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HomeMy WebLinkAboutEHPR-2-10-4025 (2).TIF A THIS IS NOT A PERMIT Case # EHPR-2-10-4025 CATAWBA COUNTY HEALTH DEPARTMENT .e, ' H - ~'~~®y®y ^C Plan Review Application for Environmental Services 184 sM Environmental Health Plan Review - OSWP 1842 IMPROVEMENT A PPLICANT - _ OWNER CONTRACTOR 7-7 FE-ANC,IS'X LIB INGST0 N, 'FRANCIS,X LIVINGSTON` ~1525KING -HENRY-DR 1525 KING HENRY. DR PITTSBURGH PA 15237-1535 PITTSBURGH PA 15237-1535 (412)759-5865 (412)759-5865 NAME TO APPEAR ON PERMIT FRANCIS X LIVINGSTON Pin#: 461603028586 SITE ADDRESS: 5130 LEISURE LN, Sherrills Ford, NC DIRECTIONS: SLANTING BRIDGE_RD, LEFT KEISTLER STORE RD, I ST LEFT BARKLEY RD, RIGHT LEISURE LN, HOUSE ON LEFT NAME of SUBDIVISION: Lot # 35 Section/Block/Phase PROPERTY SIZE: Square Feet Acres 0.759 Date Platted/Recorded TYPE OF FACILITY: House X Mobile Home Dimension of Structure Bedrooms Basement: Yes Water Using Fixtures in Basement No No. in Family 2 Whirlpool Tub : (jal: Capacity: MULTIPLE FAMILY RESIDENCE: Units 1.00 L.~ Total Number of Bedrooms DAYCARE: Number of Children RESTAURANT: Seats Square Feet Dining' A ea 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: TEARING DOWN EXISTING CARPOR"T" AND.B.UILDING 40 X 33 GARAGL IN FOOTPRINT. 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? t iNKNO Type of Water Supply: Individual Well X Community well 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 representation by you of house or structure location should conform to applicable setbacks. Date: 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 1 (FOR OFFICE USE ONLY) Zoning Approval: Yes No Zoning Approval UDO Zoning Form A Minimum Setbacks Front 30 FEE NAME _ ,DATE AMOUNT Side to Impio-VTn nt Permt~ Fee 02/24/2010. - $150.00 Rear 30 TOTAL FEES $150.00 Max Hght *If a permit has to be redesigned and / or RETRIPS made to the property, there is an additional $60 charge 02/24/10 17:10 THIS IS NOT A PERMIT r.- 11"b `J CATAWBA COUNTY HEALTH DEPARTMENT 2~Application for Environmental Services V_ IP F-! AC F S.T. Rpr. S.T. Exp. F' Exist. S. T. F- Well Permit F7 Replacement Well N7,to ea o~ ermit:2. Permit Requested By: ~ rVCtS x, ~-j~ r,gs-fc) Business Phone: Address: Home Phone: 3. Property Owner: FRANck S k - -w I S+w f J441, kI v) r1* Business Phone: Address: Home Phone: 4. Name of Subdivision: - Lot Section/Block/Phase: F- Property Address: ,136 4,e-14Q, ~AlVC r skcrn Us r9d) AJC ag& 73 Directions to Property: _ ~1 i~ 3~ (1~COl v 1 Ie A~ 16tn} ( -f t, 'f r,~:f I<eisKe . e- i~e- ~f l ~F~i~sf- I~ tQf 12 K Iq J~d) tt r t~ r q I t Cc t I,ei * re . Me-- r1 b7Lt~ i s Q 5. Property Size: Square Feet F-Acres oa qff q Date Platted/Recorded House C` Mobile Home 6. TYPE OF FACILITY: Dimension of Structure F Bedrooms. Any r"oom that will be intended for"slreping »t;the time of.construction r,.for future;consideration should I+A noted asa bedr"oom and counted.on all a~n' inns. The number of bedroon~~ vvil he cor firme&b rooms ideniifi d on the hose"plans as a bedn n) at the time of building permit issuance: Th' revent the n t<ih Feed for system size increase in the future > Basement: O Yes C' No Water Using Fixtures in Basement: ^C' Yes KNO No. In Family: Whirlpool Tub: C' Yes ~No Gallon Capacity: MULTIPLE FAMILY RESIDENCES: Units Total Number of Bedrooms DAYCARE: Number of Children FEB 2 2 2010 RESTAURANT: Seats F--Square Feet Dining Area F Square Feet Food Stand/Meatlw%V W.~ TYPE OF BUSINESS: No. of Employees 1 st F-2nd F-.3rd OTHER : (Specify) 7. Do you anticipate any additions to Facility? (-Yes (\No If so describe pet 8. Has any grading, removal, or addition of soil been done to this property? C` Yes C(No If so describe 9. Are there easements/right-of-ways recorded on this property? Yes X NoQf) r f F~~ ~J 21 D ? 10. Is a public water supply available on or adjacent to the above property? (-Yes VNo Check type that is available: F Community Well F_ Semi-public Well F_ County/City/Township waterline 11. Well Type Applying For: Individual Well r Community Well f- Semi-public Well F_ Irrigation Well r Geothermal Well 12. Monitoring Well Request: (-Yes X No # of Wells: Fof Site: I understand that this 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 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 set backs. **IF A PERMIT HAS TO BE REDESIGNED AND/OR RETRIPS MADE TO THE PROPERTY, THERE IS AN ADDITIONAL CHARGE Date: ~q1~ Signature of Owner or Agent: Print Form J: l' lr f 4 ;t r t. 3 } w t , J %f` ai~ „8-,4Z f z 0 U h N Z O U o W U• o ? Z °v ap W ~ W U O cn 0 a Y U cli z O F U F 2 1 ~ U O F O z E N a FILED C&Tvfb7 Ctttipa ti earl 1-5, 9-010 8f -10:56-00 aT-fl ac1se -lay .OCR {-R" INST. 37 00818 DONNEl ICKS SPENCER, Re alor'A Goods L;[ 13 01 Pg 159-0161 NORTH CAROLINA GENERAL WARRANTY DEED Excise Tax: none No title opinion rendered Parcel Identifier No. Verified by County on the day of 20_ By: Mail/Box to: Russ West 618 N. Main Street Mooresville NC 28115 This instrument was prepared by: Russ West Brief description for the Index: THIS DEED made this 7th day of January 2010 by and between GRANTOR GRANTEE Francis X. Livingston and wife Francis X. Livingston and wife Judith A. Livingston Judith A. Livingston 1525 King Henry Drive 1525 King Henry Drive Pittsburgh, PA 15237-1535 Pittsburgh, PA 15237-1535 Enter in appropriate block for each party: name, address, and, if appropriate, character of entity, e.g. corporation or partnership. 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 the City of Township, Catawba County, North Carolina and more particularly described as follows: See attached Exhibit A. The property conveyed herein is not the primary residence of the Grantor. The property hereinabove described was acquired by Grantor by instrument recorded in Book 2244 page 1503 A map showing the above described property is recorded in Plat Book page NC Bar Association Form No. 3 © 1976, Revised © 1977, 2002 + James Williams & Co., Inc. Printed by Agreement with the NC Bar Association - 1981 www.JamesWilliams.com 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 fee 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: All exceptions of record. 0160 IN WITNESS WHEREOF, the Grantor has duly executed the fore g as of the day a year first above written. ,lit~~• (SEAL) (Entity Name) Francis A. Liv" gston By: Z (SEAL) Title: x udith A. Living ton z_ By: (SEAL) Title: a ca By: (SEAL) e. a State of North Carolina -County of Iredell I, the undersigned Notary Public of the County and State aforesaid, certify that Francis X. Livingston v: 0 T R f =z and Judith A. Livingston personally appeared before me this day and _ ®e ® 6 ? acknowledged the due execution of the foregoing instrument for the purposes therein expressed. Witness my 7- • P V B L hand and Notarial stamp or seal this 7th day of January 120 10 My Commission Expires: 12-9-14 R C C ooA a~ Notary Public }1;;~_ ~'~'Fte?R:!~UeA~ ..'4• rte. lv State of North Carolina - County of I, the undersigned"Notary Public of the County and State aforesaid, certify that a personally came before me this day and z 0 acknowledged that he is the of z a North Carolina or corporation/limited liability company/general partnership/limited Y partnership (strike through the inapplicable), and that by authority duly given and as the act of each entity, Q he signed the forgoing instrument in its name on its behalf as its act and deed. Witness my hand and Notarial stamp or seal this day of 120 w a My Commission Expires: Notary Public a State of North Carolina - County of Z I, the undersigned Notary Public of the County and State aforesaid, certify that _z Y U Witness my hand and Notarial stamp or seat this day of , 20_ w My Commission Expires: Notary Public The foregoing Certificate(s) of is/are certified to be correct. This instrument and this certificate are duly registered at the date and time and in the Book and Page shown on the first page hereof. Register of Deeds for County By: Deputy/Assistant - Register of Deeds NC Bar Association Form No. 3 © 1976, Revised © 1977, 2002 * James Williams & Co., Inc. Printed by Agreement with the NC Bar Association - 1981 www.JamesWilliams.com PROPERTY DESCRIPTION H j. BEGINNING at a rebar located in the eastern margin of the right of way of Leisure Lane, said rebar marking the common corner of the Grantor and John C. Edwards (ref DB 652pg 305), and running thence with the right of way of Leisure Lane the following two lines: N 15-59-20 W 79.97 feet to an iron, thence N 1S-S6-56 W 99.86 feet to a nail, a common corner of the Grantor and Marilyn F. Groner Massey (ref DB 1742pg 420; 2007E-1102), and running thence with the Massey line N 84-20-23 E 245.36 feet to a rebar (passing an iron at 126.65 feet), and running thence S 44-34-00 E 11.20 feet to a point, thence S 05-14-00 W 106.13 feet to a point marking the common corner of the Grantor and John C. Edwards (DB 652 pg 305), and running thence with the Edwards line S 66-36-42 W 210.15 feet to the POINT AND PLACE OF BEGINNING, containing 0.759 acre, more or less, all according to survey of Phillip A. Harris, PLS, dated January 4, 2010, reference to which is made for greater certainty of description. Being all of the property shown on plat book 6 J at page ''7 in the Catawba County Public Registry. PURPOSE OF CONVEYANCE: this conveyance is made for the purpose of combining adjoining parcels into one parcel. The adjoining parcels are identified as Catawba County tax parcel 4616-0302-8586 and Catawba County tax parcel 4616-0302-8498. CATAWBA COUNTY HEALTH DEPARTMENT NEWTON, NORTH CAROLINA COMPLETION PERMIT FOP SEPTIC TANKS PERMIT 2233 OWNER & DATE:~'"~, ~~d e _ ADDRESS BUILDING CONTRACTOR SUBDIVISION LOCATION T 4 s LOT LOT SIZE 21d, G C BLOCK OR SECTION HOUSE MpBILE HOME ( ) BUSINESS C ) OTHER t ) FI-IA-VA LOAN { ) SEPTIC TANK:t c; IZE GG~Q GALS) WATER SUPPLY: NO. BEDROOMS NO FIXTURES ;NDIVIDUAL T GARBAGE DISPOSAL UNIT:YES PUBLIC AUTO WASHING MACHINE : Y S ( 11) - N0 ( IF WELL, TYPE : BORED DRI±,i~ED DUG NITRIFICATION FIELD: S F ) DISTANCE FROM SEPTIC TANK OR j~F;REST 1) 'o 0- NUMBER OF LINES Q • ` T • POLLUTION SEPTIC TANK ilvST'ALLE'D FT. 2) LENGTH AND WIDTH OF LINES ,rte a) BED SY T rERMIT FEE Y b) TRENCH SYSTEM ( ) CERTIFICATE OF COI~PPLETIO~ BY: 3) DEPTH OF STONE IN LINES ah~ ~ P`El'r'RKS -ADEQUATE FALL (GRADE) ON: 1) YESL(I (HOUSE) SEWER LINE: 2) NITRIFI ATION LINES: YES ( NO ( ) DATE INSTALLED:_ _ SEPTIC TANK LAYOUT JJ i f i i (-4 0 P4 H ~ I 4 HEALTH DEPARTMENT COPY CAT•AWBA COUNTY HEALTH DEPARTMENT a IMPROVEMENT 10469 PERMIT FOR SEPTIC TANKS Permit No. g Id ' OF 'ER ~~J~' ~GG P DATE ADDRESS F OWNER-201 crf ECi~B- ST ) ~Gi>1lPr~ ~ ~~~lCx/ PHONE 2.( 3 - X-2 t NAME OF CONTRACTOR ADDRESS LOCATION r t2 iiwz c~ ~ /Cep /tit s t Ul f e 4:G~Tii 1~ ' 6 -6-zei Via'[-',, SUBDIVISION6vyZ/ltr~ LOT NO. SECTION OR BLOCK LOT SIZE 7060 0 } C FHA, VA LOAN HOUSE ( MOBILE HOME ( ) BUSINESS ( ) OTHER ( ) SEPTIC TANK LAYOUT NO. BEDROOMS (3) NO. FIXTURES (3) GARBAGE DISPOSAL UNIT: YES ( ) NO PLUMBING UNDER BASEMENT FLOOR: YES (~0 ( ) SIZE OF TANK U 0 LIQUID GALLONS NITRIFICATION FIELD: 1. Number of lines _ 2. Length and width of lines:. a. Bed System *6 ~ 12.5 ft. b. Trench system ft. 3. Total Depth of stone / inches GROUNDWATER INTERCEPTOR DRAIN: (IF REQUIRED) fZa WATER SUPPLY: PRIVATE ( PUBLIC ( } OWNER NOTIFIED TO CHECK ZONING: YES (q1NO ( ) OWNER AGREES WITH LAYOUT: YES (v~ NO ( ) OWNER AGREES WITH SPECIAL INSTRUCTIONS:' YES (-)'NO ( ) 5d o h /o or OWNER OR CONTRACTOR SIGNATURE PERMIT FEE $ 3 0. PERMIT VOID AFTER 36 MONTHS IMPROVEMENT PERMIT ISSUED BY SEPTIC TANK CONTRA FOLLOW ALL DETAILS OF THIS PERMIT (LAYOUT) ~ ~n If' SANITARIAN HEALTH DEPARTMENT COPY SOIL CLASSIFICATION: SUITABLE ( ) PROVISIONALLY SUITABLE U~ISUITABLE ( ) SITE FACTORS: 1. SLOPE U 7. SOIL PERMEABILITY S - ~ - U 2. SOIL TEXTURE (12-48 IN.) S P - U UNDER 60 MIN. - OVER 60 MIN. SANDY LOAMY CLAYEY 8. OTHER S - PS - U 3. SOIL STRUCTURE 12-48 IN.) S - L' SPECIFY SOIL DEPTH IN. S - - U 9. SOIL SERIES: 5. RESTRICTIVE HORIZONS (IN.) S - S - U A. CECIL ( B. HIWASSEE ( ) IMPERVIOUS STRATA ROCK C. MADISON ( ) D. APPLING ( ) 5. SOIL DRAINAGE - GROUNDWATER S - P - U E. PACOLET ( ) F. FLOOD PLAIN ( ) (EXTE&NAL - INTERNAL) G. 2-1 CLAY SOIL H. OTHER-SPECIFY 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: 4616-03-02-8586 1 inch = 40 feet Prepared for: 45 5.36 8-61 2_ 5 4 9 i 8 5-8~0 40 1 20.70 roo CY) THIS IS NOT A LEGAL DOCUMENT Monday, February 22, 2010 02:46 PM CATAWBA COUNTY NC - Parcel Repo.rt ' Information Regarding Selected Parcel(s) Parcel ID: 4616-03-02-8586 Name: LIVINGSTON FRANCIS X Name2: LIVINGSTON JUDITH A Address: 1525 KING HENRY DR Address2: City: PITTSBURGH State: PA Zip: 15237-1535 Account: 147371 Calc Acreage: 0.76 Tax Map: 018BX 02011 LRK: 19249 Deed Book: 2244 Deed Page: 1503 Subdivision Name: Subdivision Block: Lots: 35 Plat Book: 69 Plat Page: 94 Building Number: 5130 Street Name: LEISURE LN Site Zip: 28673 Township: MOUNTAIN CREEK Fire Code: SHERRILLS FORD City Code: COUNTY State Road: Total Bldgs Value: $218,200 Land Value: $250,600 Total Value: $468,800 Year Built: 1980 Year Remodeled: Last Sale Date: Last Sale Amount: Neighborhood: 132 Watershed: WS-IV Critical Area Watershed Split: NO Voter Precinct: P41 E911 District: COUNTY Zoning: R-30 Zoning2: Zoning3: Zoning Split: N Zoning Overlay: CRC-O,WP-O Zoning District: COUNTY Split Zoning Dist: N Split Zoning Dist(1): 0 Split Zoning Dist(2): 0 School District: COUNTY Elementary School: SHERRILLS FORD Middle School: MILL CREEK High School: BANDYS School Split: NO P&Z Case Number: LOMA 1/20/04 Census Tract 2010: 011502 Census Block 2010: 4033 Small Area Plan: SHERRILLS FORD Agricultural District: Printed: Monday, February 22, 2010 02:46 PM V-POS - Transaction Receipt Page 1 of 1 Transaction Receipt Catawba County, NC Catawba County Permit Center 100 A SW Blvd Newton, NC 28658 828-4658404 02/24/2010 11:27AM Catawba022410112423 745 Eng 28781287 EHPR-2-10-4025 FRANCIS LIVINGSTON 1 N/A FRANCIS X LIVINGSTON 1525 KING HENRY DR, PITTSBURG, PA 15237 ************8739 Authorization and Capture Amount: $150.00 Cardmember acknowledges receipt of goods and/or services in the amount of the total shown hereon and agrees to perform the obligations set forth by the cardmember's agreement with the issuer. Signature Yl/ click here to continue. https://www.velocitypayment. com/admin/catawbacountync/vpo s/942/transactions/receipt/?... 2/24/2010 ~~'A Cp CATAWBA COUNTY, NC 100-A South West Blvd f~ ` RECEIPT Qt ~ Newton, NC 28658- PLAN V (828)465-8399 Wednesday, February 24, 2010 84 sM www.catawbacountync.gov Plan Case: EHPR-2-10-4025 Invoice Number: INV-2-10-259847 Environmental Health Plan Review Invoice Date: 02/24/2010 Site Address: 5130 LEISURE LN, Sherrills Ford, NC APPLICANT OWNER FRANCIS X LIVINGSTON FRANCIS X LIVINGSTON 1525 KING HENRY DR 1525 KING HENRY DR PITTSBURGH PA 15237-1535 PITTSBURGH PA 15237-1535 Fee Name Fee Amount Improvement Permit Fee Fixed $150.00 Total Fees Due: $150.00 PAYMENTS Date Pay Type Check Number Amount Paid Change 02/24/2010 Credit Card -1 $150.00 $0.00 Total Paid: $150.00 Payer: FRANCIS LIVINGSTON Total Due: $0.00 plan receipt ; a 1 5bd3e 1-dba8-484d-abc7-3e2 13b3 I ab99, .rpt 02/24/2010 11:30