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HomeMy WebLinkAboutRBPR-07-2017-26914.TIFTHIS IS NOT A PERMIT Case # RBPR-07-2017-26914 CATAWBA COUNTY HEALTH DEPARTMENT PLAN REVIEW APPLICATION FOR ENVIRONNIENTAL SERVICES Residential Building Plan Review - Modular RUTH CONST -NEW WELL FJMPROVEMENT� � — — (I � VIII ICFU�SO i� 1•,e "k I� wfwsl"KA. Applicant *CLAYTON HOMES 4 81 /CMH INC (UNLICENSED), 1230 CONOVER BLVD, CONOVER NC 28 6:828-465-3450F:828-464-0261 JWHOLDER(Di.HOTMAIL.COM Contact Person *PROCESS MANAGEMENT GROUP (STEVE OSTERI-IOI-Z), 260 JORDAN BRANCH RD, MARS NC 28754 C:8284186374 l'ROCESSN9GN1"I'GROUPrrr GMAIL.COM Owner THOMAS LAZARIDES, 1230 CONOVER BLVD W, CONOVER NC 28613 C:8282173168 Paid By CLAYTON I IOMES (ELIZABETH OSTERIIOLZ), 260 JORDAN BRANCH RD, MARS HILLS NC NAME TO APPEAR ON PERMIT THOMAS LAZARIDES SITE ADDRESS: 1509 CONESTOGA CROSSING, CATAWBA NC 28609 PIN# 460901080045 NAME of SUBDIVISION: AUTUMNWOODS PH 2 Lot # 1 Section/Block PROPERTY SIZE: Square Feet Ames 1 43 DIRECTIONS: Balls Creek Rd, r Bandys Cross Rd, left Buffalo Shoals, r E Sandys Cross Rd left Long Island, right Eulaha Ln, Right Conestoga Crossing PRIMARY CONTACT: Applicant SEWER TYPE: Septic Tank GALLONS PER DAY: 360 WATER SUPPLY: Private Well DESCRIBE WORK: New, 32x72 ,off -frame modular home, 3 bedrooms, 6x6 front deck & 14x14 rear deck, SITE INFORMATION Do any of the following apply to the property for which this application is applied? If the answer to any of the questions below is "YES', then supporting documentation is required Does this site contain any jurisdictional wetlands? No Does this site contain any existing wastewater systems? No Is any of the wastewater going to be generated on the site other than domestic sewage? No Is the site subject to approval by any other public agency? Yes Are there any easements or right-of-ways on this property? No APPLICATION FOR: STRUCTURE TYPE: FACILITY TYPE: Single Family Residence DESCRIPTION OF EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: New Structure PRIMARY RESIDENCE OTHER DESCRIPTION: NUMBER OF EXISTING BEDROOMS: # OF OCCUPANTS: 1 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 32x72 with 6x6 front & 14x14 rear decks # OF NEW BEDROOMS:: 3 BASEMENT? No BASEMENT FIXTURES? No PLUMBING REQUIRED? Desired system types (Improvement Permit or Authorization to Construct)' ACCEPTED: ALTERNATIVE: CONVENTIONAL' OTHER INNOVATIVE ANY: YES Other described APPLICATION FOR WELL CONSTRUCTION PROPOSED WELL TYPE: Individual Well REPLACE WELL?: NO 1:9 - ch;lpphLali,m 07/28/2017 12 22 Page I ur 4 A CATAWBA COUNT Y RBPIZ-07-2017-26914 /S � Cuss 8 Public Health Department AUTUMNWOODS PH 2 r, 'I Subdivision (2 Environmentalis I lealth Division 460901080045 460901080045 / PO Box 389, 1 u0 -A SOnthtNTSt Rh d, Newton. NC 28658 il g 2 NAME ON PERMIT: ("THOMAS LAZARIDES), 1230 CONOVER BLVD W, CONOVER NC 28613 ( THOMAS LAZARIDES) Site Address: 1509 CONESI'OGA CROSSING, CATA"BA NC 28609 Property Size: Square feet Acres 1 43 Directions: Balls Creek Rd, r Bandys Cross Rd, left Buffalo Shoals, r E Bandys Cross Rd left Long Island, right Eulalia Ln, Right Conestoga Crossing Improvement Permits Issued as a result of this Information are valid for 5 years or may be non -expiring under certain specified conditions An Authorization to Construct Issued by this department Is valid for (5) five years from the date Issued and Is not transferable, Improvement Permits and Well Permits are transferrable. Permits may be revoked If the Information on this application, site plans or Intended use changes for the proposed facility. I have read this application and certify that the information provided herein Is true, complete and correct Authorized county and state officials are granted right of entry to conduct necessary Inspections to determine compliance with applicable laws and rules I understand that I am solely responsible for the proper Identification and labeling of all property Imes and corners and making the site accessible so that a complete site evaluation can be performed d� Date: 7(ag�)'H Signature of Applicant or Agent CZEt(F6-A An'W44 G FG�CK-. An Environmental Health Specialist will contact VOL] vtiithin 5 working days of application date. If you need further information or assistance please call 828-466-7291 AREA1 I'i;-'111'_hPNIIL til{: ?amifl iFEENAMF,ii!`.. <�l�L._a! J{ ,t "ihl���'liifwl `. 16 Siil{II ii L�a''_.'saIIDATFII} ` l!1 FF,E AMOUNT�!iil' Authorization to Construct Fee (New/Expansion) 07/06/2017 $150.00 Fee Well Permit & Inspection Fee 07/06/2017 $300.00 Improvement Permit Fee 07/28/2017 $150.00 akalpuUN dllllllTTA'°7ilH("�;Illii$600.00 0!"4111 'lL FEES ARE NON-REFUNDABLE ONCE A SITE VISIT IS MADE OR WORK ON A PLAN REVIEW HAS COMMENCED SYSTEM REDESIGN AND/OR RETRIP WILL INCUR AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) 1:'I - chappLcaunn 07/28/21117 12 22 Pagc 2 of 4 Catawba County Environmental Health 1510 225.00 100.00 4. CONESTOGA CROSSING U, X6.74 48A I 135.00 J I I I � I I n � s 1� eti509 rj© J- 9 3 •t K_? �- I I � I I I J 171.51 1 135.00 _ I Parcel: 460901080045, 1521 CONESTOGA CROSSING CATAWBA, 28609 � a o •1521 135.00 &MITT11 492.00 C a 1 in=60ft This map/report product was prepared from the Catawba County, INC Geospa0al Information Services. Catawba County has made substantial efforts to ensure the accuracy of location and labeling information contained on this map or data on this report Catawba County promotes and recommends the independent verification of any data contained on this map/report product by the user The County of Catawba, its employees, agents, and personnel, disclaim, and shall not be held liable for any and all damages, loss or liability, whether direct, induecl or consequential which arises or may arise from this map/report product or the use thereof by any person or entity Copyright 2014 Catawba County NC 07/28/2017 PAYOR Clayton Homes CATAWBA COUNTY IOOA SOUTIIWEST BLVD NEWTON, NORTH CAROLINA 28658 PHONE: 828 465.8 399 ClaN2on Homes (Oslerholz, Elizabeth) PAYMENTS TRANSACTION NUMBER' PAYMENT DATE: PAYMENT TYPE: 188674292 INVOICE NUMBER 07-17-343146 www.catawbaccu ntync.gov TRC -1707970-28-07-2017 07/28/2017 Credit Card TOTAL PAYMENTS: RBPR-07-2017 26914 FEE NAME Improvement Permit Fee RECEIPT Friday, July 28, 2017 FEE AMOUNT $150.00 $150.00 CASE TYPE: Residential Buildin- Plan Review WORK CLASS: Modular SITE ADDRESS: 1509 CONESTOGA CROSSING, CATAWBA NC 28609 Applicant *CLAYTON HOMES 4 81 /CMII INC (UNLICENSED), 1230 CONOVER BLVD, CONOVER N( B:828 -465-3450F828-464-0261 JWHOLDER;itHO"ITIAIL.0081 Contact Person *PROCESS MANAGEMENT GROUP, 260 JORDAN BRANCH RD, MARS HILL NC 28754 0.8284186374 PROCESSMGM"I'GROUPrrGMAIL.COM Owner THOMAS LAZARIDES, 1230 CONOVER BLVD W, CONOVER NC 2861 0:8282173168 Paid By CLAYTON HOMES, 260 JORDAN BRANCH RD, MARS HILLS NC 28754 ** NO PEOPLESOFT ACCOUNT ASSIGNED ** raeipl 07/28/2017 1213 Page I of I THIS IS NOT A PERMIT Case # RBPR-07-2017-26914 CATAWBA COUNTY HEALTH DEPARTMENT PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES Residential Building Plan Review - Modular AUTH CONST -NEW WELL �11111 nevi s(d d00 ei)tru Applicant *CLAYTON HOMES 8 81 /CMH INC (UNLICENSED), 1230 CONOVER BLVD, CONOVER NC 286 B:828 -465-3450F:828-464-0261 JWIIOLDLRaIIOTMAIL.COM Contact Person *PROCESS MANAGEMENT GROUP (STEVE OSTERHOLZ), 260 JORDAN BRANCH RD, MARS I NC 28754 C:8284186374 PROCESSMGMI'GROUPaGMAIL.COM Owner THOMAS LAZARIDES, 1230 CONOVER BLVD W, CONOVER NC 28613 C:8282173168 NAME TO APPEAR ON PERMIT THOMAS LAZARIDES SITE ADDRESS: 1509 CONESTOGA CROSSING, CATAWBA NC 28609 PIN # 460901080045 NAINIEofSUBDIVISION: AUTUMNWOODS PH 2 Lot# 1 Section/Block PROP EI2TY SIZE: Square Feet Acres 1.43 DIRECTIONS: Balls Creek Rd, r Bandys Cross Rd, left Buffalo Shoals, r E Bandys Cross Rd left Long Island, right Eulalia Ln, Right Conestoga Crossing PRIMARY CONTACT: Applicant SEWERTYPE: Septic Tank GALLONS PER DAY: 360 WATER SUPPLY: Private Well DESCRIBE WORK: New, 32x72 ,off -frame modular home, 3 bedrooms, 6x6 front deck & 14x14 rear deck, SITE INFORMATION Do any of the following apply to the property for which this application is applied? If the answer to any of the questions below is "YES', then supporting documentation is required: Does this site contain any jurisdictional wetlands? No Does this site contain any existing wastewater systems? No Is any of the wastewater going to be generated on the site other than domestic sewage? No Is the site subject to approval by any other public agency? Yes Are there any easements or right-of-ways on this property? No APPLICATION FOR: STRUCTURE TYPE: FACILITY TYPE: Single Family Residence DESCRIPTION OF EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: New Structure PRIMARY RESIDENCE OTHER DESCRIPTION: NUMBER OF EXISTING BEDROOMS: # OF OCCUPANTS: 1 _ —PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 032x72 ith 6x front 14x14 rear decks # OF NEW BEDROOMS:: 3 BASEMENT? <f9 BASEMENT FIXTURES? (ED PLUMBING REQUIRED? Desired system types (Improvement Permit or Authorization to Construct): ACCEPTED: ALTERNATIVE: CONVENTIONAL: OTHER: INNOVATIVE: ANY: YES Other described: APPLICATION FOR WELL CONSTRUCTION PROPOSED WELL TYPE: Individual Well REPLACE WELL?: NO 179 - ehapplicquu'n 07/07/2017 14:23 Page I of 4 CATAWBA COUNTY Case N RBPR-07-2017-26914 .i Public Health Department Subdivision AUTUMNWOODS PH 2 ., Environmental Health Division PIN# 460901080045 r 2 � PC Box 389. 100-A Southwest Blvd. Newton. NC 28658 NAME ON PERMIT: ( THOMAS LAZAR[DES), 1230 CONOVER BLVD W, CONOVERNC 28613 ( THOMAS LAZARIDES) Site Address: 1509 CONESTOGA CROSSING, CATAW BA NC 28609 Property Size: Square Peet Acres 1.43 Directions: Balls Creek Rd, r Bandys Cross Rd, left Buffalo Shoals, r E Bandys Cross Rd left Long Island, right Eulalla Ln, Right Conestoga Crossing Improvement Permits issued as a result of this information are valid for 5 years or may be non -expiring under certain specified conditions. An Authorization to Construct issued by this department is valid for (5) five years from the date issued and is not transferable: Improvement Permits and Well Permits are transferrable. Permits may be revoked if the information on this application, site plans or intended use changes for the proposed facility. I have read this application and certify that the information provided herein is true, complete and correct. Authorized county and state officials are granted right of entry to conduct necessary inspections to determine compliance with applicable laws and rules. I understand that I am solely responsible for the proper identification and labeling of all property lines and corners and making the site accessible so that a complete site evaluation can be performed. Date: Signature of Applicant or Agent An Environmental Health Specialist will contact you within 5 working days of application date. If you need further information or assistance please call 828-466-7291 AREA1 R++444#4++##4+4t4tt######t#tt####################4++++#######4#tttt##+++++####t#########k########4+++####+tt wn�n�;mglrllnr 4 : � „a�.•, ,.,, r � i ;,I u ; 1 ,..i � r ; • w !� i +{,hill{fUdM ..I. ari 111111 I" I,iI„l 't DATE (.�' Ce ,FEGNAME.Ir„Vlri�il!,jlYlt,.� �p,.III�V),jf�f{„j,t• - „� ,y4�iI FEE AMOUNT Authorization to Construct Fee (New/Expansion) 07/06/2017 $150.00 Fee Well Permit & Inspection Fee 07/06/2017 $300.00 nliilj�'I'I! "•'ll{9'iTOTAL?'FFESII'ileil a{.r• 1'•1d' 11 I 'rly' ;hPa „i l' illt� ..1j1'1 Vhlal!1,4J„ilaa:f:•:. A;,:,,ai,k„til hlii,blilt!a .,X14nL ,h,l,I' •,,icjS450.001jj r PI ...,n” nn . �, co !WtW!iillr]rr+ ry,^nN,dwAbmm . . an!rr... : •rpq.., FEES ARE NON-REFUNDABLE ONCE A SITE VISIT IS MADE OR WORK ON A PLAN REVIEW HAS COMMENCED SYSTEM REDESIGN AND/OR RETRIP WILL INCUR AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) I}I - c6apphcatum 07/07/2017 14:23 Pagc 2 of 4 Applicant Contact Person THIS IS NOT A PERMIT Case # RBPR-07-2017-26914 CATAWBA COUNTY HEALTH DEPARTMENT PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES Residential Building Plan Review - Modular RUTH CONST -NEW WELL ❑° *CLAYTON HOMES 9 81 /CMH INC (UNLICENSED), 1230 CONOVER BLVD, CONOVER NC 286 8:828-465-3450F:828-464-0261 JN'FIOLDER@Ilo,rMAIL.COM *PROCESS MANAGEMENT GROUP (STEVE OSTERHOLZ), 260 JORDAN BRANCH RD, MARS I NC 28754 C:8284186374 PROSCESSMGMTGROUPu,GMAIL.COM Owner THOMAS LAZARIDES, 1230 CONOVER BLVD W, CONOVER NC 28613 C:8282173168 NAME TO APPEAR ON PERMIT THOMAS LAZARIDES SITE ADDRESS: 1509 CONESTOGA CROSSING, CATAWBA NC 28609 PIN # 460901080045 NAME of SUBDIVISION: AUTUMNWOODS PH 2 Lot 4 1 Section/Block PROPERTY SIZE: Square Fect Acres 1.43 DIRECTIONS: Balls Creek Rd, r Bandys Cross Rd, left Buffalo Shoals, r E Bandys Cross Rd left Long Island, right Eulalia Ln, Right Conestoga Crossing PRIMARY CONTACT: Contact Person SEWER TYPE: Septic Tank GALLONS PER DAY: 360 WATER SUPPLY : Private Well DESCRIBE WORK: New, 32x72 ,off -frame modular home, 3 bedrooms, 6x6 front deck & 14x14 rear deck, SITE INFORMATION Do any of the following apply to the property for which this application is applied? If the answer to any of the questions below is "YES', then supporting documentation is required Does this site contain any jurisdictional wetlands? No Does this site contain any existing wastewater systems? No Is any of the wastewater going to be generated on the site other than domestic sewage? No Is the site subject to approval by any other public agency? Yes Are there any easements or right-of-ways on this property? No APPLICATION FOR: STRUCTURE TYPE: FACILITY TYPE: Single Family Residence New Structure PRIMARY RESIDENCE OTHER DESCRIPTION: DESCRIPTION OF EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: NUMBER OF EXISTING BEDROOMS: # OF OCCUPANTS: 1 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 30x72 with 6x6 deck & 14x14 rear deck Desired system types (Improvement Permit or Authorization to Construct): ACCEPTED. ALTERNATIVE. CONVENTIONAL OTHER. INNOVATIVE: ANY. YES Other described: APPLICATION FOR WELL CONSTRUCTION PROPOSED WELL TYPE: Individual Well REPLACE WELL?: NO E1-ehapplicaunn 07/06/2017 13 28 Page 1 oro ,en CATANN'BACOUNTY Case# RBPR-07-2017-26914 Z Public Health Department Subdivision AUTUMNWOODS PH 2 Environmental I"lealth Division PIN# 460901080045 PO Box 389, 100-A Southwest Blvd. Newton. NC 28658 NAME ON PERMIT: ('rHOMAS LAZARIDES), 1230 CONOVER BLVD W, CONOVER NC 28613 ( THOMAS LAZARIDES) Site Address: 1509 CONESTOGA CROSSING, CATAWBA NC 28609 Property Size: Square Feet Acres 1.43 Directions: Balls Creek Rd, r Bandys Cross Rd, left Buffalo Shoals, r E Bandys Cross Rd left Long Island, right Eulalia Ln, Right Conestoga Crossing Improvement Permits issued as a result of this information are valid for 5 years or may be non -expiring under certain specified conditions An Authorization to Construct issued by this department is valid for (5) five years from the date issued and is not transferable, Improvement Permits and Well Permits are transferrable Permits may be revoked if the information on this application, site plans or intended use changes for the proposed facility. I have read this application and certify that the information provided herein is true, complete and correct. Authorized county and state officials are granted right of entry to conduct necessary inspections to determine compliance with applicable laws and rules. I understand that I am solely responsible for the proper identification and labeling of all property lines and corners and making the site accessible sothat �a/complete site evaluation c be performed. Date: -71(C, 1-7 Signature of Applicant or Agent rLq,(, le? , rn,pyit %c/ An Environmental Health Specialist will contact you within 5 working days of application dUte. If you need further information or assistance please call 828-466-7291 7J AREA1 I. _FEENAME _ DATE_ Authorization to Construct Fee (New/Expansion) 07/06/2017 Fee Well Permit & Inspection Fee 07/06/2017 TOTAL FEES FEES ARE NON-REFUNDABLE ONCE A SITE VISIT IS MADE OR .......... FEEAMOUNT j S150.00 S300.00 $450.00 WORK ON A PLAN REVIEW HAS COMMENCED SYSTEM REDESIGN AND/OR RETRIP WILL INCUR AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) E9 - chappl icanon 07/062017 13 28 Page 2 of 4 �vA�AVV, JJA THIS IS NOTA PERMIT cuuNTL CATAWBA COUNTY HEALTH DEPARTMENT „e Application for Environmental Services Page t Improvement Permit ❑ Authorization to Con ruct,� Septic Repair ❑ Septic Malfunction ❑ Septic Expansion ❑ Nen' Well Permit Replacement Well ❑ Well Abandonment ❑ Well Repair ❑ Existing System Inspection (Pre -Approval Required) ❑ Application is for New Construction ❑ Existing Facility ❑ 19opertyAddress 15Cq C�Ofk/6" C�Subdivision A-tt,+Vrt11 wOi7j/�-, CA,,-&WWC t lJC 10iD0I( J Lot b 1 7 Acres , C(5 Driving Directions to Property .2.e -Z. A-(+(4LC�X d NAME TO APPEAR ON PERMIT? ❑ Owner Applicant Contact Information Name kD,XW J Address l L30 (,CyjoVef �(V� I Phone Wi) 4(8` (e3114 Owner Contact Information Name -rh A Mgf) 4ZO t' t (1.4/3 Address -1 Phone -1vL- G13(e-V(" Contractor outset Information Name Address Phone Applicant Section/Block/Phase V,1i .2.r ❑ Contractor CAnaver, EJC 2i�(Pf3 Cell Phone Dcnsc�, n(c 1 gi031 Cell Phone I Cell Phone WHO WILL BE THE PRIAMARY CONTACT? ❑ Owner D�;:Applicant ❑ Contractor Description of Fxisting Strucr gyros on Site # of Bedrooms *'r - Structure Dimensions # of Occupants Basement ❑ Yes _ 'No Basement Fixtures Q Yes The Applicant shall notify the local health department upon submittal of this application if any of the following apply to the property in question. If the answer to any question is "),es", applicant must attach supporting documentation ® Yes 2%10 Does the site contain anyjaisdictional wetlands? * Yes -0-1\10 Does the site contain any existing wastewater systems? * Yes XNo Is an), wastewater going to be generated on the site other than domestic sewage? %Yes No Is the site subject to approval by any other public agency? ® Yes X No Are there any easements or right of ways on this property? Describe Existing water supply in use ❑ Individual Well ❑Community Well ❑ Semi -Public Well ❑ County/City/Township Rater Lure Is a public water supply available? ** ❑ Yes 'N�No If applying for an Improvement Permit or Authorization to Construct, Please Indicate Desired System Type(s): (systems can be ranked in order of your preference) 0 Accepted ❑ Alternative 0 Conventional 0 Innovative 0 Other !4 Any C'vATAYY B I'1I(S I NCif :\ @Eh.1\1i`I COUNTY CATAWBA COUNTY BLALTH DEPARTMENT ENT Application for Environmental Services Rage 2 Proposed Facility Type 'Xi'rintary Residence ❑ New Residence ❑ Addition to Residence # of Nev Bedrooms Project Descriintion_��1# Q-O%f_�r2lrce_Mod Wt tv��(�eG�t I tj !! v Structure Dnrensions ��u 'j,:l, _ ^ n of Occupant; t Basement ❑ Yes igNo Basement Fixtures 0 Yes C2 No ❑ Accessory Structure(s) Describe # of New Bedrooms *'j if applicable Structure Dimensions # of Occupants Accessory Dwelling ❑ Yes ❑ No Plumbing ❑ Yes ❑ No Describe Plumbing Needed ❑ Multi -Family Residence # Units Total # Bedrooms *T ❑ Food Service Specify Type #Bedrooms per Unil''J' Struclure Dimensions # Seats Floor Space -Entire Food Service Facility (Sq Ft) # Employees per Shift _ J # of Sid (Is . ^ Dining Area (Sq. Ft.) ❑ Business Specific Type of Business Retail Floor Space _ # of Employc,� per Shif'i _ # of Sl.i.is ❑ Other Facility Type Speeify If Church # of Seats Kitchen ❑ Yes ❑ No If Daycare Specify Occupancy Application for Well Consh'uction/Abandonment/Repair Proposed Well Type tfT,'dndividual Well ❑ Semi -Public Well ❑ Community Well Abandonment Type C Drilled L Bored ❑ Dug 71 Unknown Well Repair Requested ❑ Yes ❑ No Describe Calculated Design Flow; Commercial 'j Additional information may be required to determine desisrn flow from certain facilities. 'Phis value will be determined during consultation with on-site staff. °Any room that will be 'Wended for sleeping at the time of construction or for future consideration shmild be noted as a bedroom and counted on all applications. The number of bedrooms will be crnliunod by rooms identified on house plans as a bedroom at the time of building permit issuance. This may prevent tine need for septic system size increase in the fixture. T If stn uclure is plumbed but no bedrooms, calculated design flow is required. ', If No, a well permit must be issued with the Authorization to Construct. SYSTEM REDESIGN AND/011 RFTRIP WILL INCUR AN ADDIT'ION'AL CHARGE (SEE FEE SCHEDULE) Improvement Permits issued as a result of this information are valid for 5 years or may be non -expiring under certain specified conditions. An Authorization to Construct issued by this deparnnent is valid for (5) five years from the date issued and is not transferable; lmpiovement Permits and Well Permits are nm ;sferrable. Permits may be revoked ifthe information on this application, site plans or intended use changes for the proposed facility. I have read this application and certify that the information provided herein is true, complete and correct. Authorized county and state officials are granted right of entry to conduct necessary inspections to determine compliance with applicable laws and rules. I understand that I am solely responsible for the proper identification and labeling of all property lines and corners and making the site accessible so that a complete site evaluation call be performed. Signature ofOwrneroiAgent CeAq o � � '1 t�" t / ralirf-7 Printed Name of Owner or Agcnt aaqj�,rt _Hvmea, by • t u� 1 u P I ..,e Lot 1 Rabert W 8,,q, BB X248 P9 195 S 86-24'10•E 166.22' —� e 1 4 0 c�a.a ..ma r ? , of imdy M,,P / \ Scale None 1 1465 Conesto90 trocsln0. e,\ cut... NC. 29609 • \ Pln 3699-02-99- 6325 �\ 06 3382 P9 401 \ Lo[ 2 P9 24 P9 70 NO/F- a \ Eli? of All Camera Unress alherva"sc Noted S SERI4CNS. J0" Re., \\S' Side \1x1475 Cones[u9u Cross4ry, Coto.bo NC, 20609 C PDB, 3699-02-98-6292\ apron i 00 vat P9 401 of 3 `I 24 PY 20 1 rs Co CS L2 e mm, w6rA PIWaIYccla//Yryed w''.1��1M Ne J d/WjU I7uc -Y .0y Uu 1 uLnuval{ca de dx c.mlWn of IM1e f NL"I-_.]a 11 oe: Lot 232 A ores N. Numb., 1509 1495 LonestoYo Lrossing, E I Co N to.bo C 266P «; Pln 3699 02-99/U6 Otl 3362 P9 101 Lot 1 P8 24 P9 70 .I a I \ /735• ----------- ' -- S 14-44'40'V ?48 FILED May 05, 2017 01 35 pm POOH 0032 CNNA HICKS S ErY NC � ` PAGE 0x02 DONNA NICKS SPENCER '+Il REGISIEN OF DEEDS W INST N 0773Y AL LJcw 21.19 Aaauo,-ICCR�fi, Flu, I cN(y"- W b,u d mY.6lbey 1 Nve Jnerwn,d INI the plu .hovn hae un o ucmPl hom Cuewbo ...1111 Sah,UvYau N olslba Thu phl lAso W -hwl un-ceo,nientoton of Wnwna of Wenewly Plansl lun x411 W tluu of sl dY.a L. beu aaJ sod R.—k Wb ue e, -I to w e—IJt he aluduJ. dlh. C-1, a, b W l6d 0,v.l'. (AcuIw a I�.�.ILI I _ 1�6ulouf Pl..lwu � .__ " Mcs Kv (10{v Ce6dKak sure or Nom cwYna coann orc,uwa 1. _QTR: ffi �}�_ J 6e.le., n1n.� el r.uwh.1 n„I�I. cetiI "e., plubwk" R..411". 11 aff.ul ll¢m Cl aumnry ¢9ul m nl lo.rzendmMs Ne," Ow— r/�'F—._ IY/t/1 / Shede A Sherr— P8 2989 P9 12110 Nu Numb., 1521 Lot I 0.930 Acre 1509 Conestoga Crosshp. Coto.bo NC. 2tl6UY Pln 4609-01-06-0045 DU 3391 PYJ12L- — ---- 135 00' 1 135.00'(I otuU �UU S 114'44'40'-4 270,00' • "44 r1 ?, 162 Tota/lows un er nh.r lir•r•nutGinatiu❑ ave Cour.9 Bearing 1119tan C0 LI S 34.45'30• E 71.70' , L2 N 84'44'39' E 6_26 411.26- L3 L3 N 04-46'02• E L4 N 63.36'43' E 52.60' 1 I Curvn gadlu. Len9111 Oe 1 t a Clmrd Chard Bear. u' D- CI 1 84.46' 116.64' 36.13-46• 0_ 114_]---5-14 --3 1 -' 2fFE1 '-3 I 01' _CY 1164.46' 15.43' 4.47'35• 15.43' -_S 35.02'O7' E_ O 1 1 x C'] 193.96' 36.14' 11'15'57' 38.00' S 40'19'50' E __4 193.90' 100.01' 29.32'19• 96.90' S 611'43'56' E CS 103.96' 66.62' 19-40'34• 66.211' S 6.'20'24' E fF,\,��y conestnga Cr•osscng- L9—/— _......,.c a'/0.09'rTot.D_—^ --- Shede A Sherr— P8 2989 P9 12110 Nu Numb., 1521 Lot I 0.930 Acre 1509 Conestoga Crosshp. Coto.bo NC. 2tl6UY Pln 4609-01-06-0045 DU 3391 PYJ12L- — ---- 135 00' 1 135.00'(I otuU �UU S 114'44'40'-4 270,00' • "44 r1 ?, 162 Tota/lows un er nh.r lir•r•nutGinatiu❑ ave I I I I lferhbrook Ln I =aaa= ,i , iM1 C( b.: Bo F, W C' -� 01-02 CC A d6➢� £�: 10 V$x '' I iii m N N - , •Sryy��`• ........I F, W C' -� 01-02 CC A d6➢� £�: Parcel Report Parcel Report - Catawba County NC Parcel Information: Parcel ID: 460901080045 Parcel Address: 1521 CONESTOGA CROSSING City: CATAWBA, 28609 LRK(REID): 18307 Deed Book/Page: 3383/1121 Subdivision: AUTUMNWOODS PH 2 Lots/Block: 1/ Last Sale: Plat Book/Page: 76/169 Legal: LOTS 5-7 PL 76-169 Calculated Acreage: 1.430 Tax Map: 017BY 03006 Township: CATAWBA State Road #: TaxlValue Information: Tax Rates(pdf) City Tax District: All in County County Fire District: BANDYS Building(s) Value: $0 Land Value: $10,700 Assessed Total Value: $10,700 Year Built/Remodeled: / Current Tax Bill Miscellaneous: Building Permits for this parcel. Building Details Watershed: WS -IV Protected Area Voter Precinct: P21 Parcel Report Data Descriptions List all Owners Deed History Report Page 1 of 1 Owner Information: Owner: LAZARIDES THOMAS G Owner2: Address: 1509 CONESTOGA CROSSING Address2: City: CATAWBA State/Zip: NC 28609-8091 School Information: School District: COUNTY Elementary School: CATAWBA Middle School: MILL CREEK High School: BANDYS School Map Zoning Information: Zoning District: COUNTY Zoningl: R-40 Zoning2: Zoning3: Zoning Overlay: WP -O Small Area: SHERRILLS FORD Split Zoning Districts: / Zoning Agency Phone Numbers Firm Panel Date: 2007-09-05 Firm Panel #: 2010 Census Block: 1022 2010 Census Tract: 011503 Agricultural District: Proximity Assessment Report This map/report product was prepared from the Catawba County, NC Geospatial Information Services Catawba County has made substantial efforts to ensure the accuracy of location and labeling information contained on this map or data on this report Catawba County promotes and recommends the independent verification of any data contained on this map/report product by the user. The County of Catawba, its employees, agents, and personnel, disclaim, and shall not be held liable for any and all damages, loss or liability, whether direct, indirect or consequential which arises or may ause from this map/report product or the use thereof by any person or entity. © 2017, Catawba County Government, North Carolina. All rights reserved. y Sep So 3a 360508 pew Weil 30 http://gis.catawbacountync.gov/noniap/parcel_report. php?key=460901080045&typ—P 6/26/2017 CATAWBA COUNT/' Public licalth Dep;utment IY Frivi roil nen tal I Icolth Drviaua er 110 Box 389, 100-A Southwcel Blvd, Newton. NC 28658 D E Cal e N IMPV-05-2017-084978 Subdivision AUTUMNWOODS PH 2 PINd 460901080045 LU'I'h 1 NAME ON PERMIT: THOMAS LAZARIDES, 1230 CONOVER BLVD W, CONOVER NC 28613 Site Address: 1509 CONESTOGA CROSSING, CATAWBA NC 28609 Property Size: Square Feet, 62,290.80 Acres 1.43 Directions: Balls Creek Rd, r Bandys Cross Rd, left Buffalo Shoals, r E Bandys Cross Rd left Long Island, right Eulalia Ln, Right Conestoga Crossing Improvement Permit E� ihilFA x•1:#mj =1;: d l•�§i► t tlr-1l A IWA r 101,1 R922992191&= Facility: Primary Residence - House Permit Category: New Septic ncdloou,s 3 WATER SUPPLY, Private Well Basement? No Basement Plumbing? INITIAL SYSTEM SPECIFICKHONS Permit Valid: Expires In Five Years: _X_ No Expiration: Projected Daily Flow 360 g.p.d Proposed Wastewater System: 25% REDUCTION Type: /II6-Sl'S'I'EM1V/SINCI.F.FFFI-UIT'TPUh1P PUNIP REQUIRED Permit conditions: 'Do not grade, fill, or drive over any designated septic area. REP�VR Sl'S'I�li�4 SPECIFIC/Cl-IONS Repair System Required? Required Proposed Wastewater system: DRIP IRRIGATION Type: WA - ANY SYSTEM WITH LPP DISTRIBUTION PUW REOUIRED '" OPERATOR REOUIRED Landscaping or other site alterations that potentially divert groundwater or surface water toward the septic system, or prevent proper drainage away from the septic system, including the direction of gutter vows or foundation drains, is not aptovpd, and may result in faiiure to approve the initial system instahation, or the suspension/revocation of existin0 permils The issuance of this permit by the I lealth Dcpal lmenl does not guaranwe the Issuance of oilier permits. It is the mresponsibility of the apphcanUpropeny owner to Insure thal all Catawba Counq• Planning/7.oning and Building Inspections requirements arc et This Improvement Permit is subject to revocation if the site plan, plat or the intended use changes, or if site conditions are altered. The Bnprovement Permit is not affected by a change in ownership of the properly. This permit svgs issued in compliance with the provisions of the North Carolina 'Lrrw•,s and Holes for Sesame 7'renrment and Disnosed St -stems' (15A NCAC ISA .1900). Neither Cataw'ho County nor the Environmental Ilcalth Specialist warrants that the septic tank system will continue to function satisfactorily for am• given period of time. Robbie Phelps 05102/2017 AU 1110Rl%IID S FATE AGFN'I' APPROVAL DNI I' Permit Expiration Date: 05/02/2022 Aro grueling or consuvCtmn activily "s allolve,l in ureas dc�lgmlterl iw srs7rw and repair mahout approval o.017c Ilcalth Depwinient. ehhwamir 05/04/2017 16:58 TA t11- a4-20ll—ag49?Y Catawba County Environmental Health /it zi _ rf r Id � 24Y,K6" Parcel: 460901080045, 1509 CONESTOGA lin=60ft CROSSING CATAWBA, 28609 � „+s 2 - S This mapfri product was prepared from the Catawba County, NC Geospabal Infoemation Services. Catawba County has made substantial efforts to ensure the accuracy of location and labeling mformatlon oontalnod on thus map or dal" on this report. Catawba County prornolos and recommends the independent venficahon of any data contained on this map/report product by the user. The County of Catawba, its employees, agents, end personnel, disclalm, and shalt not be held Gable for any and all damages, loss or liability, whether direct, indiroct or consequential which arises or may arse from this maplreport product or the, use thereof by any person or entity. Copyright 2014 Catawba County NC 05102/2017 �v(_�T)Ll� iLt-ti tt] .''J ruff J�,2 .r7 _i 02.0'3:00 f� ,_..-11207 i:+ rN NA HI C3G5- YiPElsif-ER. Feglal,:r OT NsrS M4 P -:z+07'4-0735 NORTH CAROLINA GENERAL WARRANTY DEED Excise Tax: 0.00 Purchase Price: $0.00 ParcelldentifierNo.3699-02-98-6325,3699-02-98-6292,4699-02-98-7069,4609-01-08-0045 Verified by County on the day of 20 By: .� Mail/Box to: Grantee (HB) Instrument prepared by: Ben S. Thomas of THOMAS & GODLEY, PLLC, 514 Williamson Road, Ste. 421, Mooresville, NC 28117 Brief description for the Index: Lots t and 2 of Thomas Lazarides THIS DEED made this day of 2017, by and between GRANTOR Thomas G. Lazarides, Unmarried 4812 Grassy Creek Road Denver, NC 28037 GRANTEE Thomas G. Lazarides, Unmarried Property Address: 1465, 1475, 1485, 1495, Catawba, NC 28609 Mailing Address: 4812 Grassy Creek Road Denver, NC 28037 1509, 1521 Conestoga Cross The designation Grantor and Grantee as used herein shall include said parties, their heirs, successors, and assigns, and shall include singular, plural, masculine, feminine or neuter as required by context. WITNESSETH, that the Grantor, for a valuable consideration paid by the Grantee, the receipt of which is hereby acknowledged, has and by these presents does grant, bargain, sell and convey unto the Grantee in fee simple, all that certain lot or parcel of land situated in Catawba County, North Carolina and more particularly described as follows: Being all of Lots I and 2 of Thomas Lazarides Subdivision as recorded in Plat Book of 77, Page 32 which includes and is a revision of Lot I of Plat 76, Page 169, and also includes, and is a revision of Lots 2-7 of Plat Book 24, Page 70, Autumnwoods Subdivision, Catawba County Registry. Delinquent propem takes. if any. are to be paid bY the closing attomey to the county Tar Adm ini;trator upon disbursement or the closing proceed. The property hereinabove described was acquired by Grantor by instrument recorded in Book . Page All or a portion of the propem herein conveyed _ includes or _x_ does not include the primary residence of a Grantor. A map showing the above described property is recorded in Book 77, Page 32, a revision of Plat Book 76, page 169 and Plat Book 24. Page 70. TO HAVE AND TO HOLD the aforesaid lot or parcel of land and all privileges and appurtenances thereto belonging to the Grantee in fee simple. And the Grantor covenants with the Grantee, that Grantor is seized of the premises in tee simple, has the right to convey the same in fee simple, that title is marketable and free and clear of all encumbrances, and that Grantor will warrant and defend the title against the lawful claims of all persons whomsoever, other than the following exceptions: I. Any and all easements, rights of way and restrictions of record. 2. Any and all zoning and planning ordinances. 3. Any discrepancies as an accurate survey of the premises might reveal. 4. Any and all other matters of record. IN WITNESS WHEREOF, the Grantor has duly executed the foregoing, (SEAL) _ ✓l.c, (SEAL) Thomas G. Lazarides (SEAL) (SEAL) State of North Carolina -County or City of ko" r eA n (n 1, the undersigned Notary Public of the County and State aforesaid, certify that Thomas G. Lazarides. personally appeared before me this day and acknowledged the due execution of the foregoing instrument for the purposes therein expressed. Wimess my hand and Notarial stamp or seal this 34" day of 5V A-9— %.rr, t20a. Jxs`5�ke R e ��'sr ��� II My Commission Expires: lP4Str o P t7. Notary Public (Affix Seal) Npt°tY Notary's Printed or Typed Name P oblic 0 i !. _Z State of North Carolina - Count)/ or City of Iredell i,p 1, the undersigned Notary Public of the Counry� tttttt"�A)d, certify that Witness my hand and Notarial stamp or seal, this _ day of 20 My Commission Expires: Notary Public (Affix Seal) Notary's Printed or Typed Name