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Home My WebLink AboutEHPR-2-10-3771 (2).TIF A THIS IS NOT A PERMIT Case # EHPR-2-10-3771 - a CATAWBA COUNTY HEALTH DEPARTMENT V~ ~amo C Plan Review Application for Environmental Services Environmental Health Plan Review - OSWP 1842 SM EXS_SYSTEM APPLIGAN.T OWNER CONTRA"CTOR GLORIQ•STItEE"f GLORIA'S"I'kEEh SAMEAS OWNER " 4492 WELCH DR 4492 WELCH DR NEWTON NC 28658 NEWTON NC 28658 828-312-0609 - 828-312-0609 NAME TO APPEAR ON PERMIT GLORIA STREET Pin#: 360802590412 SITE ADDRESS: 4492 WELCH DR, Newton, NC DIRECTIONS: HWY 10 W TOWARDS VALE/ RT ON SPRINGDAL,E DR/ 2ND RD ON RT IS WELCH/ FIRST HOUSE ON LT NAME of SUBDIVISION: SPRINGDALE Lot # 23A Section/Block/Phase PROPERTY SIZE: Square Feet Acres 0.419 Date Platted/Recorded TYPE OF FACILITY: House _ Mobile Home X Dimension of Structure Bedrooms 4 Basement: No Water Using Fixtures in Basement:N_o_ No. in Family Whirlpool Tub : Gal. Capacity: MULTIPLE FAMILY RESIDENCE: Units 1.00 Total Number of Bedrooms DAYCARE: Number of Children RESTAURANT: Seats Square Feet Dining Area Square Feet Foodstand/Meat Market Floor Space TYPE OF BUSINESS: Number of Employees Ist 2nd 3rd OTHER: (Specify) Do you aniticipate any additions to Facility? If so, describe: 15 X 30' OPEN DECK ON FRONT,OF'HOME Has any grading, removal, or addition of soilbeen (loneto:this property? ' If so, describe _ Are there easements/right-of-ways recorded on this property? NO Type of Water Supply: Individual Well Community Nell X'. i Municipal Semi-Public 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 re re ntati ' by you of house or structure location should co form to applicable setbacks. Date: -2- h Signature of Applicant or Agent 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 AREA 2 (FOR OFFICE USE ONLY) Zoning Approval: Yes No Zoning Approval UDO Zoning Form A Minimum Setbacks Front 30 FEE NAME, DATE _ AMOUNT Side 15 ExiStt~~' g nk Check Ice - 02/08'201 a 8U.VU Rear 30 TOTAL FEES $80.00 Max Fight *If a permit has to be redesigned and / or RETRIPS made to the property, there is an additional $60 charge 02/08/10 15:30 THIS IS NOT A PERMIT WLS # CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services Improvement Permit ❑ orization to Construct ❑ Septic Repair ❑ Septic Expansion ❑ Existing Tank Check New Well Permit ❑ Replacement Well ❑ Well Abandonment ❑ I . Name to Appear on Permit 2. Permit Requested By Business Phone Address - Home Phone ' Z.4-A 3. Property Owner r a Business Phone III-L4 Address 44u c Home Phone %z4%41V6-ZZ4/ 4. Narne of Subdivision Lot # ~3-A Section/Block/Phase Property Address Directions to Property: / o r r Lkq 1 7 / P 5. Property Size: Square Feet Acres Date Platted/Recorded _ 6. TYPE OF FACILITY: House Mobile Home_ t---Dimension of Structure 2" L'W) Bedrooms*_ Am/ room that will lilt' IlllCllll~~~ 1 Slet~llll Ut dl's' UI11" 01 ~~~Il~llUeU~~il ~f U ~~Itllfl ~~Il 1~1~fUtI~~I1 ;~1~~Ul,~ h", Ilot"d (I' :i I)CC11,00111 (llld COtmt_d till a11 1 11C IllllllKI ~d h ~ll'~~~Ill ~ vv III hC CA'Ill ll lll~'J I)v loom I'LlItIl[I2d"i'll hou"', hialls ds a bedroolll at;the,,1111 Ut JU 1 1,11 p,:m ll I»~yIIICC I Itl~ lwl\ A~Illtl ICI ~yslClll p1Ll'~IR~I~d~~ III the luture.' Basement: yes/ co _ Water Using Fixtures in Basement: yeri~ No. in Family t!v Whirlpool Tub yes/no Gallon Capacity MULTIPLE FAMILY RESIDENCES: Units Total Number of Bedrooms DAY CARE: Number of Children _ RESTAURANT: Seats Square Feet Dining Area -Square Feet Food stand/Meat Market Floor Space TYPE OF BUSINESS: Number of Employees Ist 2nd 3rd OTHER: (Specify) 7. Do you anticipate any additions to Facility? e If so, describe: O(DeAectolvlk CW 8. Has any grading, removal, or addition of soil been done to this property? &e / No If so, describe: ~yC 5 A✓c &«11 W Je -/E) -i a ~c~~ 9. Are there easements/right-of-ways recorded on this property? Yes / No 10. Is a public water supply available of r adjacent to the above property?~/ No Check type that is available: ommunity well [ ] Semi-public well [ ] County/City/Township water line **If No, a Well Permit must be issued with the Septic Permit.** 11. Well Type Applying For: [ ] Individual well [ ] Community well [ ] Semi-Public well 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 valid for 5 years or may be non-expiring under certain specified conditions. Improvement Permits and Well Permits are transferable, 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 (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. **IF A PERMIT HAS TO BE REDESIGNED AND/OR RETRIPS MADE TO TH OP TY, TH IS AN ADDITIONAL CHARGE" Date 2 S Signature of Owner or Agent Catawba County, North Carolina This map prochrcl eras prepanedJiom the Catmrba Comrty, NC. Geographic hformalion Susienr. N Calmrha C011171 ' V has made subslarniol effin'l.r to ensure the oecuracv of location and lahchog it formalion camained ore Nri.s map- Calmrha Colntt- promoles and recommends the iodepeodenl verification of onv data conraincot on INS map proclrrcl by the user. 77re Comm- ofCcrlamho, its employees, agents and personnel disclaim, and shall not he hell Kahle far am, and all damages, lass or liobilitY, whether unreel, indirect or consequential which arises or nrav arise fi 0111 this map product or the use thereof in- arm person or enlin:. Legend Selected Parcel Number: 3608-02-59-0412 1 inch = 60 feet Prepared for: 10, 6 2 3 f3 600 28 q, 21,_A 01 . 26 ~ _ o 's 576 g 125 68 s 22-B -846 8 00 1 1 cry 49,.6 . 9338 2~ 0 ° 1258 s o s 0 p 16 1"% THIS IS NOT A LEGAL, DOCUMENT Monday, February 08, 2010 03:03 PN'I fa -CJ C/ CATAWBA COUNTY. HEALTH PAIL MENT ' Telephoyfe: (828) 465-8270 TDLIa (828) 465-8200 WLS # c) V Q a 3 O Improvement Permit AC Repair Permit. Operation Permit.System Type Well Permit. Replacement Well Owner/Agent (p c, r Phone d 16,4 - O 5 1 Address A L n Subdivision 5 E - ; r%-- ~z I .z. Section/Block/Phase Loo-D-3- Lot Size -C) : a Directions: c, Ac r)a 14.. a_ L. r . a n Property Address a Lj 2 c f)(,, tK00-i to Facility: House Mobile Home Business Multi-family Other: Pin Number 3 (o 0 2S LN 3 S ZQ 1 Other . Zoning Approval # # Bedroo # Seats # Employees . Application Rate GPD Flow. Hot Tub ms or Spa yes o pecial Fixtures Basement ye n 100% Repair Area yes0 Basement Plumbing ye no Water Supply.--Private Well Public Semi-Public Type of System: Trench Bed a/Pump Pump/Panel Panel LPP Other Septic Tank Size ia_?uomp Tank Size Nitrification Field: Total Square Feet U O Depth of Stone C9 4 t r Bed Size I O X.5 U Trench Width Total Length of All Trenches Number of Trenches Trench Length /Feet on Center Maximum Trench Depth Distance of Nearest Well ic> U *DO NOT INSTALL SEPTIC WHEN WET* *WELL RECORD REQUIRED AT COMPLETION* Topo L..(. % Slope I 1 rl +:S a lW ! r.. I 'V 2. Structure I~e-t f ~i i ~J Q c 5 y Sri . •t Clay Min. Soil Wetness Soil Depth I r Restric. Hoz. at 1. ` r 4 ca ^ Y Available space yes/no Overall Class S PS U L- Comments: lnz-c) an' i 1~• J ti .`f" ' I 1 a { v t M : A- L --A rc - t) 1 t J (a O T c--, 1 i d F L U r f Filter Required j-tt_n~ h S}r_v~ Jzr S Y ~tr_-,'~ c'r fa"P rt.- Riser required when tank is more than 6 I P u P a cl C. r'-) X t s'' inches deep. I J **NO GUARANTEE OR WARRANTY IS IMPLIED OR GIVEN AS TO THE PERFORMANCE OR LENGTH OF TIME THIS SYSTEM WILL FUNCTION** se *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 (5) 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 an site by the Health Department. Permit Date 13 o EHS 6wner/ gent b Septic Tat Installed By t^^ ' ; c.. ( Date t f &44- f EHS Well Installed By Well Grout Approval Date Well Head Approv Date Date Sample Collected Date of Results Results EHS White - Office Yellow - Owner/Agent Pink - Building Inspection Authorization to Construct CATAWBA COUNTY NC - Parcel Report Information Regarding Selected Parcel(s) ParceQq, 3608-02-59-0412 N'aine: STREET GLORIA DIANE NaMe2: Address: 4492 WELCH DR Address2: City: NEWTON State: NC Zip: 28658-8711 Account: 196151 Calc Acreage: 0.42 Tax Map: 002EJ 01023 LRK: 2212 Deed Book: 2584 Deed Page: 1297 Subdivision Name: SPRINGDALE Subdivision Block: B Lots: 23A Plat Book: 45 Plat Page: 5 Building Number: 4492 Street Name: WELCH DR Site Zip: 28658 Township: JACOBS FORK Fire Code: PROPST City Code: COUNTY State Road: Total Bldgs Value: $99,400 Land Value: $10,900 Total Value: $110,300 Year Built: 2004 Year Remodeled: Last Sale Date: 6/11/2004 Last Sale Amount: $20,000 Neighborhood: 89 Watershed: Watershed Split: Voter Precinct: P3 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: BLACKBURN Middle School: JACOBS FORK High School: FRED T FOARD School Split: NO P&Z Case Number: Census Tract 2010: 011802 Census Block 2010: 4000 Small Area Plan: MOUNTAIN VIEW Agricultural District: PROXIMITY Printed: Monday, February 08, 2010 03:03 PM