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Home My WebLink AboutEHPR-3-11-10134.TIF � C � THIS IS NOT A PERMIT Case # EHPR-3-11-10134 �' � CATAWBA COUNTY HEALTH DEPARTMENT v ,:;;: '�' Plan Review Application for Environmental Services 1842 SM Environmental Health Plan Review - OSWP � �ii �� .- � � �t s�� IMPROVEMENT Ia.1 �I�w�I�� HZ�rnE'S 1 t.� pti6l�L NAME TO APPEAR ON PERMIT �� CLAYTON HOMES CLAYTON HOMES SITE ADDRESS: ZION CHURCH RD Hickory, NC Pir�: 370016842737 NAME of SUBDIVISION:BARBARA ANN GRAY Lot # i Section/B►ock/Phase PROPERTY SIZE: Square Feet Acres 1 DIRECTIONS: HIGHWAY 10 W- TURN RIGHT ONTO ZION CHURCH RD - PROPERTY ON RIGHT BEFORE PITTSTOWN RD APPLICANT OWNER CONTRACTOR CLAYTON HOMES CLAYTON HOMES BARBARA GRAY 1230 CONOVER BLVD W 1707 MENNONITE CHURCH RD CONOVER NC 28613- HICKORY NC 28601- (828)465-3450 (828)241-4935 PRIMARY CONTACT: Applicant APPLICATION FOR: New Construction DIM EXISTING STRUCTURE: 14 X 70 EXISTING FACILITY TYPE: Mobile Home NUMBER OF EXISTING BEDROOMS: 3 SEWER TYPE: Septic T NUMBER OF EXISTING OCCUPANTS: 2 EXISTING WATER SUPPLY IN U . ublic Water CALCULATED DESIGN FLOW: Public water IS available for this property. PUBLIC WATER TYPE AVAILABLE: County/City/Township Water DESCRIBE WORK: DNIDING PROPERTY AND PUTTING NEW MOBILE HOME ON PROPERTY - HOME ALREADY REMOVED DESCRIPTION OF SINGLE WIDE EXISTING STRUCTURES ON SITE (IF ANY) PR EASEMENTS: NO PROPOSED CONSTRUCTION PRIMARY RESIDENCE NEW RESIDENCE? New Residence # OF NEW BEDROOMS: 2 # OF STRUCTURE OCCUPANTS: 2 PROJECT DESC: PUTTING NEW SINGLE WIDE ON PROPERTY PROJECT DIMENSION: 14 X 76 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 Environ,mental 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 ********************************************�************************�************************************************ 04/13/I1 08:09 � 4 ' A � THIS IS NOT A PERMIT Case # EHPR-3-i 1-10134 �" � CATAWBA COUNTY HEALTH DEPARTMENT U yv ''C Plan Review Application for Environmental Services I842 sM Environmental Health Plan Review - OSWP �,v'�� .c� C c'�(� IMPROVEMENT ��,�.�,� ��r �� ! � � NAME TO APPEAR ON PERMIT CLAYTON HOMES CLAYTON HOMES SITE ADDRESS: ZION CHURCH RD Hickory, NC Pir�s: 370016842737 NAME of SUBDIVISION:BARBARA ANN GRAY Lot# 1 Section/B1ock/Phase PROPERTY SIZE: Square Feet Acres 1 DIRECTIONS: HIGHWAY 10 W- TURN RIGHT ONTO ZION CHURCH RD - PROPERTY ON RIGHT BEFORE PITTSTOWN RD APPLICANT OWNER CONTRACTOR CLAYTON HOMES CLAYTON HOMES BARBARA GRAY 1230 CONOVER BLVD W 1707 MENNONITE CHURCH KD CONOVER NC 28613- HICKORY NC 28601- (828)465-3450 (828)241-4935 PRIMARY CONTACT: A APPLICATION FOR: New Construction DIM EXISTING STRUCTURE 14 X 70 EXISTING FACILITY TYPE: Mobile Home NUMBER OF EXISTING BEDROOMS: 3 SEWER TYPE: Septic Tank NUMBER OF EXISTING OCCUPANTS: 2 EXISTING WATER SUPPLY IN USE: Private Well CALCULATED DESIGN FLOW: Public water IS available for this property. PUBLIC WATER TYPE AVAILABLE: County/City/Township Water DESCRIBE WORK: DIVIDING PROPERTY AND PUTTING NEW MOBILE HOME ON PROPERTY - HOME ALREADY REMOVED DESCRIPTION OF SINGLE WIDE EXISTING STRUCTURES ON SITE (IF ANY) PROPERTY EASEMENTS: NO PROPOSED CONSTRUCTION PRIMARY RESIDENCE NEW RESIDENCE? New Residence # OF NEW BEDROOMS: 2 # OF STRUCTURE OCCUPANTS: 2 PROJECT DESC: PUTTING NEW SINGLE WIDE ON PROPERTY PROJECT DIMENSION: 14 X 76 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 ca11828-466-7291 AREAZ ****************�******************************************************************�*�***********�***************�**** 04/O 1 / 11 11:54 . _ . ., ypr. 4. �011 1:5iPNi (;l,:,y�ton Horr�:;—C�naver PJo. fii;i�Q P, 1 RECEIVED '�`�' �P� 0 4 2011 � � homes �r�w� courmr 9 230 Conover Bivd. West ��Ta� t��,� Conover, NC 28613 (828) 465-3450 (828) 464-0261 (Fax) DATE � � ll TO /�/( �� , FAx# �Z�-c{��_ �5 2�?� FROM � .• ��-,L # PAGES (including cover sheet) MESSAGEa _ P 1� C �i4t � jn,'�' �✓ � t� x► �• C��..f r c.�r �� - _ 1 � I ^�1 1 � � I I %� 1 �I '� "I �� n y��r. 4. tr�ll 1:51?i��i �:I,;.yi��r ror��;-�,onov�r id�;. (i,i,i, r. [ FlLED C2lar�b,e Gots� �� an S�iar �U, �Oi9 s� b1:a2:44 psn �p � �15e �cx �`il-GQ i P � � ��{vT..�`r �.1J�J�3 .�/ C, q h �� ^1. 4'�kA t�LIG�G ��@i�fER, �z 3 0 � e n avc � a�V� �• ��a� �s [�cts c�o�� Nc�� 3, CK�;t'17O F� �6?C1�-'�� NOR�'H C:AROLINA EASENiENT �'OR SEPTIC TA.�rK LLti'E CATA�'4�A COUNTY THIS AGREEIvLENT, made this the 28th day of March, 2011, by and between BARBARA A?v�i GRAY and CAROLYI� CA1�E, T?arty of the First Part, and E�RBARA A��i 1 GRAY and CAROLYI�T CA1'��SPE, Party of the Second Part. �'VITNES SETH V�'HEREAS, the parties hereto own a cerr.ain tract of land i.n Hickory• Tow�ship, Catawba County, !�orth Caroli.na, the sazae being the land con�•eyed to them by deed recorded in Book306�, Page 1412, of the Catawba Counry Re;is�y; and bVI3EREAS, the parties desire to ditiide the propezty into tu-o lots, �ne of which �rill bave a septic tank installed (new lot), a.nd the lines to the sepric t,ink will nw onto the remaining lot (p4ent tract); and �VHER�AS, the parties hereto desire that a definite agreement be made as to the use and maintenance of said septic tank; and NO�V, THEREFORE, in consideration of the mutual rights and adva.nrzges herei.n set out, tbe said parties hereto mutually a�ee as follows: - Party of the Second Part herein agrees to allo«% Pazty o� the Fizst �art berein to install and matntain a septic �ank line on the propercy ofthe Party of the Second Part (the pazent tcact) for a septic tank tlialwill be installed on the property of the Pa.rty of the First Part {new� lot from parent t�act); for tbe puzpose of pro�•iding sewer services to a residenrial dwe? ling located on property of rhe Pazry of the �irst Part (Aew 1ot from pazent tract). II� TESTIMOI�Y VJHEREOF, the parties hereto ha��e set their hands and seals the day and year first above �vritten. (SEAL) Barbara Ann Crray ( S�AL) Carolyn anipe � , p � .. � , ��If. �t. ��il� �:��IY�I (.��'.VI'Jil IiOf�i��: I��O. ��Irl�l� '. J �. STATE OF NORTH CAROLINA � `� �at,�'etvJ b� COUNTY. I, V Q n G SS G� �. • Gl rn d f , a Notary Public of the County and state aforesaid, certify that B�1RB:i�ZA !LI`'N GRAY and CAROLY�1 CANIFE personally appeared before me this day and acknowledged the execution of the foregoing i.nstrument. �4Yitaess my hand and official stamp or seal, this ��'day of � Gl r�� , 2011. ` ' ' ��= \ � I � %>�i.�. �/ � . `.^i - ``,`,\f✓ . l' o l�� ' � •',, n n �n � _� = ' _,.,�.1 -,�_ Nota�ubli� � � :.�_ _ My commission eapires: 0 3 0 � n : �_ ��s A� �� _:� � % �`'• : � STATE OF NORTH CAROLIN.4 ��'�� 4 C O ��`�' � ��//l; l ll lllll\U B�L�.KE COUNTY. � - I, , a Notary Public of the County and state aforesaid, certi�y that personally appeare� betore me this day and acl�owledged the execution of the foregoing instrument. Wibness my hand and official stamp or seal, this day of , 2011. Notarv Public My commission expires: ! '� �t [Q'1 1Q:lif�Ni C1=y't+�n Ho��:—f.onov�r No, (O�;i; �. 1 .I'��, GI� n � homes 1230 Conover Blvd. West Conover, NC 28613 (828) 465-3450 (828) 464-0261 (Fax) DATE � t � �i� TO � � �n - - FAX# � ZSr -�{ l� Sr-- 2�-� � FROM _�vS�I�in ��,�� # PAGES (including cover sheet) MESSAGE: f ( o r� u f�` � r�� I. Lll� I �i;. 1 jANi �;�-.yron Hs� .. �d�. Gi,'`�(I �. � �mall.fv�,.., ,..., ....._.,...ir, .,_.. / Sgt,�ae� u�rements ,' �rarrt - 30' / :..�e - �5' , �,t�ar - 30' ' � ,' � ' / ./ � � � �. ,� �tl�� c k , � �4c. ��4, �. �� / � , \ ��a�t �.. . . , - � �� a�►��++°��r �,� � ,./ � �a+�� , � 1 � i � ��/ �n��r �f �� , / �k• �, Pg. 1 �8q �' ' s �'� � �� !�� i�?L� - '�j �. �V�"� � „ �/ �� . 1 J�y�q�ere � 3B�&s � . , ,Slf�� '� �f �Q�� 2�.08' ,/ nb94 ��fi / �: �' r � , � Re��f# � � � �` �, ��k. �� '�'�'' � �'�� .� � � ti� , a , \ � �°' � � '�S' �� (� � � � � ', ' � ,.� �a.� .� �� ,��" �'i� �'� � ,� � � \ . a � � "�'�� , \ \\ w�� • ,�ti, � � ^N �/� � S / � \ \� , �ontrol � � \ � ,� �' � _ �/�"� �s�1��fe �� ==- 2a� — � – `� �~,� �1/2"�� ,, � � �a � N a3•�h2'�� , � _ � i �'�� p/ � � � � � �, I►��_ \ rv 5s�2s.�^ - '� �• �A. 1 �@0 � �`� �. _ , eA: 14� .- q � r � ' . ` r � ,� � �n 4��"�� • • 1 , Mli+��l L, M�r�l � � r � Q � �{/� � ��k. gQ93, �fl, �� ` � �,� , ��:7�� `��'�R� ►r�� li�� 0��.. \ ��Q�� ' ° , / �.� �� -- -- � � i � ;Stone � � ., � � i�'t�l'�.�t � . • �c,4� ` � �� i �� _ ,. . . �� _'►,�� a�� ` k;�r.�' �. (i;i i �i,:'� iH�ii �: .,V��)n r;��,;�_—;;:�nov:�� i"V;. f,i;,�i? . j Description for tf��e Barbara Ann Crray and Carolyn Canipe survey - Septic Easement An Easemerrt Area is reserved for the Sepfiic Draina�e and is described as follows: Commencin� at the 3/4" Iron Pipe v�zth in the NE portion of the right of way for Zion Church Road, (SR 1008), and in the division ]ine for Lot Z and the Citifinancial Services, Inc. parcel as shown by sun•e}� plat for a�finor Subdi�lsion surveyed for Barbara rinr► Gray and Caroly�n Canipe, surveyed and platted by Donald G. Bolick, L-3638, 3/16/201 l, and proceedin� thence N?5'16'�8"E. a distance of 162.45' to the POI'�1T OF BEGINNII� G; The Point of Beginnin� being an unmarked point in the aforementioned division line, thence rurulin� through the Lot 2 a.rea, I�$5 1"�', a distance ot 80.26' to an unmarked point in the division line for Lot 1 and Lot 2 as showm by the $arbara Ann Crray and Caroljm Canipe plat; thence u�ith said division line I�T31 °26'31 "E, a distance of �0.00' to an unrnarked point; thence crossin� through the Lot 2 area, S86`51'�1"E, a distance of 15.36' to a 1 i2" Iron Pipe; N`V comer of the Citifinancial Ser�ices, Inc. pa.rcel: thence S25°16'38"��1, a distan.ce of 50.00' to ihe pO1NT' OF BEGI'�'_�1NG; Said described Area bein� 0.08 Acres (3538.02 Square Feet), more or less, as computed from the :vlinor Subdi��ision plat b_y Donald G. Bolicl� L-368S, 4/03/201 l. !/�" ��° S� � �� l �� .�� g ��o a �� I� � �,ome� 1230 Conover Blvd. West Conover, NC 286� 3 (828) 465-3450 (828) 464-0261 (Faz) DATE � � ll TO /l/( �v( G �' FAX# � 2, �- - c{ �, �' — � � �? � FROM J v � (` �- �. # PAGES (including cover sheet) � MESSAGE: �C � t ✓ � �_ t � � •� �1�. v r c.�r � � • � � � � -� G �� / � � .-Y c� � Gc S NO w �� ,- w� ,•�I G �� r l'd �809'°N i��nouo,�_,.�aaoH uol��<<�J ��Jd��i)�� 110� �ll'.i�H i � � � / r �c yl►�� . '�� , 0 �—�—'"_ %� /: . ' �� '� / �� . . i� �� /� � Carmie Carlos Cook � y ' , Dbk. 870, Pg. 210 ;.�'�� '/ ` p�va J. Co� '� � �� Dbk.2057, \ s ,/ � . � o � �� \ eptic Easement , � „ Id Bearin Distance � '� � 38 50.00' � �� N 65°13'31" W 80.26' ' s ` \\ . L3 N 31 °26'31" E 100.00; �� LOt 2 � � • Ashle S. Lindler \ , Remainder of � Y , ' �/ Dbk. 3046, Pg. 1380 Dbk. 2243, Pb. 1513 ,� , , S 2168 Zion Churcfi Rd , � Lot 1 includes � ;�,�� 3/6"Rebar _ _ r - � � r r � � D.06 acres J + /� 3565.70 sq ft LOt 1 bb, � 1��IPf/square S 30'04'ST' w `. o� stree�t R/UV Part of CiOC}�1'0� � ��'� � �.sa� Nw of Dbk. 3046, s , �� Robert E. Johnson, Sr. '� property line .;� Pg. 1380 �; � `, Dbk. 2449, Pg. 704 � 3/4 ��i� �,� 1,OO acres � �� 43560.00 sq R � �� 1.56' NW of ,��;'`� Removed home,� / Septic Easement /� � � \ / property line o,'� se�;r., site o . , . ::y ,/ �.�,° � 1/2"IPf �' vv�ter �� j� ti`' ;, ��'� � � . � E y ,' 112"1Pf � /' .�.� - _ ;: � �• � �/ � , � :J� �-� � ��- , Control , , �, �= -�::�" �. o �� . .:.:•. � � e �I/7��Ptls uare � �e'� ,� Possible � ,� ;�>;`' 4 � q � � Overlap � ':. Bid �~ a �1/2"Rebar \\, - P Area � � �`�' 38.21' g ,�ti � ��`� ( 59"04'CO„ W ``, � � . � h,� aCitifinancial S ivices, Inc. \ � � .� � =� e�l�n �w Dbk.3046�Pg. 1380 � ea� ` � y Pbk. 23� Pg. 143 � _ p� �, �S i2a�' � � _ � / Axle \ �' r � ' nllichael L. Nenry � 3 T . N 60"3Z'45" W 3 � \s4 �� "IPflbase � Dbk. 2873, Pg. 83 ' a � S 2S°16"38" W � ` S1w � , 17.79 � /Z'Rebar �\ Dn Church Road ` ag ' � , S R 10 08 �nr so� �•�'� � 25.23 � � � . ' . ' `�\ / ,� �� ,� Surveyors Cert� c t�'o "I, Donald G. Bolick, Professional Land Sutveyor, certify that this plat v�ras drawn under my supervision from an actual survey made under my ; That the boundar��.s'not suroeyed are Gearly indicated as drawn from infi� found in the references shown hereon; Tha� the ratio of preasion as calc is in excess of 1/10000 unless otherwise noted; That this plat was prepa in accordance with G. S. 47�0 as amended, any exception is duly noted Witness my ori inal signature, ragi tion n mber and seal this 1" = 100 Graphic S _ , �� day of �� , 2011 A `__ � �c,� o ,.i:�ncu��_.�.�o uc .�.� �::�-; ; , ll h � �� N ". I , �,� � �� :�� ,,,�dr�� - < <�� .�,� Description for tahe Barbara Azw Gray-Carokyn Canipe Sutvey - Segtic Easement 0.12 ac An Easement Area is reserved for the Septic Thainage and is descri�bed as follows: Conomez�cizwg at the 3I4" Iron Pipe with in the NE poz�tion o£the zig,krt of way for Zion Church Road, (SR 1008), a.nct in the dxvision line for Lot 2 and the Citifinancial Services, Tnc. parcel as show,n by survey plat for a Mmor Subdivision surveyed for Barbara Ann Gray and Carolyu Canipe, surveyed and platted by Donald G. Bolicl� Ir3688, 3/16/ZO11, and proceeding thence N25°16'38"E, a dastance of 162.45' to the POINT OF BEGINNING; T'be Point ofBeuinning beivg an uopaarked poirn in �thhe aforementioned di�visio� uoe; thence z�m�i.ng through the Lot 2 are� N85°13'31 "W, a distance of 80_26' to an unmarked point in the division liz�,e for Lot 1 and Lot 2 as shown by the Barbara Ann Crray and Catolyn Canipe ptat; thence wi�th said di�ri�sion line, N31 °26'31 "E, a distance of 100.00' to an unmarked poi�xt; thence crossing through the Lot 2 area, S46°25'13"E, a discance of 68.87' to a 1/2" Iron Pipe; NW corne�r of the Citifmancial Services, Inc. paccel; thence S25°16'38"W, a distance of 50.00' to th� POII�T OF BEGINNING; Said descnbed A.rea being 0.08 A�es (3538.02 Squa�e Feet), more or less, as computed from the Minor Subdi�vuion plat by Donald G. Bolick, L-3688, 4/08/2011. �� b o �� 6 9 D 1 3 3 '�' � � � �� a � �c �'�' �°N ��nouo,,,_s��.uo� ue�.��l:) i�Nd60�� llL� 'll '�oH