HomeMy WebLinkAboutEHPR-04-2023-44089.tif y14'A •� THIS IS NOT A PERMIT Case# EI-IPR-04-2023-44089
CATAWBA COUNTY III ALTI-I DEPARTMENT
PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES
!g sw Environmental Health Plan Review-Septic Malfunction
AUTH CONST- SEPTIC MALFUNCTION
Applicant TWO TREES SPORTS BAR&GRILL (SHANNON PORTER),6713 KIDVILLE RD,DENVER NC 28037
13:7044839034 C:7044218446 SPORTER123(rCI1ARTER.NET
NAME TO APPEAR ON PERMIT
Two Trees Sports Bar & Grill (Shannon Porter)
SITE ADDRESS: 5242 SLANTING BRIDGE RD,DENVER NC 28037 PIN # 460604600932
NAME of SUBDIVISION: Lotk Section/Block
PROPERTY SIZE: Square Feet 79,279.20 Acres 1.82
DIRECTIONS: Slanting Bridge Rd,on left past Blackwelder Rd
PRIMARY CONTACT: Owner SEWER TYPE: Septic Tank
GALLONS PER DAY: 1285 WATER SUPPLY: Private Well
DESCRIBE WORK: Failing septic system. Bar seats, 31x20 gal/seat=620 gpd, restaurant seats, 11x40 gal/seat=440 gpd, food
service employees, 9x 25 gal/employee=225 gpd. TOTAL 1285 gpd. Single use cups, plates, utensils only
cooking/baking dishware gets washed
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? No
Are there any easements or right-of-ways on this property? No
APPLICATION FOR: Existing Structure
STRUCTURE TYPE: **NO STRUCTURE SELECTED**
FACILITY TYPE: Business OTHER DESCRIPTION:
DESCRIPTION OF restaurant, bar
EXISTING STRUCTURES
ON SITE(IF ANY)
DIM EXISTING STRUCTURE:
NUMBER OF EXISTING BEDROOMS: #OF OCCUPANTS:
PROPOSED CONSTRUCTION
EMPLOYEES PER SHIFT: NUMBER OF SHIFTS: TOTAL EMPLOYEES: 9
SEATING CAPACITY: TOTAL FLOOR SPACE(SQ FT):
DAYCARE OCCUPANCY: KITCHEN: Yes
Desired system types(Improvement Permit or Authorization to Construct):
ACCEPTED: ALTERNATIVE: CONVENTIONAL:
OTHER: INNOVATIVE: ANY:
Other described:
t6appliLatma 04/24/2023 16:54 Page 1 of6
AWet CATAWBACOUNTY Case# EHPR-04-2023-44089
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Public Health Department Subdivision
d *� Y Environmental Health Division PIN# 460604600932
.. PO Box 389,100-A Southwest Blvd,Newton,NC 28658
/g. w
NAME ON PERMIT: TWO TREES SPORTS BAR&GRILL (SHANNON PORTER),6713 KIDVILLE RD,DENVER NC 28037
Two Trees Sports Bar&Grill (
Site Address: 5242 SLANTING BRIDGE RD,DENVER NC 28037
Property Size: Square Feet 79,279.20 Acres 1.82
Directions: Slanting Bridge Rd,on left past Blackwelder Rd
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 of Applicant or Agent
If you need further information or assistance please call 828-465-8270
AREAS
************************************************************************************************************
FEENAME DATE FEE AMOUNT
Authorization to Construct(Repair) Fee 04/19/2023 $900.00
TOTAL FEES $900.00
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)
ehapplicatan 04/24/2023 16:54 Page 2 of 6
catawba county
public health
Application for Environmental Health Services Viet)
THIS IS NOT A PERMIT
Application is for: ❑New Construction Existing Facility
❑ Improvement Permit ❑Authorization to Construct
❑New Septic .:l Septic Repair/Malfunction ❑Septic Relocation ❑ Septic Expansion
❑ Existing System Inspection or Reconnection
❑ New Well ❑ Replacement Well ❑ Well Abandonment gill Well Repair
Property Address S03 —51Qh}"I nq '�ri �r lSrll Pn vP('- e- c99 /Acres Subdivisio J J_ JJ_ - �� Lot#•
Driving Directions to Property Subdivision,
Ile .1-D) 5a n i,1i1 b ,'clr e e-d• @do't,les 0�1 > T
Describe work e t i L has 3 5 JC S c n 7rc' •h ) , ►1 e /Jeas 9 rec./
Applicant Name Gs�a �lt'�J� S 0"�� t r' -r ' rill
Applicant Address c, ), 5)du f i y wISrrr/c I Rd Ilt'n✓P( ' , 5(i 3
Phone '76M 4S,3- g631 J ) Email $' c)rI e r ).a--3 c.? t'J'ci r fr f' ,ije'f
Owner Name 5 A.in o� o,--f-e r
Owner Address 7 p M�
13 �'(: 0;,I10 K� ben l
J�� �r
Phone Di- . ' sq Email Sa ry► `6;%
Contractor Name
Contractor Address
Phone Email
Name to Appear on Permit? Owner ❑ Applicant ❑Contractor
Who will be the Primary Contact? Owner ❑ Applicant ❑Contractor
Proposed New Construction-Residential
Primary Residence ❑ New Residence El Addition to Residence #of New Bedrooms*t -_ N of Occupants
Project Description
Structure Dimensions,also specify dimensions of decks&porches
(Choose One) 0 Basement ❑Crawl Space ❑ Slab If Basement,Will There Be Water Using Fixtures In Basement 0 Yes ❑ No
Retaining Wall>2' 0 Yes 0 No
Accessory Dwelling #of New Bedrooms*t #of Occupants Structure Dimensions
(Choose One) ❑Basement ❑Crawl Space ❑ Slab If Basement,Will There Be Water Using Fixtures In Basement ❑Yes ❑ No
Retaining Wall>2' ❑ Yes ❑ No
Accessory Structure(s)Describe Structure(s)Dimensions
Plumbing 0 Yes ❑No Describe Plumbing Needed
(Choose One) ❑Basement ❑Crawl Space ❑ Slab If Basement,Will There Be Water Using Fixtures In Basement ❑Yes ❑ No
Retaining Wall>2' ❑ Yes ❑ No
Multi-Family Residence #of Apartments - #Bedrooms per Apartment*t Total#Bedrooms in Structure*t #of Occupants
Structure Dimensions
(Choose One) ❑Basement ❑Crawl Space ❑ Slab If Basement,Will There Be Water Using Fixtures In Basement ❑Yes ❑ No
Retaining Wall>2' ❑ Yes ❑ No
Well Construction/Abandonment/Repair
Proposed Well Type ❑ Individual Well ❑Semi-Public Well ❑Community Well
Abandonment Type El Drilled ❑ Bored ❑ Dug ❑ Unknown
Well Repair Requested ❑Yes ❑No Describe
Will Certified Well Contractor Install Water Line or Electrical Line from Well Head to Pressure Tank?❑ Yes ❑ No
Environmental Health
Catawba County Government Center, 25 Government Drive I PO. Box 389, Newton, NC 28658
Phone: (828)465-8270 I Fax: (828) 465-8276 I EHAdmin@CatawbaCountyNC.gov
Existing Structures on Site
Describe F,NO( 4 6""11+ Structure Dimensions
#of Bedrooms* #of Occupants
Basement ❑Yes ❑ No Basement Plumbing ❑ Yes ❑ No
Existing Water Supply __ ___
Individual Well ❑ Shared Well—Number of Connections ❑Community Well ❑County/City/Township Water Line
Is a public water supply available? ** ❑ Yes NI No
Commercial ❑Proposed New Construction ❑ Existing/Change of Use ,;Repair
Food Service Specify Type Bar 4 gefstatgart • Bar Seats IASIde • 9 (Zeit Utant Sc 1 --II
#Seats Dining Area(Sq. Ft.) 84r Seects otAsia6=Z2
#Employees per Shift #of Shifts a &CIo-�ees an dai 5hl j _, 1 employes OK i't bf SI^)
Church #of Seats Daycare ❑Yes ❑No #of Children #of Employees per Shift #of Shifts
Commercial Kitchen 0 Yes ❑No Residential Kitchen ❑Yes ❑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
11 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.
❑Yes IS No Does the site contain any jurisdictional wetlands?
la Yes 0 No Does the site contain any existing wastewater systems?
❑ Yes LR No Is any wastewater going to be generated on the site other than domestic sewage?
❑ Yes ®No Is the site subject to approval by any other public agency?
❑ Yes lB No Are 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 0 Alternative 0 Conventional 0 Innovative 0 Other__ iSt 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 SCHEDULE)
Environmental Health soil/site evaluations require digging,augering,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 they effect_permit conditions or installation requirements.
r 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 the owner.
/ 023
o�wner.
Signature of Owner or Legal Agent ,1Q,�}j N L J , s2 (�' Date di `
Printed Name of Owner or Legal Agent $na fn O Il /. ��O! t e/—
g• CATAWBA COUNTY Case# OP-8-10-9859
`. Public Health Department Subdivision
• e' `
Environmental Health Division
Q 71 E) PO Box 389,100-A Southwest Blvd,Newton,NC 28658 Lot#
PIN# 460604600932
Applicant/Owner TWIN OAKS BAR& GRILL
Site Address: 5242 SLANTING BRIDGE RD, DENVER,NC J(t,5Db a8 6 7►9
Property Size: SF ACRES
Directions:
Catawba County Health Department Operation Permit
IIIB - SYSTEM W/SINGLE EFFLUENT PUMP
System Type:
(In accordance with Table Va)
Description: 25%REDUCTION
Types V and VI systems expire in 5 years.
Owner must contact health department 6 months prior to exiration for permit renewal.
System Installation Comments:
PERMIT CONDITIONS:
1. All maintenance, monitoring, and performance requirements shall be in accordance with
15A NCAC 18.1900, Rule .1961
2. Operation & Maintenance Specifics:
Subsurface system operator required? Yes NoX.__
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
This system has been installed in compliance with applicable North Carolina General Statutes, Rules for Sewage
Treatment and Disposal, and All conditions of the Improvement Permit and Construction Authorization.
Ray's Septic 07/19/2010
SYSTEM INSTALLER INSTALLATION DATE
Susan Bumgarner 08/03/2010
AUTHORIZED STATE AGENT DATE OF OPERATION PERMIT ISSUANCE Form F
08/04/10 15:46
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. ,,, `. I a Case# WLS2008-007I9
'rift ",.1 Public Health Department ( ( ;
,\ „ ) Environmental Health Division Subdivision
\ \ �/ PC Box38S;100-A Southwest Blvd,Newton,NC 28658 Sect/BL/Ph/Lot#
'-,t�z� (828)465-8270 FAX(828)465-8276 'MD(&28)465-8200 PIN/ 460604600932
ApplicantlOwner TWIN OAKS BAR&GRILL I C�+
Site Address: 5242 SLANTING BRIDGE RD DENVER NC CO-�tI,`a
Property Size: SF 1.82 ACRES "
Directions: HWY 150 TO SLANTING BRIDG RD/RT 2.5 MILES ON LFT***1280 GPD
Improvement Permit
Permit Valid For: Five years ✓ No Expiration
Facility(Residential): Restaurant
House Mobile home Multi-Family Bedrooms 0 New? _ Addition?
Projected Daily Flow a8C g.p.d Water Supply Private Well? %/Public? Semi-Public?
Basement: Basement Plumbing: HotTub/Spa: Special Fixtures(explain):
Proposed Wastewater System: . `/o_RL(ur,Td' C!!J —---Type: .fft-b.cLi
Proposed Repair: -_
Permit Conditions: —_ —
Owner or Legal Representative Signature: Date:
Authorized State Agent: -___ ,+aGl�r 1/4.1/_1,: �, —___ Date: S a(, .v 8
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 Rules for Sewage Treubnent 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 for any given period of time.
Authorization to Construct Wastewater System (Required for Building Permit)
* See site plan and additional attachments( ).
Proposed Wastewater System: S°rlo riA f 71.u-'r. Type L,r, Wastewater Flow _ Se() _-g.p.d
New Repair ✓ Expansion : Soil LTAR:J • 35 g.p.d./ft2
Type of Facility: _tr`4 C d 11 ( 1 )
Basement: Basement Plumbing: HotTub/Spa: - Special Fixtures(explain):
rr,, Wastewater System Requirements
Tank Size: Septic Tank ��;.&,, i+ggal Pump Tank i500gaI Grease Trap e.)(.i&I-i+t, gal
Drainfield: Total Area: sq ft Total Length: �i-to _ ft Maximum Trench Depth AY- in
Trench Width . ft Minimum Soil Cover L„ _in Minimum Trench Seperation ft
Distribution: Distribution Box Serial Distribution Pressure Manifold V LPP—_ Other—
Additional Specifications: _
Authorized State Agent: 4JflJ)Vk j.4(., "'`" Date: g Le 08
Permit Expiration Date: luto/20I'
I have read and accept the specifications and all conditions of this permit as indicated
POwner or Legal Representative Signature: -26-e-eL V Date: F- G al
Form B
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r!. -.'1 1 2 Public Health Department
Case# W LS2008-00719
/• ) Environmental Health Division Subdivision
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/ PQ Box 389. 100-A Southwest 13Ivd,Newton.NC 28658 Seci/BUPIt/Loi#
\-::%. i (828)465-8270 FAX(828)465-8276 TDD(828)465-8200 PIN# 460604600932
Applicant/Owner TWIN OAKS BAR &GRILL
Site Address: 5242 SLANTING BRIDGE RD DENVER NC
Property Size: SF 1.82 ACRES
Directions: HWY 150 TO SLANTING BRIDG RD/RT 2.5 MILES ON LFT-Eampp
® Improvement Permit El Authorization To Construct 0 Well Permit
SITE PLAN
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Scale
System components represent approximate contours only. The contractor must flag the system prior to beginning the
installation to ensure that proper grade is maintained. Do not install system under wet conditions. This permit is subject of
revocation if the site plan or site conditions are altered.
___,.__(1\6 IA.
Authorized Sta a Agent Date Form C
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\�� CATAWBA COUNTY HEALTH DEPARTMENT f O54ed
Telephone (828)465-8270 TDD (828)465-8200 WIC #(M$-D432 Y9
Improvement Permit AC Repair Permit. Operation Permit, System Type Well Permit. Replacement Well K
Owner/Agent 7-465Tir L/a/3 Phone
Address .353/ Re,ci &-z 'Subdivision
Joierr//is /r —J Section/Block/Phase Lot// _
Lot Size /.$a it Directions /G S ``) /SO � ,5%0E-r✓ /:?,-j /:?,-f�� �f 41/S'4/
Clu ow o reAf --7---
_Property Address Sot c2 3/ ' ,(}r c✓ As/ P
Facility. House Mobile Home Business Multi-family Other: Pin Number '4/CO< -D//6Q- Orj.Z
Other ,(f/-t:4,' CG4 8 C Zoning Approval#
#Bedrooms If Seats #Employees Application Rate GPD Flow k
Hot Tub or Spa yes/no Special Fixtures Basement yes/no 100% Repair Area yes/no
Basement Plumbing yes/no Water Supply' Private Well Public Semi-Public
*************************************************************************** ********************************************
Type of System: Trench Bed Pump Pump/Panel Panel LPP Other
Septic Tank Size Pump Tank Size Nitrification Field: Total Square Feet Depth of Stone
Bed Size Trench Width Total Length of All Trenches Number of Trenches
Trench Length / / I I / Feet on Center Maximum Trench Depth Distance of Nearest Well
*DO NOT INSTALL SEPTIC WHEN WET* *WE L RECORD REQUIRED AT COMPLETION*
************************************************************************** *************** **************************
Topo % Slope c2k) 14,
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Texture f I0 -t xivv. $
Structure
Clay Min. �wt 5 ?ire.-Chi
Soil Wetness . -1,_�Z L SU'( Lr t
Soil Depth • �� �j1 r
Restric Hoz it " �eP 3 ` a `5
Available space yes/no
Overall Class S PS U `-__— OP)
Comments 3 1 / 1>-`\•` n
il
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sePSTc)
— Ax
11—n-
2l
Filter Required sly /5'J V
Riser required when
tank is more than 6
inches deep.
**NO GUARANTEE OR WARRANTY IS IMPLIED OR GIVEN AS TO THE PERFORMANCE OR LENGTH OF TIME THIS SYSTEM
WILL FUNCTION**
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:ILA:'' An Authorization to Construct is valid for(5) five years from date issued and is not transferable. Well Permit valid for 5 years
provided site conditions do not change. Well location,installation,and protection must meet state and local regulations, and must be
inspected and approved by a representative of the Catawba County Health Department before any portion of the installation is put into use.
The siting of the well by the Health Department staff is to provide protection from know ssible sources of contamination. No volume of
water is guaranteed at ite b the Health Department.
Permit Dte yy ' ENS
(Owner/ ge (9/L,,e Septic T Ins t ried By
L / 11 Installed ByDate
Approval Date/1- /- ram' Well Grout Approval D to//- j.�,,5" Well Head
pp 1� 5 Date Sample Co Collected
Date of Results Results EHS
White-Office Yellow-Owner/Agent Pink-Building Inspection Autho ' ion to Co ct
Catawba County Environmental Health
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Parcel: 460604600932, 5242 SLANTING 1 in=100ft
BRIDGE RD DENVER, 28037
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 2023 Catawba County NC
04/12/2023
Parcel Report - Catawba County NC
Parcel Information: Owner Information:
Parcel ID: 460604600932 Owner: SPORTERS AMUSEMENT LLC
Parcel Address: 5242 SLANTING BRIDGE RD Owner2:
City: DENVER, 28037 Address: 6713 KIDVILLE RD
LRK(REID): 17863 Address2:
Deed Book/Page: 3642/1794 City: DENVER
Subdivision: State/Zip: NC 28037-6444
Lots/Block: /
Last Valid Sale: $109,000 on 1995-02-01 School Information:
School District: COUNTY
Plat Book/Page: Elementary School: SHERRILLS FORD
Legal: Middle School: MILL CREEK
Calculated Acreage: 1.820
Tax Map: 017 X 03006A High School: BANDYS
Township: MOUNTAIN CREEK School Map
State Road #: 1844
TaxNalue Information: Tax Rates Zoning Information:
City Tax District: All in County Zoning District: COUNTY
County Fire District: SHERRILLS FORD Zoningl: HC
Building(s) Value: $192,500 Zoning2:
Land Value: $84,800 Zoning3:
Assessed Total Value: $277,300 Zoning Overlay: CRC-O,WP-O
Year Built/Remodeled: 1961/ Small Area: SHERRILLS FORD
Tax Revaluation 2023: Info, COMPER Split Zoning Districts: /
Online Appeals Zoning Agency Phone Numbers
Valid Sales (COMPER) for this parcel
Contact Tax Dept. at 828-282-2009 ¶h
Current Tax Bill $� 1,
)5Vto> 13Z0/0 I
Miscellaneous: Firm Panel Date: 2007-09-05 ZZ
Building Permit Address Search for this parcel. Firm Panel #: 3710460600J 9
If available, Building Permits for this parcel. Septic 2010 Census Block: 4042 7 2S
links are not permits. 2010 Census Tract: 011504
Septic Final Permits prior to 08/2018, contact Agricultural District:
Environmental Health.
Building Details 5111^1Q 1156 LAP), 1 k 5, u4en5,IS
WaterShed: WS-IV Critical Area
OM/ Cpc`4001 duhWarc, gef5 vgitsiled
Voter Precinct: P41/Voting Map J J
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
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CATAWBA COUNTY
37 111*/, 100A SOUTHWEST BLVD
NEWTON,NORTH CAROLINA 28658 RECEIPT
) .5, PHONE:828.465.8399
Monday,April 24,2023
8 4 2 sM www.catawbacountync.gov
PAYOR: Two Trees Sports Bar&Grill
Two Trees Sports Bar&Grill(Porter,Shannon)
PAYMENTS
TRANSACTION NUMBER: TRC-62604484-24-04-2023
PAYMENT DATE: 04/24/2023
PAYMENT TYPE: Credit Card
304263333
INVOICE NUMBER ACCOUNT FEE NAME FEE AMOUNT
04-23-421647 110-580200-663000 Authorization to Construct(Repair) $900.00
Fee
TOTAL PAYMENTS: S900.00
EHPR-04-2023-44089
CASE TYPE: Environmental Health Plan Review WORK CLASS: Septic Malfunction
SITE ADDRESS: 5242 SLANTING BRIDGE RD,DENVER NC 28037
Applicant TWO TREES SPORTS BAR&GRILL,6713 KIDVILLE RD,DENVER NC 28037
B:7044839034C:7044218446 SPORTER123@CHARTER.NET
**NO PEOPLESOFT ACCOUNT ASSIGNED**
receipt 04/24/2023 16:52 Page 1 of I