HomeMy WebLinkAboutEHPR-2-10-4057 (2).TIF
A THIS IS NOT A PERMIT Case # EHPR-2-10-4057
CATAWBA COUNTY HEALTH DEPARTMENT
Plan Review Application for Environmental Services
1842 SM Environmental Health Plan Review - OSWP
IMPROVEMENT - EXPANSION
APPLICANT OWNER CONTRACTOR
DAVID HATFIELD DAVID HATFIELD
1028 GRAPEVINE DR 1028 GRAPEVINE DR
CATAWBA NC 28609 CATAWBA NC 28609
704-677-9491/ 828-241-3996 704-677-9491/ 828-241-3996
NAME TO APPEAR ON PERMIT DAVID HATFIELD Pin#: 470003025645
SITE ADDRESS: 1028 GRAPEVINE DR, Catawba, NC
DIRECTIONS: SHERRILLS FORD RD/ EAST ON ISLAND DR/ 1/4 MILES TO GRAPEVINE DR ON RIGHT
NAME of SUBDIVISION: Lot # 2 Section/Block/Phase
PROPERTY SIZE: Square Feet Acres 11.739 Date Platted[Recorded
TYPE OF FACILITY: House X Mobile Home Dimension of Structure 30 X 76 Bedrooms 4
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 Ist 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 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 prope Any~pr enta ou of house or structure
location should conform
~`t}o applicable setbacks.
Date: -Z~' /v Signature of Applicant or Agent
An Environmental Health Specialist will contact you within 2 working ay 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 15 Authorization to Construct Fee (New/Expansion) Fee 02/25/2010 $275.00
Rear 30 Improvement Permit Fee 02/25/2010 $150.00
Max Hght TOTAL FEES $425.00
*If a permit has to be redesigned and / or RETRIPS made to the property, there is an additional $60 charge
02/25/10 12:31
THIS IS NOT A PERMIT W LS #
CATAWBA COUNTY HEALTH DEPARTMENT
Application for Environmental Services
Improvement Permit 9 Authorization to Construct El Septic Repair ❑ Septic Expansion
Existing Tank Check ❑ New Well Permit El Replacement Well ❑ Well Abandonment ❑
1. Name to Appear on Permit W04 W K15 p
2. Permit Requested By b4V Business Phone 704-677-
9%,,
Address Q Home Phone lUb-ZQ-59%,
3. Property Owner Business Phone -Aw1b 0A7 JA Address .d Home Phone - Z8 60q 4. Name of Subdivision Lot # Section/Block/Phase
Property Address
Dir~eectiQtions to Pro erty: 4604 a-4440 9br- 1, 4 M99 720 MkiLf-
,Vg
5. Property Size: Square Feet ZZ3,0 Acres 14 Jr Date Platted/Recorded
6. TYPE OF FACILITY: House X_ Mobile Home Dimension of Structure 310-X 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 is uance. This may prevent the need for system size increase in the future.
Basement: yes no Water Using Fixtures in Basement: yes No. in Family
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 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:
4. Are there easements/right-of-ways recorded on this property? Yes / No ,hp
10. Is a public water supply available on or adjacent to the above property? Yes No ('ji W -
Check type that is available: [ ] Community well [ ] Semi-public well [ ] County/City/Township water line
**If No, a Well Permit must be issued with the Septic Permit.**
I l. 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. 1 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 T E P P TY, H IS AN ADDITIONAL CHARGE."
Date Z-z5" !0 Signature of Owner or Agent
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: 4700-03-02-5645
1 inch = 100 feet Prepared for:
1440.00
r
X231 q °
211'2
Plat'
v
- \34
Plat 33-5~'~
0 ,~rL T
~Q Plat 58-12
19,01 21-
J
99
9 02
~j THIS IS NOT A LEGAL DOCUMENT Thursday, February 25, 2010 12:03 PM
Poo T
05873
.***Op. Permit and/or Cert. Op. Required (Must be completed prior to final)
CATAWBA COUNTY HEALTH DEPARTMENT
(704) 465-8270
Lot Eval._4e:Lfmprove. Permit 4~epair Permit Cert. of Comp. Permit=-°''bper. Permit
Owner/Agent pW V S- - ~ Phone
Address ox .~i3 Subdivision
C>.~T fA;9,po . ey -;Z, ~ Section/Block/Phase Lot#
Lot Size %s Directions: dSi,~C,lLlel tc,.S- Fnn-D " ~/=T t~-T ,C 1)
l: N L r~r7~G %S_ _ 'Pap, v, N P.P C )4)m 0.4 t-n i L e
Facility:-House Mobile Home Business Other: Tax Map #
Multi-family Other Zoning Approval # Zq4o oc~gQ
Bedrooms 3 Seats Employees Application Rate GPD Flow
Hot Tub or Spa yes~Special Fixtures 100% Repair Area yes/no REPAIR NOTICE:
Basement yes Basement Plumbing ye . REPAIRS MUST BE WITHIN 30 DAYS OR
Water Supply: Private/ Public DAYS FROM DATE OF PERMIT.
Type of System: Trench rs Bed Pump Pump/Panel Panel LPP Other
Tank Size: Septic Tank /060 Pump Tank
Nitrification Field: Total Square Feet 906 Depth of Stone Bed Size
Trench Width 3 e Total Length of All Trenches 3 00 Number of Trenches
Individual Trench Length 7-5-1 7f-1 75-1 2-5-1- Feet on Ce ter ~ Maximum Trench Depth--2,v'!,-
Distance of Nearest Well .SU Lot Evaluation Ap oved e o (Void After 24 months)
7*
Topo 1..2 % Slope I Sketch of lot Evaluation S'te System Design Final
Texture C!! s :KI
Structure
Clay Min.
Soil Wetness
Soil Depth ~V.~2,
Restric. Hoz. at I YyS~ r - - ` _
Available space not
Overall Class P
Comments: I '
I n~
T; E'qi~ i~ 2 NGr~C
1WfA If -3 .4
Septic Tank Contractors I
MUST contact the ( <<+
Sanitarian BEFORE
changing permit. I'c c t 6
**NO GUARANTEE OR WARRANTY IS IMPLIED OR GIVEN THROUGH THE ISSUANCE-OF THIS PERMIT"
Permit Date (Improvement Permit void after 60 months)
Owner/Agent M~ Sanitarian _ I--
_
Installed By " Date 0-X2,-7_3 Sanitarian
(Note any changes/information in red or by sketch on back)
*******IF A PERMIT HAS TO BE REDESIGNED AND/OR RETRIPS MADE TO THE PROPERTY. THERE********
IS AN ADDITIONAL $25 CHARGE.
whito-nff;,.o ui„o_nlrln. Tncn. cmmn_ YR11nw-Owner/Agent Green-Bldg. InSD. I.P.
CATAWBA COUNTY tqC - Parcel Report
Information Regarding Selected Parcel(s)
Parcel ID: 4700-03-02-5645
Name: HATFIELD DAVID
Name2: HATFIELD PATRICIA
Address: 1028 GRAPEVINE DR
Address2:
City: CATAWBA
State: NC
Zip: 28609-8244
Account: 101597
Calc Acreage: 11.74
Tax Map: 016 Y 03016B
LRK: 300022
Deed Book: 2100
Deed Page: 1371
Subdivision Name:
Subdivision Block:
Lots: 2
Plat Book: 58
Plat Page: 125
Building Number: 1028
Street Name: GRAPEVINE DR
Site Zip: 28609
Township: CATAWBA
Fire Code: BANDY'S
City Code: COUNTY
State Road:
Total Bldgs Value: $88,800
Land Value: $52,000
Total Value: $140,800
Year Built: 1995
Year Remodeled:
Last Sale Date:
Last Sale Amount:
Neighborhood: 128
Watershed: WS-IV Protected Area
Watershed Split: NO
Voter Precinct: P21
E911 District: COUNTY
Zoning: R-40
Zoning2:
Zoning3:
Zoning Split: N
Zoning Overlay: WP-O
Zoning District: COUNTY
Split Zoning Dist: N
Split Zoning Dist(1): 0
Split Zoning Dist(2): 0
School District: COUNTY
Elementary School: CATAWBA
Middle School: MILL CREEK
High School: BANDYS
School Split: NO
P&Z Case Number:
Census Tract 2010: 011502
Census Block 2010: 1021
Small Area Plan: SHERRILLS FORD
Agricultural District:
Printed: Thursday, February 25, 2010 12:02 PM
CATAWBA COUNTY, NC
100-A South West Blvd PLAN INVOICE
F-; Newton, NC 28658-
(828)465-8399 465-8399 Thursday, February 25, 2010
1842 sm www.catawbacountync.gov
Plan Case: EHPR-2-10-4057 Invoice Number: INV-2-10-259885
Environmental Health Plan Review Invoice Date: 02/25/2010
Fee Name Fee Amount
Improvement Permit Fee Fixed $150.00
Authorization to Construct Fee Adjustable $275.00
(New/Expansion) Fee
Total Fees Due: $425.00
PAYMENTS
Date Pay Type Check Number Amount Paid Change
02/25/2010 Cash -1 $425.00 $0.00
Total Paid: $425.00
Total Due: $0.00
plan imoice ;azf (lfct h-e3ea-lti> 1-31?'-922cc~ t09 }049~.Ipt 02/25/2010 12.30