HomeMy WebLinkAboutEHPR-2-10-3964 (2).TIF
A
$ C THIS IS NOT A PERMIT Case # EHPR-2-10-3964
a CATAWBA COUNTY HEALTH DEPARTMENT
Plan Review Application for Environmental Services
184 5M Environmental Health Plan Review - OSWP
EXS_S YS TEM
APPLICANT OWNER CONTRACTOR
GUY CLIFFORD BAKER III GLADYS BAKER
1693 SKYHAWK LN PO BOX 702
CONOVER NC 28613- CONOVER NC 28613-0702
(828)312-8731
NAME TO APPEAR ON PERMIT GUY CLIFFORD BAKER III Pin#: 3743 1 1 566099
SITE ADDRESS: 1387 CESSNA LN 21, Conover, NC
DIRECTIONS: HWY 16N/ LT C & B FARM RD/ LT CESSNA LANE/ TAILDRAGGERS MHP ON LF FOLLOW RD TO SKY KING MHP /
LOT 21 ON LF AT END
NAME of SUBDIVISION: Lot # Section/Block/Phase
PROPERTY SIZE: Square Feet Acres 12.079 Date Platted/Recorded
TYPE OF FACILITY: House Mobile Home X Dimension of Structure 14 X 70 Bedrooms
Basement: No Water Using Fixtures in Basement:No No. in Family 4
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 1st 2nd 3rd
OTHER: (Specify)
Do you aniticipate any additions to Facility?
If so, describe:
Has any grading, removal, or addition of soil been done to this property?
If so, describe
Are there easements/right-of-ways recorded on this property? NONE
Type of Water Supply: Individual Well Community Well Municipal X 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 representation by you of house or structure
location should conform to applicable setbacks.
Date: L'- jq 11c) Signature of Applicant or Agent 6Z& CL'46"t'.s C-xn- 1'e"-, ~„-Y-
An Environmental Health Specialist will contact you within 2 working days of application dam.
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 10 FEE NAME DATE AMOUNT
Side 10 Existinp_ Tank Check Fee 02/19/2010 $80.00
Rear 10 TOTAL FEES
Max Hght $80.00
*If a permit has to be redesigned and / or RETRIPS made to the property, there is. an additional $60 charge
02/19/10 12:28
A C ' THIS IS NOT A PERMIT Case # EHPR-2-10-3964
r Y T
d CATAWBA COUNTY HEALTH DEPARTMENT
Plan Review Application for Environmental Services
1842 sM Environmental Health Plan Review - OSWP
EXS_SYSTEM
APPLICANT OWNER CONTRACTOR
GLADYSBAKER GLADYSBAKER
PO BOX 702 PO BOX 702
CONOVER NC 28613-0702 CONOVER NC 28613-0702
NAME TO APPEAR ON PERMIT GLADYS BAKER ~ ~ C( ~er. Pin#: 37431 1566099
SITE ADDRESS: 1387 CESSNA LN 21, Conover, NC ` .2
DIRECTIONS: HWY 16N/ LT C & B FARM RD/ LT CESSNA LANE/ TAILDRA~, O OLLOW RD TO SKY KING MHP /
LOT 21 ON LF AT END
NAME of SUBDIVISION: Lot # Section/Block/Phase
PROPERTY SIZE: Square Feet Acres 12.079 Date Platted/Recorded
TYPE OF FACILITY: House Mobile Home X Dimension of Structure 14 X 70 Bedrooms 3
Basement: No Water Using Fixtures in Basement:No No. in Family 4
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 1 st 2nd 3rd
OTHER: (Specify)
Do you aniticipate any additions to Facility?
If so, describe:
Has any grading, removal, or addition of soil been done to this property?
If so, describe
Are there easements/right-of-ways recorded on this property? NONE
Type of Water Supply: Individual Well Community Well Municipal X 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 representation by you of house or structure
location should conform to applicable setbacks.
Date: _ Signature of Applicant or Agent f
An nvironmental Health Specialist will contact you within 2 workin ays of application date.
If you need further information or assistance please call 828-466-7291
AREA 2
(FOR OFFICE USE ONLY) A\ p ~w ~i
Zoning Approval: _/Yes No Zoning Approval 1O %U O Zoning Form A
Minimum Setbacks
Front 10 FEE NAME DATE AMOUNT
Side 10 Existing Tank Check Fee 02/19/2010 $80.00
Rear 10 TOTAL FEES $80.00
Max Hght
If a permit has to be redesigned and / or RETRIPS made to the property, there is an additional $60 charge
02/19/10 12:09
THIS IS NOT A PERMIT WLS #
CATAWBA COUNTY HEALTH DEPARTMENT
Application for Environmental Services
Improvement Permit ❑ Authorization to Construct ❑ Septic Repair ❑ Septic Expansion ❑
Existing Tank Check ❑ New Well Permit ❑ Replacement Well ❑ Well Abandonment ❑
1. Name to Appear on Permit -4 Ake
2. Permit Requested By Business Phone $2-'E - z/ (o q
Address iLpg3 Sk- lk&A,,.rk LaPr2 , Co,,,e-ve2 , N/ C. 2%cvi3 Home Phone ~s28~3~2- 8731
3. Property Owner G(46T a k>? r Business Phone
Address 8n, r3ox 7o 2 C,.,ovef Home Phone
4. Name of Subdivision Skv k NU lM,o 6, le- l-n e 64,1<, Lot I Section/Block/Phase
Property Address 1387 CP_5S;"p L✓ lVt Cor.jayev'
Directions to Property: oiv C-t 13 fL ~e 55Nff Ll4NL'
6> CIND
5. Property Size: Square Feet Acres Date Platted/Recorded
6. TYPE OF FACILITY: House Mobile Home Dimension of Structure t_4 X -7 U Bedrooms*
*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 system size increase in the future.
Basement: yes/ _ Water Using Fixtures in Basement: yes~~ No. in Family
Whirlpool Tub y s/rno 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 I st 2nd 3rd
OTHER: (Specify)
7. Do you anticipate any additions to Facility? Yes/(No
If so, describe:
8. Has any grading, removal, or addition of soil been done to this property? Yes No
If so, describe: v
9. Are there easements/right-of-ways recorded on this property? Yes / 1)o
10. Is a public water supply available on or adjacent to the above property? (S) / No
Check type that is available: [ ] Community well [ ] Semi-public well [bounty/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 0 BE REDESIGNED AND/OR RETRIPS MADE TO THE PROPERTY, TH E IS AN ADDITIONAL CHARGE.**
Date 2 Signature of Owner or Agent
Catawba County, North Carolina
This mop product was prepared ji•om the Calawbo Count A'C. Geographic hiform(mon S- seem.
N Cmmrba Coruvi~ has made substanlin/ efforts to ensm'e the accurnc>> of locution and labeling infornralion
comained ou this mop. Calmrbn Counrn promotes mid recommenels the independent verification of mnv
data contained on this map product by the user. A e Count vof Catmrba, its emplo-vees, agents and
persmmel disclaim, and shall not be held liable for am and all clanutges, loss m liabilav, whether direct, indirect
or consequential which arises or map orise from this map product or the it-se thereof hi' am persrnt or cntilu Legend
Selected Parcel Number: 3743-11-56-6099
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THiS IS NOT A LEGAL DOCUMENT Friday, February 19, 2010 11:27 AINI1 C~~/:
Catawba County, North Carolina
This map product was prepared from the Catawba County, NC, Geographic Information System.
N Catawba County has made substantial efforts to ensure the accuracy of location and labeling information
contained on this map. Catawba County promotes and recommends the independent verification of any
data contained on this map 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 arise from this map product or the use thereof by any person or entity. Legend
Selected Parcel Number: 3743-11-56-6099
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4 CATAWBA COUNT 1EALTH DEPARTMENT NO 6320
Telephone (828) 4b:)- 270 TOD (828) 465-82
Imp Prmt. Auth. to Const. Rpr Prmt. Opr Prmt. Sys Type Well Print. Well Rpr Prmt.
Owner/Agent ~rro K Q Phone C
Address Q~ o yc `7(? C 0 .'1e t J Q r Subdivision
1. Section/Block/Phase ,
L
Lot Size -~-,-r a Directions LT C- Z 1 2 5 5 t-, L C, v%
1 -1; 9
Facility- House Mobile Home Business Multi-family Other- Tax Map or Pin Number . - - - O
Other Zoning A~,proval # 601
# Bedrooms # Seats # Employees Application Rate -ZIP 5 GPD Flow 3 6 c>
Hot Tub or Spa yes/ 0pe 'al Fixtures Basement yes/i~ 100% Repair Are e o
Basement Plumbing yes/t 0 Water Supply- Private Well Public Semi-Public
Type of System- Tr n ~ Bed Pump Pump/Panel Panel LPP Other
l
Septic Tank Size 00 Pump Tank Size Nitrification Field. Total Square Feet I OX $ Depth of Stone
Bed Size Trench Width Total Length of All Trenches 3~0~, Number of Trenches
Trench Length ) ~tl-ffq/ Feet on Center Maximum Trench Depth 36 Distance of Nearest Well
*DO NOT INSTALL SEPTIC WHEN WET* *WELL RECORD REQUIRED AT COMPLETION*
Topo % Slope li Q55hC" L C. h Q,
Texture 5 1
.Structure ( 30 p`iQ
Clay Mine
Soil Wetness
Soil Depth q
Restric Hoz at -0" ti q
Available space (ej/no I M
Overall Class S 111~'U i ~D 0 `n
Comments
r-as Try
,A, p~oWemSj
-3 b`\ Tf-e 'c
~ X60 °1G ('e~G-~r' GGhu
N
Filter Required
Riser required when
tIrd
ank is more than 6
inches deep. I t- r= e
**NO GUARANTEE OR WARRANTY IS IMPLIED IS SYSTEM
WILL FUNCTION**
*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 guarantee at an site by the Health Department.
Permit Date - `1 EHS
Owner/Agen Septic Tank Installed By Date
EHS ell Installed By Well Grout App va Date
Well Head Appr val Date Date Sample Collected
Date of Results Results EHS
White Office Blue Buildine Inspection ODeration Permit Yellow Owner/Aeent Green Building Inspection Authorization to Construct
CATAWBA COUNTY PERMIT
~A co ZONING AUTHORIZATION (R)
Manufactured Home
~qp, P. o. B°` 339 PERMIT NO: ZONR-2-10-4838
100A Southwest Blvd APPLIED: 02/19/2010
J
Newton, North Carolina 28658 ISSUED: 02/1 912 0 1 0
SM Phone: 828-465-8380 EXPIRES: 03/18/2010
PAX: 828-465-8484
Nvww.catawhacountlmc.gov
APPLICANT OWNER CONTRACTOR
GLADYSBAKER GLADYSBAKER
PO BOX 702 PO BOX 702
CONOVER NC 28613-0702 CONOVER NC 28613-0702
PROPERTY ID#: 37431 1566099 CENSUS TRACT:
STREET ADDRESS: 1387 CESSNA LN 21, Conover, NC LOT#
PROJECT DESCRIPTION: SW MOBILE HOME / Must meet County Appearance Criteria and each manufactured home space shall be provided at one
door location with a concrete pad or a treated wooden deck of a minimum of 100 square lect. Which shall be connected to the
parking area by an impermeable walkway.
DIRECTIONS:
COMMENTS: SW MOBILE HOME 14 X 70 / Must meet County Appearance Criteria and each manufactured home space shall be provided at
one door location with a concrete pad or a treated wooden deck of a minimum of 100 square Icct. which shall be connected to
the parking area by an impermeable walkway.
FLOOD ZONE? OWNER TYPE: Residential (Private) REQUIRED SETBACKS
100 YEAR FLOOD ZONE PLAIN? No LAND OWNER:
FRONT: 10.00 SIDE: 10.00
FLOOD PLAIN, STRUCTURE? No MAX HEIGHT: 45.00 REAR: 10.00 SIDE I:
VALUE: 0 CORNER: SIDE 2:
1. Before an inspection can be made by the Building Inspection Office, the applicant must pull a string to designate the side and rear
property lines where the structure is being placed or constructed.
2. Home shall be placed on the lot in harmony with the site-built structures, or have the front door face the road frontage.
3. All manufactured homes must he underskirtcd before power can be connected.
4. Only one manufactured home shall be allowed per lot or parcel of land.
5. Home shall have either deck or porch with steps, located in the front of the home (minimum sire shall measure at least 36 square feet).
FEE DESCRIPTION DATE FEE AMOUNT
Residential Zoning Pee 02/19/2010 $25.00
TOTAL FEES $25.00
The applicant hereby certifies that all information and attachments to this Certificate of Zoning Coil] pilialice are true and correct, and
acknowledues that this icrmit was issued on the basis of the information required herein. The applicant further acknowled-cs 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 applicant.
It is the responsibility of Applicant to comply with all existing deed restrictions pertaining to the property. Issuance of this permit is not ccrtifiaition ol'
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 buildin
peri
nit is secured and remains active.
.1 Al -
APPLICANT NAME (I'RINTED) APPLIC) SI ,NATURE ZONING AiTROVED BY
"ZONING FEES ARE NON-REFUNDABLE
CON,IPANY NAME
02/19/2010 12:08 Page I of I
~g'p' C~~ ^ • CATAWBA COUNTY, NC
100-A South West Blvd PLAN INVOICE
Q+ F-] Newton, NC 28658-
(828)465-8399 465-8399 Friday, February 19, 2010
184 2 sM www.catawbacountyiic.gov
Plan Case: EHPR-2-10-3964 Invoice Number: INV-2-10-259743
Environmental Health Plan Review Invoice Date: 02/19/2010
Fee Name Fee Amount
Existing Tank Check Fee Fixed $80.00
Total Fees Due: $80.00
PAYMENTS
Date Pay Type Check Number Amount Paid Change
02/19/2010 Check 1808 $80.00 $0.00
Total Paid: $80.00
Total Due: $0.00
phn invoice : cb5ccabd-r-10-4345 1)bb I - 31;02756e2;()c; .rpt 02/19/2010 12:10