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HomeMy WebLinkAboutEHPR-7-11-11646.TIF A '� CATAWBA COUNTY No d..l u I"0 ,< P 0 Box 389-Newton,North Carolina 28658 -(828)465-8270-Fax(828)465-8276-TDD(828)465-8200 Ig 42 sm www.c.atawbacountvnc.gov/phealthiehmain.asp Public Health—Environmental Health Division Application for a Waiver of Existing Wastewater System and Well Inspection For Properties of Two Acres and Greater ugso n Lav-4er4 (print your name) certify that I am the owner or authorized agent(owner's signed authorization required)representing the owner of the property described as(property address and PIN): \9,93 L-L-s c1c DP-We._ t ltc._ ,.5 cos E 1V miQ autetj 4,5,aitud al l Cur( PIN By signing this waiver application,I acknowledge and certify the following: • All proposed building and property line setbacks currently required by law or local zoning ordinance can be met. • The minimum required building setbacks from any component of the wastewater system, designated repair area,or private water supply well can be met in accordance with the following applicable North Carolina Laws and Administrative Codes: o Laws and Rules for Sewage Treatment and Disposal Systems(15A NCAC 18A .1900) • Any building foundation 5 feet • Any water line 10 feet • Any swimming pool 15 feet o Well Construction Standards(15A NCAC 02C). • • Any building foundation 25 feet • I,as the owner of thproperty described above,or as the owner's authorized agent accept full responsibility for and all damage as a result of the proposed construction. Applicant Signature c�- jeti�„ --/` Date b— `7— 1 O v Required attachments: . • Plat of property or site plan(drawn to scale)showing all proposed and existing structures • Copies of current applicable permits(septic system,well, zoning, etc.) Waiver: Approved Denied Comments MONA c 1\)L-CWc-- 'ram t ff✓a 0 c i•Pe `- -t kl'...1 Signature � .• Title(?. A- AC on,t+41J.. — Date 6I tl t 10 Notice to the Applicant:Approval of this waiver provides only an exemption for an existing wastewater system or well inspection. Any deviation from the submitted site plan voids this waiver. All waiver applications shall be reviewed by the On-site Water Protection Program Supervisor,or the Environmental Health Administrator. Please allow three business days for processing. rye{` Hr• ahh t E. 4)iI1Pnfnenl,"ig:. ' .'°=[/ "Keeping the Spirit Alive Since 1842!" HICKORY TRo CATAWBA COUNTY NC- Parcel Report Information Regarding Selected Parcel(s) • Parcel ID: 3648-08-88-8883 Name: ;.AMBERT JASON BENNARD Name2: Address: 1893 ELLICK DR Address2: City: NEWTON State: NC Zip: 28658-9015 Account: 159759504 Calc Acreage: 0.64 Tax Map: LRK: 901935 Deed Book: 2343 Deed Page: 0582 Subdivision Name: BROOKRIDGE Subdivision Block: Lots: 65 Plat Book: 46 Plat Page: 87 Building Number: 1893 Street Name: ELLICK DR Site Zip: 28658 Township: NEWTON Fire Code: NEWTON RURAL City Code: COUNTY State Road: Total Bldgs Value:$94,000 • Land Value: $10,800 Total Value: $104,800 Year Built: 2002 Year Remodeled: Last Sale Date: 2/27/2002 Last Sale Amount: $26,000 • Neighborhood: 113 • Watershed: Watershed Split: Voter Precinct: P32 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:TUTTLE Middle School: MAIDEN High School: MAIDEN School Split: NO P&Z Case Number: Census Tract 2010: 011600 Census Block 2010: 1004 . Small Area Plan: BALLS CREEK Agricultural District: PROXIMITY Printed:Thursday, June 03, 2010 01:23 PM