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Home My WebLink AboutEHPR-3-11-10081.TIF Ea�v�ro�m�nta� I��alt� Additio�al Fee Collection Notice � The following additionai fees as che�ked below must be collected prior to further action by our department: � . 0 Repair Permit Application � . . ❑ Permit revision (re-draw) . . � , . 0 Well Permit � � ❑ Authorization to Construct (system upgrades, etc.) � � Other (please explain below) � � . / ' .� �,�'�l�II�C. lYl��,�� t'�� (2/� �Zv"t'r�1 . EHS � Date - . A �� C p� THIS IS NOT A PERMIT Case # EHPR-3-11-10081 � �` � CATAWBA COUNTY HEALTH DEPARTMENT v �� ''C Plan Review Application for Environmental Services 1842 SM Environmental Health Plan Review - OSWP � C� '' � � � IMPROVEMENT � �. NAME TO APPEAR ON PERMIT �� Cherie Bish s�TE A��RESS: 3982 MILLER DR, Newton, NC Pir�: 361803042359 NAME of SUBDIVISION:G C PARK SUB Lot # ]� Section/Block/Phase PROPERTY SIZE: Square Feet Acres 0.46 DIRECTIONS: Hwy 10 West - Lf Hickory Lincolnton Hwy - RT Miller Dr - Gray trailer beside blue house APPLICANT OWNER CONTRACTOR Cherie Bish Cherie Bish 3982 Miller DR 3982 Miller DR Newton NC 28658 Newton NC 28658 828-640-3315 82&640-3315 PRIMARY CONTACT: Owner APPLICATION FOR: New Construction DIM EXISTING STRUCTURE: 12 x 60 EXISTING FACILITY TYPE: Mobile Home NUMBER OF EXISTING BEDROOMS: 2 SEWER TYPE: Septic Tank NUMBER OF EXISTING OCCUPANTS: 3 EXISTING WATER SUPPLY IN USE: Private Well CALCULATED DESIGN FLOW: Public water is **NOT** available for this property. PUBLIC WATER TYPE AVAILABLE: N/A DESCRIBE WORK: Change out Mobile Home * Must have 36 SF Front Deck - Must be Vinyl Underpinned - Must have min 3 foot landing on rear door - must screen or remove towing tongue - must be paralle to road DESCRIPTION OF mobile home ** to be removed and repalced with larger home EXISTING STRUCTURES ON SI7E (IF ANY) P EASEMENTS: none PROPOSED CONSTRUCTION PRIMARY RESIDENCE NEW RESIDENCE? New Residence # OF NEW BEDROOMS: 3 # OF STRUCTURE OCCUPANTS: PROJECT DESC: New Single Wide ** USing existing well PROJECT DIMENSION: 16 x 72 BASEMENT? No BASEMENT FIXTURES? No 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 properiy. 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 AREAZ **************************�*****�******************************�************�*********�*******�*�**************�****** 04/06/11 10:50 � CATAWBA COUNTY Case # EHPR-3-11-10081 G Public Health Department ¢ �2. Subdivision (', C PARK SUB � Environmental Health Division - Plan Review � av '�' PO Box 389, 100-A Southwest Blvd, Newton, NC 28658 L�� 1 rg 2 s� PM# 361803042359 Applicant/Owner Cherie Bish, 3982 Miller DR, Newton NC 28658 Site Address: 3982 MILLER DR, Newton, NC Property Size: SF 0.46 ACRES DireCtions: Hwy 10 West - Lf Hickory Lincolnton Hwy - RT Miller Dr - Gray trailer beside blue house Minimum Setbacks Front: 30 Side: 15 Rear: 30 Side St: Max Height: FEE NAME DATE AMOUNT BALANCE DUE Autharization to Construct Fee (New/Expansion) Fee 03/28/2011 $150.00 $0.00 Improvement Permit Fee 03/28/2011 $150.00 $0.00 TOTAL FEES $300.00 $0.00 CHANGE WORK ORDER REQUIRING REDESIGN AND/OR RETRIP WILL INCURE AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) 04/06/11 10:50 .��' Cp CATAWBA COUNTY, NC �,� �,� '°°-A S°°t" West B'�d PLAN RECEIPT � f.-] Newton, NC 28658- V G�� (828)465-8399 Wednesday, April 6, 2011 1$�Z sM www.catawbacountync.gov P�an case: EHPR-3-11-10081 �nvoice Number: INV-3-11-273482 Environmental Nealth Plan Review Invoice Date: 03/28/2011 Site Address: 3982 MILLER DR, Newton, NC APPL�CANT OWNER CONTRACTOR Cherie Bish Cherie Bish 3982 Miller DR 3982 Miller DR Newton NC 28658 Newton NC 28658 828-640-3315 82&640-3315 Fee Name Fee Amount Improvement Permit Fee Fixed $150.00 Authorization to Construct Fee Adjustable $150.00 (New/Expansion) Fee Total Fees Due: $300.00 PAYMENTS PAYER: Cherie Bish Date Pay Type Check Number Amount Paid Change 03/28/2011 Cash -1 $300.00 $0.00 04/06/2011 Refund -1 ($150.00) $0.00 Total Paid: $150.00 Total Due: $0.00 plan receipt 04/06/2011 10:50 " : . , . . . , . '77 � _..,, � Catawtia Coun North:Carolina - Disbu:rsement�Voucher . ` Vendor No. Date 04/06�11 Make Payment To: � �'O� Voucher No(s). Cherie Bish �.., t �` 'Z 3982 Miller Dr Q � v "�'� � Newton, NC 28658 ?g�� ATTACHMENT Description Amount Permit found for 3 bedroom system expansion no longer required 150.00 credit AC Sub-Total $ � so.00 Food Tax Sales Tax Total $ 150.00 : ; . . � . . - For Accounting Account Fund. Organ.: � � Project - .: Use Only °:. : Total - The undersigned hereby certifies that the goods or services specified above have been received or performed. Payment has not been previously authorized and this expenditure is a proper charge to the appropriation indicated. The above charge is certified to you for payment. (SIGNATURE - APPROPRIATE OFFICIAL) E�av�ro�me��a� H�alt� Additio�a� Fee Collectioa� Notice The following additional fees as checked below must be collected prior to further action by our department: � . .0 Repair Permit Application � . . ❑ Permit revision (re-draw) . , . ❑ Well Permit � � ❑ Authorization to Construct (system upd ades, etc.) � � Other (please explain below) � � . /• (��'�i�. rr��",�c� c�d � � EHS � Date � � . � F ' A C� THIS IS NOT A PERMIT Case # EHPR-3-ll-10081 �" � CATAWBA COUNTY HEALTH DEPARTMENT v ��: ''�' Plan Review Application for Environmental Services 1842 sM Environmental Health Plan Review - OSWP C� '� � � i IMPROVEMENT NAME TO APPEAR ON PERMIT `�� Cherie Bish SiTE a��Ress: 3982 MILLER DR, Newton, NC Pin#: 361803042359 NAME of SUBDIVISION:G C PARK SUB Lot # 11 Section/Block/Phase PROPERTY SIZE: Square Feet Acres 0.46 DIRECTIONS: Hwy 10 West - Lf Hickory Lincolnton Hwy - RT Miller Dr - Gray trailer beside blue house APPLiCANT OWNER CONTRACTOR Cherie Bish Cherie Bish 3982 Miller DR 3982 Miller DR Newton NC 28658 Newton NC 28658 828-640-3315 82&640-3315 PRIMARY CONTACT: Owner APPLICATION FOR: New Construction DIM EXISTING STRUCTURE: 12 x 60 EXISTING FACILITY TYPE: Mobile Home NUMBER OF EXISTING BEDROOMS: 2 SEWER TYPE: Septic Tank NUMBER OF EXISTING OCCUPANTS: 3 EXISTING WATER SUPPLY IN USE: Private Well CALCULATED DESIGN FLOW: Public water is **NOT** available for this property. PUBLIC WATER TYPE AVAILABLE: N/A DESCRIBE WORK: Change out Mobile Home * Must have 36 SF Front Deck - Must be Vinyl Underpinned - Must have min 3 foot landing on rear door - must screen or remove towing tongue - must be paralle to road DESCRIPTION OF mobile home ** to be removed and repalced with larger home EXISTING STRUCTURES ON SITE (IF ANY) PROPERTY EASEMENTS: none PROPOSED CONSTRUCTION PRIMARY RESIDENCE NEW RESIDENCE? New Residence # OF NEW BEDROOMS: 3 # OF STRUCTURE OCCUPANTS: PROJECT DESC: New Single Wide ** USing existing well PROJECT DIMENSION: 16 x 72 BASEMENT? No BASEMENTFIXTURES? No 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 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 AREA2 ******************�****�*�******************************************************************************************** 04/06/11 ]0:50 � CATAWBA COUNTY Case # y � G Public Health Department EHPR-3-11-10081 �' � Environmental Health Division - Plan Review Subdivision G C PARK SUB v a'�'v "�' PO Box 389, 100-A Southwest Blvd, Newton, NC 28658 Lot# 11 Ig 2 5� PIN# 361803042359 Applicant/Owner Cherie Bish, 3982 Miller DR, Newton NC 28658 Site Address: 3982 MILLER DR, Newton, NC Property Size: SF 0.46 ACRES DireCtions: Hwy 10 West - Lf Hickory Lincolnton Hwy - RT Miller Dr - Gray trailer beside blue house Minimum Setbacks Front: 30 Side: 15 Rear: 30 Side St: Max Height: FEE NAME DATE AMOUNT BALANCE DUE Authorization to Construct Fee (New/Expansion) Fee 03/28l2011 $150.00 $0.00 Improvement Permit Fee 03/28/20ll $150.00 $0.00 TOTAL FEES $300.00 $0.00 CHANGE WORK ORDER REQUIRING REDESIGN AND/OR RETRIP WILL INCURE AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) 04l06/11 10:5� �$A � caTAwBa covrrTY, Nc �� ,� 1°°-A S°uth West B'�d pLA N RECEI PT � � Newton, NC 28658- U �� (828)465-8399 Wednesday, April 6, 2011 �► 1842 srn www.catawbacountync.gov p�an case: EHPR-3-11-10081 �nvoice Number: INV-3-11-273482 Environmental Health Plan Review Invoice Date: 03128/2011 Site Address: 3982 MILLER DR, Newton, NC APPLICANT OWNER CONTRACTOR Cherie Bish Cherie Bish 3982 Miller DR 3982 Miller DR Newton NC 28658 Newton NC 28658 82&640-3315 828-640-3315 Fee Name Fee Amount Improvement Permit Fee Fixed $150.00 Authorization to Construct Fee Adjustable $150.00 (New/Expansion) Fee Total Fees Due: $300.00 PAYMENTS PAYER: Cherie Bish Date Pay Type Check Number Amount Paid ChangE 03/28/2011 Cash -1 $300.00 $0.00 04/06/2011 Refund -1 ($150.00) $0.00 Total Paid: $150.00 Total Due: $0.00 plan receipt 04/06/2011 10:50 � �A � � �� CATAWBA COUNTY c� `y��'• '`C' P O Box 389 - Newton, North Carolina 28658 -(828) 465-8270 - Faac (828) 465-8276 - TDD (828) 465-8200 1g,�2 5M Public Health — Environmental Health Division AUTHORIZATION OF REFUND Date `� Case # � ��, - �' � � - ��f� � � A licant ` ��,�i ' �� rr Refund Amount �� Q. Q G� Refund Reason un , L � ► ` , � Q S �S � Authorizing Signature Received By Permit Center Staff "` ��-�' +� Date `� ��' � � � ; � . . . . . .. , : _ . Catawba County; North �Carolina -�Disbursement�Voucher , ` Vendor No. Date 04/06/11 Make Payment To: �� C O� Voucher No(s). Cherie Bish H� t � 'Z 3982 Miller Dr � y J� � Newton, NC 28658 jg�2 ATTACHMENT Description Amount Permit found for 3 bedroom system expansion no longer required 150.00 credit AC Sub-Totai $ 150.00 Food Tax Sales Tax Total $ 150.00 . ,. _. � � For Account'ing , ,. Account Fund. �, � Organ.: Project � _: Use Only Total - The undersigned hereby certifies that the goods or services specified above have been received or performed. Payment has not been previously authorized and this expenditure is a proper charge to the appropriation indicated. The above charge is certified to you for payment. (SIGNATURE - APPROPRIATE OFFICIAL) � � THIS IS NOT A PERMIT Case # � EHPR-3-11-10081 �' � CATAWBA COUNTY HEALTH DEPARTMENT v :;; ''C Plan Review Application for Environmental Services Ig�2 sM Environmental Health Plan Review - OSWP (� 1'I S� � �r�n��?' EXPANS/ON .-�� L�.�• ��((v�j NAME TO APPEAR ON PERMIT ��r� Sherie Bish SITE ADDRESS: 39$2 MILLER DR Newton, NC Pirr�: 361803042359 NAME of SUBDIVISION:G C PARK SUB Lot # ll Section/Block/Phase PROPERTY SfZE: Square Feet Acres 0.46 DIRECTIONS: Hwy 10 West - Lf Hickory Lincolnton Hwy - RT Miller Dr - Gray trailer beside blue house APPLICANT OWNER CONTRACTOR Sherie Bish Sherie Bish 3982 Miller DR 3982 Miller DR Newton NC 28658 Newton NC 28658 828-640-33 l 5 828-640-3315 PRIMARY CONTACT: Owner APPLICATION FOR: New Construction DIM EXISTING STRUCTURE: 12 x 60 EXISTING FACILITY TYPE: Mobile HQ ne NUMBER OF EXISTING BEDROOMS: 2 SEWER TYPE. Sept�c ank_� NUMBER OF EXISTING OCCUPANTS: 3 EXISTING WATER SUPPLY IN USE: Private Well CALCULATED DESIGN FLOW: Public water is *'`NOT*" available for this property. PUBLIC WATER TYPE AVAILABLE: N/A DESCRISE WORK: Change out Mobile Home * Must have 36 SF Front Deck - Must be Vinyl Underpinned - Must have min 3 foot landing on rear door - must screen or remove towing tongue - must be paralle to road DESCRIPTION OF mobile home ** to be removed and repalced with larger home EXISTING STRUCTURES ON SITE (IF ANY) PROPERTY EASEMENTS: none PROPOSED CONSTRUCTION PRIMARY RESIDENCE NEW RESIDENCE? New Residence # OF NEW BEDROOMS: 3 # OF STRUCTURE OCCUPANTS: PROJECT DESC: New Single Wide ** USing existing well PROJECT DIMENSION: 16 x 72 BASEMENT? No BASEMENTFIXTURES? No 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 nor}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 AREA2 ********************�**********�***�****************�*************************�*************************************** 03/29/11 09:05 � $A �G � � � CATAWBA COUNTY v '�' P O Box 389 - Newton, North Carolina 28658 -(828) 465-8270 - Fax (828) 465-8276 - TDD (828) 465-8200 1842 SM Public Health — Environmental Health Division AUTHORIZATION OF REFUND Date `� Case # � �� -��'� � - �1��?� � � Applicant � � [?.�`, ', l.-�� s� Refund Amount � � �� aG� Refund Reason � un , C � � ` , � Q S �5 � Authorizing Signature Received By Permit Center Staff '`��'�-�' ^� Date � ��' l 1 ,� 't ... � . � CATAWBA COUNTY'�HEALTH DEPARTMENT NEWTON, NORTH CAROLINA COMPLETION PERMIT FOR SEPTIC TANKS PERMIT N- � � � r � + � DATE: 1 OWNER � r � � , .G C, �ADDRESS . � BUILDING CONTRACTOR SUBDIVISION LOCATION LOT �� LOT SIZE BLOCK OR SECTION HOUSE ( ) MOBILE HOME ( ) BUSINESS ( ) OTHER ( ) FHA-VA LOAN ( ) SEPTIC TANK: (SIZE GALS) WATER SUPPLY: N0. BEDROOMS NO FIXTURES INDIVIDUAL PUBLIC GARBAGE DISP�AL UNIT:YES (� NO () IF WELL, TYPE: B RED DR LLED DUG AUTO WASHING MACHINE: YES () NO () DISTANCE FROM SEPTIC TANK OR NEAREST NITRIFICATION FIELD: SQ.FT. POLLUTION: FT. 1) NUMBER OF LINES SEPTIC TAN . 2) LENGTH AND WIDT IN� E Z EE a BED STEM CER�IFICATE C LET B: b) TRENCH SYSTEM ( ) � 3) DEPTH OF STONE IN LINES REMARK : ADEQUATE FALL (GRADE) O�i: 1) BUILDING (HOUSE) SEWER LINE: YE S ( ) NO ( ) 2) NITRIFICATION LINES: D E N T LL . YE S ( ) NO ( ) SEPTIC ANK LAYOUT H x z � a � � w H E .., o o a � NEALTN DEPARTMENT COPY , , ,� I ' � A� � .-, CATAWB� CC�iT:QTY �HEr1LTH DEPARTMENT �' ; � � � 'S2 � � . ,� IME'ROVEMEti'T PERMIT FOR SEPTIC TANKS Pe it No. � � p � r1:'� OF OWNER � � � �'� � D!LTE � 9 ADDRES� OF OWNER PH�NE NAME OF CONTRACTOR ADDRESS r l - / -� LOCATIO:V (� ! �tii - �c. � � � Gc�-v ' � �� - 7 � �� . � � � / e SUBDZVISIOi� LOT N0. �l SECTIO;i OR BLOCK LOT SIZE FHA, VA L0�1N eptic Tank Contractor must follow all HOUSE O r:OBILE HOME (x) BUSINESS O OTHER O etails of this erm' (la out Ir'0. BEDROOMS (�) N0. FIXTURES ((� SEPTIC T LAYOUT GARBAGE DISPOSAL UNIT: YES () NO t`�'R PLUTiBING UNDER BASEMENT FLOOR: YES � NO � �, U SIZE OF TANK �Q O Q LIQUID GALLONS NITRIFICATION FIELD . 1. Numher of lines �k' 2. Length and width o ine : � a. Bed Sys tem .�°� X t. � (_ b. Trench system ft. '� �p Ni `� 3. TotaZ Depth of stone Z inches / GROUNDWATER INTERCEPTOR DRAIN: (IF REQUIRED) kATER SUPPLY: PRIVATE �) PUBLZC ( ) �' � OWI3ER NOTIFIED TO CHECK ZONING: YES OO NO O �' ^> � OWNER AGREES WITH LAYOUT: YES (� NO () � OT•di�TER AGREES WI'TH SPECIAL INSTRUCTIONS : YES �) Id0 O � OWNcR OP. CO�iTRACTOR SIGNATURE $� PERMIT FEE $ � 5��"''�- PERhfIT VOID AFTER 36 MONTHS !� � ! FINAL APPROVAL Of TN►S SEPTlC TANK SYSTEM BY I�W`PROVE�iENT PERMIT ISSUED __.._.-� J' ,�.' TNE HEALTH D£PARTMENT SHALI IN0ICATE 7HAT ?HE �� c'� SYSTEM HAS BEEN CONStRUCTED ACCORDIN(3 TO SANITF�RI•AN � 1 THE STANOARDS 5E1' FORTH IN 7HE GATAWBr� COUNTY SEWAL3E DISPOSAL R£QUL.ATIONS, BUT ly NO WAY EALTEt DEPT . COPY S�LL 6E TAKEN AS A GUARANTEE THAT�E SYSTEh! WILL FUNC N SATISFACTORIL FOR (�LY GIVEN PER�,bD oF Tlr.� . S OIL CLASSIFICATION: SUITABLE O PRUVISZONALLY SUITABLE O UNSIi�T�'I,E O SITE Ft?CTORS Z. SLOPE (%) S- PS - U 7. SOIL PERMEABILITY S- PS - U 2. SOIL TEXTURE (12-48 IN.) S- PS - l3 U\DER 60 .fiN. - OVER 60 MIN. SE1.�DY� LOAMY, CLAYEY 8. OTHER S- PS - U 3. SOIL STRUCTURE (12-4$ IN.) S- PS - U (SPECIFY) 4. SOIL DEPTfI (IN.) S• - PS - U 9. SOIL SERIES: 5. RESTRICTIVE HOP.IZONS (IN.) S- PS - U A. CECIL () B. HIT7rlSSF.E () (IriPERVIOliS ST?tATA, ROC�) C. M.ADISON () D. �pPLI:vG () 6. SOIL DRAINAGE - GROUND?dA'tER S- PS - U E. PACCLET () F. FLOOD PLAIN () (EXTEILtiAL - Ir;TERNAL) G. 2-1 CLAY SOIL H. OTHER-SPECIFY — i �5 � `� 5 � / � % r� ° ,. , r