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Home My WebLink AboutEHPR-9-10-7303 (2).TIF C• THIS IS NOT A PERMIT Case # EHPR -9 -10 -7303 ��,...� � CATAWBA COUNTY HEALTH DEPARTMENT Tit Plan Review Application for Environmental Services 842 sM Environmental Health Plan Review - OSWP EXS SYSTEM NAME TO APPEAR ON PERMIT RICK TRAVIS SITE ADDRESS: 5458 BUDDY ST, Conover, NC Pin#: 373412967852 NAME of SUBDIVISION:HOUSTON Lot # 18 Section/Block/Phase PROPERTY SIZE: Square Feet Acres 0.36 DIRECTIONS: SPRINGS RD PAST FIRE DEPT/ RT ON H OUSTON MILL RD/ TAKE 1ST PAVED RD TO LEFT (BUDDY ST)/ ON RT/ LOT 18 APPLICANT OWNER CONTRACTOR RICK TRAVIS RICK TRAVIS CMH HOMES INC DBA CLAYTON HOMI 5458 BUDDY ST 5458 BUDDY ST 2026 NORTHSIDE DRSTATESVILLE NC CONOVER NC 28613 CONOVER NC 28613 704-873 -2547 828-238-2159 828-238-2159 PRIMARY CONTACT: APPLICATION FOR: New Construction DIM EXISTING STRUCTURE: EXISTING FACILITY TYPE: N/A NUMBER OF EXISTING BEDROOMS: SEWER TYPE: Septic Tank EXISTING WATER SUPPLY IN USE: Public Water CALCULATED DESIGN FLOW: WELL TYPE: Public water IS available for this property. PUBLIC WATER TYPE AVAILABLE: N/A DESCRIBE WORK: 14 X 66 SINGLEWIDE MOBILE HOME/ CLASS E/ METAL ON METAL/ MUST HAVE A 36 SQ FT DECK ON FRONT/ MUST BE UNDERPINNED/ MUST SCREEN OR REMOVE TOWING TONGUE; MUST BE PARALLEL TO RD PROPERTY EASEMENTS: NO PROPOSED CONSTRUCTION PRIMARY RESIDENCE NEW RESIDENCE? New Residence # OF NEW BEDROOMS: 3 # OF STRUCTURE OCCUPANTS: PROJECT DESC: SINGLEWIDE MOBILE HOME/ 14 X 66 PROJECT DIMENSION: 14 X 66 BASEMENT? No BASEMENT FIXTURES? No 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: / .7 `6) Signature of Applicant or Agent A T 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 16:42 B RA � CATAWBA COUNTY Case # EHPR 9 10 7303 G Public Health Department � ` •t Subdivision HOUSTON , ti Environmental Health Division - Plan Review �P1� < PO Box 389, 100 -A Southwest Blvd, Newton, NC 28658 Lot# 18 /842 sN PIN# 373412967852 Applicant/Owner RICK TRAVIS, 5458 BUDDY ST, CONOVER NC 28613 Site Address: 5458 BUDDY ST, Conover, NC Property Size: SF 0.36 ACRES Directions: SPRINGS RD PAST FIRE DEPT/ RT ON H OUSTON MILL RD/ TAKE 1ST PAVED RD TO LEFT (BUDDY ST)/ ON RT/ LOT 18 Minimum Setbacks FEE NAME DATE AMOUNT BALANCE DUE Front 30 Side 15 Existing Tank Check Fee 09/13/2010 S80.00 Rear 30 TOTAL FEES 580.00 Side St Max Hght CHANGE WORK ORDER REQUIRING REDESIGN AND /OR RETRIP WILL INCURE AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) 09/13/10 16:42 • Catawba County, North Carolina N This map product was prepared f - om the Catawba County, NC, Geographic /formation System. A 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 ally data contained on this map product by the user. The County of Catmyba, 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 f"on, this map product or the nse thereof any person nr entity. Legend Selected Parcel Number: 3734-12-96-7852 • A 1 inch = 60 feet rcpared for: 7 i r j u u U o 8 L094 ti ; ; �, i '+ �' 11 �° • 7 co i '' 4 '9 . 63 ; ' , 8070 0 0 . 78 ' 9' 9 co Lo v- 9408 • • • 97 . 7 88,33 6 . 4 t i 101 • 1 .. 83 Ns 1 CSD 'E�` ,t. N� 19 • t— 20 �• j CD ,'_ ; / — 880 0-5 8 3 ;f �- 9 729 c\ • 2 = 1' c CV • i 888 ; ='. /C CO ,,� • � / 00 Ord' 87 30 f 82 t ; 100 98 82. • r J CO i' n f' , f _ - l i r ! i ``' 16623 n - • r �1 f THIS IS NOT A LEGAL DOCUMENT / Monday, September 13, 2010 04:05 PM • r 1 5 1 > 1 co CATAWBA COUNTY NC - Parcel Report Information Regarding Selected Parcel(s) Parcel ID: , 3734 -12 -96 -7852 Name: TRAVIS CHRISTOPHER R Name2: TRAVIS KIMBERLY L Address: PO BOX 817 Address2: City: CONOVER State: NC Zip: 28613 -0817 Account: 159747806 Calc Acreage: 0.36 Tax Map: LRK: 800328 Deed Book: 2940 Deed Page: 1271 • Subdivision Name: HOUSTON Subdivision Block: Lots: 18 Plat Book: 37 Plat Page: 20 Building Number: 5458 • Street Name: BUDDY ST Site Zip: 28613 Township: CLINES Fire Code: • ST. STEPHENS City Code: COUNTY State Road: • Total Bldgs Value: Land Value: $7,500 Total Value: $7,500 Year Built: Year Remodeled: Last Sale Date: Last Sale Amount: Neighborhood: 67 Watershed: Watershed Split: Voter Precinct: P33 E911 District: COUNTY Zoning: R -20 Zoning2: • Zoning3: Zoning Split: N Zoning Overlay: DWMH -0 Zoning District: COUNTY Split Zoning Dist: N Split Zoning Dist(1): 0 Split Zoning Dist(2): 0 School District: COUNTY Elementary School: LYLE CREEK Middle School: RIVER BEND High School: BUNKER HILL School Split: NO P&Z Case Number: Census Tract 2010: 010201 Census Block 2010: 1034 Small Area Plan: ST STEPHENS /OXFORD Agricultural District: Printed: Monday, September 13, 2010 04:05 PM a v,A c THIS IS NOT A PERMIT CATAWBA COUNTY HEALTH DEPARTMENT s ue ' Application for Environmental Services Page 1 1842 )M Improvement Permit ❑ Authorization to Construct ❑ Septic Repair ❑ Septic Malfunction ❑ Septic Expansion ❑ New Well Permit ❑ Replacement Well ❑ Well Abandonment ❑ Well Repair ❑ Existing System Inspection (Pre- Approval Required) ❑ Application is for New Construction ❑ Existing Facility ❑ Property Address 3 ,I71,c�� , . Subdivision O b n o Us 2 Lot # / Acres Section/Block/Phase Driving Directions to Property Op do L" N S f(L i CS Rd , P aS -1 4-he t De pt C 1k+ a,v 1 i�r h f it. 4 tt S n 111 I l kcal , . To k� 4z_64- p4 2d . � L - 1 - ei -f (BIA61(ct s4.) fa br / / - L.o+ is bN ei h,f Lai W • NAME TO APPEAR ON PERMIT? ❑ Owner ❑ Applicant ❑ Contractor Applicant Contact Information ✓ Name . (� - R� A v i- _ W m Address 2 314 23 rd Ave_ . D2 . N,E 1 _, Phone ( z3 ?— 2 IS-9 Cell Phone(' 2 (o i (p (, • Owner Contact Information Name • Address O Phone Cell Phone Contractor Contact Infor ation 11At11, Name L H Address H = Phone Cell Phone WHO WILL BE THE PRIMARY CONTACT? ❑ Owner ❑✓Applicant ❑ Contractor Z Description of Existing Structures on Site r �(.6 - # of Bedrooms *1* Structure Dimensions # of Occupants Basement ❑ Yes ❑ No Basement Fixtures ❑ Yes ❑ No Planned Future Additions or Improvements (Building Permit NOT requested at this time) CC Describe Proposed Future Structure Dimensions # of Bedrooms if applicable Z Are there easements or right -of -ways recorded on this property ❑ Yes g'go Describe Is a public water supply available on or adjacent to the above property ** ❑✓Yes ❑ 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) THIS IS NOT A PERMIT CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services Page 2 , Prop ed Facility Type rimary Residence ❑ New Residence ❑ Addition to Residence # of New Bedrooms *f Project Description ► ' l D b i / *ni Structure Dimensions / 9 X (o 4 # of Occupants 2 _ Basement ❑ Yes g No Basement Fixtures ❑ Yes R'lUo ❑ Accessory Structure(s) Describe # of New Bedrooms *j if applicable Structure Dimensions # of Occupants Accessory Dwelling ❑ Yes ❑ No Plumbing ❑ Yes ❑ No Describe Plumbing Needed ❑ Multi - Family Residence # Units #Bedrooms per Unit* j _ 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 ❑ No 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 j 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. i 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. 0 CHANGE WORK ORDER REQUIItING REDESIGN AND /OR RETRIP WWL 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 m 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 i transferable Signature of Owner or Agent ,.. Printed Name of Owner or Agent Date q — / ,3 L r * * *Op. Permit and /or Cert. Op. Required v (Must be completed prior to final) N o 7 8 8 8 CATAWBA COUNTY HEALTH DEPARTMENT (704) 465 -8270 Lot•Eval. Improve. Permit)( Repair Permit Cert. of Comp. Permit )(Oper. Permit Owner /Agent R. UA1LIc -C (1 &(.Z5I'J Phone Address Subdivision J-1SUZ tr>9J Section/Block/Phase a 5 Lot* / L9Size eirections : . ‘2,,.../. ��3emr: i' -iti.... nu( 0 t L . k,. Facility: House Mobile Home)( Business . Other: Tax Map-) /5'00 - Multi-family Other . Zoning Approval( 7 e;5030 2_3 Bedrooms„? Seats Employees . Application Rate ((`),[p GPD Flow360 Hot Tub or Spa yes / Special Fixtures . 100% Repair Area../no REPAIR NOTICE: Basement yes 4g) Basement Plumbing yes /no . REPAIRS MUST BE WITHIN 30 DAYS OR I Water Supply: Private Public X. . DAYS FROM DATE OF PERMIT. *********************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Type of System: Trench )( Bed Pump Pump /Panel Panel LPP Other Tank Size: Septic Tank /000 Pump Tank Nitrification Field: Total Square Feet 90C) Depth of Stone /Zinc Bed Size Trench Width 3 3 Total Length of All Trenches ` A CC ' Number of Trenches 0 Individual Trench Length !CC C C % /CO Feet on Center / Maximum Trench D e p t h � �d Distance of Nearest Well •-i r Lot Evaluation: Approved /no (Void After 24 months) *********************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Topo 21_ % Slope Sketch of lot Evaluation Site - System Design - Final Texture Cbar DO NOT INSTALL Structure OW \________________3 WHEN WET Clay Min. j / ___` Soil Wetness " I io� 1 .- ,, 1 Soil Depth 4 n l Restric. Hoz. at "ti Available space .yes/no 1 �,/ o j'` Overall Class S__ ES, U d I -'' Comments : nl l Ce , t } 41U-41). re- 14, m t `a { r " 1 -\' � .'= t r + < / = r ` p g top,. ( _ , ) 1 1(1 I!( , I (w 1 Ill 11 Septic Tank Contractors . - -U I -O &3: MUST contact the I IN Sanitarian BEFORE changing permit .d.l( Stlt * *NO GUARANTEE OR WARRANTY IS _ED OR ROUGH THE ISSUANCE OF T PERMIT ** Permit Date a— -r3' , (Improvement P rm j / -voi_ . months) i 1 ! 1 Owner /Agent, 1�, -� �t c , I�rn j Sanitariaiz�/ I . i. , —_ I nstalled By 'v -- , ;; c_._' ,-n Date ;r .,7 r Sanitaria , /, (Note any changes /information in red or by sketch on'bacIc l/ * * * * * * *IF A PERMIT HAS TO BE REDESIGNED AND /OR RETRIPS MADE TO THE PROPERTY, HERE * * * * * * ** IS AN ADDITIONAL $25 CHARGE. . White - Office Blue - Building Inspection Completion Yellow - Owner /Agent Green - Building Inspection IP T C� CATAWBA COUNTY, NC �7' r { �, 100 -A South West Blvd PLAN RECEIPT r Newton, NC 28658 - V \ o 0.4 7 (828)465 - 8399 Monday, September 13, 2010 1 84 2 sM www.catawbacountync.gov Plan Case: EHPR -9 -10 -7303 Invoice Number: INV -9 -10- 266926 Environmental Health Plan Review Invoice Date: 09/13/2010 Site Address: 5458 BUDDY ST, Conover, NC APPLICANT OWNER CONTRACTOR RICK TRAVIS RICK TRAVIS CMH HOMES INC DBA CLAYTON 5458 BUDDY ST 5458 BUDDY ST HOMES #72 CONOVER NC 28613 CONOVER NC 28613 STATESVILLE NC 28625 828 -238 -2159 828 -238 -2 159 704 -873 -2547 Fee Name Fee Amount Existing Tank Check Fee Fixed $80.00 Total Fees Due: $80.00 PAYMENTS PAYER: RICK TRAVIS Date Pay Type Check Number Amount Paid Chang( 09/13/2010 Cash -1 $80.00 $0.00 Total Paid: $80.00 Total Due: $0.00 plan rcccipt 09/13/2010 16:45