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HomeMy WebLinkAboutEHPR-9-10-7292 (2).TIF • co THIS IS NOT A PERMIT Case # EHPR - - 10 - 7292 CATAWBA COUNTY HEALTH DEPARTMENT U \"r 0417 Plan Review Application for Environmental Services /842 Environmental Health Plan Review - OSWP SM AUTH CONST - NEW WELL NAME TO APPEAR ON PERMIT CALEB MOSER SITE ADDRESS: 4850 ACRELAND DR, Claremont, NC Pin#: 376404621131 NAME of SUBDIVISION: STEVEN ALEXANDER + PAMELA P MOSER Lot # 1 Section/Block/Phase PROPERTY SIZE: Square Feet Acres 0.689 DIRECTIONS: ROCK BARN RD - GO STRAIGHT AT INTERSECTION OF OXFORD SCHOOL RD AND ROCK BARN RD ONTO ROCK BARN EXTENSION - TURN RIGHT ONTO FARMFIELD DR - TURN LEFT ONTO ACRELAND DR - LAST LOT ON RIGHT APPLICANT OWNER CONTRACTOR CALEB MOSER CALEB MOSER OAKWOOD HOMES #712 4842 ACRELAND DR 4842 ACRELAND DR 1265 HWY 70 WNEWTON NC 28658 CLAREMONT NC 28610 CLAREMONT NC 28610 82- 464 -2662 828 - 850 -0646 828 - 850 -0646 PRIMARY CONTACT: Contractor APPLICATION FOR: DIM EXISTING STRUCTURE: EXISTING FACILITY TYPE: N/A NUMBER OF EXISTING BEDROOMS: SEWER TYPE: Septic Tank EXISTING WATER SUPPLY IN USE: Private Well CALCULATED DESIGN FLOW: WELL TYPE: Public water is * *NOT ** available for this property. PUBLIC WATER TYPE AVAILABLE: DESCRIBE WORK: 1 STORY ON FRAME MODULAR DWELLING / copy of bond on file PROPERTY EASEMENTS: NONE PROPOSED CONSTRUCTION PRIMARY RESIDENCE NEW RESIDENCE? New Residence # OF NEW BEDROOMS: 3 # OF STRUCTURE OCCUPANTS: 2 PROJECT DESC: 1 STORY ON FRAME MODULAR DWELLING PROJECT DIMENSION: 28 X 52 BASEMENT? No BASEMENT FIXTURES? No APPLICATION FOR WELL CONSTRUCTION /ABANDONMENT /REPAIR PROPOSED WELL TYPE: ABANDONMENT TYPE: WELL REPAI REQUESTED? 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. 4 7 Date: �l 7—o / v Signature of Applicant or Agent -lilt - t.�uQ t �r, 4S -- — 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 AREA2 09/13/10 12:16 A CATAWBA COUNTY, Case # EHPR -9 -10 -7292 / Public Health De artment 0 Environmental Health Division - Plan Review Subdivision STEVEN ALEXANDER + P/ PO Box 389, 100 - A Southwest Blvd, Newton, NC 28658 Lot# 1 4 PIN# 376404621131 Applicant/Owner CALEB MOSER, 4842 ACRELAND DR, CLAREMONT NC 28610 Site Address: 4850 ACRELAND DR, Claremont, NC Property Size: SF 0.689 ACRES Directions: ROCK BARN RD - GO STRAIGHT AT INTERSECTION OF OXFORD SCHOOL RD AND ROCK BARN RD ONTO ROCK BARN EXTENSION - TURN RIGHT ONTO FARMFIELD DR - TURN LEFT ONTO ACRELAND DR - LAST LOT ON RIGHT Minimum Setbacks FEE NAME DATE AMOUNT BALANCE DUE Front 30 Side 15 Authorization to Construct Fee (New /Expansion) Fee 09/13/2010 $150.00 $0.00 Rear 30 Well Permit & Inspection Fee 09/13/2010 $300.00 $0.00 Side St Max Hght TOTAL FEES $450.00 $0.00 CHANGE WORK ORDER REQUIRING REDESIGN AND /OR RETRIP WILL INCURE AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) 09/13/10 12:16 THIS IS NOT A PERMIT ® CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services Page 2 1g.2 a+ Proposed Facility Type '4—Primary Residence ❑ New Residence ❑ Addition to Residence # of New Bedrooms *j 3 Project Description L? t 2— `IA ¢ _ 2-40 Structure Dimensions 2 2d 2 - # of Occupants ryZ Basement ❑ Yes (No Basement Fixtures ❑ Yes 5 No ❑ Accessory Structure(s) Describe # of New Bedrooms *1* if applicable Structure Dimensions # of Occupants Accessory Dwelling ❑ Yes E''lo Plumbing ❑ Yes ❑ No Describe Plumbing Needed ❑ Multi - Family Residence # Units #Bedrooms per Unit *t Total # Bedrooms *j Structure Dimensions ❑ Food Service Specify Type # Seats Floor Space - Entire Food Service Facility (Sq Ft) # Employees per Shift # of Shifts Dining Area (Sq. Ft.) ❑ Business Specific Type of Business Retail Floor Space # of Employees per Shift # of Shifts ❑ Other Facility Type Specify If Church # of Seats Kitchen ❑ Yes giNo If Daycare Specify Occupancy Application for 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 Calculated Design Flow, Commercial 1 - Additional information may be required to determine design flow from certain facilities. This value will be determined during consultation with on- site staff. *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 septic system size increase in the future. t If structure is plumbed but no bedrooms, calculated design flow is required. ** If No, a well permit must be issued with the Authorization to Construct. 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. CHANGE WORK ORDER REQUIRING REDESIGN AND /OR RETRIP WILL INCURE AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) I understand that this is a formal application for Environmental Services and authorize Catawba County Environmental Health 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 V specified conditions. Improvement Permits and Well Permits are transferrable, but may be revoked if this information, site CO 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 Signature of Owner or Agent r gsl,Awv� � �'P.� -�v� 7 Printed Name of Owner or Agent /-� Date J3 / (r ) i ` ^l �� �,� THIS IS NOT A PERMIT , t j CATAWBA COUNTY HEALTH DEPARTMENT y li g €. , Application for Environmental Services Page 1 1842 sM Improvement Permit ❑ Authorization to Construct E Septic Repair ❑ Septic Malfunction ❑ Septic Expansion 4 New Well Permit ❑ Replacement Well ❑ Well Abandonment ❑ Well Repair ❑ Existing System Inspection (Pre- Approval Required) ❑ Application is for New Construction 2 Existing Facility ❑ Property Address Itr-,-r) A c t,21 d ) r . Subdivision 0 k e o ,J }- _c 2-$6 (Z Lot # Acres Section/Block/Phase Driving Directions to Property ,. ( � ; r� .. .._._ _ _. t%dr.. .) �,.0_ ,--F ?A A- © -rd! P _s 0 _Leo L pd o.--a 4 / /. p o r [ L Ar4 kJ- c 6. A -1-15 K ' 0 c_ k 45 c------ - a c.,_•i--1---. -- P - - -; Al_______ f-- Arc 0.A Po ..LI A 1 6 kik' 1, f\ 4 - 0 1, 4 pi-, La. c+ 1-- k p ,.i it_ f t it Co W a NAME TO APPEAR ON PERMIT? 0 Owner ❑ Applicant ❑ Contractor O Applicant Contact Information U Name Cie />tis sz_,•--/ 0 sb U Q __ ett Iu Address 4 - Si It c _r < 1 r . C ,,r 47 1.... Phone �-�_ ` 0._1, 5 -t p __) Cell Phone g - J -- _ ��( 7 G z Owner Contact Information Z Name ..- o�/S 4.4, .e_.,_ . z Address y- S 0 _,-sue 14 —.1 'Q r ' , S - s- , 0 Phone Cell Phone 1� _ Contractor Contact Information W Name /1.4/2X Address z Phone R-�8- _ y i 7— 2 3 3 3 Cell Phone tF2j- - 7 2J - _ S'. e' , z WHO WILL BE THE PRIMARY CONTACT? ❑ Owner ❑ Applicant ❑ Contractor Z Description of Existing Structures on Site Q # of Bedrooms *1' Structure Dimensions # of Occupants I► Basement ❑ Yes 8- No Basement Fixtures ❑ Yes ❑ No cZC Planned Future Additions or Improvements (Building Permit NOT requested at this time) (X Describe Proposed Future Structure Dimensions # of Bedrooms * if applicable Z Are there easements or right -of -ways recorded on this property ❑ YesNo Describe Is a public water supply available on or adjacent to the above property ** ❑ Yes -"i] No Check type available ❑ Community Well ❑ Semi - Public Well ❑ County /City /Township Water Line Existing water supply in use ❑ Individual Well ❑ Community Well ❑ Semi - Public Well ❑ County /City /Township Water Line ❑ I WOULD LIKE TO SCHEDULE A COMBINED FLAGGING AND SOIL EVALUATION (SEE COMBINED EVALUATION PROCEDUES) Catawba County, North Carolina N This map product was prepared fon the Catawba County, NC, Geographic Information System. Catawba County has made substantial efforts to ensure the accuracy of location and labeling information A 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: 3764 -04 -62 -1131 1 inch = 40 feet Prepared for: / J,,,s ". J/ f r y J � f . .' " /�,. mfr /i r f � r'` est" I .... ..... __. , ..> -,--......,--- °N. - . ,,,st, ?. . 4 4t ,1_,..„ , , ,,,„-''' '' ''''''." '-. 4 ^ , - \ ,..,,-.... tS \• _,_,....„.,--.....‘".-- TASJ 61(51\\ ad 1 .. ,,„ OL(2 \------ ,, II q ''\,..--- ...., c aik_3_ _ _ _...-----\-- ..- 0 -\\ • - C------i \ (...? ---- \ . -. _---- f VIO X 1111 " -"7-‘ -; .6 .--- ''*- --.-..e. ....• % X4_3- ------ ------ - --- s /� ♦ - - (MP THIS IS NOT A LEGAL DOCUMENT ` Monday, September 13, 2010 12:18 PM CATAWBA COUNTY PERMIT • c o ZONING AUTHORIZATION (R) 7 7e ; New Dwelling g ` P. O. Box 389 Phone: 828-465-8380 -ik PERMIT NO: ZONR -9 -10 -10993 (� r y 100A Southwest Blvd FAX: 828-465-8484 _ -- Newton, North Carolina 28658 APPLIED: 09(13(2010 p www.catawbacountync.gov ISSUED: 09/ 13/2010 1O �c !r SM EXPIRES: 03/12/2011 APPLICANT OWNER CONTRACTOR • CALEB MOSER CALEB MOSER 4842 ACRELAND DR 4842 ACRELAND DR CLAREMONT NC 28610 CLAREMONT NC 28610 P. 828 - 850 -0646 F. P. 828 - 850 -0646 F. P. F EMAIL: EMAIL: EMAIL: . PROPERTY ID #: 376404621131 CENSUS TRACT: STREET ADDRESS: 4850 ACRELAND DR, Claremont, NC LOT# 1 PROJECT DESCRIPTION: 1 STORY ON FRAME MODULAR DWELLING / copy of bond on file DIRECTIONS: COMMENTS: SINGLE FAMILY MODULAR DWELLING FLOOD ZONE? OWNER TYPE: Residential (Private) REQUIRED SETBACKS 100 YEAR FLOOD ZONE PLAIN? No LAND OWNER: FRONT: 30.00 SIDE: 15.00 REAR: FLOOD PLAIN, STRUCTURE? No MAX HEIGHT: 45.00 R: R: 30.00 SIDE 1: VALUE: 120000 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. FEE DESCRIPTION DATE FEE AMOUNT Residential Zoning Fee 09/13/2010 $25.00 TOTAL FEES $25.00 The applicant hereby certifies that all information and attachments to this Certificate of Zoning Compiliance are true and correct, and acknowledges that this permit was issued on the basis of the information required herein. The applicant further acknowledges 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 It is the responsibility of Applicant to comply with all existing deed restrictions pertaining to the property. Issuance of this permit is not certification of such compliance and does not relieve Applicant of the duty to comply. * *This Zoning Authorization Permit shall expire six months from e date of issuance unless a bui in ermit is secured and remains active. • c q -- A juL APPLICANT NAME (PRINTED) APPLICANT SIGN • RE ZONING APPROVED BY �� � * * * ** ZONING FEES ARE NON - REFUNDABLE * * * ** COMPANY NAME perrnn 09/13/2010 12:17 Page I of] CATAWBA COUNTY NC - ParcelReport' • Information Regarding Selected Parcel(s) Parcel ID: 3764 -04 -62 -1131 Name: MOSER CALEB ALEXANDER Name2: Address: 4842 ACRELAND DR Address2: City: CLAREMONT State: NC Zip: 28610 -9401 Account: 159763658 Calc Acreage: 0.69 Tax Map: 1720 04010 LRK: 58686 Deed Book: 3032 Deed Page: 1046 Subdivision Name: STEVEN ALEXANDER + PAMELA P MOSER Subdivision Block: Lots: 1 Plat Book: 69 Plat Page: 192 Building Number: 4850 Street Name: ACRELAND DR Site Zip: 28610 Township: CLINES Fire Code: OXFORD City Code: COUNTY State Road: Total Bldgs Value: Land Value: $21,000 Total Value: $21,000 Year Built: Year Remodeled: Last Sale Date: Last Sale Amount: Neighborhood: 67 Watershed: WS -IV Protected Area Watershed Split: NO Voter Precinct: P27 E911 District: COUNTY Zoning: R -30 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: OXFORD Middle School: RIVER BEND High School: BUNKER HILL School Split: NO P &Z Case Number: Census Tract 2010: 010101 Census Block 2010: 2003 Small Area Plan: ST STEPHENS /OXFORD Agricultural District: Printed: Monday, September 13, 2010 12:18 PM • CATAWBA COUNTY . Case # �o , [vfPV -6 10 8523 e X - . 5 G Public Health Oe,artment Subdivision r)I. �t,:3 Environmental tiealth Division '\ e PO Box 389, l00 -A Southwest Blvd, Newton, NC 28658 Lot # 10 48 2 P1N# 376404621131 Applicant/Owner CALEB MOSER �s� Site Address: ACRELAND DR, CLAREMONT, NC Property Size: SF 2.24 ACRES Directions: ROCK BARN RD - GO STRAIGHT AT INTERSECTION OF OXFORD SCHOOL RD AND ROCK BARN RD ONTO ROCK BARN EXTENSION - TURN RIGHT ONTO FARIv1FIELD DR - TURN LEFT ONTO ACRELAND DR - LAST LOT ON RIGHT Improvement Perm Facility: House Permit Category: New Septic Bedrooms 3 WATER SUPPLY: Well Type: Individual Well v Basement? No Basement Plumbing? No O INITIAL SYSTEM SPECIFICATIONS Permit Valid: Expires In Five Years: _X_ No Expiration: __ Projected Daily Flow 360 9 P.d Proposed Wastewater System: 25% REDUCTION Type: IIIG - OTHER NON - CONV TRENCH SYSTEMS Pump Required ?: No Operator Required ?: NO Permit Conditions: REPAIR SYSTEM SPECIFICATIONS Repair System Required? Required Proposed Wastewater System: PRETREATMENT Type: IVA - ANY SYSTEM WITH LPP DISTRIBUTION Pump Required ?: Yes Operator Required ?: YES 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 flows or foundation drains, is not approved, and may result in failure to approve the initial system installation, or the suspension/revocation of existing permits. The issuance of this permit by the Health Department does not guarantee the issuance of other permits. It is the responsibility of the applicant/property owner to insure that all Catawba County Planning/Zoning and Building Inspections requirements are met. This Improvement Permit is subject to revocation if the site plan, plat or the intended use changes, or if site conditions are altered. The Improvement Permit is not affected by a change in ownership of the property. This permit was issued in compliance with the provisions of the North Carolina 'Laws and Rulesfor Sewage Treatment and Disposal Systems' (15A NCAC 18A .1900). Neither Catawba County nor the Environmental Health Specialist warrants that the septic tank system will continue to function satisfactorily Megen McBride 06/22/2010 AUTHORIZED STATE AGENT APPROVAL DATE Permit Expiration Date: 06/21/2015 No grading or construction activity is allowed in areas designated for system and repair without approval of the Health Department. • 06/22/10 10:26 1P drawin5 irg - S - I0 - 555 Pot) and Dr. 4 ft/mil iS 11b+ ihiO ci -6( Se- s\s er LO r\rtuS - { 6c recorr po'Dv jsSuari AG. (Jp 11.4 GLYiJG �}r de, (� �' �1 0 \t" iL aYeo5. `J Pct` 01 35' a - Pj 3a le. t-0USG ' , v -'( c� • Tnji0,\ 4i& Area ) keclitkiork (C5 x-15) N vG ' Q "G r• r- WGI v ,q CATAWBA COUNTY Case # IMPV -6 -10 -8523 Public Health Department Subdivision 2 .- Environmental Health Division Y PO Box 389, I00 -A Southwest Blvd, Newton, NC 28658 Lot # 10 -411 w P1N# 376404621131 Applicant/Owner CALEB MOSER Site Address: ACRELAND DR, CLAREMONT, NC Property Size: SF 224 ACRES Directions: ROCK BARN RD - GO STRAIGHT AT INTERSECTION OF OXFORD SCHOOL RD AND ROCK BARN RD ONTO ROCK BARN EXTENSION - TURN RIGHT ONTO FARtMIFIELD DR - TURN LEFT ONTO ACRELAND DR - LAST LOT ON RIGHT Owner /Authorized Representative Acknowledgement of Permit Receipt of - I certify that I am the owner or authorized agent (owner's authorization required) representing the owner of the property described above. As the property owner or authorized representative, I have received the above referenced permit(s) as requested in the application for service EHPR - - 10 - 5558 , by the following method(s): pfio Received in Person Facsimile Transmittal (Return form with signature required) Electronic Image Transmittal / E -mail (Return receipt required) As the property owner or authorized representative I have reviewed and understand the specific conditions of the permit issued, and further understand that all applicable regulatory requirements specified under the North Carolina Laws and Rules for Sewage Treatment and Disposal Systems (15A NCAC 18A .1900), and/or Well Construction Standards (15A NCAC 2C .0100), shall apply to the issuance of • this permit and the construction of the wastewater system and /or water supply well permitted. Permit Issue Date: 06/22/2010 Owner /Authorized Representative Signature aW Date ,- /D Documentation of Permit(s) Transmittal (permit transmitted by electronic or other means) Permit transmitted by (name of person sending permit) • Signature Date /Time Method: Fax Email US Mail Other Owner's request to send by the above indicated method of transmittal in lieu of signature acknowledges the conditions and statements above. 06/22/10 10:26 LEGEND use the following standard abbreviations • SOIL CONVENTIONAL LPP MINERALOGY/ J ANDSCAPE POSITION GROUP TEXTURE .1955 LTAR* .1957 LTAR• CONSISTENCE STRUCTURE 1.2 - 0.8 0.6 - 0.4 NEXP (Non- expansive) G (Single Grain) CC ( Concave p)) I S (Sand) SEXP (Slightly Expansive) M (Massive) • CV (Convex Slope) Foamy Sand) E P (Expansive) CR (Crumb) • D ((menage Way) 0 0 - 0.3 GR (Granular) DS ( load Slump) II (Lonna) ��) SBK (Subangular Blocky) PS (Flood lo ps ) ) ARK (AngularBlocky) FS (Foot Slops) III SCL (Sandy Clay Loam) 0.6 - 03 03 - 0.15 PL (Platy) H (Fiend Sloes) SiL (Silt Loam) PR (Prismatic) • L (I ia�r Slops) • N (Nose Slope) CL (CIaY Loam) MOIST wrr R �dg)) SiCL (Silty Clay Loam) . S (Shoulder Slope) Si (Silt) VFR (Very Friable) NSO�Y) T Crime) IV SC (Sandy Clay) 0.4 - 0.1 0.2 - 0.05 FR (Friable) SS (Slgbaly Sticky) SIC (Silty Clay) . Fl (Faro) S (Stay) • C (Clay) VF1 (Very Firm v. Very Stich y) VS (Wry Sticky) None EF1(Exae Y Fain) NP (Na - plastic) 0 (Organic) SP (SLstaly Ptuaie) ' *Adjust LTAR due to depth, consls1euee, structure, soil wetness, landscape, position, wastewater flow and quality. P (Plastic) ]yOTPS VP (Very Plastic) • HORIZON DEPTH In inches below naturel soil surface • DEPTH OF FILL In inches from land sulfa= R_S RIGTNE Th ickness and depth from land surface • S4PROLIT3 S(suitable) or U(tmsuitable) SOIL WETNESS Inahes from land surface to Exec water er inches tinm land surface to soil colors with chmma 2 or less - record Mlmsctl color chip desig;radoo CLASSIFICATION (Suitable), P' . , isionally Suitable), or U (Unsuitable) Evaluation of sapro Etc shall ix by , 'ts Long- t ®At..-ptanme Rate (LT • ): g ► .. l Show pro • ocntion d other site features (dimensions, reference or benchmark. and North). : • i i • • ; : H ..._a..r.b «.-. . t • 4. 1 1 i ...- .... «.. ._.. »...,...... ..— ...... DENR ( Review (r1) f IO(�taY•A . l0 (Nol Iv Jcatz Amilaii■ig. --;. DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES • . Sheet of DIVISION OF ENVIRONMENTAL HEALTH PROPERTY ID #: ON-SITE WASTEWATER SECTION COUNTY: SOIL/SITE EVALUATION for ON-SITE WAS'I'EWATER SYSTEM OWNER Ueb Mer APPLICATION DATE 51 P 4 /o- 5 • AD D RE SS: DATE EVALUATED: bki 110 PROPOSED FACILITY:. 3 i3P-.- HOV,— PROPOSED DESIGN FLOW (.1949): 3 • PROPERTY SIZE: O. (,12, wc.A.norT OF SITE: hr,rela",c Dr. PROPERTY RECORDED: WATER SUPPLY: 0 Private 0 Public a Well 0 Spring 0 Other • EVALUATION METHOD: 0 Auger Boring g Pit 0 Cut TYPE OF WASTEWATER: Sewage 0 Industrial Process 0 Mixed • ., , .. :ffit.. . SOIEMOMIDECPCV..... QTEER ._ (1941 - ii ::::: .... i m!!!! . 7 -.. ::::::::::::::::::::: • • — . . .. . . , . .. , ..:: :::T.: - • • • r ID r 1942 & 'g ISiiitiL ---. 1041.: .... ...-........ '''''''' •SOIL '''''' :: ::::::1241:::, ...... A956:...... ...... .12)44 EitiEttitim D.Erril STRIICTURD NESSf: : .. .. S..c1L .... ....... ::::S:knotr.t8TR:::::: . r ...,.., R° , ..7?" •:::::::: SLOPE ..... .-.• ::,::! ..... TEN-au mstRADDiiiii.-- .:-.DEPTII::: --CLASS ---HORIZ. . ', ITA i iii. . L.:in::: :,::.- O21 (,.' ) 50/- 2 'ILI a-, vis.4-jc4)1 ;fv.sc Sexj Iii . .__ 3 _ 1 , _ P5 • _ 0 )5 . . . . . • . • . — .....' . . 4- r ; cc. 2. -Li(i C,I., ls6&1 -f( t _ss, st.f FS 2 . . _ LI c t. — _ • , 03)6 – - - . e5 3 . , O. 5 • • 27 e- s v44,W , .\ ; ss . se21 . P5 • . X7 SC , \I-10-W1017) fr ,cs 5c)9 V Lig ......... ._.... 4 - v-4(6 su,%40-b -fi (cs, , . DESCRIPTION INITIAL SYSTEM R.EPAIR SYSTEM OTHER FACTORS (.1946): ' SITE CLASSIFICATION (.1948): _ Available Spa= (.1945) PS P5 _ PmAnji, . System. Type(s) Itrc 3 5 41 , Lfp EVALUATED BY: pA . 01 H.L.R(S) PRESENT: • Site LTAR 0 ■ 3) 5 D.35 . COMMENTS: rt., . Ur. k4.1N rYN1/ . t. Ott/ I f • ' )A-- Co CATAWBA COUNTY, NC ( � � 100 -A South West Blvd PLAN RECEIPT H Newton, NC 28658- 1 tir (828)465 - 8399 Monday, September 13, 2010 1542 sM www.catawbacountync.gov Plan Case: EH PR-9-10-7292 Invoice Number: INV -9 -10- 266901 Environmental Health Plan Review Invoice Date: 09/13/2010 Site Address: 4850 ACRELAND DR, Claremont, NC APPLICANT OWNER CALEB MOSER CALEB MOSER 4842 ACRELAND DR 4842 ACRELAND DR CLAREMONT NC 28610 CLAREMONT NC 28610 828 - 850 -0646 828 - 850 -0646 Fee Name Fee Amount Well Permit & Inspection Fee Fixed $300.00 Authorization to Construct Fee Adjustable $150.00 (New /Expansion) Fee Total Fees Due: $450.00 PAYMENTS PAYER: JONATHAN LAIL S & L LANDSCAPING & GRADING Date Pay Type Check Number Amount Paid Change 09/13/2010 Check 7409 $450.00 $0.00 Total Paid: $450.00 Total Due: $0.00 plan receipt', 11 L 4cd9 -h83h -121 h- Q3ce -t 113c3ael'003 i rpt 09/13/2010 12.15