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Home My WebLink AboutEHPR-9-10-7268.TIF THIS IS NOT A PERMIT Case # EHPR - - 10 - 7268 L_ :4 CATAWBA COUNTY HEALTH DEPARTMENT V " 0 `C Plan Review Application for Environmental Services 1842 5M Environmental Health Plan Review - OSWP EXS SYSTEM NAME TO APPEAR ON PERMIT MELVIN & TAMMY SETZER SITE ADDRESS: 3061 LEDFORD RD, Vale, NC Pin#: 269803219409 NAME of SUBDIVISION: Lot # Section/Block/Phase PROPERTY SIZE: Square Feet Acres 0.49 DIRECTIONS: HWY 10/ TURN LEFT AT BANOAK STORE ONTO HEFNER RD/ GO 1 MI TO STOP SIGN/ TURN RT ON LEDFORD RD/ 3RD HOUSE ON RT APPLICANT OWNER CONTRACTOR MELVIN & TAMMY SETZER MELVIN & TAMMY SETZER 3061 LEDFORD RD 3061 LEDFORD RD VALE NC 28168 VALE NC 28168 704 - 462 -2633 704 - 462 -2633 PRIMARY CONTACT: Owner APPLICATION FOR: New Construction DIM EXISTING STRUCTURE: 14 X 55 EXISTING FACILITY TYPE: Mobile Home NUMBER OF EXISTING BEDROOMS: 2 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: N/A DESCRIBE WORK: SINGLEWIDE MOBILE HOME CHANGE -OUT/ OLD SW MOH BURNED/ CLASS B/ 14X76 / MUST HAVE A 36 SQ FT DECK ON FRONT / MUST BE UNDERPINNED/ MUST SCREEN OR REMOVE TOWING TONGUE/ MUST BE PARALLEL TO ROAD DESCRIPTION OF SINGLEWIDE MOBILE HOME BURNED AND IS NO LONGER THERE 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: 14 X 76 SINGLEWIDE MOBILE HOME CHANGE -OUT PROJECT DIMENSION: 14 X 76 BASEMENT? No BASEMENT FIXTURES? 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 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. ,5 Date: r 2)2 Signature of Applicant or Agent / ✓I✓' An Environmental Health Specialist will contact you within 2 working day of application d e. —/ 6 - /C) If you need further information or assistance please call 828 - 466 -7291 AREA2 09/10/10 14:53 �gA \ CATAWBA COUNTY Case # EHPR -9 -10 -7268 P H ealth Department L Environmental Health Division - Plan Review Subdivision ) ,`Smirug PO Box 389, 100 -A Southwest Blvd, Newton, NC 28658 Lot# 1842 PIN# 269803219409 Applicant/Owner MELVIN & TAMMY SETZER, 3061 LEDFORD RD, VALE NC 28168 Site Address: 3061 LEDFORD RD, Vale, NC Property Size: SF 0.49 ACRES Directions: HWY 10/ TURN LEFT AT BANOAK STORE ONTO HEFNER RD/ GO 1 MI TO STOP SIGN/ TURN RT ON LEDFORD RD/ 3RD HOUSE ON RT Minimum Setbacks FEE NAME DATE AMOUNT BALANCE DUE Front 80 Side 15 Existing Tank Check Fee 09/10/2010 $80.00 Rear 30 TOTAL FEES $80.00 Side St Max Hght CHANGE WORK ORDER REQUIRING REDESIGN AND /OR RETRIP WILL INCURE AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) 09/10/10 14:53 C ATAWBA cm:1 yiEALn i DEPARTMENT ,_ . __V Lot .Evaluation Improvement Permit /,,Repair Permit Completion Permit F 9 7 , t/ Owner /Agent _.r a .1 a 3 4 - ciJ.&_._`r! Phone Address i ubdiv sion Section /Block Lot # Lot Size �, Direction : /, rt f —Z; Facility: House Mobile Home tusness i ' Other: Zoning Approval yes /no # i i 3 Multi -famil Other . 100% Repair Area yes /no Bedrooms Baths d •Seats Employees . GPD Flow Application Rate Garbage Disposal Special Fixtures . REPAIR NOTICE: REPAIRS MUST BE WITHIN 30 Basement yes /no Ba PEWIT. Plumbing yes /no : D OR DAYS FROM DATE OF PEIT. Water Supply: Private Public - * * **** * * * * * * *** * *** * * * * * * * ** ***************** *********** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Type of System: Trench L/Bed System Other (Specify) Tank Size: Septic Tank f �v 9, Purnp Tank ` Nitrification Field: Total Square Feet '7 Depth of Stone I Bed Size Trench Width 36 Total Length of All Trenches 14 0 Number of Trenches .5 r c Individual Trench Lengtl &/g ,, / ()/ / Feet on Center T ' Maximum Trench Depth . Distance to Nearest Well Lot Evaluation: Approved Disapproved ************************************ * * * * * * * * * * * * * * * * * * *** * * * * * * * * ** **fir ** * * * * * * * * * * * * * * * ** Sketch of Lot Evaluation Site - System Design - Final /`- • ..;,. ff (it 7 J / � _I 1\ 1 -..,:„,,- ( '------) ik 1 f'.�: 7 Li ___..---w�. ) : I / Permit Date - T , .. r (Lot Evaluat on and Improvemen, unit void of r 36 months) Owner /Agent r,V(7.4) (4 ,)A / d ,l Sanitar'. �4� CI -0/6 Installed By h i i.e ,. / ,.s,,.,y T �y�.,.a to f , anitarian./ • . / 2 , � (Note any changes /information in red or by s :'c / 'n Lack) Topo S PS U Drainage S PS U Depth S PS U Restrictive Hoz. S PS U Space S PS U Soil S PS U III Loams: Sandy Clay, Silt, Clay, Silty Clay 6 -.4 IVa Clays: Sandy, Silty, Clay .4 -.2 WHITE - OFFICE COPY YELLOW - OWNER/AGENT COPY a y,A THIS IS NOT A PERMIT fi d CATAWBA COUNTY HEALTH DEPARTMENT i ; Application for Environmental Services Page 1 /842 SM Improvement Permit ❑ Authorization to Construct ❑ Septic Repair ❑ Septic Malfunction Septic Expansion ❑ New Well Permit ❑ Replacement Well ❑ Well Abandonment ❑ Well Repair ❑ Existing System Inspection 1' • • pproval Required) ✓J // Application is for New Construc ion a, - Existing Facility [l Property Address -3 6 / / Q - c14 0 4 Subdivision 1/7/ /v'/I 95 /6.2 Lot # Acres r Section/Block/Phase Driving Directions to Property 1Y�:,� I / 0 / Lssitl�l�Octj� ,� j'a f t..Q__ ` LE_:.r /� f y f d //C N�/ /� / & Ci , , / rl7 //e—, ,S Df7,S j n/ / ( : c k- o / �_d-= Ad ,.. r � , ::. ft 6 _.4,S - 4., . 1 . / 5 7 W J Q, NAME TO APPEAR ON PERMIT? [ I Owner Applicant ❑ Contractor Z Applicant Contact Information r V O Name 44 41 1-( (5.:1-2—Q)&--, � W AddressJoL 1 4 e_c {- � i- - 77 C 7--Ed‘ Q _ / .. Phone 7v % 46 oc 63' 3 / ''Cell Phone Pp 1 .!p 6?bc33 Owner Contact Information (4)4 -- j/l, lje,L' e -.61. IQ- ✓A C Name _5 %P f.Q4f/L- yY, 25,E 1 Z Address Q Phone Cell Phone U Contractor Contact Information uu Name ( Address z Phone Cell Phone 7 c/' Z WHO WILL BE THE PRIMARY CONTACT? ❑ Ownerpplicant ❑ Contractor Description of Existing ructures on Site D Q # of Bedrooms *t Structure Dimensions 29 # of Occupants O 1 Basement Yes No Basement Fixtures ❑ Yes o Planned Future Additions or Improvements (Building Permit NOT requested at this time) CC Describe 0 0 Proposed Future Structure Dimensions 0 # of Bedrooms *t if applicable ? Are there easements or right -of -ways recorded on this property ❑ Yes,[I1 Describe i Is a public water supply available on or adjacent to the above property ** ❑ Yes ( o Check type available ❑ Commu ity Well [ , Semi - Public Well Li Coun /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) ,.1.A THIS IS NOT A PERMIT L7 t 111 1 4 CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services Page 2 /842 SM Proposed Facility Type ❑ Primary Residence n New Residence n Addition to Residence # of New Bedrooms *t Project Description / (L . 4 /Le, t / l/ MO b •ZQ_ ^ /4 0.1 �-=' Structure Dimensions A-02 y / `y # of Occupants ; jL' Basement n Yes , f No Basement Fixtures ❑ Yes ❑ No ❑ Accessory Structure(s) Describe r7 of New Bedrooms *t if applicable X# l"- Structure Dimensions Accessory Dwelli /�� 'y �� of Occupants �- Dwelling n Yes n No e // Plumbing Yes n No Describe Plumbing Needed - 5 - 'f i t/7'iI 7( ulti- Family Residence # Units #Bedrooms per Unit *t Total # Bedrooms *1' Structure Dimensions ,___/27 #4 y 7 v ❑ 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 n Community Well Abandonment Type ❑ Drilled n Bored ❑ Dug ❑ Unknown Well Repair Requested ❑ Yes ® No Describe Calculated Design Flow, Commercial 1' 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. CZ CHANGE WORK ORDER REQUIRING REDESIGN AND /OR RETRIP WILL INCURE AN W ADDITIONAL CHARGE (SEE FEE SCHEDULE) a I understand that this is a formal application for Environmental Services and authorize Catawba County Environmental C Health employees to go on this property for evaluation purposes. I certify the above information to be correct and understand 0 that an Improvement Permit issued as a result of this information is valid for 5 years or may be non - expiring under certain L.i 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 I... (5) five years from the date issued and is not transferable VI Signature of Owner or Agent , . Z Printed Name of Owner or Agent 1 Ai y,-,m 4/ ,S .0 e � z. - .. - ,-- Date 5 • /0 - /0 Catawba County, North Carolina N This map product was prepared from the Catawba County, NC, Geographic h jonnation System. Catawba County has trade substantial efforts to ensure the accuracy of location and labeling it formation A contained on this snap. Catawba County promotes and recommends the independent verification of any data contained on this nap product by the user. The County of Catawba, its employees, agents and personnel disclaim, and shall not he held liable for any and all damages, loss or liability. whether direct. indirect or consequent,a ch arises or may arise from this map product or the use thereo_ f by any person or entity. Legend / / / /// Selected Parcel Number: 2698-03-21-9409 1 inch = 60 feet /0— `0 Prepared for: • �V ` V • 8678 ......... 0-, . 31 51.3 ;- 2 ?.2 N r . � o 3 96x12 ,-,...... .,.,. ofc _____________„ 1 -------„,____,,,s..s.s...„ .,.,.. . ., , .,,,.:,,, .... .._., , . Is 70 . .....,.., . ,,li .. a -. 41* co . . w ...„. I? I� a t ... .,,, w , ,_... . A; . ,4 � /g CI 2 0 07 1 2 / •Plat 60 -79 ,. -....„ N) 1-------- j ....,. 0..) . . , _., cp co , • ... THIS IS NOT A LEGAL DOCUMENT — OCUMENT Fri, September 10, 2010 02:08 PM • 1 Ammo. I CATAWBA COUNTY NC - Parcel Report Information Regarding Selected Parcel(s) Parcel ID': 2698 -03 -21 -9409 Name: SETZER MELVIN LEE Name2: SETZER TAMMY SUE Address: 3061 LEDFORD RD Address2: City: VALE State: NC Zip: 28168 -8948 Account: 137277 Calc Acreage: 0.49 Tax Map: 009 B 05019A LRK: 8621 Deed Book: 2216 Deed Page: 1186 Subdivision Name: Subdivision Block: Lots: Plat Book: Plat Page: Building Number: 3061 Street Name: LEDFORD RD Site Zip: 28168 Township: BANDY'S Fire Code: PROPST City Code: COUNTY State Road: 2041 Total Bldgs Value: Land Value: $6,700 Total Value: $6,700 Year Built: Year Remodeled: Last Sale Date: Last Sale Amount: Neighborhood: 89 Watershed: Watershed Split: Voter Precinct: P2 E911 District: COUNTY Zoning: R -40 Zoning2: Zoning3: Zoning Split: N Zoning Overlay: DWMH -O Zoning District: COUNTY Split Zoning Dist: N Split Zoning Dist(1): 0 Split Zoning Dist(2): 0 School District: COUNTY Elementary School: BANOAK Middle School: JACOBS FORK High School: FRED T FOARD School Split: NO P &Z Case Number: Census Tract 2010: 011802 Census Block 2010: 3015 Small Area Plan: PLATEAU Agricultural District: PROXIMITY Printed: Fri, September 10, 2010 02:08 PM .�4'A Cow CATAWBA COUNTY, NC X 5 7 i 100 -A South West Blvd PLAN N RECEIPT V '" 0 (828)465 - 8399 Friday, September 10, 2010 jg 42 sM www.catawbacountync.gov Plan Case: EHPR -9 -10 -7268 Invoice Number: INV -9 -10- 266863 Environmental Health Plan Review Invoice Date: 09/10/2010 Site Address: 3061 LEDFORD RD, Vale, NC APPLICANT OWNER CONTRACTOR MELVIN & TAMMY SETZER MELVIN & TAMMY SETZER 3061 LEDFORD RD 3061 LEDFORD RD VALE NC 28168 VALE NC 28168 704 - 462 -2633 704 - 462 -2633 Fee Name Fee Amount Existing Tank Check Fee Fixed $80.00 Total Fees Due: $80.00 PAYMENTS PAYER: MELVIN & TAMMY SETZER Date Pay Type Check Number Amount Paid Chang( 09/10/2010 Cash - 1 $80.00 $0.00 Total Paid: $80.00 Total Due: $0.00 Lin rcccipt 09/10/2010 14:57