The URL can be used to link to this page

Home My WebLink AboutEHPR-6-11-11214.TIF � C O� THIS IS NOT A PERMIT Case # EHPR-6-11-11214 �' ' v �" �� CATAWBA COUNTY HEALTH DEPARTMENT ,•��• ''�' Plan Review Application for Environmental Services 1842 sM Environmental Health Plan Review - OSWP IMPROVEMENT NAME TO APPEAR ON PERMIT JOHN & SUSAN MOOREFIELD siTE a��RESS: 4322 CIRCLE DR, Claremont, NC Pin#: 377403402303 NAME of SUBDIVISION: LAKE CITY SUBDIVISION Lot # 14-20 Section/Block/Phase PROPERTY SIZE: Square Feet Acres 0.419 DIRECTIONS: OXFORD SCHOOL RD TO BOLICK RD, RIGHT ON TO CARPERTERS COVE RUNS INTO CIRCLE DR, WHITE BRICK HOUSE ON RIGHT. APPLICANT OWNER CONTRACTOR JOHN & SUSAN MOOREFIELD JOHN & SUSAN MOOREFIELD 1441 DOWNINGTON RD 1441 DOWNINGTON RD CLEMMON NC 27012 CLEMMON NC 27012 336-978-7272 336-978-7272 PRIMARY CONTACT: Owner APPLICATION FOR: Existing Structure DIM EXISTING STRUCTURE: 60X40 EXISTING FACILITY TYPE: House NUMBER OF EXISTING BEDROOMS: 2 SEWER TYPE: Septic Tank NUMBER OF EXISTING OCCUPANTS: 2 EXISTING WATER SUPPLY IN USE: Private Well CALCULATED DESIGN FLOW: 240 Public water is **NOT** available for this property. PUBLIC WATER TYPE AVAILABLE: DESCRIBE WORK: APPLICANT WANTS TO SEE IF IT IS POSSIBLE TO EXPAND SYSTEM TO MAYBE LATER FINISH BASEMENT WITH ADDITIONAL BEDROOM AND BATH. DESCRIPTION OF 2 BDRM HOUSE EXISTING STRUCTURES ON SITE (IF ANY) PR O P ERTY EASEMENTS: N PROPOSED CONSTRUCTION PRIMARY RESIDENCE NEW RESIDENCE? Add/Alt to Residence # OF NEW BEDROOMS: 1 # OF STRUCTURE OCCUPANTS: 2 PROJECT DESC: POSSIBLE FINISH BASEMENT WITH NEW BEDROOM AND BATH PROJECT DIMENSION: BASEMENT? Yes BASEMENT FIXTURES? Yes 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: ��$� a� � � Signature ofApplicant or Agent An Environmental Health Specialist will contact you within 2 wo k g days of application date. If you need further information or assistance please call 828-466-7291 AREA2 *********************��*******************�********�*******************************�**********************�*********** O6/08/ l I 14:42 �BA CATAWBA COUNTY Case # EHPR-6-11-11214 � ,, G� Public Health Department .� �nvironrriental Health Division - Plan Review Subdivision LAKE CITY SUBDIVISION �`�' PO Box 389, 100-A Southwest Blvd, Newton, NC 28658 Lot# 14-20 rg 2 s� PIN# 377403402303 ApplicantlOwner JOHN & SUSAN MOOREFIELD, 1441 DOWNINGTON RD, CLEMMON NC 27012 Site Address: 4322 CIRCLE DR, Claremont, NC Property Size: SF 0.419 ACRES Directions: OXFORD SCHOOL RD TO [30LICK RD, RIGHT ON TO CARP�RTERS COVE RUNS INTO CIRCLE DR, WHITE BRICK HOUSE ON RIGI-IT. Minimum Setbacks Front: Side: Rear: Side St: Max Height: FEE NAME DATE AMOUNT BALANCE DUE Improveme Per mit Fee 06/ $15 0.00 $0.00 TOTAL FEES $150.00 $0.00 CHANGE WORK ORDER REQUIRING REDESIGN AND/OR RETRIP WILL INCURE AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) 06/08/11 14:42 0h;'�B:'''�011 1F�: �4 3�5h517�9F3 BRACJCHELIrJ I�JC PHGE �31!0'� �,; �•� ` TkIIS IS NOT A PERTvii? •� �'x.y CA'TAWBA COUNTl I�EALTH nEPARTPZENT ,�t 1 r Application for En��ironmental Services Page 1 \ �v� �, �mpro��ement Pe�rmit ��uthoria�tiun to Construct ❑ 5eptic RepAir ❑ Septtc ��alfunction ❑ Se�tic Ezpansion Q Ne�r� ��'ell Permit � Replacement �Vell ❑�Vell AbAndonment ❑ Well Repair ❑ Elistin� System Inspection (�re-�lpprovAl Requia ❑ ,�pplication is for New Construction ❑ Exist�ng Facility ❑ Pro�erty ;�cldress 4322 circle d rive Subdi�'ision claremont, n.c. Lot # Aeres Section/B1ocl:IPhase �1'i\%lIl Di��eetions to Property �.AO �� .'��;' ��no�i �� ! Ir, Gr, Ir,p: M ir. r¢�,� en cxpenlere ::o:a rtl aer�Cniars r.c.c rwv �.n�e.:ircle rJr riouae nn rcnt .rnrte rnce. nnuea. Q _. _ -. _. w � � - `� NA11E TO APPEAR ON PER\ ■ O�t�ner Applicant Contractor 4 � ��_p�licAnt C'�►ntact Information � N 3m e joh n ke lly mooref J _. � W Qcldr�ss iad dpwningtan rd demm n.c 2701� ' CQ _... _.__ -_ �-.. Phone Cell Phon . , � O��ner Contact in#'c,rmation .. _. � JNartle;usan dayton moorefi�id _, � laddre 1441 downingtonn rd, �lernmons n.c. 27012 r � O Phone Cell Phone3 36-40E-01 7 6 I � Co ntractor CUntxct T nformation ..... W Name , � tlddress . � � _ . _. � Phone _. Cel) Phone { � � ��-HO «'ILL BE `TT PktI��tARI' COI�'T,�CT? ❑ Owner npplicsnt �] Contractor � � Descri�tion of Pxisting Structures on Sicc no�,se r,�ni �n zooa _ Q � of Bedrooms '��' z _ Sti�acture Dirnensions ��JO X�-I�O _?? �t'Occupants � _ � Basement Q Yes ❑ No B a s e m ent k'i�tures �■ Yes ❑ No C r � 1 Planned Fuhire Additions or Improvements (,�uilding Y�rmit NOT requc:sted at this time) �r 1,JeyC1•]be me.y qdd o�iG �c,nroom in houmc and o�v b�1h wo h3vo n�m�n �n pa.emcn� to do it. q Proposed Punire St�ucture Dimensions _� of Bedrooms 'f if applicable � Are tihere easements or righ�-of-way� recorded on this property Ve; ■�10 Describe Is a public ��'ater supply a��ailable on or adja.cent to the ahove property �* Yes ■ No Cnec.l� rype available ❑ Community V�'ell ❑ Semi-Public tiGell ❑ Coi�ntyiCit}�'Township \�'ater Line F.xisting �i'ater st�pply in use (� Individual �T��ell ❑ Com�nuniry ��'e11 Sen�i-Puhlic 1�%ell ❑ Count��/Cit}�`To�vn \�Jatzr I..inc �❑ I �VOULD LiKE TO SCHEDULE A COMBIN�� FLAG(�1NC AND SOII, E�r��Lli�TION (SEE COPIBINED E V�,�, U. �TI O N PRO CEDUES) ��5!F�B�''��11 1�:�4 3355517893 ERAhJCHE�Ihd IhJ�� FAGE ��2i�3'� ��, THIS IS NOT A PERMIT �� f2 1 CA�'A�'�'SA CUUN'T�C' ��EAL7'H AEPAktTi�'IENT � jr. �(,'��` � •�T �ppl.ication for Enviroitimenta] Servir.es p ��!Ft�l . /�i Proposed Facilzty T�•pc � � Primary Residence ❑ Ne�a� Resideiice ❑ Additiora to Resid�nce = of Ncw Bedroon)s''1" .. Project T�escription add ber and both 1 n b „_ Stnlcture Dimensions _ # of Occupant5 _�_,._ aasement 1"es ❑ No T�asement Fix.n.�?'es 'es ❑?v'o Acce5sol'}' Structu.re(51 Describc — # of Iv'e«� I3edroorn: '�t if applicable Stnichire i�imen;ions � of Occupanr,; Accesso�y C)"�ellinfi ❑ Z�e; ❑ Na Plun�bing ❑ Yes ❑ No Uescribe Plucnbing Ne�ded \Iulti-Famil�� Residence # Uni�s �=l3edzoom� per Unita`7 , Total ,� Bedrooms 'j' Structure Dimensions _ ❑ kood Ser��ice Specify �T}�e � Seats Floor Space -Entii�z Food Sen�icc Facility (Sq Ff) t= Employees �er Shift # ot' Shifts T�inir�� Area (Sy. Ft.j ❑ Business Specific �ype of Business Rctail Floor Space � of �,mploy�e� per S1iif� #r of Shifcs Other Facility Type Specit� � If Church � of Seats Kitchen ❑ 1'es ❑ No IfDaycare Specify Or�ups«cy �_ �ppl3cAtion ii�r «'ell ConslructioniAbandonmentlRepair proposed \�'ell Type ❑ Indi��idual WEII ❑ Sen�i-Fublic �Vell ❑ Cornmunity Well i�handonment Type ❑ Drilled ❑ Bored ❑ DuC ❑ Unkno��-n ti��ell Repair Reques�ed ❑ Yes ❑ T�o T�cscriUe Calculated Desien Flo�t�, Commerci.al t . Additionai �nformation may be required to detex�rnine desi�n tlo�i� frona cc�•tain facilities. This �'�lue n�ill be determined during consultatfon with on- site staff. ',1nv roam that �vill be intended for sleeping at the ti��e of consctuction or for fun�re con�iderauen should be r.oted as a Ledtoom and counted an all applications. The number of bec3reoms �till be ccntin)led by rooms id��iified on house plans as a bedroom at the time of huilding pc. mit �ssuance. l'his may pre� the need frn� septic s ,�stem size increasc in chc fucwe. fIf �truc�urr is plumbed bvt no bedrooms, cnlculnted design flo�1' is required, �"' If ?va, s��ell pennit must he �ssued �vith nc�r Aurht�rizaqon to Consti�uc�. Npte: YUU IntzSt Jb�ain ZoninK sppro�'al pri.or to locatin� a home or structure on th.is properh�•. An}' representst�on by ,lou of house or Sttucture locati4n should contonn to applicable setbac}:s. � CHANG� «`ORK URDER CtEQUIRING RFnF,SiGN .�ND!OR kETRIP «'ILI, 1NCL'R� AN f-• .aDDTTIO�'AL CNARGE (SEE FEE SC;HEllULE) lu � I understand that this ic a fornlal applicarion for Em•iranmental Se» ices and a�thorize Cata��Ua Cr.unt}� Fnvironmen�ai � Hoaltli a.rtploye�s to go on this prcpert}• for cvnluation purpos T ceriify thc above infonnahon tr� be corre�t an�i undertt�t)d � tha.t an Tmpro<<einent Permit iss'aed as a rzsult of this tnfermation �s �•alid for 5;�ears or may bc non-e�pirin� under certain U specified conditiont Impto�'e�nent Pernnts and �Yell Permits are trans.i'emable, but ma}' be r?�'ok�d if this mfarmation, site � plex�; or intended use change.� for the proposed fncili.ry. i�n Authonzation to Construct issued bj tnis dep�rt?nent i5 � alid for � (Sl fit�e years from �he d.t�tr i�yuc�l at�d i. ot tr<uisfcrablc � Signature of Owiier or :��ei�t �- � � � Printed Nan).e Of�O��ncr or A ��hn kelly mooref�eid Date G-e->> Catawba County, North Carolina N This map product tiras pi�epared from lhe Catawba Corm[y, NC, Geographic /nformation System. Catawbp Coi�nry has made subs�antial eJforts to ensttre the accuracy oflocation and labeling information contained on this map. Catawba County p��omotes and recommends the independent verlfication of any data contained on this mnp prodact by the user. The County ofCatawba, its employees, agents and personne( disc/aim, mad shal! not be held liable for nny and aA damages, loss or liab!/ity, whether direct, indirect or consequentinl which arises or neay nrise from tkis mnp product or dte use thereo by any person or entity. L@g@Ild Selected Parcel Number: 3774-03-40-2303 1 inch = 40 feet Prepared for: �� , ..`' �r� � �� , .., , � �, ��j`, ; � �► � �'�.,�.� .. ' ` �C � ~ � t� c; , � , ' '�� C �� !� � , � . �'� � (� ,\ , �� "� __ / \��/� +, �' f, � � � � � �� V , f �`� ` i � � � r' , ii, ''`, / i / , w�, � °'��u°u"4 ! ` � ` , 'J ! �/ 1/ ,., �, � J �� . I . ` ^ .. ! ^ j � ,,�,t � � � ` � ..� �"� . e "` i � �,,, , : � � ,� .. \ . . , ,� , �, : �! / � � • �� 4 � � � i ��"""n / / , " / � r,, �, ` y L "`�,. O `� • rr� • / �.» �'n„� �, � . . ,..,,,� �.,.. � � , � � \ , ^w •�, e � , _.\ . � `~ Ma .. f � ��,�. . , � � t / ` ., t �,„ � f �/ / N, � �,. � ,,* �' � �� ...._�.,. i /�;, / ! � � , ��" ` � / vi `5 � / ! > ` ( � ,� / l� f � � "�.,� � � S �� u, / � J �,' � � a' / � �/ � 1 �� 1 �V� / y �� J i � �� , J � ♦ � , ' �" l � .r� i� ��,; f � :�� , , � o �^ C� , , � .�.-..---- , �� , p . �6 � � � ��. � ' o � � � �,,5 co Q ''� '� � s THIS IS NOT A LEGAL DOCUMENT ��"' Wednesday, June 08, 2011 02:16 PM rY ^ Y _--------'" , � �;-� CATAWBA COUNTY NC - Parcel Report Information Regarding Selected Parcel(s) ParcellD: 3774-03-40-2303 Name: MOOREFIELD JOHN KELLY Name2: MOOREFIELD SUSAN Address: 1441 DOWNINGTON RD Address2: City: CLEMMONS State: NC Zip: 27012-9605 Account: 207840 Calc Acreage: 0.42 Tax Map: 1819 03003 LRK: 60438 Deed Book: 2792 Deed Page: 1781 Subdivision Name: LAKE CITY SUBDIVISION Subdivision Block: Lots: 14-20 Plat Book: 10 Plat Page: 9 Building Number: 4322 Street Name: CIRCLE DR Site Zip: 28610 Township: CLINES Fire Code: OXFORD City Code: COUNTY State Road: Total Bldgs Value: $310,200 Land Value: $42,800 Total Value: $353,000 Year Built: 2006 Year Remodeled: Last Sale Date: Last Sale Amount: Neighborhood: 67 Watershed: WS-IV Critical Area Watershed Split: NO Voter Precinct: P27 E911 District: COUNTY Zoning: R-40 Zoning2: Zoning3: Zoning Split: N Zoning Overlay: CRC-O,WP-O,FPM-O Zoning District: COUNTY Split Zoning Dist: N SplitZoning Dist(1): 0 Split Zoning Dist(2): 0 School District: COUNTY Elementary School: OXFORD Middle School: RIVER BEND High School: BUNKER HILL School Split: NO P&Z Case Number: Census Tract 2010: 010101 Census Block 2010: 3011 Small Area Plan: ST STEPHENS/OXFORD Agricultural District: Printed: Wednesday, June 08, 2011 02:16 PM ! �/ . , ,.►:,1 v►� CATAWBA COUNTY DEPARTMENT � ° ,�� - � �j .: � � '°`" Telephone (828) 465-8270 TDD (828) 465-8200 Rlj_,S #/ ,?OOS"-Qo�O� Improvc;ment Pernut f AC ✓� Re air Permit._ Operation Permit. '✓ System Type� We11 Permit. Replacement Well bwner/Agent � p � Phone - Address / v r, Tra; Subdivision �.�.... C/�., s/, " .em �7la Section/Block/P se Lot!{ Lot Size .'t�2 ,d�e. ^ Directions �Q�c 8�,�� Qe/ - o.� a -� 0„�30/ /�,/` —�L' �a„�_,�r�. — o � Property Address � Facility: House ✓ Mobile Home Business Multi-family Other• Pin Number 7'7Y- p 3�' O� 3� O Other Zoning Approval l/ �/ Bedrooms � # Seats tl Employees Appiication Rate . 3 GPD Flow ��D Hot Tub or Spa yes no , ecial Fixtures Basement yes/� 100% Repair Area es no Basement Plumbing ye no VVater Supply• Private Well r/ Public Semi-Pu,blic ********************�*************************��***********************�*****�*******************�*****�******�*****�r** Type of System: Trench Bed Pump Pump/Panel �/ Panel LPP Other Septic Tank Size jppD Pump Tank Size /006 Nitrification Field. Total Square Feet l�DO Depth of Stone - Bed Size Trench Width 3 Total Length of All Trenehes �3 3� Number of Trenches �/' Trench Length ,3.3 /.�3 !�/33/_/_ Feet on Center 5' Maximum Trench Depth �Q �� Distance of Nearest Well �SO' *DO NOT INSTALL SEPTIC WHEN WET* *WELL RECORD REQUIRED AT COMPLETION* **********�*****************************�* Topo p�/g % Slope � yE-.�e a��.efr�..-� /�.? .._ /'�u-�'� Texture S�, � � - Structure - � / / � / �KG �/G�D /' _' .�� ,e� OC'P y�Q�l �{ �I1 � ✓ Clay Min. r � S ,y �• /� I�� Soil Wetness��" � 7 � z(I (_' f ��►�' � ^�. / �y�� Soil Depth — �� i �, �'fFf,� - (�i�(S�� ?� lU�" Restric Hoz. at - " � ; � f��Pc✓o�%S' Available space yes/no � - tA� '�e. �r� Overall Class S�S�[J � _ Sa r�o� rh H6 f' 6� l G33 Comments �.TAR' 3 � ?SO' {'�o,,, o� 2 �u��'�� i f � � �� H, wa�.- ��.-e,� �z� i .�..�F � �� 4 �e� • E�-s �,.� W�� I '�� `� n�� - 6� �6�,.�.� �/ I , ' �- - � _ b�ore 1�:nrJ.� � I 1 �/ , �e>„�,� i p o�� 1 sys�4.� �,�� ;� - '�p��,. Pr � � - �„" � - � � s%� ee�su l� � s � t- � _' , i � , °�u��a/ w; ¢ti, � �--__ _ ;� l� ; � � � C�ti �f�.�� d � 1 ' � � I , �J r� � � ,��; o� � �-�,,,sf��{., a � , Ce.�4:� �ra,�o�' I � - _ ... ___ � ; � '+� ?�,,1'{.^a �u,Ine�/ I � '`_`_ �p i � �� n, Filter Required � i IQePQ, r�i re a (P�13PS� � �� /' Q� Riser required when � � r ( �� tank is more than 6 � @x. s�� w� inches deep. � . �� - fo �e u�x..�o.�us/� **NO GUARANTEE OR WARRANTY IS IMPLIED OR GIVEN AS TO '1'�� PERFORMANCE OR LENGTH OF TIME THIS SY3TEM WILL FUNCTION** *********�*******�*�***s******�******************�********w********************************�************s***********#*** *Improvement 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 (S� five years from date issued and is not transferable. Well Permit valid for 5 years provided site conditions do not change. Well location, installation, and protection must meet state and local regulations, and must be inspected and approved by a representative of the Catawba County Health Department beFore any portion of the installation is put into use. The siting of the well by the Health Department staff is to provide protection from known possible sources of contamination. No volume of water is guaranteed at any site by the Health Department. �� Permit Date . �- .- o EHS Owner/Agent � Septic Tank Installed By �t,+p y � /[,�„r Date�6 EHS Well Installed By r' (,y. J We11 Approval Date tp-, Well Head Approval Date 'L- - 0 Date Sample Collected -/Y �.`.�(,...- "D � Date of Results Results EHS White - Office Yellow - Owner/Agent Pink - Building Inspection Authorization to Construct � C�� , CATAWBA COUNTY, NC �,� ��, '°°-A S°uth West B'�d pLAN RECEIPT � rJ Newton, NC 28658- U �� `S` (828)465-8399 Wednesda June 8 2011 �I► Y, , 1842 srn www.catawbacountync.gov P�an �ase: EHPR-6-11-11214 �nvoice Number: INV-6-11-276196 Environmental Health Plan Review Invoice Date: 06I08/2011 Site Address: 4322 CIRCLE DR, Claremont, NC APPLICANT OWNER CONTRACTOR JOHN & SUSAN MOOREFIELD JOHN & SUSAN MOOREFIELD 1441 DOWNINGTON RD 1441 DOWNINGTON RD CLEMMON NC 27012 CLEMMON NC 27012 336-978-7272 3 36-97 8-72 7 2 Fee Name Fee Amount Improvement Permit Fee Fixed $150.00 Total Fees Due: $150.00 PAYMENTS PAYER: JOHN MOOREFIELD Date Pay Type Check Number Amount Paid Change 06/08/2011 Credit Card -1 $150.00 $0.00 Total Paid: $150.00 Total Due: $0.00 pla,t rcceipt 06/08/2011 14:41