Loading...
HomeMy WebLinkAboutRBPR-07-2022-41600.tif °A11.1N catawba county public health AUTHORIZATION OF REFUND Date: 6/1/2023 Case#: RBPR-07-2022-41600 Applicant: Clayton Homes of Statesville Refund Amount: S450 Refund Reason: Application denied. Refunding AC and Well Fees '7/4Authorizing Signature: ' 4` Received By Staff: Lt14(ta /14/AL, 1 Date: big 1)3 catawbacountync.gov Environmental Health Cctcwho County Government Center 25 Government Drive I PO Box 389 I Newton NC 28658 1828.465.8270 MAKING. LIVING. BETTER. Catawba County, North Carolina - Disbursement Voucher Vendor No. Date: 6/1/2023 Make Payment To: (;figliwCpVoucher No(s) Clayton Homes of Statesviller��1 2026 Northside Dr <C Statesville, NC 28625 a ��� y 8 42 ATTACHMENT Prepared by: Julia English Description Amount RBPR-07-2022-41600 Application denied. Refunding AC and Well fees $450.00 Sub-Total Food Tax Sales Tax Total $ 450.00 For Accounting Use Fund Cost Center Object Project Amount Only 110 580200 663000 Total The undersigned hereby certifies that the goods or services specified above have been received or performed. Payment has not been previously authorized and this expenditure is a proper charge to the appropriation indicated. The above charge is certified to you for payment. (SIGNATURE-APPROPRIATE OFFICIAL) ‘0- CATAWBA COUNTY 100A SOUTHWEST BLVD NEWTON,NORTH CAROLINA 28658RECEIPT V �,� PHONE:828.465.8399 Thursday,June 1, 2023 1842 sM www.catawbacountync.gov PAYOR: *CLAYTON HOMES, INC. (STATESVILLE) *CLAYTON HOMES,INC. (STATESVILLE) PAYMENTS TRANSACTION NUMBER: TRC-65361486-01-06-2023 PAYMENT DATE: 06/01/2023 PAYMENT TYPE: DV INVOICE NUMBER ACCOUNT FEE NAME FEE AMOUNT 07-22-408844 110-580200-663000 Well Permit& Inspection Fee ($300.00) 07-22-408844 110-580200-663000 Authorization to Construct Fee (N (S150.00) ew/Expansion) Fee TOTAL PAYMENTS: ($450.00) RB PR-07-2022-41600 CASE TYPE: Residential Building Plan Review WORK CLASS: Building New SITE ADDRESS: 2388 BAYLEIGH DR,VALE NC 28168 Owner JAMES GILLILAND JR,904 TRACY GROVE RD,FLAT ROCK NC 28731 Contractor *CLAYTON HOMES,INC. (STATESVILLE),2026 NORTHSIDE DRIVE,STATESVILLE NC 28677 B:(704)239-3693C:(704)873-2547F:704-872-1166 HC072@CLAYTONIIOMES.COM **NO PEOPLESOFT ACCOUNT ASSIGNED** receipt 06/01/2023 14:14 Page I of 1 catawba county public health May 24, 2023, James Gilliland Jr 904 Tracy Grove Rd, Flat Rock, NC 28731 Re: Application for Improvement Permit and Authorization to Construct for 2388 Bayleigh Dr,Vale Health Department file number RBPR-07-2022-41600. To Whom It May Concern: The Catawba County Health Department, Environmental Health Division on 9/09/22, evaluated the above referenced property at the site designated on the plat/site plan that accompanied your Improvement Permit application. According to your application the site is to serve a 3 bedroom with a design wastewater flow of 360 gallons per day.The evaluation was done in accordance with the laws and rules governing wastewater systems in North Carolina General Statute 130A-333 including related statutes and Title 1SA, Subchapter 18A,of the North Carolina Administrative Code, Rule.1900 and related rules. Based on the criteria set out in Title 15A,Subchapter 18A,of the North Carolina Administrative Code, Rule.1940 through .1948,the evaluation indicated that the site is UNSUITABLE for a sanitary system of sewage treatment and disposal. Therefore,we must deny your request for an Improvement Permit. A copy of the site evaluation is enclosed. The site is unsuitable based on the following: Unsuitable soil topography and/or landscape position (Rule .1940) Unsuitable soil characteristics(structure or clay mineralogy) (Rule.1941) Unsuitable soil wetness condition (Rule.1942) Unsuitable soil depth (Rule .1943) Presence of restrictive horizon(Rule .1944) X Insufficient space for septic system and repair area (Rule.1945) Unsuitable for meeting required setbacks(Rule .1950) Other(Rule .1946) These severe soil or site limitations could cause premature system failure, leading to the discharge of untreated sewage on the ground surface, into surface waters, directly to ground water or inside your structure. The site evaluation included consideration of possible site modifications, as well as use of modified, innovative, or alternative systems. However, the Health Department has determined that none of the above options will overcome the severe conditions on this site. A possible option might be a system designed to dispose of sewage to another area of suitable soil or off-site to additional property. catawbacountync.gov Environmental Health Cctcwbc County Government Center 25 Government Drive PO Box 389 Newton INC 28658 ( 828.465.8270 F.i i' per, §: . L L 9 E 4 a Page 2 For the reasons set out above,the property is currently classified UNSUITABLE, and no improvement permit shall be issued for this site in accordance with Rule.1948(c). Note that a site classified as UNSUITABLE may be classified as PROVISIONALLY SUITABLE if written documentation is provided that meets the requirements of Rule .1948(d). A copy of this rule is enclosed. You may hire a consultant to assist you if you wish to try to develop a plan under which your site could be reclassified as PROVISIONALLY SUITABLE. You have a right to an informal review of this decision. You may request an informal review by the soil scientist or environmental health supervisor at the local health department. You may also request an informal review by the North Carolina Department of Health and Human Services regional soil scientist. A request for informal review must be made in writing to the local health department. You also have a right to a formal appeal of this decision. To pursue a formal appeal,you must file a petition for a contested case hearing with the Office of Administrative Hearings, 1711 New Hope Church Rd, Raleigh, NC 27609. To get a copy of a petition form,you may write the Office of Administrative Hearings or call the office at 984-236- 1850 or download it from the OAH web site at http://www.oah.nc.gov. The petition for a contested case hearing must be filed in accordance with the provision of North Carolina General Statutes 130A-24 and 150E-23 and all other applicable provisions of Chapter 150B. N.C. General Statute 130A-335 (g) provides that your hearing would be held in the county where your property is located. Please note: If you wish to pursue a formal appeal,you must file the petition form with the Office of Administrative Hearings WITHIN 30 DAYS OF THE DATE OF THIS LETTER. The date of this letter is 5/24/2023. Meeting the 30 day deadline is critical to your formal appeal. If you file a petition for a contested case hearing with the Office of Administrative Hearings,you are required by law(N.C.General Statute 150B-23)to serve a copy of your petition on the Office of General Counsel, N.C. Department of Health and Human Services, 2001 Mail Service Center, Raleigh, N.C. 27699-2001. Do not serve the petition on your local health department. Sending a copy of your petition to the local health department will not satisfy the legal requirement in N.C. General Statute 150E-23 that you send a copy to the Office of General Counsel, N. C. Department of Health and Human Services. You may call or write the local health department if you need any additional information or assistance. Sincerely, CiWeAk 111.4 Cheyanne Morgan, REHS Environmental Health Specialist Enclosures: Site evaluation Rule.1945, .1948 I)1 PAR I\4F.NT OF HEALTH AND HUMAN SERVICES Sheet 1 01 I 1)1%Isli P.OF PI'MAC IlE ALTH,ENVIRONMENTAL HEALTH SECTION PROPERTY II)III: II•1.1o!J9f+/5S 1)N-SITT:WATER PROTECTION BRANCH COUNTY:la awbq_ SOIL/SITE EVALUATION for ON-SITE WASTEWATER SYSTEM (Con%pkte all fields in full) OWNER: C194/n P+MPS SIC _ APPLICATION DATE / /Z ADDRESS: DATE EVALUATED: I riz PROPOSED FACILITY: NCIJ 1 04Se PROPOSED DESIGN FLOW(.1949): 360 6PD PROPERTY SIZE: 0.ffS acres LOCATION OF SITE: Z33i EQy(tg�h j?Cyy via lL iW ZflWr PROPERTY RECORDED: WATER SUPPLY: 4rivate a Public LY`�µ'ell ❑Spring ❑Other EVALUATION METHOD: 1-2 Auger Boring ` 'Pit 0 Cut TYPE OF WASTEWATER: Sewage 0 Industrial Process 0 Mixed • • • • P R o SOIL MORPHOLOGY OTHER F. (.1901) PROFILE FACTORS I, .1940 E LANDSCAPE HORIZON POSITION! DEPTH .1942 PROFILE M SLOPE% (IN.) .1941 .1941 SOIL .1943 .1956 .1944 CLASS STRUCTURE/ CONSISTENCE! WETNESS/ SOIL SAPRO RESTR &LTAR TEXTURE MINERALOGY COLOR DEPTH CLASS HORIZ Li o—ZB C 58K 1;srsrOr s zs 35' C ct15BC frr S,sPr.0 1 3s L/ CL $c tat Thss,3t/saf yy L S 0-30 C AK 5 51,,50cr fil5 30-Ll0 C 1 st3* �tSrSr54X II �8 2 Ko -YS a eCwseic rss se p et O. 3 LS 0-23 c $f< rrslspi.s&f. r' S Z$-33 , C IAJSBk. 4 si5fj sacf 3 33-L/ CL BC Gat ii-I si56 far- �3 op 0.3 . . Cf 0-3o , c wseK FfslSp,SelP PS 3O-lig a. a wsat Fri ss,sp,riq . ►I 4 tit go/. 0. 73-S DESCRIPTION lurrlAl.SYSTEM REPAIR SYSTEM OTHER FACTORS(.1946): I, ! SITE CLASSIFICATION(.1948): (,( Available Space(-1945) f 5 (A y_ 5o' rn / EVALUATED BY: trleyAim/ M_9to SystemType(s) / of O'FFIlI((S)PRESENT: Site LTAR 0.3 — COMMENTS:_ ---- — — - -- Updated February 2014 Catawba County Environmental Health 1 343.00 , 1 1 1 x 1 1 �* 1 •2376 1 8 II I I I 323.76 1 ' DriVC 1,,,/ay ZS 3Z 50r I I So' Prop 0 /0' I cr 0 o) Jar 3�R '� y°_,—�l •23B8 ' �5r 0 N. O rGo C7 N !D o PoaSC n>- 17 Q 1 Palter lint eosemen4_ Cil q, is' 1 , 303.10 1 y 3' II5'no 1 I Ls' f' X0u1 0-1:";Al c I I I •2aoo 1 ('�e f L i n.ft- 134.84 I I I'..nt fon),rtJ.%1 f u Iflch II -F dr tit), r,y1t;r I d"a,t 247.39 1 Parcel: 266801398453, 2388 BAYLEIGH DR lin=50ft VALE, 28168 This map/report product was prepared from the Catawba County,NC Geoapatlel 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 dela 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 2023 Catawba County NC 05/22/2023 I5A NC'AC 18A.1945 AVAILABLE SPACE (a) Sites shall have sufficient available space to permit the installation and proper functioning of ground absorption sewage treatment and disposal systems,based upon the square footage of nitrification field required for the long-term acceptance rate determined in accordance with thcsc Rules. (b) Sites shall have sufficient available space for a repair area separate from the area determined in Paragraph(a)of this Rule. The repair area shall be based upon the area of the nitrification field required to accommodate the installation of a replacement system as specified in Rule.1955,.1956,or.1957 of this Section. Prior to issuance of the initial Improvement Permit for a site,the local health department shall designate on the permit the original system layout,the repair area,and the type of replacement system_ (c) The repair area requirement of Paragraph(b)of this Rule shall not apply to a lot or tract of land: (1) which is specifically described in a document on file with the local health department on July 1, 1982,or which is specifically described in a recorded deed or a recorded plat on January 1. 1983;and (2) which is of insufficient size to satisfy the repair area requirement of Paragraph (b) of this Rule, as determined by the local health department;and (3) on which a ground absorption sewage treatment and disposal system with a design daily flow of: (A) no more than 480 gallons is to be installed;or (B) more than 480 gallons is to be installed if application for an improvement permit which meets the requirements of Rule.1937(c)of this Subchapter is received by the local health department on or before April I. 1983. (d) Although a lot or tract of land is exempted under Paragraph(c)from the repair area requirement of Paragraph(b),the maximum feasible area,as determined by the local health department,shall be allocated for a repair area. History Note: Authority G.S. 130A-33Sre►and(lr: E41:July 1, 1982: Amended Lfr February 1, 1992. Juh• 1. 19<Y3.January 1. 1983. 15A NCAC I8A.1948 SITE CLASSIFICATION (a) Sites classified as SUITABLE may be utilized for a ground absorption sewage treatment and disposal system consistent with these Rules. A suitable classification generally indicates soil and site conditions favorable for the operation ofa ground absorption sewage trcatmcnt and disposal system or have slight limitations that arc readily overcome by proper design and installation. (b) Sites classified as PROVISIONALLY SUITABLE may be utilized for a ground absorption sewage treatment and disposal system consistent with these Rules but have moderate limitations. Sites classified Provisionally Suitable require sonic modifications and careful planning.design.and installation in order for a ground absorption sewage trcatmcnt and disposal system to function satisfactorily. (c) Sites classified UNSUITABLE have severe limitations for the installation and use of a properly functioning ground absorption sewage treatment and disposal system. An improvement permit shall not be issued for a site which is classified as UNSUITABLE. I lowever.where a site is UNSUITABLE.it may he reclassified PROVISIONALLY SUITABLE if a special investigation indicates that a modified or alternative system can be installed in accordance with Rules.1956 or_1957 of this Section. (d) A site classified as UNSUITABLE may be used for a ground absorption sewage treatment and disposal system specifically identified in Rules .1955. .1956. or.1957 of this Section or a system approved under Rule .1969 if written documentation,including engineering,hydrogcologic.geologic or soil studies,indicates to the local health department that the proposed system can be expected to function satisfactorily. Such sites shall be reclassified as PROVISIONALLY SUITABLE if the local health department determines that the substantiating data indicate that: (I) a ground absorption system can be installed so that the effluent will be non-pathogenic.non-infectious. non-toxic.and non-hazardous; (2) the effluent will not contaminate groundwater or surface water:and (3) the effluent will not be exposed on the ground surface or be discharged to surface waters where it could come in contact with people.animals,or vectors. The State shall review the substantiating data if requested by the local health department. Moore Note: Authority G.S. 130.1-335(e): Efj':July 1. 1982: Amended Eli:April 1. 1993:January 1. 1990. U.S. Postal Service" CERTIFIED MAIL® RECEIPT .0 Domestic Mail Only Ui IT' For delivery information,visit our website at www.usps.com°D. Gilliland Env.Health CM Certified Mail Fee 1-n $ FL) Extra Services&Fees(check box,add fee as appropriate) 0 Return Receipt(handcopy) f; a 66 rg 0 Return Receipt(electronic) $ C ark f� a ❑Certified Mall Restricted Delivery $ • Here t QAdun Signature Required $ i ❑Adult Signature Restricted Delivery$ Crd Ir c•• Postage N Lr) $ c. OTotal Postage end Fees JAL, vSQ/ $ '7 ,a Sent To RBPR-07-2022-41600 rU 'Sfreet and APt."paffil s3t"iffland Jr state,BP+904Tracy Grove Rd, PS Form 3800 A--.i'1 ,.,. ,.r_ t-Pia>_•ua1113ttr[•tlt•�,t= Certified Mail service provides the following benefits: •A receipt(this portion of the Certified Mail label). for an electronic return receipt,see a retail •A unique identifier for your mailpiece. associate for assistance.To receive a duplicate •Electronic verification of delivery or attempted return receipt for no additional fee,present this delivery. USPS®-postmarked Certified Mail receipt to the •A record of delivery(including the recipient's retail associate. signature)that is retained by the Postal Service'" -Restricted delivery service,which provides for a specified period. delivery to the addressee specified by name,or to the addressee's authorized agent. Important Reminders: -Adult signature service,which requires the •You may purchase Certified Mail service with signee to be at least 21 years of age(not First-Class Mail*,First-Class Package Service®, available at retail). or Priority Mail*service. -Adult signature restricted delivery service,which •Certified Mail service Is not available for requires the signee to be at least 21 years of age international mail. and provides delivery to the addressee specified •Insurance coverage is not available for purchase by name,or to the addressee's authorized agent with Certified Mail service.However,the purchase (not available at retail). of Certified Mail service does not change the •To ensure that your Certified Mail receipt is insurance coverage automatically included with accepted as legal proof of mailing,it should bear a certain Priority Mail items. LISPS postmark.If you would like a postmark on •For an additional fee,and with a proper this Certified Mail receipt,please present your endorsement on the mailpiece,you may request Certified Mall item at a Post Office'"for the following services: postmarking.tf you don't need a postmark on this -Return receipt service,which provides a record Certified Mail receipt,detach the barcoded portion of delivery(including the recipient's signature). of this label,affix it to the mailpiece,apply You can request a hardcopy return receipt or an appropriate postage,and deposit the mailpiece. electronic version.For a hardcopy return receipt, complete PS Form 3811,Domestic Return Receipt;attach PS Form 3811 to your mailpiece; IMPORTANT.Save this receipt for your records. PS Form 3800,April 2015(Reverse)PSN 7530-02-000-9047 41A• THIS IS NOT A PERMIT Case# RBPR-07-2022-41600 CATAWBA COUNTY HEALTH DEPARTMENT PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES 1 w Residential Building Plan Review- Building New IMPROVEMENT-AUTH CONST- NEW WELL 7 13 PPttStd deArenkg Contractor *CLAYTON HOMES,INC. (STATESVILLE),2026 NORTHSIDE DRIVE,STATESVILLE NC 28677 B:(704)239-3693 C:(704)873-2547F:704-872-1166 HC072@CLAYTONHOMES.COM Owner JAMES GILLILAND JR,904 TRACY GROVE RD,FLAT ROCK NC 28731 NAME TO APPEAR ON PERMIT *CLAYTON HOMES, INC. (STATESVILLE) SITE ADDRESS: 2330 BAYLEIGII DR,VALE NC 28168 PIN# 266903308092 NAME of SUBDIVISION: ELLENS WAY Loth 10 Section/Block PROPERTY SIZE: Square Feet Acres 1.23 DIRECTIONS: Right off of Old Shelby Rd onto Jacob Fork River Rd. Right onto Bayleigh Dr.8th lot on right,2nd lot after Dobbin Ct. PRIMARY CONTACT: Contractor SEWER TYPE: Septic Tank GALLONS PER DAY: 360 WATER SUPPLY: Private Well RIBE /AC/New Septic/New We11/360 GPD—New 56x28 with 6x6 decks front and rear, steps on side,3 bedroom modular home I no attached garage, no basement NATION 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? Yes Are there any easements or right-of-ways on this property? Yes Property Easements Description: powerline easement APPLICATION FOR: New Structure STRUCTURE TYPE: PRIMARY RESIDENCE FACILITY TYPE: Single Family Residence OTHER DESCRIPTION: DESCRIPTION OF EXISTING STRUCTURES ON SITE(IF ANY) DIM EXISTING STRUCTURE: NUMBER OF EXISTING BEDROOMS: #OF OCCUPANTS: 4 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 56x28 modular with decks a OF NEW BEDROOMS:: 3 BASEMENT? No BASEMENT FIXTURES? No PLUMBING REQUIRED?Yes Desired system types(Improvement Permit or Authorization to Construct): ACCEPTED: ALTERNATIVE: CONVENTIONAL: OTHER: YES INNOVATIVE: ANY: Other described: 25%reduction APPLICATION FOR WELL CONSTRUCTION PROPOSED WELL TYPE: Individual Well REPLACE WELL?: NO dmpplicaiwn 07/13/2022 15:14 Page 1 of3 F' •,,,,:., .( THIS IS NOT A PERMIT Case# RBPR-07-2022-41600 CATAWBA COUNTY HEALTH DEPARTMENT 4C PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES : Residential Building Plan Review- Building New IMPROVEMENT- AUTH CONST- NEW WELL Contractor *CLAYTON HOMES,INC. (STATESVILLE),2026 NORTHSIDE DRIVE,STATESVILLE NC 28677 B:(704)239-3693 C:(704)873-2547F:704-872-1166 HC072@CLAYTONFIOMES.COM Owner JAMES GILLILAND JR,904 TRACY GROVE RD,FLAT ROCK NC 28731 NAME TO APPEAR ON PERMIT *CLAYTON HOMES, INC. (STATESVILLE) SITE ADDRESS: 2330 BAYLEIGH DR,VALE NC 28168 PIN# 266903308092 NAME of SUBDIVISION: ELLENS WAY Lot 01 10 Section/Block PROPERTY SIZE: Square Feet Acres 1.23 DIRECTIONS: Right off of Old Shelby Rd onto Jacob Fork River Rd.Right onto Bayleigh Dr.8th lot on right,2nd lot after Dobbin Ct. PRIMARY CONTACT: Contractor SEWER TYPE: Septic Tank GALLONS PER DAY: 360 WATER SUPPLY: Private Well DESCRIBE WORK: IP/AC/New Septic/New Well/360 GPD—New 56x28, 3 bedroom modular home/no attached garage, no basement 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? Yes Are there any easements or right-of-ways on this property? Yes Property Easements Description: powerline easement APPLICATION FOR: New Structure STRUCTURE TYPE: T PRIMARY RESIDENCE _,_.___, FACILITY TYPE: Single Family Residence OTHER DESCRIPTION: DESCRIPTION OF EXISTING STRUCTURES ON SITE(IF ANY) DIM EXISTING STRUCTURE: NUMBER OF EXISTING BEDROOMS: S OF OCCUPANTS: 4 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 56x28 modular with decks #OF NEW BEDROOMS:: 3 BASEMENT? No BASEMENT FIXTURES? No PLUMBING REQUIRED?Yes Desired system types(Improvement Permit or Authorization to Construct): ACCEPTED: ALTERNATIVE: CONVENTIONAL: OTHER: YES INNOVATIVE: ANY: Other described: 25%reduction APPLICATION FOR WELL CONSTRUCTION PROPOSED WELL TYPE: Individual Well REPLACE WELL?: NO ehapplicalum 07/08R022 09'50 Page 1 of 3 I CATAWBACOUNTY Case# RBPR-07-2022-41600 Public Health Department Subdivision ELLENS WAY . ._ 41 Environmental Health Division PIN# 266903308092 PO Box 389, 100-A Southwest Blvd,Newton,NC 28658 NAME ON PERMIT: *CLAYTON HOMES,INC. (STATESVILLE) ( ),2026 NORTHSIDE DRIVE,STATESVILLE NC 28677 'CLAYTON HOMES, INC. (STA Site Address: 2330 BAYLEIGH DR,VALE NC 28168 Property Size: Square Feet Acres 1.23 Directions: Right off of Old Shelby Rd onto Jacob Fork River Rd. Right onto Bayleigh Dr.8th lot on right,2nd lot after Dobbin Ct. 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 I 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 the owner of the property or legal agent of the owner. Date: Signature o f Applicant or Agent If you need further information or assistance please call 828-465-8270 AREA1 FEENAME DATE FEE AMOUNT Authorization to Construct Fee(New/Expansion) 07/08/2022 $150.00 Fee Improvement Permit Fee 07/08/2022 $150.00 Well Permit& Inspection Fee 07/08/2022 $300.00 TOTAL FEES $600.00 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) ehapplicarion 07/08/2022 09-50 Page 2 of 3 Authentisign ID:BA83B6OC-144C.t2C1-B098-3401DC716589 acatawba county public health Application for Environmental Health Services — -- — THIS IS NOT A PERMIT Application is for: New Construction Existing Facii improvement Permit ( Authorization to Construct 0 Septic Repair/Malfunction 0 Septic Relocation ----- [ New Septic 0 Septic Expansion ❑ Existing System Inspection or Reconnection New Well 0 Replacement Well CI Weil Abandonment El Well Repair Property Address_ a 330 l'y l 1i. Dr 1/a'c- NC 24 i 4�' — Acres_ I,. `� Subdivision (i/r„I s ►s)tel _ — 1 D ,.f _ LotAt wing Directionslo Property �" ,c ir ` rL `\ t �`r,k� ` Or , ?( 1 �J\ -�1LL �,•�C,■l Jn�/l�Ll f �`Vt' I. f. �hk Q^ Describe wott �t 7 r� r T 1 APPlicaat Name Uc I f of gores 0/ ci4ki l/t'llt ,# Applicant Address 20L 6 .v,,,iLvd, 4-- Sfclr,v.71 ...t/c 2y6 z-5 Phone 70,/- V 71_ 2�54 7 1 Email A/`ts fJ jj..sQ,t�Cl J jG,J Owner Name jm„..,3 LGWre,KL C,4r-a I Jr 2- IhP�7 �10�-�1�. �0�"* Owner Address i 3111- & h:i r vale. AIL.- ti i Lk Phone ] Email Contractor Name G1e7+0.. yt,,-e_I rf t4it,,,.Ifc Contractor Address it Mr rVoftkt,d, Qf t f41-,1,,/f Nc 2f4 z, Phone `70'i 1-7 C 2-5'f i 1 Email n. use.. Name to Appear on Permit? Vpplicant //t. 6� c%i''�''l`„rs.« — ❑Owner ElContractorWho will be the Primary Contact? ❑Owner Applicant 0 Contractor Proposed New Construction-Residential Primary Residence New Residence(� 0 Addition to Residence #of New Bedrooms+# 3 +�of Occupants Project Description NC w - ,- Structure Dimensions,also specify imens ons o decks&porches 6,; � ±—ri„&fste,..1 ,�i f S - (Choose One) 0 Basement (S Crawl Space ❑ Slab If Basement,Will There Be Water Using Fixtures In Basement Retaining Wall>2' 0 Yes 0 No ❑Yes 0 No Accessory Dwelling #of New Bedrooms*t #of Occupants Structure Dimensions_ (Choose One) 0 Basement ❑Crawl Space ❑ Slab If Basement,Will There Be Water Using Fixtures In Basement Retaining Wall>2' ❑ Yes 0 No ❑Yes 0 No Accessory Structure(s)Describe Structure(s)Dimensions Plumbing ❑Yes ❑No Describe Plumbing Needed (Choose One) ❑Basement 0 Crawl Space 0 Slab If Basement,Will There Be Water Using Fixtures In Basement Retaining Wall>2' 0 Yes 0 No ❑Yes 0 No Multi-Family Residence #of Apartments #Bedrooms per Apartment' Structure Dimensions t_ Total#Bedrooms in Structure•t_ #of Occupants (Choose One) ❑Basement ❑Crawl Space 0 Slab If Basement,Will There Be Water Using Fixtures In Basement Retaining Wall>2' 0 Yes 0 No ❑Yes 0 No Well Construction/Abandonment/Repair Proposed Well Type ® Individual Well 0 Semi-Public Well Abandonment Type 0 Drilled 0 Bored El Community Well ❑ Dog 0 Unknown Well Repair Requested 0 Yes 0 No Describe / Will Certified Well Contractor Install Water Line or Electrical Line from Well Head to Pressure Tank?eYes ❑No Environmental Health Catawba County Government Center, 25 Government Drive I PO. Box 389, Newton, NC 28658 Phone:(828)465-8270 ( Fax: (828)465-8276 I EHAdmin@CatawbaCountyNC.gov Autnenusign m:IAe3a6OC-isse42C1-eosg-34010C7iesee • Existing Structures on Site Describe __/f f A Structure Dimensions #of Bedrooms* #of Occupants Basement 0 Yes 0 No Basement Plumbing 0 Yes ❑ No Existing Water Supply ❑Individual Well - - - -- 0 Shared Well-Number of Connections _ 0 Community Well 0 County/City/Township Water Line Is a public water supply available?** ❑ Yes ( No t•.1/a Commercial ❑Proposed New Construction ❑Existing/Change of Use ❑Repair Food Service Specify Type #Seats_ Dining Area(Sq.Ft) #Employees per Shift #of Shifts Church #of Seats Daycare❑Yes ❑No #of Children #of Employees per Shift #of Shifts Commercial Kitchen ❑Yes ❑No Residential Kitchen 0 Yes 0 No Daycare#of Children #of Employees per Shift #of Shifts Business/Other Specify Type _ Structure Dimensions Retail Floor Space _ _ #of Employees per Shift #of Shifts Other Information — Calculated Design Flow,Commercial t (This value will be determined by EH staff) The Applicant shall notify the local health department upon submittal of this application if any of the following apply to the property in question. If the answer to any question is"yes",applicant must attach supporting documentation. Cl Yes I]No Does the site contain any jurisdictional wetlands? Cl Yes jia No Does the site contain any existing wastewater systems? Y. El No Is any wastewater going to be generated on the site other than domestic sewage? \ i 'No is the site subject to approval by any other public agency? FYes 0 No Are there any easements or right of ways on thisproperty?yr Describe p�++�.' Gtrrltfj CciSihc-A t if applying for an Improvement Permit or Authorization to Construct,Please Indicate Desired System (systems can be ranked in order of your preference) Type(s): ❑Accepted 0 Alternative ❑Conventional ❑Innovative la Other _ZS cc zr A 0 Any *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 floor 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 EH Staff. **If No,a well permit must be issued with the Authorization to Construct. RETRIP TO THE PROPERTY AND/OR SYSTEM REDESIGN WILL INCUR AN ADDITIONAL CHARGE(SEE FEE SCHEDULEI Environmental Health soil/site evaluations require digging,angering,and/or probing into the ground.Property owner/applicant is responsible for marking all underground utilities,including but not limited to:underground power,cable,telephone,gas,water lines,and irrigation systems/sprinkler systems.Catawba County Environmental Health is not responsible for damage to unmarked utilities. 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 theN effect permit conditions or installation requirements. I 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 the owner of the p or,feral agent of the owner. w Signature of Owner or Legal Agent J + 4 s+1� 06/22/2022 e 220-WP�EDTDate Printed Name of Owner or Legal Agent James L. Gilliland, Jr. • • • Catawba County Environmental Health 0 •2314 11 425.55 UG I Boa `�- 10 e V74:: #2330 402.93 •2344 9 382.98 •2356 Parcel: 266903308092, 2330 BAYLEIGH DR 1 in=60ft VALE, 28168 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 2021 Catawba County NC 07/08/2022 Catawba County Environmental Health I I I I a � I I S I •2314 0 N 1� m I I 1 1 I 425,5 I I I I I 0 cri •2330 r.. 1 402,93 I I I I r2344 id I I I h„ 382.98 I I I I .2356 I • Parcel: 266903308092, 2330 BAYLEIGH DR 1in=60ft VALE, 28168 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 2021 Catawba County NC 07/08/2022 3059-1042 FILED Calavi to Cattily on Jan 10,2011 at 12:44:00 prn Excise Tax $18 00 (TP) Nsr.#00585 DONNA HOCKS SPENCER Itegtaler of Deeds BS 03059 Pg 1042-1043 Excise Tax $f Tax Lot No. Parcel Identifier No. Verified by County on the day of ,20 .By 0 YES)LINO DOES PROPERTY INCLUDE THE PRIMARY RESIDENCE OF GRANTOR? This is In accordance with NCOS:105-221.12 i 10S-117.2 Mail after recording to STEVEN M.CHEUVRONT,211 East Union Street,Morganton,NC 28655 This instrument was prepared by. STEVEN M.CHEUVRONT, 211 E Union Street,Morganton,NC 28655 Brief Description for the Index NORTH CAROLINA SPECIAL WARRANTY DEED THIS DEED made January 4,2011, by and between GRANTOR GRANTEE • BANK OF GRANITE JAM• 1 4.E GILLILAND JR Post Office Box 579 05�. Asir Crick lid Hickory,NC 28603 {I�K({ Y/la✓t, 4/L 2,7 91- Enter m approprols Mork for each party name.address,and,1 appnwla clwectm o�entb,/G.,cow /Son 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,fora 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 Bandy's Township,Catawba County,North Carolina and more particularly described as follows: BEING all of Lots Number 5,8,10,14,20,22 and 25 of"Ellen's Way Subdivision, Phase One"as shown on plat recorded in Plat Book 48,at Page 42,of the Catawba County Registry. Subject to the Declaration of Covenants,Conditions and Restrictions for Ellen's Way Phase One,"recorded in Book 2161 at Page 1013,Catawba County Registry. BACK REFERENCES: Book 2939,Page 1051; Book 2791,Page 1746;all of the Catawba County Registry. r 3059-1 043 1043 TO HAVE AND TO HOLD the aforesaid lot or parcel of land and al;privileges and appurtenances thereto belonging to the Grantee in fee simple. And the Grantor covenants with the Grantee,that Grantor has done nothing to Impair such title as Grantor received,and Grantor will warrant and defend the title against the lawful claims of all persons claiming by, under or through Grantor,except for the exceptions hereinafter stated. The warranties passing to the Grantee are limited solely to those matters arising from acts of the Grantor, its agents or representatives,occurring solely during the period of the Grantors ownership. Title to the property hereinabove described is subject to the following exceptions: Easements,rights of way,and restrictions of record,If any;and utility lines in existence under and over the subject property,if any. IN WITNESS WHEREOF,the Grantor has hereunto set his hand and seal,or if corporate,has caused this instrument to be signed In its corporate name by its duly authorized officers and its seal to be hereunto affixed by authority of its Board of Directors,the day and year first above written. BANK OF GRANITE (SEAL) Corporate me) > z By: O x (SEAL) Al5:5tw.4' V:Lt. President z c) ATTEST: (SEAL) VA Setxetary (Corporate Seal) (SEAL) 4 SEAL-STAMP NORTH CAROLINA,hitce County. x I. G Q can i/V1Q V Ne a,( , a Notary S• it Pu*D�C at ny and State aforesaid, certify that O,I A io 1�( I f r 0.r71 -tnVrCf 1�0.tsB r7 personally came before me �} W this day end acknowledged that h e/she Is A-ss,S-frrn'1' V u 4 of BANK OF GRANITE,a N , Carolina corporation,and that : ' s O rr� being authorized to do so, t� AU ` � helshe,as �iS'�Ct/rf'f y B L b executed the foregoing on behalf of the corporation. Witness my ''•,0. �'''p. "' + hand and official stamp or seal,this the /! Day of January, \.!q�e(,,0 CO 2011. 2011. rrrrrII My commission expires:or/-fit/ r 5 -o cvnvna V G{Je at Notary Public Page 1 of 1 Parcel Report - Catawba County NC Parcel Information: Owner Information: Parcel ID: 266903308092 Owner: GILLILAND JAMES LAWRENCE JR Parcel Address: 2330 BAYLEIGH DR Owner2: City: VALE, 28168 Address: 904 TRACY GROVE RD LRK(REID): 100733 Address2: Deed Book/Page: 3059/1042 City: FLAT ROCK Subdivision: ELLENS WAY State/Zip: NC 28731-9720 Lots/Block: 10/ School Information: Last Sale: Plat Book/Page: 48/42 School District: COUNTY Legal: LOT 10 ELLENS WAY PL 48-42 Elementary School: BANOAK Calculated Acreage: 1.230 Middle School: JACOBS FORK Tax Map: High School: FRED T FOARD Township: BANDYS School Map State Road #: TaxNalue Information: Tax Rates(pdf) Zoning Information: City Tax District: All in County Zoning District: COUNTY County Fire District: COOKSVILLE Zoningl: R-40 Building(s) Value: $0 Zoning2: Land Value: $9,900 Zoning3: Assessed Total Value: $9,900 Zoning Overlay: WP-O Year Built/Remodeled: / Small Area: PLATEAU Current Tax Bill Split Zoning Districts: / Zoning Agency Phone Numbers Miscellaneous: Firm Panel Date: 2007-09-05 Building Permit Address Search for this parcel. Firm Panel #: 3710266800J If available, Building Permits for this parcel. 2010 Census Block: 1000 Septic links are not permits. 2010 Census Tract: 011802 Septic Final Permits prior to 08/2018, contact Agricultural District: PROXIMITY Environmental Health. GC OcIAD 5epC, Building Details , 1/ WaterShed: WS-III Protected Area �ccr;�t �p . 00 Voter Precinct: P2/ Voting Map Parcel Report Data Descriptions NAA) We l\ 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 map/report product or the use thereof by any person or entity ©2022, Catawba County Government, North Carolina. All rights reserved. 7/8/2022