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EHPR-04-2018-28932.TIF
THIS IS NOTA PERMIT Case# EHPR-04-2018-28932 ��¢ --to��� —3I3 CATAWA COUN'I'Y HEALTH DEPARTMENT ''' ��❑° � PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES 1842 Environmental Health Plan Review- OSWP ReY1&c' �R.J 4 / IMPROVEMENT ve • 4-11-61 r o'er . Applicant AMERICA'S HOMES PLACE INC (CHAD HOLLOWAY), 1206 GREENLAND DR,STATESVILLE NC 28677 13:7048724400 C:7047467094 NAME TO APPEAR ON PERMIT America's Homes Place Inc (Chad Holloway) SITE ADDRESS: 1430 LOETIN DR,CATAW I3A NC 28609 PIN # 378001176467 NAME of SUBDIVISION: /// Lot# 2 Section/Block PROPERTY SIZE: Square Fect 94,438.08 Acres 2.168 DIRECTIONS: Turn right onto SW Blvd,turn left WC Stm le onto WNC 10 East,turn right on Murrays,turn left onto Troy St,turn right onto Rayne!!St,continue onto Loftin Dr,property on the right PRIMARY CONTACT: Applicant SEWER TYPE: Septic Tank GALLONS PER DAY: 480 WATER SUPPLY: Private Well DESCRIBE WORK: IP Only-combining 4 lots-66x54 4 BR house, possible future 24x36 shop and 20x30 pool with 4 ft cement 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? No Are there any easements or right-of-ways on this property? No APPLICATION FOR: New Structure STRUCTURE TYPE: PRIMARY RESIDENCE FACILITY TYPE: House OTHER DESCRIPTION: DESCRIPTION OF EXISTING STRUCTURES ON SITE(IF ANY) DIM EXISTING STRUCTURE: NUMBER OF EXISTING BEDROOMS: 0 #OF OCCUPANTS: 4 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 66x54 house,24x36 shop,20x30 pool 4ft cement #OF NEW BEDROOMS:: 4 BASEMENT? No BASEMENT FIXTURES? No PLUMBING REQUIRED?Yes Desired system types(Improvement Permit or Authorization to Construct): ACCEPTED: ALTERNATIVE: CONVENTIONAL. YES OTHER: INNOVATIVE: ANY: Other described: cIappliamia, 04/19/2018 12:23 Parc 1 of4 y14A �G THIS IS NOTA PERMIT Case# EHPR-04-2018-28932 MUG CATAWBA COUNTY HEALTH DEPARTMENTa• 'I E �Y �❑ 4: PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES { r '{ 842 sr+ Environmental Health Plan Review- OSWP •0.3• G d O k IMPROVEMENT ` ms C O~.rhF Applicant AMERICA'S HOMES PLACE INC (CHAD HOLLOWAY), 1206 GREENLAND DR.STATISVILLE NC 28677 B:7048724400 C:7047467094 NAME TO APPEAR ON PERMIT America's Homes Place Inc (Chad Holloway) SITE ADDRESS: 1430 LOFTIN DR,CATAWI3A NC 28609 PIN# 378001176467 NAME of SUBDIVISION: Lot# 2 Section/Block PROPERTY SIZE: Square Feet 894,722.40 Acres 2.1680.54 DIRECTIONS: Turn right onto SW Blvd,turn left WC Stm left onto WNC 10 East,turn right on Murrays,turn left onto Troy St,turn right onto Raynell St,continue onto Loftin Dr,property on the right PRIMARY CONTACT: Applicant SEWER TYPE: Septic Tank GALLONS PER DAY: 480 WATER SUPPLY: Private Well DESCRIBE WORK: IP Only-combining 4 lots-66x54 4 BR house, possible future 24x36 shop and 20x30 pool with 4 ft cement 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? No Are there any easements or right-of-ways on this property? No APPLICATION FOR: New Structure STRUCTURE TYPE: PRIMARY RESIDENCE FACILITY TYPE: House OTHER DESCRIPTION: DESCRIPTION OF EXISTING STRUCTURES ON SITE(IF ANY) DIM EXISTING STRUCTURE: NUMBER OF EXISTING BEDROOMS: 0 #OF OCCUPANTS: 4 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 66x54 house,24x36 shop,20x30 pool 4ft cement #OF NEW BEDROOMS:: 4 BASEMENT? No BASEMENT FIXTURES? No PLUMBING REQUIRED?Yes Desired system types(Improvement Permit or Authorization to Construct): ACCEPTED: ALTERNATIVE: CONVENTIONAL: OTHER: INNOVATIVE: ANY: YES Other described: eheppfic:vion 04/182018 13:46 Parc I of4 CAflWIIA COUNTY Case a EHPR-04-2018-28932 .T kat Public Health Department Subdivision Sr C3 Environmental Health Division11/1 PIN/ 378001176467 4.4. PO Box 389,100-A Southwest Blvd,Newton,NC 28658 / w NAME ON PERMIT: AMERICA'S HOMES PLACE INC (CI IAD HOLLOWAY). 1206 GREENLAND DR,STATESVILLE NC 28677 America's Homes Place Inc (CI Site Address: 1430 LOI'TIN DR.CATAW 13A NC 28609 Property Size: Square Feet 894,722.40 Acres 2.1680.54 Directions: Turn right onto SW Blvd,turn left WC Stm left onto WNC 10 East,turn right on Murrays,turn left onto Troy St,turn right onto Rayne!!St,continue onto Loftin Dr,property on the right Completed applications are valid for a period of 2 years.Improvement Permits are valid:with complete site plan=60 months(5 years);with complete plat =without expiration. An Authorization to Construct will remain valid as long as the Improvement Permit is valid.An Authorization to Construct issued for septic repair is valid for 60 months(5 years).Permits may be revoked if the information on this application/site plan changes or if the intended use for the proposed facility changes. Permits may be revoked if site conditions are altered such that they effect permit conditions or installation requirements 1 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. The undersigned is th own of the property or legal agent of the owner. Date: i Signature ofApplicant or Agent /j%j/ //i y If you need further information or assistance please call 828-466-7291 AREA1 4******44444* ****4****444**4************44444********+48+*44*4**44*44*1**********4**8******4******4*4*44444 I,-I'1'.1'.N.1\II? DATE FEE AMOUNT Improvement Permit Fee 04/18/2018 S150.00 r — — TOTAL FEES $150.000.. FEES ARE NON-REFUNDABLE ONCE A SITE VISIT IS MADE OR WORK ON A PLAN REVIEW HAS COMMENCED SYSTEM REDESIGN AND/OR RETRIP WILL INCUR AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) dwpplicaliar 14/I8/2018 13:46 Page 2 of 4 CAT `�(]BA THIS IS NOT A PERMIT \couprr VV JtJ CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services Application is for: FiNtew Construction Existing Facility 19/Improvement Permit _- Authorization to Construct [New Septic n Septic Repair/Malfunction n Septic Relocation n Septic Expansion n Existing System Inspection or Reconnection New Well n Replacement Well n Well Abandonment n Well Repair Property Address I". L—art C Subdivision 2nk b& NS.-7u�� Lot # Z Acres Z. 16¢P Driving Directions to Property 1 Q OrA0 6(1.3 'ft oc4:0 tor,5f, eil,nh.76 Let-c. rxcLo NC/DE 1 rn».Nn v^�vrray6 it o r 1-Cy 6b ' Z o�Lo rcayr`ell & e e L nvQ o c Jo ^ &r vtkvsa` y 11 Z ht�f� Applicant Contact Information Name Ars t-CCA5klon'e P__kl•_i'&e Address (7A(Q Grow\k L t7r6kiaan Phone 7Dy-P72- '$IGW Cell Phone Owner Contact Information Name v-e.e t- t t • • Address 57 - -.*.t_ tj{. . Cakcico 'C 261.009' Phone e-e— t*i— 6037 s Cell Phone Contractor Contact Inform.. Name 6 stat' ..1,067C License # 36a3y1 Address Phone Cell Phone Name to Appear on Permit? Owner plicant 7 Contractor Who will he the Primary Contact? ❑ Owner Applicant L Jontractor Existing Structures on Site? ❑ Yes 12(No lives, describe # of Bedrooms * # of Occupants Structure Dimensions Basement ❑ Yes ❑ No Basement Plumbing ❑ Yes ❑ No Existing Water Supply? ❑ Individual Well ❑ Community Well ,❑/County/City/Township Water Line Is a public water supply available? ** ❑ Yes ✓� No Well Construction/Abandonment/Repair Proposed Well Type Individual Well ❑ Semi-Public Well ❑ Community Well Abandonment Type ❑ Drilled ❑ Bored ❑ Dug ❑ Unknown Well Repair Requested ❑ Yes ❑ No Describe Will Certified Well Contractor Install Water Line or Electrical Line from Well I-lead to Pressure Tank? ; Yes 111 No LATA\\T A THIS IS NOT A PERMIT ,caN2 :N-JrlwY �JL� CATAWBA COUNTY III�AL'ITI DEPARTMENT ;,he,,, Application I'or Environmental Services Proposed New Construction - Residential Primary Residence U New Residence ❑ Addition to Residences # of New Bedrooms *j_ Project Description_t ) U oFn41Q `�°'V ly -Halel(r5 Structure Dimensions la(b't43( �T( 'D �# of Occupants 11 Basement ❑ Yes No Basement Plumbing ❑ Yes No �cI 5ixW Accessory Structure(s) Describe Z-HK:ar. CAtm-c_5 t-opTool Structure Dimensions 2403(2 a:C-'O Plumbing ❑ Yes �b Describe Plumbing Needed_ YforILN w. 2 py --Co.n:,n b 4y,1kt,Xty Accessory Dwelling ri{ t'es n No # of New Bedrooms *1. #of Occupants I Proposed New Construction - Commercial Food Service Specify Type # Seats Floor Space-Entire Food Service Facility (Sq. Ft.) # Employees per Shill #of Shifts Dining Area (Sq. Ft.) Business/Other Specify Type Structure Dimensions Retail Floor Space #of Employees per Shill #of Shifts If Church#of Scats . Commercial Kitchen ❑ Yes ❑ No If Daycare,#of Children If Multi-Family Residence,#of Apartments #Bedrooms per Apartment*j Total # Bedrooms 41- Other jOther In formation Calculated Design Flow, Commercial t (This value will be determined by EI-I stall) The Applicant shall notify the local health department upon submittal of this application if any of the following apply to the property}at question. If the answer to any question is "yes", applicant must attach supporting documentation. ❑ YesNo Does the site contain any jurisdictional wetlands? ❑ Yes LTJ No Does the site contain any existing wastewater systems? ❑ Yes BiNo Is any wastewater going to be generated on the site other than domestic sewage? ❑ Yes ITlyNo Is the site subject to approval by any other public agency? ❑ Yes ft(No Arc there any easements or right of ways on this property? Describe 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) ❑ Accepted ❑ Alternative eConventional ❑ Innovative ❑ Other ❑ Any *Any room that will be intended for sleeping at the time of construction or for tiunre consideration should be noted as a bedroom and counted on all applications.The number of bedrooms will be confirmed by rooms identified on Iloor plans as a bedroom at the time of building permit issuance. This may prevent the need for septic system expansion in the future. t If structure is plumbed but has no bedrooms,calculated design flow will be determined by Eli Staff, ** I'No_a well permit must be issued with the Authorization to Construct. RE RIP TO THE PROPERTY AND/OR SYSTEM REDESIGN WILL. INCUR AN ADDITIONAL CHARGE(SEE FEE SCHEDULE) Completed applications arc valid for a period of 2 years. Improvement Permits arc valid: with complete site plan=60 months(5 year); with complete plat=without expiration. An Authorization to Construct will remain valid as long as the Improvement Permit is valid. Permits may be revoked if the information on this application/site plan changes or if the intended use for the proposed facility changes. Permits may be revoked if site conditions are altered such that they effect permit conditions or installation requirements. I have read this application aid 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 ant solely responsible Inr 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. The undersigned is the owner of the prof -ty o- •gt I agent of the owner.Signature of Owner or Legal Agent ,L I •i.. ' Date 0y/A Printed Name of Owner or Legal Agent Yir i lleitaa Catawba County Environmental Health ..------7/c. 1I3112.oz 1 91`' 11/ 1 1 23 .0' \i„,,,, 70 1 °' _980 ^p -6 266 99 1 1 *m _ 905 990 , °' _____—•------------- 615] /� 9) �O 1%S.., n ryo 1 995 gyp¢ 1t O v O 1 h. h. 1000 .44. • O 120 7 • ^ti '� 96•6 , ./ 9•e v4 e 0• I I I 4 Selected Parcels 1 in=80ft 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 arise from this map/report product or the use thereof by any person or entity. Copyright 2014 Catawba County NC 04/18/2018 Parcel Report Page 1 of 1 Parcel Report - Catawba County NC Parcel Information: Owner Information: Parcel ID: 378001176467 Owner: STRONG MARTA HUFFMAN Parcel Address: 1430 LOFTIN DR Owner2: City: CATAWBA, 28609 Address: 1414 LOFTIN DR LRK(REID): 300808 Address2: Deed Book/Page: 2134/0160 City: CATAWBA Subdivision: State/Zip: NC 28609-8227 Lots/Block: 3/ School Information: Last Sale: School District: COUNTY Plat BooWPage: 46/83 Legal: LOT 3 LOT 3 PL 46-83 PL 46-83 Elementary School: CATAWBA Middle School: MILL CREEK Calculated Acreage: .540 High School: BANDYS Tax Map: Township: CATAWBA School Map State Road #: 2637 TaxNalue Information: Tax Rates(pdf) Zoning Information: City Tax District: All in County Zoning District: COUNTY County Fire District: BANDYS Zoningl: R-40 Building(s) Value: $0 Zoning2: Land Value: $10,000 Zoning3: Assessed Total Value: $10,000 Zoning Overlay: DWMH-O,WP-O Year Built/Remodeled: / Small Area: SHERRILLS FORD Current Tax Bill Split Zoning Districts: / Zoning Agency Phone Numbers Miscellaneous: Firm Panel Date: 2007-09-05 Building Permits for this parcel. Firm Panel #: 3710378000J Building Details 2010 Census Block: 2006 WaterShed: WS-IV Protected Area 2010 Census Tract: 011501 Voter Precinct: P5 Agricultural District: PROXIMITY Parcel Report Data Descriptions List all Owners Deed History Report 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 at damages,loss or liability,whether direct,indirect or consequential which arises or may arise from this map/report product or the use thereof by any person or entity. ©2017, Catawba County Government, North Carolina. All rights reserved. http://gis.catawbacountync.gov/nomap/parcel_report.php?key=378001176467&typ=P 4/18/2018 Parcel Report Page 1 of 1 • Parcel Report - Catawba County NC Parcel Information: Owner Information: Parcel ID: 378001177537 Owner: STRONG MARTA HUFFMAN Parcel Address: 1434 LOFTIN DR Owner2: City: CATAWBA, 28609 Address: 1414 LOFTIN DR LRK(REID): 300807 Address2: Deed Book/Page: 2134/0160 City: CATAWBA Subdivision: State/Zip: NC 28609-8227 Lots/Block: 2/ School Information: Last Sale: Plat Book/Page: 46/83 School District: COUNTY Legal: LOT 2 LOT 2 PL 46-83 PL 46-83 Elementary School: CATAWBA Middle School: MILL CREEK Calculated Acreage: .550 Tax Map: High School: BANDYS Township: CATAWBA School Map State Road #: 2637 TaxNalue Information: Tax Rates(pdf) Zoning Information: City Tax District: All in County Zoning District: COUNTY County Fire District: BANDYS Zoning1: R-40 Building(s) Value: $0 Zoning2: Land Value: $10,100 Zoning3: Assessed Total Value: $10,100 Zoning Overlay: DWMH-O,WP-O Year Built/Remodeled: / Small Area: SHERRILLS FORD Current Tax Bill Split Zoning Districts: / Zoning Agency Phone Numbers Miscellaneous: Firm Panel Date: 2007-09-05 Building Permits for this parcel. Firm Panel #: 3710378000J Building Details 2010 Census Block: 2006 WaterShed: WS-IV Protected Area 2010 Census Tract: 011501 Voter Precinct: P5 Agricultural District: PROXIMITY Parcel Report Data Descriptions List all Owners Deed History Report 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 at damages,loss or liability,whether direct,indirect or consequential which arises or may arise from this map/report product or the use thereof by any person or entity. ©2017, Catawba County Government, North Carolina. All rights reserved. http://gis.catawbacountync.gov/nomap/parcel_report.php?key=378001177537&typ=P 4/18/2018 Parcel Report Page 1 of 1 • Parcel Report - Catawba County NC Parcel Information: Owner Information: Parcel ID: 378001175398 Owner: STRONG MARTA HUFFMAN Parcel Address: 1424 LOFTIN DR Owner2: City: CATAWBA, 28609 Address: 1414 LOFTIN DR LRK(REID): 300809 Address2: Deed Book/Page: 2134/0160 City: CATAWBA Subdivision: State/Zip: NC 28609-8227 Lots/Block: 4/ Last Sale: School Information: School District: COUNTY Plat Book/Page: 46/83 Elementary School: CATAWBA Legal: LOT 4 LOT 4 PL 46-83 PL 46-83 Middle School: MILL CREEK Calculated Acreage: .520 Tax Map: High School: BANDYS School Map Township: CATAWBA State Road #: 2637 Tax/Value Information: Tax Rates(pdf) Zoning Information: City Tax District: All in County Zoning District: COUNTY County Fire District: BANDYS Zoningl: R-40 Building(s) Value: $0 Zoning2: Land Value: $9,900 Zoning3: Assessed Total Value: $9,900 Zoning Overlay: DWMH-O,WP-O Year Built/Remodeled: / Small Area: SHERRILLS FORD Current Tax Bill Split Zoning Districts: / Zoning Agency Phone Numbers Miscellaneous: Firm Panel Date: 2007-09-05 Building Permits for this parcel. Firm Panel #: 3710378000J Building Details 2010 Census Block: 2006 WaterShed: WS-IV Protected Area 2010 Census Tract: 011501 Voter Precinct: P5 Agricultural District: PROXIMITY Parcel Report Data Descriptions List all Owners Deed History Report 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 trap/report product by the user.The County of Catawba,its ernployees,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 ariso from this map/report product or the use thereof by any person or entity. ©2017, Catawba County Government, North Carolina. All rights reserved. http://gis.catawbacountync.gov/nomap/parcel_report.php?key=378001175398&typ=P 4/18/2018 Parcel Report Page 1 of 1 Parcel Report - Catawba County NC Parcel Information: Owner Information: Parcel ID: 378001175238 Owner: STRONG MARTA HUFFMAN Parcel Address: 1420 LOFTIN DR Owner2: City: CATAWBA, 28609 Address: 1414 LOFTIN DR LRK(REID): 300810 Address2: Deed Book/Page: 2134/0160 City: CATAWBA Subdivision: State/Zip: NC 28609-8227 Lots/Block: 5/ School Information: Last Sale: Plat Book/Page: 46/83 School District: COUNTY Legal: LOT 5 LOT 5 PL 46-83 PL 46-83 Elementary School: CATAWBA Middle School: MILL CREEK Calculated Acreage: .550 High School: BANDYS Tax Map: School Map Township: CATAWBA State Road #: 2637 Tax/Value Information: Tax Rates(pdf) Zoning Information: City Tax District: All in County Zoning District: COUNTY County Fire District: BANDYS Zoningl: R-40 Building(s) Value: $0 Zoning2: Land Value: $10,100 Zoning3: Assessed Total Value: $10,100 Zoning Overlay: DWMH-O,WP-O Year Built/Remodeled: / Small Area: SHERRILLS FORD Current Tax Bill Split Zoning Districts: / Zoning Agency Phone Numbers Miscellaneous: Firm Panel Date: 2007-09-05 Building Permits for this parcel. Firm Panel #: 3710378000J Building Details 2010 Census Block: 2006 WaterShed: WS-IV Protected Area 2010 Census Tract: 011501 Voter Precinct: P5 Agricultural District: PROXIMITY Parcel Report Data Descriptions List all Owners Deed History Report 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 arise from this mapkeport product or the use thereof by any person or entity. ©2017, Catawba County Government, North Carolina. All rights reserved. http://gis.catawbacountync.gov/nomap/parcel_report.php?key=378001175238&typ=P 4/18/2018 r .C- , CATAWBA COUNTY �lEIL�41 100A SOull4WEST 131X1) NEWTON,NORTH CAROLINA 28658 RECEIPT mini Ir d OQV` PHONE: 828.465.8399 \C,)\V• 'v�svr � Wednesday,April 18, 2018 18 p® 42 Su xcww.catawbacomttyne.gov PAYOR: America's Homes Place Inc America's 1-fomes Place Inc(Holloway,Chad) PAYMENTS TRANSACTION NUMBER: TRC-3429917-18-04-2018 PAYMENT DATE: 04/18/2018 PAYMENT TYPE: Check 31471 NCDL-37708072 DOB-9/10/78 EXP-9/10/21 INVOICE NUMBER FEE NAME FEE AMOUNT 04-18-351884 Improvement Permit Fee $150.00 TOTAL PAYMENTS: 5150.00 E H PR-04-2018-28932 CASE TYPE: Environmental Health Plan Review WORK CLASS: OSWP SITE ADDRESS: 1430 LOFTIN DR_CATAWBA NC 28609 Applicant AMERICA'S HOMES PLACE INC. 1206 GREENLAND DR,STATESVILLE NC 28677 13:7048724400C:7047467094 " NO PEOPLESOFT ACCOUNT ASSIGNED** receipt 04/182018 13:42 Page 1 o(1