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Home My WebLink AboutEHPR-3-10-4526.TIF e 5 ~e'Sc -3/a q/ 10 Pct A $ C~~ THIS IS NOT A PERMIT Case # EHPR-3-10-4526 H CATAWBA COUNTY HEALTH DEPARTMENT Plan Review Application for Enviromnental Services 1842 sM Environmental Health Plan Review - OSWP IMPROVEMENT APPLICANT OWNER CONTRACTOR WILLIAM ANDREW SIPE WILLIAM DWAYNE SIPE 1922 CAMPBELL RD 1932 CAMPBELL RD NEWTON NC 28658- NEWTON NC 28658 (828)428-4968 NAME TO APPEAR ON PERMIT WILLIAM ANDREW SIPE Pin#: 364820902088 SITE ADDRESS: 1932 CAMPBELL RD, Newton, NC DIRECTIONS: 321 S/ LEFT MAYS CHAPEL RD/ RT CAMPBELL/ ON LEFT (LESS THAN A MILE) NAME of SUBDIVISION: Lot # Section/Block/Phase PROPERTY SIZE: Square Feet Acres 16.12 Date Platted/Recorded TYPE OF FACILITY: House X Mobile Home Dimension of Structure 40 X 60 Bedrooms 4 Basement: Yes Water Using Fixtures in Basement:Yes 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 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? ROAD EASEMENT 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: 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 AREA 1 (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 03/24/2010 $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 03/24/10'17:46 A C THIS IS NOT A PERMIT Case # EHPR-3-10-4526 CATAWBA COUNTY HEALTH DEPARTMENT Plan Review Application for Environmental Services 1842 5M Environmental Health Plan Review - OSWP IMPROVEMENT APPLICANT OWNER CONTRACTOR WILLIAM DWAYNE SIPE WILLIAM DWAYNE SIPE 1932 CAMPBELL RD 1932 CAMPBELL RD NEWTON NC 28658 NEWTON NC 28658 NAME TO APPEAR ON PERMIT WILLIAM DWAYNE SIPE Pin#: 364820902088 SITE ADDRESS: 1932 CAMPBELL RD, Newton, NC DIRECTIONS: 321 S/ LEFT MAYS CHAPEL RD/ RT CAMPBELL/ ON LEFT (LESS THAN A MILE) NAME of SUBDIVISION: Lot # Section/Block/Phase PROPERTY SIZE: Square Feet Acres 16.12 Date Platted/Recorded TYPE OF FACILITY: House X Mobile Home Dimension of Structure 40 X 60 Bedrooms 4 Basement: Yes Water Using Fixtures in Basement:Yes 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 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? ROAD EASEMENT 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. Any representation by you of house or structure location should conform to applicable setbacks. Date: 110 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 AREA 1 (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 03/24/2010 $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 03/24/10 17:17 THIS IS NOT A PERMIT WLs# CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services r IP 1X AC l- S.T. Rpr. S.T. Exp. Exist. S. T. F- Well Permit Replacement Well 1. Name to Appear On Permit: William Andrew Sipe and Kristin Sipe 2. Permit Requested By] Kristin Sipe Business Phone: 828-464-5620 Address: 1922 Campbell Rd Newton NC 28658 Home Phone: 828-428-4968 William Andrew Sipe 3. Property Owner: Business Phone: F1 922 Campbell Rd Newton NC 28658 Address: Home Phone: 4. Name of Subdivision: - - - Lot Section/Block/Phase: Property Address: t~ Directions to Property: 2550 16 3/18/2010 5. Property Size: Square Feet Acres Date Platted/Recorded 6. TYPE OF FACILITY: (e- House C` Mobile Home Dimension of Structure "-'x Bedrooms*F *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 the 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 No Water Using Fixtures in Basement: i* Yes r No No. in Family: 5 Whirlpool Tub: Yes ( No Gallon Capacity: MULTIPLE FAMILY RESIDENCES: Units l Total Number of Bedrooms DAY CARE: Number of Children F Seats Square Feet Dining Area Square Feet Food Stand/Meat Market Floor Space TYPE OF BUSINESS: No. of Employees 1 st 2nd F 3rd F 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 tree removal 9. Are there easements/right-of-ways recorded on this property? (0-Yes (-No 10. Is a public water supply available on or adjacent to the above property? (eYes (No Check type that is available: F Community Well I- Semi-public Well F X_ water line 11. Well Type Applying For: Fx- Individual Well F_ Community Well F_ Semi-public Well F Irrigation Well r Geothermal Well 12. Monitoring Well Request: C Yes (-No # of Wells: F of Site: I understand that this 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 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 set backs. **IF A PERMIT HAS TO BE REDESIGNED AND/OR RETRIPS MADE TO THE PROPERTY, THERE IS AN ADDITIONAL CHARGE Date: 3/24/2010 Signature of Owner or Agent: Print Form Catawba County, North Carolina N This map product was prepm ed from the Catmvba County, NC, Geographic Information System. Catawba County has made substantial efforts to ensure the accuracv of location and labeling information contained on this map. Catmvba 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 or entity. Legend Selected Parcel Number: 3648-20-90-2088 1 inch = 100 feet Prepared for: t 579.00 C' 00, D oo o, r-L te~ ~J _ 7 ° s r 00 THIS IS NOT A LEGAL DOCUMENT Wednesday, March 24, 2010 05:04 PM 16.12A Catawba County, North Carolina N This map product was prepared from 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 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 jar any and all damages, loss or liability, whether direct, indirect or consequential which arises or may arise from this map product o' the use thereof by any person or entity. Legend Selected Parcel Number: 3648-20-90-2088 1 inch = 240 feet Prepared for: tf 4 IV ,~.'R1'.y- a s. l - ' `'t f- •~Y- 1`~ yb ~h *•dr-sY,6 Y,1 y. fff fi' 0~: r ji°. s ~ St~ t~ n v` J J M f. y - 6~y F t~ia 1r` Mn• + F 1 yr e rC r r N ~1`-1 j v - 4 Vd i+ _~b^ r R x : k 1' J - r t f FE~ Y Y r. ! ~ 4 t .r..- % '4 e 1 r Q t ti y5°t~ / r r i?1 ~,>t , o e 1 r r P~~ r o a y x a; ti ~y x 74- 'Aldw &Wj ~Aa ra r ~,E3 tF s; r~ 0349 o. r 1. r_ r ~ a~~« 6a dyG,tb y)}. ~ ~ rr r Y='1 * sl ~~'+.s S 'pr ~ e -for k~ - r .a f rk?4. ~II n~ 058'37 f zj. ~-41 %SV rt w * 1,31A rbj k i pay e. 0310 l e t d7 C~ "CffiS IS NOT A LEGAL DOCUMENT Wednesday, March 24, 2010 04:55 PM CATAWBA COUNTY NC - Parcel Report Information Regarding Selected Parcel(s) Parcel ID: 3648-20-90-2088 Name: SIPE WILLIAM DWAYNE Name2: SIPE BEVERLY OWENSBY Address: 1932 CAMPBELL RD Address2: City: NEWTON State: NC Zip: 28658-9388 Account: 64223000 Calc Acreage: 16.12 Tax Map: 065N 05006 LRK: 35635 Deed Book: 1124 Deed Page: 0374 Subdivision Name: Subdivision Block: Lots: Plat Book: Plat Page: Building Number: Street Name: CAMPBELL RD Site Zip: 28658 Township: NEWTON Fire Code: MAIDEN RURAL City Code: COUNTY State Road: 1878 Total Bldgs Value: $212,300 Land Value: $95,000 Total Value: $307,300 Year Built: 1977 Year Remodeled: Last Sale Date: Last Sale Amount: Neighborhood: 113 Watershed: Watershed Split: Voter Precinct: P20 E911 District: COUNTY Zoning: R-40 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: CONTACT SCHOOL DISTRICT Middle School: MAIDEN High School: MAIDEN School Split: YES P&Z Case Number: Census Tract 2010: 011600 Census Block 2010: 1048 Small Area Plan: BALLS CREEK Agricultural District: Printed: Wednesday, March 24, 2010 04:55 PM is w.rrvv -~r•^ T TaI4 _3JVAVAIV / /F PI I /OR W-M CIS - - _ n NoLL33aw API 2i30Nn 43/r2lo3a3d A3AS~ns 013td lV(1LO~V NY V t!'lo?l: # - 1V'Id SIHi 1VHL A W 30 'aoA3mnS awl 1tM01SS3i08d 'NVM13321 BSQZ- -OZ-8i9£ .mod 99L. 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(Ywos O1 LON) a L t r t ~ O i 00~ 3Cl 3dIti7JOS T 41 4,A C~ CATAWBA COUNTY, NC 100-A South West Blvd PLAN INVOICE <1 Newton, NC 28658- v (828)465-8399 Wednesday, March 24, 2010 184 Z sM www.catawbacountync.gov Plan Case: EHPR-3-10-4526 Invoice Number: INV-3-10-260777 Environmental Health Plan Review Invoice Date: 03/24/2010 Fee Name Fee Amount Improvement Permit Fee Fixed $150.00 Total Fees Due: $150.00 PAYMENTS Date Pay Type Check Number Amount Paid Change 03/24/2010 Credit Card -1 $150.00 $0.00 Total Paid: $150.00 Total Due: $0.00 plan invoice;zi6£R8d29-fI40-134f-1~Idf-1h.3337n6 50;.rpt 03/24/2010 17:16