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Home My WebLink AboutEHPR-3-10-4508.TIF THIS IS NOT A PERMIT Case # EHPR-3-10-4508 CATAWBA COUNTY HEALTH DEPARTMENT v Plan Review Application for Environmental Services 1842 SF Environmental Health Plan Review - OSWP REPAIR APPLICANT OWNER CONTRACTOR BEAU FULBRIGHT BEAU FULBRIGHT C & C BUILDERS OF NORTH CAROLINA 1723 WELLINGTON AV 1723 WELLINGTON AV PO BOX 126 NEWTON NC 28658- NEWTON NC 28658- IRON STATION NC 28080-0126 (828)464-5270 (828)464-5270 (704)483-1696 NAME TO APPEAR ON PERMIT BEAU FULBRIGHT Pin#: 362914237961 SITE ADDRESS: 1723 WELLINGTON AV, Newton, NC DIRECTIONS: HWY 10 W/ LFT ON STARTOWN RD/ RT ON ROCKY FORD/ RT ON WELLINGTON/ HOUSE ON LFT NAME of SUBDIVISION: KENSINGTON Lot # 14 Section/Block/Phase PROPERTY SIZE: Square Feet Acres 1.039 Date Platted/Recorded TYPE OF FACILITY: House X Mobile Home Dimension of Structure 56 X 42 Bedrooms 4 Basement: No Water Using Fixtures in Basement:No No. in Family 4 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 Ist 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 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 conf rm to applicable setbacks. / Date: 3 0 1t~ Signature of Applicant or Agent v n vironmental Health Specialist will contact you within 2 working ays of application date. A ` n 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 Authorization to Construct (Repair) Fee 03/24/2010 $425.00 Rear 30 TOTAL FEES Max Hght $425.00 *If a permit has to be redesigned and / or RETRIPS made to the property, there is an additional $60 charge 03/24/10 08:49 THIS IS NOT A PERMIT WLS # j -0 -4(5"6 CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services Improvement Permit ❑ Authorization to Construct El Septic Repair R( Septic Expansion ❑ Existing Tank Check ❑ New Well Permit E] Replacement Well ❑ Well Abandonment E] 1. Name to Appear on Permit 6604- F- .&LOZ &41- 2. Permit Requested By Qah~4f h PtLlf t+( &"4 Dal e( /VC_ Business Phone 104 951 X0760, Address ) WAI W (t_t. t KO0 W6 Home Phone 704 4 51 (0(0 3. Property Owner 96A~x J:AALg(2t6-t4T ; CAC` ockf,.) 00 tJa-?14 Business Phone Address I-1.>3 %_6 t" t N lrT0r,1 141-6 Home Phone g-~(oq 6a70 4. Name of Subdivision Lot # Section/Block/Phase Property Address 1-1-42 W L t Ai0Dd Ay 60b CK~t Fy20 Directions to Property: S-M(ZJ6,3tJ J&9 Tv~JhQS L4AJ ~o L~ Irv 10T Q`r nN"V~ W Nt4 tNCr7VN / +9,-St 8rJ LF' FT 5. Property Size: Square Feet Acres t Date Platted/Recorded 6. TYPE OF FACILITY: House I/ Mobile Home Dimension of Structure -6-6 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: ye no Water Using Fixtures in Basement: yes/no No. in Family `1 Whirlpool Tub yes/no Gallon Capacity MULTIPLE FAMILY RESIDENCES: Units NIN Total Number of Bedrooms q DAY CARE: Number of Children NIA RESTAURANT: Seats Square Feet Dining Area -Square Feet Food stand/Meat Market Floor Space TYPE OF BUSINESS: Number of Employees I st 2nd 3rd OTHER: (Specify) 7. Do you anticipate any additions to Facility? Yes / No If so, describe: 8. Has any grading, removal, or addition of soil been done to this property? Yes No 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. 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: [ ] 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 3 4 a Signature of Owner or Agent Catawba County, North Carolina l'Ais map product was prepared from the Colawha Counw NC. Geogrophic lrrformalion S;wem. Calambo comity has made suhslawial efforts to censure the accm ocy of localion mid labeling iuformalion canloincd on ihis map. Cotowbu Comm promme.s mid recommends Nye independent rerifceniun of amp dnla contohied on this mop pi ochrcl by the riser. The Coma 'v ofCatau,bn, its employees, ngelns and persormel disclaim, mid s oll not be held liable for Imp and all emerges, loss or linhilihC whether direct, indil eel W. cmi.sequeuial which arises or nu{p arise from (his amp produce or the use (hereof by coy person ar emirs'. Legend Selected Parcel Number: 3629-14-23-7961 I inch = 60 feet Prepared for: i r / i 335.21 14- Plat 32=159 WJI/ L I . L 7961 20.00 80..0 j 13 87 1.06A .9850 80,00 t ~ - 0:r5 / 6X 1.02A THIS IS NOT A LGCAI, DOCUiNIFNT f ~ Thursday, February 25, 2010 02:39 11NI ' / 1 Catawba County, North Carolina N This map product was preparedfrom 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. Catenvba 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 at, 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 Selected Parcel Number: 3629-14-23-7961 1 inch = 60 feet Prepared for: f qpPl~ it 335.21 14 Plat 32-159 '1'. 04A 7961 ~t v a _ ---20.00 80.00 113.81 1. 0 6 A \1 8000 - 6' THIS IS NOT A LEGAL DOCUMENT Wednesday, March 24, 2010 08:38 AM CATAWBA COUNTY NC - Parcel Report Information Regarding Selected Parcel(s) Parcel ID: 3629-14-23-7961 Name: DOCKERY CAROLYN Name2: FULBRIGHT BEAU Address: 1723 WELLINGTON AVE Address2: City: NEWTON State: NC Zip: 28658-9149 Account: 180144 Calc Acreage: 1.04 Tax Map: 003AJ 03014 LRK: 92250 Deed Book: 2452 Deed Page: 0128 Subdivision Name: KENSINGTON Subdivision Block: Lots: 14 Plat Book: 32 Plat Page: 159 Building Number: 1723 Street Name: WELLINGTON AV Site Zip: 28658 Township: JACOBS FORK Fire Code: NEWTON RURAL City Code: COUNTY State Road: Total Bldgs Value: $157,200 Land Value: $21,800 Total Value: $179,000 Year Built: 1997 Year Remodeled: Last Sale Date: 4/1/2003 Last Sale Amount: $159,000 Neighborhood: 98 Watershed: Watershed Split: Voter Precinct: P34 E911 District: COUNTY Zoning: R-20 Zoning2: Zoning3: Zoning Split: N Zoning Overlay: ED-0 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: 1005 Small Area Plan: STARTOWN Agricultural District: Printed: Thursday, February 25, 2010 02:39 PM CATAWBA COUNTY HEALTH DEPARTMENT,, Telephone: (704) 465- 270 TDD: (704) 465-8200 15 2 Improve. PermitNuthorization to Cons truct~Repair Permit_Oper. Permit~S ystem Type i 1 Owner/Agent ~1 Phone Address o2y S ,L ^H UIj Subdivision 0ex-k} i c7w Section/Block/Phase Lot#--Z!Y_ Lot e _ Directions: ' 1~ t l y -f ~ ELP1 - Facility: House ; Mobile Home Business Other: Tax Map # lG Multi-family other Zoning Approval # C) Fr`J # BedroomsI # Seats # Employees Application Rate.. GPD Flow 1£ (3 Hot Tub or Spa yes/fpb Special Fixtures 100o Repair Areae7s/no Basement yes/r6 Basement Plumbing yes/no Water Supply: Private Well X Public Type of System: Trench_yBed Pump Pump/Panel Panel -LPP Other Tank Size: Septic Tank Size el4el ! Pump Tank Size Nitrification Field: Total Square Feet Depth of Stone / Bed Size Trench Width -34 Total Length of All Trenches `QC) Number of Trenches y Individual Trench Lengthy/eCfGl /Cck} /lCrd / Feet on Center Maximum Trench Depth Distance of Nearest Well (CFi) *DO NOT INSTALL WHEN WET* Topo Slope Texture Structure Clay Min. Soil Wetness" Soil Depth 7!" Restric. Hoz. at--" Available space '✓s/nol Overall Class SC~S U Comments: I f i i i **NO GUARANTEE OR WARRANTY IS IMPLIED OR GIVEN AS TO THE PERFORMANCE OR LENGTH 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) f've years from date issued and is not transferable. Permit Date Owner/Agent Q Sanitarian Installed By Date 4f - Sanitari s White - Office Blue - Building Tnsnectinn Oneration Permit Yellow - Owner/Agent Green - Rnilding Tnsnectinn Authorization to Convnict CATAWBA COUNTY, NC '°°-A South West Blvd PLAN RECEIPT Newton, NC 2865588- - Q+ a 0 (828)465-8399 Wednesday, March 24, 2010 O .jg 42 sM www.catawbacountync.gov Plan Case: EHPR-3-10-4508 Invoice Number: INV-3-10-260729 Environmental Health Plan Review Invoice Date: 03/24/2010 Site Address: 1723 WELLINGTON AV, Newton, NC APPLICANT OWNER BEAU FULBRIGHT BEAU FULBRIGHT 1723 WELLINGTON AV 1723 WELLINGTON AV NEWTON NC 28658- NEWTON NC 28658- (828)464-5270 (828)464-5270 Fee Name Fee Amount Authorization to Construct (Repair) Fee Adjustable $425.00 Total Fees Due: $425.00 PAYMENTS Date Pay Type Check Number Amount Paid Change 03/2412010 Cash -1 $425.00 $0.00 Total Paid: $425.00 Payer: RICHARD HICKS Total Due: $0.00 pl an receipi f-4 la(ieRln-l ce3-d6dc-,j l e t -b 455b'Z',il l aG;.rpt 03/24/2010 08:52