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Home My WebLink AboutEHPR-04-2023-44150.TIF F'i� THIS IS NOT A PERMIT Case# EHPR-04-2023-44150 G d '' r CATAWBA COUNTY HEALTH DEPARTMENT 'l PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES Ig sM Environmental Health Plan Review-Septic Malfunction AUTH CONST- REPAIR Pi Ili IV RetA.24 Owner SARAH FRYE,2285 COLEY FISH POND RD,NEWTON NC 28658 C:828-464-9030 NAME TO APPEAR ON PERMIT . ... .... .. .... .... .. Sarah Frye SITE ADDRESS: 2285 COLEY FISH POND RD,NEWTON NC 28658 PIN# 365910350535 NAME of SUBDIVISION: Lot# Section/Block PROPERTY SIZE: Square Feet 98,445.60 Acres 2.26 DIRECTIONS: Smyre Farm Rd,name changes to Bethany Ch Rd,left onto Coley Fish Pond Rd,property on the left PRIMARY CONTACT: Owner SEWER TYPE: Septic Tank • • - R D. • 360 WATER SUPPLY: Private Well DESCRIBE WORK: 7/11/23 REVISED TO ADD DRAINFIELD. PREVIOUS DESCRIPTION:Tank only.Tank has caved in. 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: PRIMARY RESIDENCE FACILITY TYPE: House OTHER DESCRIPTION: DESCRIPTION OF 1 home EXISTING STRUCTURES ON SITE(IF ANY) DIM EXISTING STRUCTURE: 70x43 NUMBER OF EXISTING BEDROOMS: 3 #OF OCCUPANTS: 1 PROPOSED CONSTRUCTION BASEMENT? No BASEMENT FIXTURES? No PLUMBING REQUIRED? EMPLOYEES PER SHIFT: NUMBER OF SHIFTS: TOTAL EMPLOYEES: SEATING CAPACITY: TOTAL FLOOR SPACE(SQ FT): Desired system types(Improvement Permit or Authorization to Construct): ACCEPTED: ALTERNATIVE: CONVENTIONAL: OTHER: INNOVATIVE: ANY: YES Other described: • ehapplication 07/11/2023 15:45 Page I of 3 may„• CATAWBA COUNTY Case# EHPR-04-2023-44150 ,y Public Health Department Subdivision (...._ e I Environmental Health PIN# 365910350535 PO Box 389,100-A SouthwestDivision Blvd,Newton,NC 28658 su NAME ON PERMIT: (SARAH FRYE),2285 COLEY FISH POND RD,NEWTON NC 28658 (Sarah Frye) Site Address: 2285 COLEY FISH POND RD,NEWTON NC 28658 Property Size: Square Feet 98,445.60 Acres 2.26 Directions: Smyre Farm Rd,name changes to Bethany Ch Rd,left onto Coley Fish Pond Rd,property on the left 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. /� Datel"l`'(3 Signature of Applicant or Agent Qd el/ ' ; ' If you need further information or assistance please call 828-465-8270 AREA4 ............................................................................................................ FEENAME ` DATE >FEE AMOUNT Authorization to Construct(Repair)Fee 04/25/2023 $150.00 Authorization to Construct(Repair)Fee 07/11/2023 $150.00 TOTAL FEES $300 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) ehapplication 07/11/2023 15:45 Page 2 of 3 ""A • CATAWBA COUNTY E-4 1111�1, 100A SOUTHWEST BLVD NEWTON,NORTH CAROLINA 28658 _ RECEIPT . V PHONE:828.465.8399 Tuesday,July 11,2023 I8 42 sM www.catawbacountync.gov PAYOR: Frye,Sarah PAYMENTS TRANSACTION NUMBER: TRC-683 1 8969-1 1-07-2023 PAYMENT DATE: 07/11/2023 PAYMENT TYPE: Check 2099 NCDL 2138944 DOB 10/04/1945 EXP 10/4/25 INVOICE NUMBER ACCOUNT FEE NAME FEE AMOUNT 07-23-425283 110-580200-663000 Authorization to Construct(Repair) $150.00 Fee TOTAL PAYMENTS: $150.00 EHPR-04-2023-44150 CASE TYPE: Environmental Health Plan Review WORK CLASS: Septic Malfunction SITE ADDRESS: 2285 COLEY FISH POND RD,NEWTON NC 28658 Owner SARAH FRYE,2285 COLEY FISH POND RD,NEWTON NC 28658 C:828-464-9030 **NO PEOPLESOFT ACCOUNT ASSIGNED** receipt 07/11/2023 15:44 Page 1 of 1