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Home My WebLink AboutEHPR-9-10-7237.TIF THIS IS NOT A PERMIT Case # EHPR - - 10 - 7237 1 � a►. CATAWBA COUNTY HEALTH DEPARTMENT u " .�. , `C Plan Review Application for Environmental Services 1842 5M Environmental Health Plan Review - OSWP REPAIR NAME TO APPEAR ON PERMIT SUE ROGERS SITE ADDRESS: 2284 E NC 10 HWY, Conover, NC Pin#: 375014246513 NAME of SUBDIVISION: Lot 4 Section/Block/Phase PROPERTY SIZE: Square Feet Acres 4.01 DIRECTIONS: HWY 10 E JUST PAST THE OLD JIM'S USED CAR LOT BELOW MOUNT OLIVE CHURCH APPLICANT OWNER CONTRACTOR SUE ROGERS BARBARA MCCOMBS 1595 SMYRE FARM RD 2284 E NC 10 HWY NEWTON NC 28658- CONOVER NC 28613 (828)464 -5292 PRIMARY CONTACT: Applicant APPLICATION FOR: Existing Structure DIM EXISTING STRUCTURE: 48 X 108 EXISTING FACILITY TYPE: House NUMBER OF EXISTING BEDROOMS: 4 SEWER TYPE: Septic Tank EXISTING WATER SUPPLY IN USE: Private Well CALCULATED DESIGN FLOW: WELL TYPE: Public water IS available for this property. PUBLIC WATER TYPE AVAILABLE: DESCRIBE WORK: PROBLEM WITH DRAIN LINES AND DISTRIBUTION BOX LID IS DETERIORATING DESCRIPTION OF BRICK HOUSE EXISTING STRUCTURES ON SITE (IF ANY) PROPERTY EASEMENTS: NO PROPOSED CONSTRUCTION PRIMARY RESIDENCE NEW RESIDENCE? # OF NEW BEDROOMS: # OF STRUCTURE OCCUPANTS: PROJECT DESC: PROJECT DIMENSION: BASEMENT? BASEMENT FIXTURES? APPLICATION FOR WELL CONSTRUCTION /ABANDONMENT /REPAIR PROPOSED WELL TYPE: ABANDONMENT TYPE: WELL REPAI REQUESTED? 09/09/10 13:55 1 �qA . CATAWBA COUNTY Case # EHPR - - - 7237 In G Public Health Department Subdivision Q j; Env Health Division - Plan Review � � `'' PO Box 389, 100 -A Southwest Blvd, Newton, NC 28658 Lot# 1 84 2 ., PIN# 375014246513 ApplicantlOwner SUE ROGERS, 1595 SMYRE FARM RD, NEWTON NC 28658 - Site Address: 2284 E NC 10 I - IWY, Conover, NC Property Size: SF 4_01 ACRES Directions: HWY 10 E JUST PAST THE OLD JIM'S USED CAR LOT BELOW MOUNT OLIVE CHURCH 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. Date: 9 ` (- () /6 Signature of Applicant or Agent 4 An Environmental Health Specialist will contact you within 2 working days of ap. lication date. If you need further information or assistance please call 828 - 466 -7291 AREA2 Minimum Setbacks FEE NAME DATE AMOUNT BALANCE DUE Front 40 Side 15 Authorization to Construct (Repair) Fee 09/09/2010 $425.00 Rear 30 TOTAL FEES 5425.00 Side St Max Hght CHANGE WORK ORDER REQUIRING REDESIGN AND /OR RETRIP WILL INCURE AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) 09/09/10 13:55 THIS IS NOT A PERMIT �Ga CATAWBA COUNTY HEALTH DEPARTMENT Q " -; Application for Environmental Services Page 1 /842 sm Improvement Permit ❑ Authorization to Construct ❑ Septic Repair D4eptic 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 22 (� �� 1 (l( V ' p t �j (lox Subdivision N Lot # Acres 1,0/ Section/B ock/Phase Driving Directions to Property W CL NAME TO APPEAR ON PERMIT? ❑ Owner [✓Applicant ❑ Contractor O Applicant Contact Information W Name S�; �� 0gecS � CO Address 15 S R l f�JV \ � f\ Z -(aS c� Phone Cell Phone 4 - 5 Zq 2_ z Owner Contact Information Name (`�ozs\ c I\Ck. r� �cslL,e_poN Z Address -22 lb O Phone Cell Phone Contractor Contact Information W Name Address = Phone Cell Phone WHO WILL BE THE PRIMARY CONTACT? ❑ Owner ❑ Applicant ❑ Contractor Description of Existing Structures on Site O # of Bedrooms *t Structure Dimensions / # of Occupants ® 1 Imo- Basement ,—, 'Y e o Basement Fixtures �s ❑ No L`A ❑ Planned Future Additions or Improvements (Building Permit NOT requested at this time) CC Describe Proposed Future Structure Dimensions # of Bedrooms *t if applicable ■ Are there easements or right -of -ways recorded on this property ❑ Yes Describe Is a public water supply available on or adjacent to the above property ** ❑ No Check type available ❑ Community Well ❑ Semi - Public Well ❑ County /City /Township Water Line Existing water supply in use iv dual Well ❑ Community Well E Semi - Public Well ❑ County/City/Township Water Line ❑ I WOULD LIKE TO SCHEDULE A COMBINED FLAGGING AND SOIL EVALUATION (SEE COMBINED EVALUATION PROCEDUES) \ ;"-A THIS IS NOT A PERMIT fi c? 4 CATAWBA COUNTY HEALTH DEPARTMENT 'Pi ^ Y Application for Environmental Services Page 2 f �G� . 5M Proposed Facility Type ❑ Primary Residence n New Residence Addition to Residence # of New Bedrooms *j' Project Description Structure Dimensions # of Occupants Basement 'Yes ❑ No Basement Fixtures ErYes ❑ No n Accessory Structure(s) Describe 3 ' c k /u- # of New Bedrooms *t if applicable Structure Dimensions # of Occupants Accessory Dwelling n Yes n No f Plumbing VYes n No Describe Plumbing Needed �Tpr..i " 1 i v en 'A 1 - , L ❑ 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 ❑ Other Facility Type Specify If Daycare Specify Occupancy Application for Well Construction /Abandonment/Repair Proposed Well Type n Individual Well ❑ Semi - Public Well ❑ Community Well Abandonment Type n Drilled ❑ Bored E Dug n Unknown Well Repair Requested n Yes n No Describe Calculated Design Flow, Commercial j' 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. tIf 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. CHANGE WORK ORDER REQUIRING REDESIGN AND /OR RETRIP WILL INCURE AN W ADDITIONAL CHARGE (SEE FEE SCHEDULE) I understand that this is a formal application for Environmental Services and authorize Catawba County Environmental 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 plans or intended use changes for the proposed facility. An Authorization to Construct issued by this department is valid for CO (5) five years from the date issued and is t transferable Signature of Owner or Agent ii ;y— Z Printed Name of Owner or Agent Date g -9- ( e)-iD Catawba County North Carolina N llns map product was prepared from the Catawba County, ANC', Geographic Information Sisrenr. Catawba Connor has made substantial efforts to ensure the accuracy o/ locution and labeling a Jurmatiun A contained on this map Catawba County promotes and recommends the independent verification of any data contained on this map product bi' the user The County of Catawba, as employees, agents and personnel disclaim, and shrill nor be held liable Jiff any and all damages, loss or liability, whether direct, indirect u couseyuenrial which arises or may arise from this map product or the use thereof by any person or entity. Legend Selected Parcel Number: 3750 -14 -24 -6513 I inch = 100 feet Prepared for: p0 9? g6 . \ ` N '*' W ∎,_ _ r U co W PLAT 54 -160 'rn cr 4.01A- -- --., ■ -. 5 3 \ • • �^` , \\\\\\\,' ' \ \ \ ' ' . \ \\ ..........'.......' \ / .2. ..-: 4�q.13 ' TilIS ISSN NOT A LEGAL DO-CUid N'I' Thursday, September 09, 2010 01:36 P:NI CATAWBA COUNTY NC - Parcel Report Information Regarding Selected Parcel(s) Parcel iD: 3750 -14 -24 -6513 • Name: MCCOMBS BARBARA SEITZ Name2: Address: 2284 E NC 10 HWY Address2: City: CONOVER State: NC Zip: 28613 -8370 Account: 43792500 Ca1c Acreage: 4.01 Tax Map: LRK: 903083 Deed Book: 2459 Deed Page: 0731 Subdivision Name: Subdivision Block: Lots: Plat Book: 54 Plat Page: 160 Building Number: 2284 Street Name: E NC 10 HWY Site Zip: 28613 Township: NEWTON Fire Code: NEWTON RURAL City Code: COUNTY State Road: Total Bldgs Value: $201,500 Land Value: $35,400 Total Value: $236,900 Year Built: 1959 Year Remodeled: Last Sale Date: Last Sale Amount: Neighborhood: 117 Watershed: Watershed Split: Voter Precinct: P22 E911 District: COUNTY Zoning: R -20 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: BALLS CREEK Middle School: MILL CREEK High School: BANDYS School Split: NO P &Z Case Number: Census Tract 2010: 011300 Census Block 2010: 2001 Small Area Plan: CATAWBA Agricultural District: Printed: Thursday, September 09, 2010 01:37 PM �A co CATAWBA COUNTY, NC Ey( 100 -A South West Blvd �—] Newton, NC 28658- PLAN RECEIPT U � (828)465 Thursday, September 9, 2010 O \ j8 42 sM www.catawbacountync.gov Plan Case: EHPR -9 -10 -7237 Invoice Number: INV -9 -10- 266817 Environmental Health Plan Review Invoice Date: 09/09/2010 Site Address: 2284 E NC 10 HWY, Conover, NC APPLICANT OWNER CONTRACTOR SUE ROGERS BARBARA MCCOMBS 1595 SMYRE FARM RD 2284 E NC 10 HWY NEWTON NC 28658- CONOVER NC 28613 (828)464 -5292 Fee Name Fee Amount Authorization to Construct (Repair) Fee Adjustable $425.00 Total Fees Due: $425.00 PAYMENTS PAYER: SUE ROGERS Date Pay Type Check Number Amount Paid Chang( 09/09/2010 Check 2660 $425.00 $0.00 Total Paid: $425.00 Total Due: $0.00 plan receipt 09/09/2010 14:02 1 CATAWBA-LINCOLN-ALEXANDER DISTRICT HEALTH DEPARTMENT HICKORY, N. C.—NEWTON, N. C.—LINCOLNTON, N. C.—TAYLORSVILLE, N. C. Phones Diamond 5-3883 INgersol 4-2011 REgent 5-5521 MElrose 2-3101 PERMIT TO INSTALL SEPTIC TANK . 27 p „---, -- ......_ Li C 2 PERMIT NO.47 y ,,, .- rt /7 PERMIT DATE 19 *, ci Owner ,-co2-,,-,_, pl c C;::` Address ..--4 L'''Cf.t Tenant / i — Address Installed by ...7a . 1 Address - . LL Location of Property . 4 i _ ,,,,,, -4 4.,_ •i ( - • • , Kind of tank Size IC 44; Length of trench '-""->-- 4--"-- ) NOTIFY HEALTH DEPARTMENT AT LEAS'f EIGHT HOURS BEFORE TANK IS TO BE INSPECTED 2/ __ C Final Inspection 2 19 (-:-) Z-- - Approved (4" ( ) Remarks: First five feet of line from outlet from house shou • be of cast iron soi pile. . , r......._._--- Sanitarian. Sk ch f tank and line showing dis- 6 1 tance fro dwelling and well on subject ,--' prope ty a d on adjoining property. 1 _