HomeMy WebLinkAboutEHPR-9-10-7234.TIF 0 A THIS IS SOT A PERMIT Case # EHPR -9 -10 -7234
' ! t - Z CATAWBA COUNTY HEALTH DEPARTMENT
� V ' ¶!/ C Plan Review Application for Environmental Services
\ , Environmental Health Plan Review - OSWP
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EXS SYSTEM
NAME TO APPEAR ON PERMIT
PEARLIE MAE CATOE
SITE ADDRESS: 3955 TOWER RD, Maiden, NC Pin#: 368703115724
NAME of SUBDIVISION:ANDERSON PARK Lot # Section/Block/Phase
PROPERTY SIZE: Square Feet Acres 1.32
DIRECTIONS: 16S / RT TOWER RD / BRICK HSE ON RT
APPLICANT OWNER CONTRACTOR
PEARLIE MAE CATOE PEARLIE MAE CATOE
3955 TOWER RD 3955 TOWER RD
MAIDEN NC 28650 -9050 MAIDEN NC 28650 -9050
(704)483 -2769 (704)483 -2769
PRIMARY CONTACT: Owner APPLICATION FOR: New Construction
DIM EXISTING STRUCTURE: 75 X 28 EXISTING FACILITY TYPE: House
NUMBER OF EXISTING BEDROOMS: 3 SEWER TYPE: Septic Tank
EXISTING WATER SUPPLY IN USE: Private Well
CALCULATED DESIGN FLOW: WELL TYPE:
Public water is * *NOT ** available for this property.
PUBLIC WATER TYPE AVAILABLE:
DESCRIBE WORK: PVT ABOVE GROUND POOL 24 FT ROUND W/ DECK
DESCRIPTION OF SINGLE FAMILY
EXISTING STRUCTURES
ON SITE (IF ANY)
PROPERTY EASEMENTS: NONE
PROPOSED CONSTRUCTION
PRIMARY RESIDENCE
NEW RESIDENCE?
# OF NEW BEDROOMS: # OF STRUCTURE OCCUPANTS:
PROJECT DESC:
PROJECT DIMENSION:
BASEMENT? BASEMENT FIXTURES?
ACCESSORY STRUCTURES
DESCRIPTION: ABOVE GROUND POOL W/ DECK
# OF NEW BEDROOMS: 0 STRUCTURE DIMENSIONS: 24 FT ROUND POOL W/ ATTA ACC DWELLING? No
PLUMBING? No NONE # OF STRUCTURE OCCUPANTS: 0
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09/09/10 12:28
a v,A CATAWBA COUNTY Case # EHPR -9 -10 -7234
G Public Health Department
'j L Subdivision ANDERSON PARK
Environmental Health Division - Plan Review
Tit PO Box 389, 100 -A Southwest Blvd, Newton, NC 28658 Lot#
/8 2 s. PIN#
368703115724
Applicant/Owner PEARLIE MAE CATOE, 3955 TOWER RD, MAIDEN NC 28650 - 9050
Site Address: 3955 TOWER RD, Maiden, NC
Property Size: SF 1.32 ACRES
Directions: 16S / RT TOWER RD / BRICK HSE ON RT
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. n
Date: `T' q (0 Signature of Applicant or Ager),Kge �„ e rn � Lf di
1 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
AREA1
Minimum Setbacks
FEE NAME DATE AMOUNT BALANCE DUE
Front
Side Existing Tank Check Fee 09/09/2010 $80.00 $0.00
Rear TOTAL FEES $80.00 $0.00
Side St
Max Hght
CHANGE WORK ORDER REQUIRING REDESIGN AND /OR RETRIP WILL INCURE AN ADDITIONAL CHARGE
(SEE FEE SCHEDULE)
09/09/10 12:28
a �A THIS IS NOT A PERMIT
? a CATAWBA COUNTY HEALTH DEPARTMENT
� i Application for Environmental Services Page 1
Ig42 �, I
Improvement Permit n Authorization to Construct ❑ Septic Repair ❑ Septic Malfunction ❑
Septic Expansion ❑ New Well Permit ❑ Replacement Well ❑ Well Abandonment ❑
Well Repair ❑ Existing System Inspection (Pre- Approval Required) ❑
Application is for New Construction Existing Facility ❑
Property Address 2 9SS 7 - Subdivision
`dY\ (CS , 77 , (1 g.R 6-51) Lot # Acres / QA --
Section/Block/Phase
Driving Directions to Property t' /tar P1A 1CrLO . v P 10 - 411.114) �1
" ,v' 1 - 0 / 74 el.
0
W
NAME TO APPEAR ON PERMIT? X] Owner Applicant ❑ Contractor
Applicant Contact Information
V Name Q,Ltc e_. m et-4- e 06LY,
W Address 3 9 S S yaw ) 2 s - ` 'YV1 ( ',P..e `'✓) , C . fs' S b
m
Phone L4 _ y � 3 _ � (i 9 Cell Phone
Owner Contact Information
Name
Address
0 Phone Cell Phone
V Contractor Contact Information
W Name
Address
= Phone Cell Phone
Z WHO WILL BE THE PRIMARY CONTACT? [ Owner ❑ Applicant ❑ Contractor
Description of Existing Structures on Site c,--; ASS
Q # of Bedrooms *� ` } i $/k,„, Structure Dimensions # of Occupants 1-
1� Basement ❑ Yes VI No Basement Fixtures n Yes g No
Planned Future Additions or Improvements (Building Permit NOT requested at this time)
CC Describe Crw .,
Proposed Future Structure Dimensions # of Bedrooms * if applicable
Are there easements or right -of -ways recorded on this property IN Yes n No
Describe /,,,.
Is a public water supply available on or adjacent to the above property ** n Yes E No
Check type available ❑ Community Well n Semi- Public Well County/City/Township Water Line
Existing water supply in use ® Individual Well ❑ Community Well ❑ Semi - Public Well
❑ County/City /Township Water Line
❑ I WOULD LIKE TO SCHEDULE A COMBINED FLAGGING AND SOIL EVALUATION
(SEE COMBINED EVALUATION PROCEDUES)
, S -A G THIS IS NOT A PERMIT
Imo f, CATAWBA COUNTY HEALTH DEPARTMENT
<119G) Application for Environmental Services Page 2
X 842 ,.
Proposed Facility Type
❑ Primary Residence n New Residence ❑ Addition to Residence # of New Bedrooms *j'
Project Description
Structure Dimensions # of Occupants
4 Basement ❑ Yes ❑ No Basement Fixtures ❑ Yes E No
Accessory Structure(s) Describe am` 6 f ._ Mr= MI . GPJ
# of New Bedroom *t if applicable to II Structure Dimensions t.0
# of Occupants 0 Accessory Dwelling n Yes [E-f1-6- ay „,,k Pe -rj
Plumbing ❑ Y•s r to Describe Plumbing Needed
Multi - Family Residence # Units #Bedrooms per Unit *t
Total # Bedrooms *t Structure Dimensions
Food Service Specify Type
# Seats Floor Space - Entire Food Service Facility (Sq Ft)
# Employees per Shift # of Shifts Dining Area (Sq. Ft.)
n Business Specific Type of Business Retail Floor Space
# of Employees per Shift # of Shifts
n Other Facility Type Specify
If Daycare Specify Occupancy
Application for Well Construction /Abandonment/Repair
Proposed Well Type ❑ Individual Well n Semi - Public Well n Community Well
Abandonment Type n Drilled n Bored ❑ Dug n Unknown
Well Repair Requested n Yes n No Describe
Calculated Design Flow, Commercial t Additional information may be required to
determine design flow from certain facilities. This value will be determined during consultation with on-
site staff.
*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 house plans as a
bedroom at the time of building permit issuance. This may prevent the need for septic system size increase in the future. tlf
structure is plumbed but no bedrooms, calculated design flow is required.
** If No, a well permit must be issued with the Authorization to Construct.
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.
O CHANGE WORK ORDER REQUIRING REDESIGN AND /OR RETRIP WILL INCURE AN
IQ ADDITIONAL CHARGE (SEE FEE SCHEDULE)
a I understand that this is a formal application for Environmental Services and authorize Catawba County Environmental
Z Health employees to go on this property for evaluation purposes. I certify the above information to be correct and understand
O that an Improvement Permit issued as a result of this information is valid for 5 years or may be non - expiring under certain
L specified conditions. Improvement Permits and Well Permits are transferrable, but may be revoked if this information, site
W plans or intended use changes for the proposed facility. An Authorization to Construct issued by this department is valid for
CO
1• (5) five years from the date issued and is n transferable
VI
Signature of Owner or Agent i, e a ,,, hic2.e- Cal IR
Z Printed Name of Owner or Agent n g a. ; r Al A C C A T o E
Date
I
Catawba County, North Carolina
N /has map product was prepared from the Catawba County, NC, Geographic h forntion System.
A Catawba Count has made substantial effort. 10 ensure the accuracy of location and labeling information
contained on thus mop. Catawba County promotes and recommend/. the independent verification of any
data contained on this map product by the user, The Count' of Catawba, as employees, agents our/
personnel disclaim, and shall not he held liable far acv and all damages, loss or liability, whether direct. Indirect •
or consequential a hrch arises or mar arise from this map produce or the use /hereof by any person or entity. Legend
Selected Parcel Number: 3687 -03 -11 -5724
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A c ri n , p / t ^ TIIIS IS NOT A LEGAL DOCUMENT Li Thursday, September 09, 2010 11:17 AM
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Catawba County, North Carolina
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('otau ha C0011, has wade substantial e1 for ts 10 ensure the acsuract 01 Iocarum and labeling Tulin illation
A contained on this map ('cacnrba ( Dinh in onwie.s and reconnnend/ the independent rerfcanon of am'
data cotaamed on this polio 0,111ct In the user The Counit oJC'atatrha, its employees, agents and
personnel (facial'', and shall not he hell liable for any and all damages loss or ltahthtt, It helper (10 cc! uuln'ect
Of consequential it itch at or mat arts( from 11,11 map product or the use the, eojhi any pe rson or elan/' Legend
Selected Parcel Number: 3687 -03 -11 -5724
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THIS IS NOT A I EGAL DO('1 \II \ h T hursday, September 09, 2010 12:02 1 yl
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CATAWBA COUNTY fV,A_ c o ZONING AUTHORIZATION (R)
Swimming Pool
H P. 0. Box 389 Ph 828 -465 -8380
dw� ►i; one: PERMIT NO: ZONR -9 -10 -10925
'� r 40: A. 100A Southwest 131vd FAX: 828 - 465 -8484 APPLIED: 09/09/2010
', Newton. North Carolina 28658
�
� `' ww� ISSUED: 09/09/2010
�.catawbacountync.gov
18 42 SM EXPIRES: 03/08/2011
•
APPLICANT OWNER CONTRACTOR
PEARLIE MAE CATOE PEARLIE MAE CATOE
3955 TOWER RD 3955 TOWER RD
MAIDEN NC 28650 -9050 MAIDEN NC 28650 -9050
P. (704)483 -2769 F. P. (704)483 -2769 F. P. F.
•
EMAIL: EMAIL: EMAIL:
PROPERTY ID //: 368703115724 CENSUS TRACT:
STREET ADDRESS: 3955 TOWER RD, Maiden, NC LOP/
PROJECT DESCRIPTION: PVT Al3OVE GROUND P001, 24 FT ROUND W/ DECK
DIRECTIONS:
COMMENTS: ABOVE POOL, W/ ATTACHED DECK
FLOOD ZONE? OWNER TYPE: Residential (Private) REQUIRED SETBACKS
100 YEAR FLOOD ZONE PLAIN? No LAND OWNER: FRONT: 30.00 SIDE: 10.00
FLOOD PLAIN, STRUCTURE? No MAX HEIGHT: 45.00 REAR: 10.00 SIDE 1:
VALUE: 0 CORNER: SIDE 2:
FEE DESCRIPTION DATE FEE AMOUNT
Residential Zoning Fee 09/09/2010 525.00
TOTAL FEES $25
The applicant hereby certifies that all information and attachments to this Certificate of Zoning Compiliance are true and correct, and
acknowledges that this permit was issued on the basis of the information required herein. The applicant further acknowledges that any
construction, alteration or addition which differs from this application shall be subject to removal or alteration so as to bring said structure into
conformance with the specifications and standards of the Catawba County Zoning Ordinance. Such corrective action shall be at the expense of the
It is the responsibility of Applicant to comply with all existing deed restrictions pertaining to the property. Issuance of this permit is not certification of
such compliance and does not relieve Applicant of the duty to comply.
* *'This Zoning Authorization Permit shall expire six months from the date of issuance unless a building is secured and remains active.
f k
HR g Ml � k C A i c F #t' t r:t �.�,�.:L Y)'1 etc_ 6 t r. � ._
APPLICANT NAME (PRINTED) APPLICANT SIGNATURE ZONING APPROVED BY
* * * ** ZONING FEES ARE NON - REFUNDABLE * * * **
COMPANY NAME
•
09/09/2010 12:30 Page 1 of 1
CATAWBA COUNTY NC - Parcel Report
Information Regarding Selected Parcel(s)
Parcel ID: 3687 -03 -11 -5724
Name: CATOE PEARLIE MAE
Name2:
Address: 3955 TOWER RD
Address2:
City: MAIDEN
State: NC
Zip: 28650 -9050
Account: 11528500
Calc Acreage: 1.32
Tax Map: 014AX 01016
LRK: 15169
Deed Book: 0972
Deed Page: 0315
Subdivision Name: ANDERSON PARK
Subdivision Block: A
Lots:
Plat Book: 6
Plat Page: 97
Building Number: 3955
Street Name: TOWER RD
Site Zip: 28650
Township: MOUNTAIN CREEK
Fire Code: BANDYS
City Code: COUNTY
State Road:
Total Bldgs Value: $77,700
Land Value: $14,400
Total Value: $92,100
Year Built: 1963
Year Remodeled: 1969
Last Sale Date:
Last Sale Amount:
•
Neighborhood: 128
Watershed: WS -IV Protected Area
Watershed Split: NO
Voter Precinct: P31
E911 District: COUNTY
Zoning: R -40
Zoning2:
Zoning3:
Zoning Split: N
Zoning Overlay: MP- O,WP -O
Zoning District: COUNTY
Split Zoning Dist: N
Split Zoning Dist(1): 0
Split Zoning Dist(2): 0
School District: COUNTY
Elementary School: BALLS CREEK
Middle School: MILL CREEK
High School: BANDYS
School Split: NO
P &Z Case Number: R -429
Census Tract 2010: 011600
Census Block 2010: 3001
Small Area Plan: BALLS CREEK
Agricultural District:
Printed: Thursday, September 09, 2010 11:51 AM
.sg'A Cp :CATAWBA COUNTY, NC
/Fit \ 100 -A South West Blvd
�—] Newton, NC 28658- PLAN RECEIPT
V 7 041!V C (828)465 -8399 Thursday, September 9, 2010
1$ 4 sM www.catawbacountync.gov
Plan Case: EHPR -9 -10 -7234 Invoice Number: INV -9 -10- 266812
Environmental Health Plan Review Invoice Date: 09/09/2010
Site Address: 3955 TOWER RD, Maiden, NC
APPLICANT OWNER
PEARLIE MAE CATOE PEARLIE MAE CATOE
3955 TOWER RD 3955 TOWER RD
MAIDEN NC 28650 -9050 MAIDEN NC 28650 -9050
(704)483 -2769 (704)483 -2769
Fee Name Fee Amount
Existing Tank Check Fee Fixed $80.00
Total Fees Due: $80.00
PAYMENTS
PAYER: PEARLIE MAE CATOE
Date Pay Type Check Number Amount Paid Chang(
09/09/2010 Check 6149 $80.00 $0.00
Total Paid: $80.00
Total Due: $0.00
pin receipt { a9 3c1) j 13- (2192- 426c- S(,(tb -e 3'81 b tc5e(hc; rpt 09/09/2010 12:28