Feet i Acres V3 Date Platted/Recorded 6. TYPE OF FACILITY: House Mobile Home Dimension of Structure L-10 XCfiO 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 iauance. This may prevent the need for system size mase in the future. Basement: yescnd Water Using Fixtr res in BasementNo. in Family Whirlpool Tub yes io Gal Qn Capacity N A MULTIPLE FAMILY RESIDENCES: Units IVA Total Number of Bedrooms _ DAY CARE: Number of Cl ildren N/A RESTAURANT: Seats if Square Feet Dining Area -Square Feet Food stand/Meat Market Floor Space TYPE OF BUSINESS: Number of Employees 1 st 2nd 3rd OTHER: (Specify) N . 7. Do you anticipaNme- additions to FacilityIf so, describe: 8. Hasany grading, removal, or dd> >o of oil been done to this property? Yes o If so, describe: 9. Are there easements/right-of-ways recorded on this property? 10. Is a public water supply available on or adjacent to the above property? es 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 MAD THE PROP Y, THERE IS AN ADDITIONAL CHARGE" Id Date ` o Signature of Owner or Agent ~ ! 14- v Catawba County, North Carolina N This map product was prepared from the Catmvba County, NC, Geographic Information System. Catmvba 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 ofany 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 an), 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 anv person or entity. Legend Selected Parcel Number: 3638-09-15-0171 1 inch = 300 feet Prepared for: 1 5655 1 Pla 3B.3) II 1 \ \ \ Ma10. I5 \ . \ \ P1a 55.5J / asa, \ r \ ~ PM x&105 dw- 4a3 4385 \ ~ .1., !fir i. ~ ~ 4N2 ~ Pla KI.]3 Y~ ] ~ 458 n t p eb,i " lam`, m s i CHA LES p OR on, , / . l 3,fl % \ U " MAD3 `fpp (6] Pa anli' \ \ m,a .F - O!S !C7jRURpL \ r} ,~4~ 3Q13 f-r ~lJ r azo ~ : ~ ~ / l eao3 L x]o °m ~ ,JJ ` ,tee wJ, .O 180 ~~~`wr.enoo x.n- s P '.800 ° THIS IS NOT A LEGAL DOCUMENT Tue, March 16, 2010 02:48 PM CATAWBA COUNTY NC - Parcel Report Information Regarding Selected Parcel(s) Parcel ID: 3638-09-15-0171 Name: SLAUGHTER WILLIAM G Name2: SLAUGHTER TONDA W Address: 1914 KINGS GRANT DR Address2: City: NEWTON State: NC Zip: 28658-9158 Account: 156183000 Calc Acreage: 16.67 Tax Map: 046N 01005 LRK: 30121 Deed Book: 2785 Deed Page: 0569 Subdivision Name: Subdivision Block: Lots: 2 Plat Book: 66 Plat Page: 53 Building Number: 1914 Street Name: KINGS GRANT DR Site Zip: 28658 Township: NEWTON Fire Code: NEWTON RURAL City Code: COUNTY State Road: Total Bldgs Value: $181,200 Land Value: $81,200 Total Value: $262,400 Year Built: 2007 Year Remodeled: Last Sale Date: 10/5/2006 Last Sale Amount: $100,000 Neighborhood: 113 Watershed: Watershed Split: Voter Precinct: P34 E911 District: COUNTY Zoning: R-20 Zoning2: Zoning3: Zoning Split: N Zoning Overlay: ED-O,DWMH-O,FPM-O Zoning District: COUNTY Split Zoning Dist: N Split Zoning Dist(1): 0 Split Zoning Dist(2): 0 School District: COUNTY Elementary School: STARTOWN Middle School: MAIDEN High School: MAIDEN School Split: NO P&Z Case Number: Census Tract 2010: 011702 Census Block 2010: 2028 Small Area Plan: STARTOWN Agricultural District: PROXIMITY Printed: Tue, March 16, 2010 02:48 PM A C~ CATAWBA COUNTY, NC I00-A South West Blvd PLAN RECEIPT Newton, NC 28658- U (828)465-8399 Tuesday, March 16, 2010 84 sM www.catawbacountync.gov Plan Case: EHPR-3-10-4393 Invoice Number: INV-3-10-260493 Environmental Health Plan Review Invoice Date: 03/16/2010 Site Address: S KINGS GRANT DR, Newton, NC APPLICANT OWNER JASON POTTER William Slaughter 1929 KINGS GRANT DR 1914 Kings Gant DR NEWTON NC 28658- Newton NC 28658 (828)695-9986 (828)850-5145 Fee Name Fee Amount Improvement Permit Fee Fixed $150.00 Total Fees Due: $150.00 PAYMENTS Date Pay Type Check Number Amount Paid Change 03/16/2010 Credit Card -1 $150.00 $0.00 Total Paid: $150.00 Payer: RONDA POTTER Total Due: $0.00 plan icccipt;8c043119-1474-41 1-3623-?cl^(i63c11u6;.i7x 03/16/2010 15:13