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BA • THIS IS NOT A PERMIT Case# RBPR-02-2023-43558
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CATAWBA COUNTY HEALTH DEPARTMENT
PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES
18. 2 sM Residential Building Plan Review-Accessory Structure
EXS SYSTEM
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Contractor SAME AS OWNER,,
OTHER:0000000000
Owner BETH&JONATHAN YOUNG,2056 EVERGREEN DR,NEWTON NC 28658
NAME TO APPEAR ON PERMIT
Beth & Jonathan Young
SITE ADDRESS: 2056 EVERGREEN DR,NEWTON NC 28658 PIN# 363918428275
SOUTH LAKES DEV PHASE 1
NAME of SUBDIVISION:
Lot# 1 Section/Block B
PROPERTY SIZE: Square Feet Acres 0.51
DIRECTIONS: Hwy 10,Right McKay DR, Right on Evergreen Dr,1st house on Left
PRIMARY CONTACT: Owner SEWER TYPE: Septic Tank
GALLON 360 WATER SUPPLY: Public Water
CRIBS WOR 8/1/23 REVISED LEAN TO 15 X 20
PREVIOUS DESCRIPTION: 12x24 wood frame accessory structure&20x20 lien to**Newton Zoning attached
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? Yes
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? No
APPLICATION FOR: Existing Structure
STRUCTURE TYPE: ACCESSORY STRUCTURE
FACILITY TYPE: Accessory Structure OTHER DESCRIPTION:
DESCRIPTION OF home
EXISTING STRUCTURES
ON SITE(IF ANY)
DIM EXISTING STRUCTURE: 45x44
NUMBER OF EXISTING BEDROOMS: #OF OCCUPANTS: 2
PROPOSED CONSTRUCTION
STRUCTURE DIM) 12x24 LEAN TO 15 X 20
BASEMENT? No BASEMENT FIXTURES? No PLUMBING REQUIRED?
Desired system types(Improvement Permit or Authorization to Construct):
ACCEPTED: ALTERNATIVE: CONVENTIONAL:
OTHER: INNOVATIVE: ANY:
Other described:
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��J ripi CATAWBA COUNTY Case w RBPR-02 2023 43558
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i Public Health Deparhnent
Subdivision SOUTH LAKES DEV PHASE 1
it_ i Fimvironmcnta!Health Division PINN
363918428275
Po Box 389,100-A Southwest Blvd,Newton,NC 28658
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NAME ON PERMIT: (BETH&JONATHAN YOUNG),2056 EVERGREEN DR,NEWTON NC 28658
( Beth&Jonathan Young)
sn.Address: 2056 EVERGREEN DR,NEWTON NC 28658
Property Size: Square Feet Acres 0.51
Directions: Hwy 10,Right McKay DR,Right on Evergreen Dr, 1st house on Left
Completed applications ere valid fora period of 2 years.Improvement Permits are v&ki;with complete site plan•B0 months(5 years);with complete plat
eftfwut eyes-bon. An Authorization to Construct wit remain valid as long as the Improvement Permit Is valid.An Authorization to Construct Issued for
septic repair is vile ter 60 months(5 years).Permits may be revoked if the information on this application/site plan changes or N the Intended use for the
proposed tadity changes.Permits may be revoked It site conditions are altered such that they effect permit conditions or Installation requirements
I have reed this application and certify that the information provided herein Is true,complete and correct. Authorized county and state officials ere
grained right or entry to conduct necessary Inspections to determine compliance with applicable Taws and ivies. I understand that I am solely
responsible
�« proper identification and labeling of an property lines end corners and making the ski ssible so that�a co lets site evaluation
can be The undersigned is the owner of the property or legal agent of the owner.
DateL Q
"/2 3 Signature ofApplicant or Agent_ L_
If you need further information or assistance please call 828-46565-8� —
AREA2
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Existing Tank Check Fee FEEMISH
02/28/2023 S80.00
TOTAL FEES '
Sa0.00
FEES ARE NON-REFUIYDA LE
ONCE A SITE VISIT IS MADE OR
WORK ON A PLAN REVIEW HAS COMMENCED
SYSTEM REDESIGN ANDIOR RETRIP WILL INCUR AN ADDITIONAL CHARGE
(SEE FEE SCHEDULE)
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