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RBPR-04-2023-44176
R6PR-or )c).3-qthict Ltti1ISp , Rcl C c n v sTATF y a ��`� „,.•,,, ti%s ROY COOPER•Governor . - z .a NC DEPARTMENT OF KODY H. KINSLEY•Secretary o y = HEALTH AND HELEN WOLSTENHOLME•Interim Deputy Secretary for Health HUMAN SERVICES .,.._,e. ,bf MARK T.BENTON•Assistant Secretary for Public Health Division of Public Health COMMON FORM FOR AUTHORIZED ON-SITE WASTEWATER EVALUATOR PERMIT OPTION FOR NON-ENGINEERED SYSTEMS See instructions for Use in Appendix A Except for"Date received",this Section to be completed by the AOWE in accordance with G.S.130A-336.2 l LHD USE ONLY: Initial submittal of this NOI received: `•t ''L —1 by 1 Dote Initials PART 1:Notice of Intent to Construct(NOI)-Please check all that apply ❑■ Single System or ❑ Multiple Systems AND ®New ❑Expansion ❑Relocation of all or part of the Existing System ❑Relocation of Repair Area ❑ Repair—LHD Permit Number ❑ Repair—EOP/LSS COVID 19/AOWE Permit Number 1. Facility Owner's name: (Owner,Company Name, Utility, Partnership, Individual,etc.): Century Complete Mailing address: 9325 Center Lake Dr., Suite 160 City: Charlotte State: NC Zip: 28216 Telephone number: 704-488-1100 E-mail Address: katie.dyess@centurycommunities.com 2. Authorized On-Site Wastewater Evaluator(AOWE) name: Larry Thompson LSS License number: 1208 AOWE Certification number:10016E Mailing address: PO Box 541 City: Midland State: NC Zip: 28107 Telephone number: 704-301-4881 E-mail Address: larry@thompsonenv.com 3. Licensed Geologist(LG)(if applicable) name: N/A License Number: Mailing address: City: State: Zip: Telephone number: E-mail Address: 4. Proof of Errors and Omissions or other appropriate liability insurance for the following persons is attached that includes the name of the insurer, name of the insured and the effective dates of coverage: ❑■ AOWE ❑ LG 5. Property location(physical address,tax parcel identification number or subdivision lot, block number of the property to be permitted): 4496 Springs Road, Conover, NC 28613 (Parcel Number: 373411752526) County Name: Catawba RECEIVED NC DEPARTMENT OF HEALTH AND HUMAN SERVICES • DIVISION OF PUBLIC HEALTH A 0 0 23 LOCATION:5605 Six Forks Road, Raleigh,NC 27609 - MAILING ADDRESS:1642 Mail Service Center, Raleigh, NC 27699-1642 www.ncdhhs.gov • TEL:919-707-5874 • FAx:919-845-3972 AN EQUAL OPPORTUNITY/AFFIRMATIVE ACTION EMPLOYER Environmental Health AOWE Common Form LHD Reference: 6. Type of facility: ❑■ Place of residence No. Bedrooms: 4 No.Occupants:8 ❑ Place of business Basis for flow calculation: ❑ Place of public assembly Basis for flow calculation: 7. Factors that would affect the wastewater load: Proposal is for domestic wastewater strength only. 8. Type and location of proposed wastewater system: Pump-to Accepted System located behind the home. System classification Type IIIb. 9. Design wastewater flow: 480 gpd Design wastewater strength: ['domestic ❑high strength ❑industrial process(For high strength and industrial process wastewater,a Professional Engineer licensed in accordance with G.S.89C shall design the on-site wastewater system.) 10. A plat as defined in G.S. 130A-334(7a)is attached: ❑Yes ❑] No A site plan as defined in G.S.130A-334(13a)is attached: ❑■ Yes ❑No 11. Location of proposed or existing wells(drinking water, irrigation,geothermal,groundwater monitoring, sampling,etc.)and any potable and non-potable water conveyance lines is indicated on attached plans and complies with 15A NCAC 18A.1950: ❑■ Yes ❑ No This is a saprolite system. ❑Yes ❑■ No 12. Evaluation(s)of soil conditions and site features in accordance with G.S. 130A-335(al)signed and sealed by a LSS is attached: ['Yes ❑ No 13. Evaluation of geologic and hydrogeologic conditions signed and sealed by a LG is attached ❑Yes ❑■ NA 14. Proposed landscape,site,drainage,or soil modifications are attached: ❑Yes ■❑NA Attestation by AOWE pursuant to G.S.130A-336.2 Larry Thompson hereby attest that the information required to be included with Authorized On-Site Wastewater Evaluator(Print Name) this Notice of Intent to Construct is accurate and complete to the best of my knowledge and that the proposed system shall meet applicable federal,State,and local laws, regulations, rules and ordinances,and that the proposed system does not require a Professional Engineer,licensed in accordance with G.S.89C,and in accordance with 15A NCAC 18A.1938 activities determined to be engineering as determined by the North Carolina Board of Examiners for E s a - urveyors. ;= 04-17-23 Signature of • horijp - . fte Wastewater oluator Dote �wner self-submittal of NO!: hereby submit this NOl prepared by Print Name of Owner Print Name of Licensed PE pursuant to G.S.130A-336.1. Signature of Owner Date DNNS/ENS/OSWP—AOWE COMMON FORM Updated April 2022 Page 2 of 6 catawba county public health OldI! Application for Environmental Health Services ����'� r/ THIS IS NOT A PERMIT ED w Application is for: El New Construction ❑Existing Facility Improvement Permit [)"Authorization to Construct ❑x New Septic ❑ Septic Repair/Malfunction ❑ Septic Relocation ❑Septic Expansion APR 2 1 2Q23 ❑ Existing System Inspection or Reconnection El New Well ❑ Replacement Well ❑Well Abandonment LI Well Repair Property Address 4496 Springs Road, Conover, NC 28613 Environmental naith Acres 0.5 ac Subdivision Spring Farms Lot# 10 Driving Directions to Property From Newton, take Main Avenue NE, remain on Highland Avenue NE, turn left onto 16th Street NE, which turns into Springs Road. Lot is located on the left just before Hall Street. Describe work Applicant Name Larry Thompson Applicant Address PO Box 541, Midland, NC 28107 Phone 704-301-4881 Email larry a(�,thompsonenv.com Owner Name Century Complete Owner Address 9325 Center Lake Dr., Suite 160, Charlotte, NC 28216 Phone 704-488-1100 Email katie.dyess@centurycommunities.com Contractor Name Contractor Address Phone Email Name to Appear on Permit? ❑x Owner ❑Applicant ❑Contractor Who will be the Primary Contact? ❑x Owner ❑Applicant ❑Contractor Proposed New Construction- Residential Primary Residence x❑ New Residence ❑ Addition to Residence #of New Bedrooms*t 4 #of Occupants 8 Project Description Constructing new 4-bedroom single-family residence Structure Dimensions,also specify dimensions of decks&porches 38 ft x 32 ft _ (Choose One) ❑ Basement 0 Crawl Space ❑x Slab If Basement,Will There Be Water Using Fixtures In Basement ❑Yes ❑ No Retaining Wall>2' ❑ Yes ® No Accessory Dwelling #of New Bedrooms*i _ _ #of Occupants (Choose One) ❑ Basement E Crawl Space E 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 ❑ Yes ❑No Describe Plumbing Needed__ (Choose One) 0 Basement 0 Crawl Space ❑ Slab If Basement,Will There Be Water Using Fixtures In Basement 0 Yes ❑ No Retaining Wall>2' ❑ Yes ❑ No Multi-Family Residence # of Apartments #Bedrooms per Apartment*t Total# Bedrooms in Structure*f #of Occupants Structure Dimensions (Choose One) 0 Basement 0 Crawl Space ❑ Slab if Basement,Will'l here Be Water Using Fixtures In Basement ❑ Yes ❑ No Retaining Wall>2' ❑ Yes ❑ No Well Construction/Abandonment/Repair Proposed Well Type 0 Individual Well 0 Semi-Public Well ❑ Community Well Abandonment Type ❑ Drilled ❑ Bored ❑ Dug ❑ 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? ❑ Ycs ❑ 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 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 ❑x County/City/Township Water Line Is a public water supply available?** x❑ Yes ❑No 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 ❑ 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 Calculated Design Flow,Commercial j (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 ®No Does the site contain any jurisdictional wetlands? ❑Yes 0 No Does the site contain any existing wastewater systems? ❑Yes ®No Is any wastewater going to be generated on the site other than domestic sewage? 0 Yes ®No Is the site subject to approval by any other public agency? ❑ Yes 0 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) I l Accepted ❑ Alternative ❑ Conventional ❑ Innovative 0 Other_ 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. ** IfNo,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 the effect ermit conditions or installation re uirements. 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 he performed. The undersigned is the owner of the property or l ' ent '` he owner. Signature of Owner or Legal Agent Date 04-17-23 Printed Name of Owner or Legal •gent LarryThom Son STATE o �0, ,.,,,, do ROY COOPER •Governor A 4"y NC DEPARTMENT OF KODY H. KINSLEY•Secretary ^'; 1:-: iiI5kW ' Es ATH AND HELEN WOLSTENHOLME• Interim Deputy Secretary for Health .ii , ,' ,_ .,w":,,,-( MARK T. BENTON•Assistant Secretary for Public Health Division of Public Health COMMON FORM FOR AUTHORIZED ON-SITE WASTEWATER EVALUATOR PERMIT OPTION FOR NON-ENGINEERED SYSTEMS See Instructions for Use in Appendix A Except for"Date received",this Section to be completed by the AOWE in accordance with G.S.130A-336.2 LHD USE ONLY: Initial submittal of this NOI received: ''1_11— Zy by 1`r Date Initials PART 1: Notice of Intent to Construct(NOT)-Please check all that apply •Single System or ❑ Multiple Systems AND ❑New ❑ Expansion ❑ Relocation of all or part of the Existing System ❑ Relocation of Repair Area ❑ Repair—LHD Permit Number ❑■ Repair—EOP/LSS COVID 19/AOWE Permit Number 1. Facility Owner's name:(Owner,Company Name, Utility, Partnership, Individual,etc.): Century Complete Mailing address: 9325 Center Lake Dr., Suite 160 City: Charlotte State: NC Zip: 28216 Telephone number: 704-488-1100 E-mail Address: katie.dyess@centurycommunities.com 2. Authorized On-Site Wastewater Evaluator(AOWE)name: Larry Thompson LSS License number: 1208 AOWE Certification number: 10016E Mailing address: PO Box 541 City: Midland State: NC Zip: 28107 Telephone number: 704-301-4881 E-mail Address: Tarry@thompsonenv.com 3. Licensed Geologist(LG)(if applicable)name: NIA License Number: Mailing address: City: State: Zip: Telephone number: E-mail Address: 4. Proof of Errors and Omissions or other appropriate liability insurance for the following persons is attached that includes the name of the insurer,name of the insured and the effective dates of coverage: 0 AOWE ❑ LG 5. Property location(physical address,tax parcel identification number or subdivision lot,block number of the property to be permitted): 4496 Springs Road, Conover, NC 28613 (Parcel Number: 373411752526) County Name: Catawba NC DEPARTMENT OF HEALTH AND HUMAN SERVICES • DIVISION OF PUBLIC HEALTH LOCATION:5605 Six Forks Road,Raleigh, NC 27609 MAILING ADDRESS:1642 Mail Service Center,Raleigh,NC 27699-1642 www.ncdhhs.gov • TEL:919-707-5874 • FAx:919-845-3972 AN EQUAL OPPORTUNITY I AFFIRMATIVE ACTION EMPLOYER AOWE Common Form LHD Reference: 6. Type of facility: ❑■ Place of residence No. Bedrooms: 4 No.Occupants:8 ❑ Place of business Basis for flow calculation: ❑ Place of public assembly Basis for flow calculation: 7. Factors that would affect the wastewater load: Proposal is for domestic wastewater strength only. 8. Type and location of proposed wastewater system: Pump-to Accepted System located behind the home. System classification Type Illb. 9. Design wastewater flow: 480 gpd Design wastewater strength: ❑■ domestic ❑high strength ❑industrial process(For high strength and industrial process wastewater,a Professional Engineer licensed in accordance with G.S.89C shall design the on-site wastewater system.) 10. A plat as defined in G.S. 130A-334(7a)is attached: ❑Yes ❑� No A site plan as defined in G.S. 130A-334(13a)is attached: ❑■ Yes ❑ No 11. Location of proposed or existing wells(drinking water, irrigation,geothermal,groundwater monitoring, sampling,etc.)and any potable and non-potable water conveyance lines is indicated on attached plans and complies with 15A NCAC 18A.1950: ❑� Yes ❑ No This is a saprolite system. ❑Yes ❑■ No 12. Evaluation(s)of soil conditions and site features in accordance with G.S. 130A-335(al)signed and sealed by a LSS is attached: ❑■ Yes ❑ No 13. Evaluation of geologic and hydrogeologic conditions signed and sealed by a LG is attached ❑Yes ❑■ NA 14. Proposed landscape,site,drainage, or soil modifications are attached: ❑Yes ❑� NA Attestation by AOWE pursuant to G.S. 130A-336.2 Larry Thompson hereby attest that the information required to be included with Authorized On-Site Wastewater Evaluator(Print Name) this Notice of Intent to Construct is accurate and complete to the best of my knowledge and that the proposed system shall meet applicable federal,State,and local laws, regulations, rules and ordinances,and that the proposed system does not require a Professional Engineer, licensed in accordance with G.S.89C,and in accordance with 15A NCAC 18A.1938 a activities determined to be engineering as determined by the North Carolina Board of Examiners for E •ri rs ' ' urveyors. ' y 04-17-23 Signature of A horiz�d. e4.71te Wastewater oluator Date r. 1. wrier self-submittal of NO!: I, hereby submit this NOI prepared by Print Name of Owner Print Name of Licensed PE pursuant to G.S.130A-336.1. Signature of Owner Date DHHS/EHS/OSWP—AOWE COMMON FORM Updated April 2022 Page 2 of 6 AOWE Common Form LHD Reference: NOTES: LIABILITY: The Department,the Department's authorized agents,or local health departments shall have no liability for wastewater systems designed,constructed,and installed pursuant to an AOWE Permit Option[G,S.130A-336.2(f)] RIGHT OF ENTRY: The submittal of this Notice of Intent to Construct grants right of entry to the Local Health Department and the State to the referenced property. ISSUANCE OF BUILDING PERMIT: Once the LHD deems that the Notice of Intent to Construct is complete via signature in the section below,the owner may apply to the local permitting agency for a permit for electrical,plumbing,heating,air conditioning or other construction,location,or relocation activity under any provision of general or special law pursuant to G.S.130A-338. DHHS/EHS/OSWP—AOWE COMMON FORM Updated April2022 Page 3 of 6 AOWE Common Form LHD Reference: This section for Local Health Department use only. PART 2: LHD Completeness Review of the Notice of Intent to Construct "(c) Completeness Review for Notice of Intent to Construct.-The local health department shall determine whether the notice of intent to construct required pursuant to subsection(b)of this section is complete within five business days after receiving the notice of intent to construct.A determination of completeness means that the notice of intent to construct includes all of the required components.If the local health department determines that the notice of intent to construct is incomplete,the local health department shall notify the owner and list the information needed to complete the notice.The owner may then submit additional information to the local health department to cure the deficiencies in the initial notice.The local health department shall make a final determination as to whether the notice of intent to construct is complete within five business days after the department receives the additional information.if the local health department fails to act within any time period set out in this subsection, the owner may treat the failure to act as a determination of completeness. The owner shall be able to apply for the building permit for the project upon the decision of completeness of the notice of intent by the local health department or if the local health department fails to act within the five business day time period." The review for completeness of this Notice of Intent was conducted in accordance with G.S.130A-336.2(c). This NOI is determined to be: ❑ INCOMPLETE(If box is checked, Information in this section is required.) Based upon review of information submitted in Part 1,the following items are missing: Copies of this form listing missing items were sent to the AOWE and the Owner on Dote via with directions to re-submit missing items using Page 5 of this form. Email,FAX,LISPS,hand-delivered Print Name of Authorized Agent of the LHD Signature of Authorized Agent of the LHD Date Er COMPLETE(If box is checked, information in this section is required.) Based upon review of information submitted in Part 1 of this form,this NOI is deemed COMPLETE. Copies of this signed form were sent to the AOWE and the Owner on via N'`14' Dote Email,FAX,USPS,hand-delivered A copy of this NOI and tracking information was sent to the State on via 11 I �a Date Email,FAX,USPS,hand-delivered ��-o ; h r "71, pj 5-2 - 20Z3 Print Name of Authorized Agent of the LHD Signature of Authorized Agent of the LHD Date DHHS/EHS/OSWP-AOWE COMMON FORM Updated April 2022 Page 4 of 6 AOWE Common Form LHD Reference: Re-submittal of NOI with missing items included This Section is for use by owner to submit items noted as missing during LHD Completeness Review above. Resubmittak must be accompanied by o cover letter from the AOWE. LHD USE ONLY: This NOI resubmittal received: by Dote initials Item ft from initial NOI Resubmittal description Attestation by AOWE certified in North Carolina pursuant to G.S.130A-336.2 I, hereby attest that the information required to be included with Authorized On-Site Wastewater Evaluator(Print Name) this Notice of Intent to Construct is accurate and complete to the best of my knowledge and that the proposed system shall meet applicable federal,State,and local laws,regulations, rules,and ordinances. Signature of Authorized On-Site Wastewater Evaluator Date The section below is far Local Health Deportment use after submittal of items noted as missing above. LHD Follow-up Completeness Review of Notice of Intent to Construct This follow-up review for completeness of this Notice and Intent was conducted in accordance with G.S. 130A- 336.2(c). This NOI is determined to be: ❑ INCOMPLETE Based upon review of information submitted in the RESUBMITTAL above,this Notice of Intent remains INCOMPETE because the following items from Part 1 of this form remain missing: Copies of this signed form were sent to the AOWE and the Owner on via Dote Email,FAX,USPS,Hand-delivered Print name of authorized Agent of the LHD Signature of authorized Agent of the LHD Date ❑ COMPLETE Based upon review of information submitted in the RESUBMITTAL above in addition to information provided in Part 1 of this form,this NOI is deemed complete. Copies of this signed form were sent to the AOWE and the Owner on via Date Email,FAX,USPS,Hand-delivered A complete copy of this form with tracking information was sent to the State: via Date Email,FAX USPS,hand-delivered Print name of authorized Agent of the LHD Signature of authorized Agent of the LHD Date DHHS/EHS/OSWP—AOWE COMMON FORM Updated April 2022 Page 5 of 6 AOWE Common Form LHD Reference: PART 3: Authorization to Operate(ATO) Except for dote received,the Section below is to be completed by the Owner. LHD USE ONLY: Initial submittal of request for ATO received: by Date Initials Date of Post-construction Conference: The following items are included in this submittal for an Authorization to Operate under an AOWE permit: 1. Signed and sealed copy of the AOWE's report that includes the information in G.S. 130A-336.2(k) ❑Yes ❑ No 2. Operation and management program ❑Yes ❑ No 3. Fee (as applicable) ❑Yes ❑ No 4. Notarized letter documenting Owner's acceptance of the system from the AOWE ❑Yes ❑ No S. On-site Wastewater Contractor name: License number: Mailing address: City: State: Zip: Telephone number: E-mail Address: 6. Proof of Errors and Omissions or other appropriate liability insurance for the On-site Wastewater Contractor is attached and includes the name of the insurer,name of the insured,and the effective dates of coverage. ❑Yes ❑ No Attestation by the Owner for Authorization to Operate I, hereby attest that all items indicated above have been provided to the Print name of Owner County LHD and the system shall meet applicable federal,State,and local laws, regulations,rules,and ordinances. Signature of Owner Date This section for LHD Use Only. LHD Review of required information for the ATO ❑ INCOMPLETE Based upon review of information submitted in the Section above,the following items are missing from the information required for an Authorization to Operate for an AOWE permit: Copies of this signed form were sent to the AOWE and the Owner on via Date Email,FAX,USPS,Hand-delivered Print name of authorized Agent of the LHD Signature of authorized Agent of the LHD Date ❑ COMPLETE Based upon review of information submitted in the Section above,this Authorization to Operate is hereby issued in accordance with G.S. 130A-336.2(m). A copy of this complete NOI/ATO with tracking information was sent to the State on via Dote Email,FAX,USPS,Hand-delivered Print name of authorized Agent of the LHD Signature of authorized Agent of the LHD Date ISSUANCE OF CERTIFICATE OF OCCUPANCY: Once the LHD determines completeness based upon the ATO submission,the owner may apply to the local permitting agency for permanent electrical service to a residence,place of business or place of public assembly pursuant to G.S.130A-339. DHHS/EHS/OSWP—AOWE COMMON FORM Updated April 2022 Page 6 of 6 • DATE(MMIDD/YYYY) ACc v® CERTIFICATE OF LIABILITY INSURANCE 9/7/2022 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: David Vaughan _ Higginbotham Insurance Agency, Inc. PHONE FAX 500 W. 13th Street (Arc,NnFXU,9187797880 _ (Arc,Not:817-882-9284 Fort Worth TX 76102 ADDR�Ess: div r inbotham.net 1@hi99 INSURER(S)AFFORDING COVERAGE NAIC# License#:2081754 INSURER A:Mid-Continent Casualty Company 23418 INSURED [FIOMFNV-01 INSURER B:Hartford Underwriters Insurance Company 30104 Thompson Environmental Consulting; Inc. PO Box 541 INSURER C: Midland NC 28107-0541 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:1600075032 REVISION NUMBER: TFIIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR - ADDL SUBR POLICY EFF POLICY EXP LTR I TYPE OF INSURANCE INSD WVD POLICY NUMBER JMMIDD/YYYY),(MMIDD/YYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY 04-GL-001086672 9/25/2022 9/25/2023 EACH OCCURRENCE $1,000,000 CLAIMS-MADE I X OCCUR PREM S(RENTED PRMI E SES(Ea occurrence) $100,000 X Professional MED EXP(Any one person) $Excluded PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER; GENERAL AGGREGATE $3,000,000 POLICY LJ PRO- JECTLOC PRODUCTS-COMP/OP AGG $3,000,000 X OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY(Per person) $ — OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY (Per accident) UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ B WORKERS COMPENSATION 38V11ECNW6175 10/17/2022 10/17/2023 X STATUTE OTH- ER AND EMPLOYERS'LIABILITY Y/N ANYPROPRIETOR/PARTNER/EXECUTIVE r1 E.L.EACH ACCIDENT $1,000,000 OFFICERIMEMBEREXCLUDED? NIA -- --- (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. For Informational Purposes AUTHORIZED REPRESENTATIVE� ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD Residential Subsurface Wastewater Treatment and Disposal System AOWE Repair Permit for Lot 10 - Spring Farms 4496 Springs Road Conover, NC 28613 Tax Parcel Number: 373411752526 April 15, 2023 Prepared for: � p� sort so,, JG THo itrA, 2 , TP Century Complete „ ` - , °,9325 Center Lake Dr., Suite 160 `r_ jl r I ~ a• Charlotte, NC 28216 ‘f ri 'l i ry 704-488-1100 ( 12874r . Prepared by: Larry Thompson, REHS, LSS Thompson Environmental Consulting, Inc. .• PO Box 541 t� Number Midland NC 28107-0541 ' a Phone: 704-301-4881 _ ' ��1�E larry@thompsonenv.com ;' ..•......•' /• fit .j. Lot 10-Spring Farms Details Century Complete has contracted with Thompson Environmental Consulting, Inc. (TEC) to prepare an AOWE septic permit package for a 4-bedroom single-family residence to be constructed at 4496 Spring Road, Conover, North Carolina (Catawba County Parcel Number: 373411752526). Based upon a soil evaluation performed by TEC, it was determined that a sufficient amount of "Provisionally Suitable" Group IV soils are available for the installation of a Pump to Accepted System, for a 480 gallon-per-day residence at a 0.3 GPD/sq/ft long-term acceptance rate (LTAR) with a Horizontal PPBPS repair system at a 0.3 LTAR. The property will be served by public water. The LSS/LG evaluation(s) attached to this application is to be used to issue an Improvement Permit in accordance with G.S. 130A-335(a1). 'l'he property owner would like to request that Catawba County Environmental Health (CCEH) issue the appropriate permits for a subsurface wastewater treatment and disposal system based upon the following AOWE proposal and the enclosed Licensed Soil Scientist Evaluation. Location From Newton, take Main Avenue NE, remain on Highland Avenue NE, turn left onto 16th Street NE, which turns into Springs Road. Lot is located on the left just before I tall Street. References Laws and Rules for Sewage Treatment and Disposal Systems, 15A NCAC 18A, Section .1900, Department of Environment and Natural Resources, Division of Environmental Health, On-Site Wastewater Section, April 1, 2017. Accepted Wastewater System No. AWWS 2005-02-R6; North Carolina Department of Environment and Natural Resources, Division of Environmental Health, On-Site Wastewater Section, August 21, 2015. Primary Investigator's Credentials NC Registered Sanitarian No. 1208 NC Licensed Soil Scientist No. 1287 NC Authorized Onsite Wastewater Evaluator No. 10016E SC Certified Professional Soil Classifier No. III NC Subsurface Septic System Operator No. 22199 NC Grade IV Wastewater System Installer No. 1762 NC Certified Wastewater System Inspector No. 17621 Lol 10-Spring Farms Plans and Specifications A. Septic Tank 1. The septic tank shall be State approved (Section .1953 of 15A NCAC 18A), watertight, structurally sound, and 1,000 gallons in capacity. 2. The septic tank shall be fitted with an approved effluent filter. 3. It is the responsibility of the septic contractor to thoroughly inspect the septic tank prior to accepting delivery to assure that the tanks have had time to properly cure and are free of cracks or other structural deficiencies. B. Pump Tank 1. The pump tank shall be State approved, of one-piece construction, watertight, structurally sound, and 1,000 gallons in capacity. Again, it is the responsibility of the septic tank contractor to thoroughly inspect each pump lank prior to accepting delivery. 2. All pipe penetrations into the tank shall be booted (i.e., C-293 boot with a stainless-steel strap). 3. The pump tank shall have access risers that extend, at a minimum, 6 inches above finished grade and must have less than 36 inches of fill over its top once finished grade has been established (a reinforced concrete tank will be required if finished soil cover is 36 inches or greater in depth). 4. The pump and alarm controls shall be provided with manual circuit disconnects within a watertight, corrosion resistant, Nema 4x rated control panel. Pump and float control wiring should be long enough to reach from the tank to the control panel without splicing, routed through wire conduit, and sealed at the openings within the pump tank as well as the control panel enclosure. It is paramount that the conduit is properly sealed to prevent the escape of flammable gases from the pump tank. Furthermore, there must be two electrical circuits for the pump tank controls: one for the pump and one for the alarm controls. 5. Panel and control equipment shall include lightning protection, be protected from unauthorized access, and always remain accessible to the system operator. 6. The pump removal system will be via a pump tether made of nylon rope or its equivalent. The tether material should be resistant to mildew and rot. C. Pipe, Fittings and Supply Line I. All discharge piping, connectors, and supply lines should be made of SCH 40 PVC and fitted with pressure-rated couplings. 2. All joints must be properly "welded" utilizing the appropriate PVC cement for each application. 3. The supply line will be constructed of 2-inch SCH 40 PVC pipe with pressure fittings. 4. The supply line length is approximately 30 feet. D. Distribution Method I. Individual drainlines shall be evenly fed via a distribution box. Lot 10-Spring Farms 2. Distribution box shall be water tested for equal flow at the time of the final inspection. E. Drainfield Installation 1. The drainfield has been previously laid out on-site utilizing metal stemmed flags. The property owner/builder should mark this area and isolate it as much as possible from construction traffic. 2. Under no circumstances shall any construction occur within the drainfield area while the soil is wet. 3. The specified system is an accepted wastewater system, specifically the Infiltrator Quick 4 chamber system or any other system with a state-approved 25% reduction in required drainline length 4. The drainfield consists of three (3) drainlines to be constructed as 3-foot wide by 140 feet long. Total drainline length is 420 feet. 5. The specified trench depth for this system is 14 inches. 6. The laterals are to be installed on contour with the land, keeping the individual trench bottoms level from beginning to end. 7. The trenches should be left open for the final inspection by the AOWE. F. Final Landscaping 1. The final soil cover over the drainfield shall be a minimum of 6 inches deep. 2. The drainfield shall be shaped to shed rainwater and be free from low spots. 3. The drainfield area should be planted with grass as soon as possible to prevent erosion. The soil should be properly tilled, limed (if necessary) and fertilized prior to planting. After applying grass seed, the area should be heavily mulched with straw or other suitable material. Maintenance G. In General 1. The homeowner must maintain the drainfield area through periodic mowing. The drainfield must not be allowed to become overgrown. 2. The septic tank should be pumped every 4 years or when the solids within the septic tank reach an elevation equivalent to 25 percent of the tank's volume. In some situations, the tanks may need to be pumped more frequently. If using a garbage disposal, it is recommended that the homeowner has the septic and pump tanks cleaned out annually. 3. When cleaning the effluent filter, the filter should be removed, and the accumulated debris will be washed back into the septic tank—not onto the lawn. 4. Any damp areas, leakages, or malfunctions in the drainfield area should be addressed immediately. 5. Divert gutter downspouts and surface water runoff away from the septic and pump tanks. Lot 10-Spring Farms Design Specifics Daily Design Flow: 480 GPD —4 bedroom house Septic Tank Size: 1,000 Gallons Pump Tank Size: 1,000 Gallons Pump Requirements: 25 GPM at 10-ft TDI-1 Recommended Pump: Liberty FL30 or equivalent Dose Volume: 240 Gallons Pump Run Time: 9.6 Minutes Pump Tank Drawdown: 11.42 Inches Effluent Loading Rate: 0.3 GPD per sq. ft. Drainfield Type: Accepted - Chamber System Distribution Method: Distribution Box Number of New Drainlines (3) 3-ft Wide x 140-ft Long Total Trench Length: 420 Linear Feet Maximum Trench Depth: 14 Inches Repair Option Effluent Loading Rate: 0.3 GPD per sq. ft. Drainfield Type: Horizontal PPBPS Required Linear Footage: 267 Feet Available Linear Footage: 270 Feet Maximum Trench Depth: 28 Inches F6-0kA Li* iu 1\;/ n 38' ‘64:, 5erta-1 G o I r io 44 4 r to l, �L J Lieh 10 3ax3g' � .0-Q e Pal SD` SPrtrlgs RQari .7(a Thompson Environmental Consulting,Inc. 2 �jSheet of• PO Box 541 PROPERTY ID#:✓73f 11 5?'5')-L4 v Midland,NC 28107 COUNTY: Ca1z(3bG3 SOIL/SITE EVALUATION for ON-SITE WASTEWATER SYSTEM OWNER:ADDRESS: DATE EVALUATED:T�/ [iaaa3 PROPOSED FACILITY: Res. PROPOSEDL1ESIGN F OW(.1949): 480 gpd PROPERTY SIZE: LOCATION OF SITE: 1 IA 1-A( M ; AA'' I D PROPERTY RECORDED: WATER SUPPLY: 7 Private 2 ublic El Well LI Spring Ii Other � / EVALUATION METHOD: [Auger• Boring 0 Pit ❑Cut TYPE OF WASTEWATER: sewage 0 Industrial Process ❑Mixed • P • P R SOIL MORPHOLOGY OTHER O F (.1941) PROFILE FACTORS 1 .1940 F LANDSCAPE HORIZON POSITION/ DEPTH PROFILE # SLOPE% (IN.) .1942 .1941 .1941 SOIL SOIL .1943 .1956 .1944 CLASS STRUCTURE! CONSISTENCE/ WETNESS/ SOIL SAPRO RESTR <AR • TEXTURE i4JJNERALOGY COLOR DEPTH CLASS HORIZ 0-a3451. '%' ry ;l L., o3-`f g ?c 1 Ski -. 1`,�` .,7 U , c)(-) 4Sr�'7,^ I i I ` ci Lf IO c_ '•�1)tc 4 `.i iJ Y�' 411° -P f 7q r J L C li . tf 1# 5- ,-.D(r Lelf-fi ‘. c (,0 0 , 3 t ( C 0 r Sl y' � '- u s L44//(i, C,t.I i4 I-� 9 1---[(40 S ll 0 'a DESCRIPTION INITIAL SYSTEM REPAIR SYSTEM OTHER FACTORS(.1946): n��r Available Space(.1945) PS PS SITE CLASSIFICATION(.1948): Provisio ,✓,A -r 19C P S EVALUATED BY: 1 9)'�HOMA fiy SystemTYPe(s) Accepted HPPBPS ""' . i1 OTHER(S)PRESENT: ]r��� ' j _.�.�,�;�� Site LTAR 0.3 0.3 L. Thompson. LSS 1. �' y � � COMMENTS: '0,. •Y "/l?1�_ --I Updated February 2014 `l -.it- ,-;0 128J 1, C. qc. 0 SOIL/SITE EVALUATION sheer a ul a ( in tannadan mica-comp/de,Ill field in/id PROPERTY ID fA'I E OE EVALUATION: COUNTY: -A/VI{ t r I, it SOIL MORPHOLOGY OTHER F (.1941) PROFILE FACTORS I .19411 — F LANDSCAPE HORIZ .1942 POSi'CIU\! ON .1941 .1941 SOIL .1943 .1956 .1944 PROFILE '' & SLOPE% DEPTHSTRUCTURE/ CONSISTENCE/ WETNESS/ son. SAPRO RESTR CLASS TEXTURE MINERALOGY COLOR DEPTH CLASS HORIZ <AR (IN-) . D -3? -_,c_ ok__ .Tsp i L 3?--*Jac i Pbk.. cr s e... (2 1,,,,,,4 P5 , ,s 71.) , 5- 4(0 syT . ._. O 3 i 0- 3o ( bif ___f2', . - )- ti 50.--/k,561510v p51.eif `-(l 0 .czi,ft ot '5 • • s s t • • • I1 COMMENTS: 1 Cpdn, I Fclmt:uy 21)14 Thompson Environmental Consulting, Inc '.oration: Spring Darius P() Box 541 Midland, NC 28107-054I Dam April 16, 2023 g .2 i:L' '--,. -(t.. •ri " o 0 °: , a H x ki"A, V — A ,1 . 1 I oa .s x a a o A J 4 _ O . a aE yH a 0 • z0 . ' e _ A o o g 1 w . • r--f.. ›- .• ... Y. , x �, 0 axl • it_ 1_.• , • •.. E El H E r .... . —I P a p . H °? a in . 34 EL' w v w U o y .- . �o � % o • a a L• o y zo a H .a .0 a ivy ,..., a Vo W V i LLJj Pumps A Family and Employee Owned Company Pump Specification fh FL30 - Series 1/3 HP Submersible Effluent Pumpskrio •,I LITERS PER MINUTE ' 1` 0 50 100 150 200 "118I 25 �� `�� ,rf — 7 20 • — 6 — 5 co 15 U- w w 2 ur — 4 z d w w x x d F- O • 10 1 i i - 3 I- - 2 5 — 1 0 0 0 10 20 30 40 50 60 GALLONS PER MINUTE Copyright C Liberty Pumps,Inc.2019 All rights reserved. Specifications subject to change without notice. FL30-Series_P1 R9/27/2079 7000 Apple Tree Avenue Bergen NY 14416 - Phone 800-543-2550 ' Fax 585-494-1839 M Email Liberty@LibertyPumps.com ■ Web www.LibertyPumps.com FL30-Series Dimensional Data 1-1/2" NPT DISCHARGE 1 FLANGE / I �V [251 mm] ����� 9.87in r ,,,_Iwl—i I ph ,,,,,h yr . .. \ 1/4•.....•, ,, vier if .0111.11A C----- .....,, ,i, JIM 2n,m 1 [ ] � 1 1 .3in 6=11 [242mm] MI [215mm] 9.5in Al_111_el 8.5in %MII= [97mm] �`�— ��`�i� 3.8i n i t i i i bbesty Pumps PROPRIETARY AND CONFIDENTIAL THE INFORMATION CONTAINED IN THIS DRAWING IS S.ANY PROPERTY RODUC OF IO FL30 SERIES DIMENSIONAL LIBERTY PUMPS.ANY REPRODUCTION DwG.NO. IN PART OR AS A WHOLE WITHOUT THE ----- WRITTENPERMISSIONOFUBERTYPUMPS SLICE DATE: REV. IS PROHIBITED. A A APPLICATION DO NOT SCALE DRAWING IWEIGHT: LBS 'SHEET HEET I OF I Copyright©Liberty Pumps,Inc.2019 All rights reserved. Specifications subject to change without notice. FL30-Series_P2 R9/27/2019 7000 Apple Tree Avenue Bergen NY 14416 ■ Phone 800-543-2550 i Fax 585-494-1839 - Email Liberty@LibertyPumps.com ■ Web www.LibertyPumps.com • Quick4M STANDARD CHAMBER 52" 0uick4 Standard Chamber — 4e" (EFFECTIVE LENGTH) • r1iiriIàiitIiiiii " 34' SIDE VIEW SECTION VIEW MultiPort End Cap44.0 16" ILIP--.111"11166._«I1 ,2" /41ilL(0.7*. IA 1111111111141 41111 34" SIDE VIEW TOP VIEW FRONT VIEW Quick4 Standard Chamber Nominal Specifications MultiPort End Cap Nominal Specifications Size(W x L x H) 34°x52"x12" Size(W x L x H) 34"x16"x12" Effective Length 48" Invert Height 8"or 1.25" Invert Height 8" INFILTRATOR SYSTEMS.INC.STANDARD LIMITED WARRANTY lab The structural ntegny of tact chamber red plate.wedge and other accessory rnars'actrred by Infiltrator("Unrs3,when installed and operated in a knch!iekl of an orate septic system in accordance with Mit:rator's nstructons is warranted to the original purchases("Holder)against defective materiels Lnd workmanship for are year from the date Mal the septic permit is issued fa Me septic system containing the Units:medal however. that if a septic permit is not required by applicable law,the warranty period wit begin upon Me date that installation of the septic system commences To exercise its warranty rights,Holder must ratify lacoatar t votingnilsfo at its Corporate Headquarters Old S thisLi iced wen fifteen 1151 I N F I LT RATD days d the alleged dalect Infiltrator wi supply replacement lJntis for Units determined by Infiltrator to be covered by this limited Warranty. Wiener's labity specificaly excludes the cos or removal and/or instalation of the Units. fbi THE LIMITED WARRANTY AND REMEDIES IN SUBPARAGRAPH fa)ARE EXCLUSIVE.THERE ARE NO OTHER WARRANTIES WITH RESPECT SYSTEMS INC TO TIT UNITS INCLUDING NO IMPLIED WARRANTIES OF MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE Icj Tin Limbed Warranty shall be void if any pan of the chamber system is manufactured by anyone other that Infiltrator. The United Warranty does not extend to incidental.consequential.special or indirect damages Infiltrator steal not be fable for penalties or lquidated damages.inducing loss of Environmental Onsite Wastewater Solutions" production and profits.labor and materials.overhead costs.or other losses or expenses incurred by the Holder or any Mid party. Specifically esck/Jed from Limited Wenenty coverage are damage to the Units due to ordnary wear and tear alteration.accident,misuse.abuse or neglect of ten Uric:the lams berg subjected to vehicle traffic or once conditions which are not permitted by the istelatran instructions:failure to maintain the 6 Business Park Road• P.O. Box 768 miiwnan swung covers set forth*,the irstala:un nsWctons:the placement o'improper materials into the system cantering the t.'its:Wore of the tints or the septic system due to Improper siting or improper sizing,excessive water usage,improper grease disposal.or inproper operation.Cr Old Saybrook, CT 06475 any other event not caused by Infiltrator This Limited Warranty shall be void if the Hods rats to comply with ell of the teme sot forth in the Limited warranty 860-577-7000• FAX 860-577-7001 Further in no event shall Infiltrator be responsible for any loss or damage to the Holder.the Units or any Mid piety making Iran installation or ship men'.or from any product tunny claim of Holder or any third party For this Limited Warranty:o apply.the Units mist be installed in accedence 800-221-4436 with all she carrdtions rerfsnM by state and kcal codes:al otter applicable laws:and Infitratoes nstallation nstructians. (d)No representatne of hRtratce has the authority to change or extend this united Warranty No warranty applies to any party other than the aigi nal Hodes The above represents the Standard brined Warranty offered by Infiltrator A finned cumber or stares and counties have diaerenl warranty require- ments.Any purchase of Units should contact Infiltrator's Corporate Headquarters in Old Saybrook.Connecticut,polo/to such purchase.to obtain a copy or the applicable warranty end should caefuy read that warranty prior to the purchase of Units U.S.Patents:4,759,661:5,017,041:5,156488:5,336,017:5,401,116;5,401,459;5.511,903;5.716.163;5.568.778;5.839,844 " Canadian Patents:1,329.959:2,004,564 Other patents pending. a111 Infiltrator,Equalizer and Sidewinder are registered trademarks of Infiltrator Systems Inc.Infiltrator is a registered trademark in France.Infiltrator Systems Inc. is a registered trademark in Mexico.Contour,Contour Swivel Connection,MicroLeaching.PolyTulf,SnapLock.ChamberSpacer.PosiLock.QuickCut,OuickPlay RECYCLED PAPER and Quick4 are trademarks of Infiltrator Systems Inc.0 2003 Infiltrator Systems Inc.Printed in U.S.A. 00112031 IP-0 Catawba County Environmental Health •4514 •4489 100.0 `+01 3799 4 co `6� 13 100.01Q�`�Gy, •4508 e��� �11 3647 •4502 ra •4496 2661 12 (.16) �� h •4490 2526 11 t9 •4484 Co 1543 rch. 19 1.7) 0479 10 cbry 9 19!44 Al• A3 8 1 •5234 gg 37 7 gA 0A w 6 10B9? 1346 Parcel: 373411752526, 4496 SPRINGS RD 1 in=60ft CONOVER, 28613 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 04/27/2023 Parcel Report - Catawba County NC Parcel Information: Owner Information: Parcel ID: 373411752526 Owner: MARTINRAY HOLDINGS LLC Parcel Address: 4496 SPRINGS RD Owner2: City: CONOVER, 28613 Address: 114 MORLAKE DR STE 103 LRK(REID): 404982 Address2: Deed Book/Page: City: MOORESVILLE Subdivision: SPRING FARMS State/Zip: NC 28117-9211 Lots/Block: 10/ School Information: Last Valid Sale: School District: COUNTY Plat Book/Page: 84/197 Elementary School: LYLE CREEK Legal: LOT 10 PLAT 84-197 Middle School: RIVER BEND Calculated Acreage: .500 High School: BUNKER HILL Tax Map: Township: CLINES School Map State Road #: TaxNalue Information: Tax Rates Zoning Information: City Tax District: All in County Zoning District: COUNTY County Fire District: ST STEPHENS Zoningl: R-20 Building(s) Value: $0 Zoning2: Land Value: $12,000 Zoning3: Assessed Total Value: $12,000 Zoning Overlay: Year Built/Remodeled: / Small Area: ST STEPHENS/OXFORD 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 Current Tax Bill Miscellaneous: Firm Panel Date: Building Permit Address Search for this parcel. Firm Panel #: If available, Building Permits for this parcel. Septic 2010 Census Block: 1000 links are not permits. 2010 Census Tract: 010202 Septic Final Permits prior to 08/2018, contact Agricultural District: Proximity Environmental Health. Building Details WaterShed: Voter Precinct: P33/Voting Map 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 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. .. _ r a r a Flood Hazard Area Certificate Actrehp to maiden pow.by One federal Cmrpancy Man.,yem•nt Agency and 4 mama Lbw Rd Con Me OWN need mama.*Rafe Mao(X.))Pant 377*Camath* 4. unts North Cavan* Renew data Soptem.,3 2007.Me Property Ma. Q ��ae ed as hereon N foal located r/Mh a weal hood nand area me Property I.envy Sp"- Ate enAh arse d•epmted•lane it-athr reu:Area/Mt n...n e•outside /* 6� 3 L co21 annvr cal n eeoaela.ores was.&lure comarone rX em„al hance MocbblA Watershed Certlncate: w SIT ro ale Me of my• ohmro a•«Mal n neweeps w oaf ease t • a tr /''r, wepsey watershedOeNpnered by w North Cann.Dirk.el / bob.Yes fnNetn.antel Maneprnant es We n n Me mt..Pro.. 1 Oa^Of I.of Cala.Count*North Ceralbe • /Environmental Health Approval of Subdlvisro.Plot This feat w•o ..en Rn lets sheen have a tawboen wCc by girl* LOf / b Deportment of Aueee NeeleA 7.0 •r 4 Vicinity Atop (NTS) %'TM 0�-�Af//- 9''2L \ 7' Notice rani.. *neat Health&ve d;er w oedipal** Don s i�`"aa��PP"••.• * o•.$14 •Poopwrr rub.at ro m n me r of wed i S `l e and aR NCDOI pram rand Op O Npn ran recrK r haler d righter o/.oy oo6 •MN survey a,title nay Male root logy DI arc deed by e R `d •M/ 0.4•° ® Approval Certificate for h" a Yam.inn seer A. P9ecy / �• ,s� Major Subdivision Plat •'lone*other plot dew not*aloe any unr.cordea written r 9481 a /' '°•��N unwritten easements,dedications r other noupp Sued ..f" Ms hna,plot and me,Leer none,shown Darlene could*wire on this property and not wear on them plot. pb„_�ae.apaamnf !e / .�4 •i'`� 1 > 1 how been found n oomph with the Accorahmes oven of MN plot ore warned lei roman art for the along fin R/W Me r \p' • :0 de $, N ry �vs 4' Suban,non Reparations I Colawha County *instance o1 et.unrecorded baron*not sham hen.. 00e !not e,LW 7 s�•N y3 and were approved by the Catawba County SOrhM A /•1 ' N Ca;w.ay Manning Director r all Mar desi e..NI •the Global NeNgatbn Satellite System(MSS)was used to mJE� Eeµmnf `Tp, improvement,theta uhnit orb een raalledd send.ff promettle•Det eor*o yy•tondeM1 part 2 a �- ,.. totpe haw been installed according sfanden for(loft co meteor**of the 95IL,.Oarcce accuracy `D�V to'pecrfication.and standard*or a class;faction(9s!confidence)using real tkno AMemdfle rho 10'a 70' .r - N d i of the installation of the spot '4 d guarantee improvements n amount and Waring Mformbfkn was used: 16 �, ` 2. ..4. manor satisfactory to in coon no. �d N aJ, �.+ o been ncs tisf MN.1 ,' I,red Renbae<rNly mot fire map woe roes under eny pal M Ma dr0 d r .aprbskn from an haled GPS money made undo-my supe.fskn �/ 1 Orh'••aY '1.-.4 Nao P. recording in the Olfce of Ma Register o/ d the wowing hformafan was used fp perform the survey f" �1.�l '4 E°"'n"k ,. never of camwao canny 1Mn'idly(eD) i $- N dewNt''y �`�+e 9• ate ear• r de r en;mnm�e,! oa,.p/sae.. 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Propsf 1 1 a • 95 1otol srgk 3 ° Leigh Ann P.P. revens 8/adgett •LeKy to a sal Ssd by aty hoer and MCMafel egrk. qA M 9l.8Z Q •Preprry rise within prodmity of oil orkWtural disfrkt. 1`' CO 1 •E 3 - D.B. 1788, Pip. 1106 11 "1�� Ian 9r eN 1S • 165 'l4 •MOM.re„ndrproune 1 ,• ® 1otp1 l� Note.• •Roe moos*treed planted no Orion than SO fleet w/MM to. \ MOcYW(,'pY`frr`h RIM . 3 yit,a Contour Ones are scaled from ripen-Of-.oy and comply with NCDOT vegetation pukre0ea ql1 Z WOO 13-pp'i 3 E sle ie Catawba CIS website. •men/a a 10'eracag•and aunty ae,arnt Gong on ref rlos. R 1 - ...t pplapinR N ��.rL ^In •rota amber of lore I) Oyh..e)• ~-- Aid (al A _ I Ted M.Rnbae,cµNly Mot tole map was drawn under My as 11 i' Eamm�t K1a{n AT'To M pr,Net from on oe Pun surer mode undo,my wprnr/an Ib. I dn9 ppi3 E 315 ,.4 (deed ee,erytloo recorded M took 373e,Poe 762) That this rn 1 �- y'Ifl Inca 13'30 '^. a 3 O fmf hot enh prate*meek the accordance naukemeent of GS-47-30 or ar rigor BS N t� of crNfo that MN Barney creale a subdivision of lone within en. W \11 l 3 ono f a county or municipality root eo.an Winona*that U1 i--/,{.(Y In R 5,Tn101 a SC j. regulates Drcah of lend •y Al °' IS�ypy I�I�R,0.00' E 291.2h a.3 _xa A 'Mines,tN•my anginal Mpnaftre,r.9lstrarin number and t4.L s Q 8, Ea.a w,tNN 13•p0 © „ •,, sal MM 29th eI August 2022 A.O. n b1 Ah° lop ... 1 WO ,n KDIn R/,'d let 3 -///���iyJ73 C 1 P. IS 00, Q•Oipe-Dip-/y j9 44 To • F.sL_L- _ .oyLiN..5o�1S:': \ $si N 73.pp 13µ 2• �.ed,.tsLrcrla�a/ 15.80 L-3r7s !�? EA!.vi 'j 1 2 ^LSD t! ® - 8 L 3175 Mon-rc•u.oµnele �"` 1 Ise Area o •':"f Q �' a1.a er RA,th.el ` 1 _ y 0.97 Acre D„aw,, 1110' •..--:�f:.bt.,!...,r- eat Suede an Lot 1 1•� MOWN;0.11 Acre M R/1s 1, !t ~` sees lead••adorerµ ndicplaa off distances shown on." tee at, D...•e- horizontal pound distances. re chin to grid -1 'semen Meanaa matter the pane losing•by Ma 1 1 4 water Walests T� „ . co..,facer. \` _-1--e--T je•hCP `. _ 13/d'OP R/W/1.Eve -g ��'.'„'1'C'Y11W'SS \ Review Officer Certificate 290.8, o a sots of North Corot. O. S 88'•30 3�_ Countyof Comoro* - S.R. 151J �. Elgin Drive I,f,}�ytpd J,A)]1:tkw1Y Renew ONkr m.cam.ea Legend �_ -" r P.B. A7• \hSSs S\_ out <rnry mot rM mop r plop to which this certification M 6W5 ON MONUMENTS set COWAN more 1 1 h 'Li ohms**meats Sur rfotutry nedu.nnete w record. SURVEYORS NAME AND LICENSE NUMBER 1 •Res............ 1/2'IRON ROD sal Inn+YELLOW cw \ i�e /den:a /��'' Dar.7`Ir •DP............ExiSTINO IRON PPE AS SNOwri •DR............cusnArG IRON ROD AS SNOW 1 Lot 1 X CP............COMPUTED Porter P.H. 66, Pg. 65 . Cane El--- 'wino. d•tonee )IE 55S............SURVEY SPIKE SET ..................ST17E17 SIGN Ownership & Dedication Certificate '$. L iiy$6Jd "' 107 ff................... them paler z for Corporations, LLCs or Non-profits-6 '*•. L"• N 6.30'7•• a:a b...................nRC NYORAM r(e1)**-flip Mal l;are(w.an)Me ewr(ef el Ion property ' j ` N 6!9'Y" 13.7 •...................WATER YALVC �� d au/al/a nr•n./a.a P'newly le rasnred dab n ...MI. . i U 0-D N,, '/ ' 1!...................PARCEL /D f/ Rf0 LMPLf TREE Mi. !reub acn of Canoe County Mal 1(ee)err..,adopt N N 5 6'S"' S0 9 PIN............PARCEL IDENI/ONCRON H/fE 0 a. Ma plan of subdivision and dedkat*I.pupae use an areas shown e. ,-L ' sp RCP...........REINFORCED CONCRETE PIPE a-,s on fin,pal such as greets.an.walla polo,opal space and a kp U N Se1e'S fe.2t { M.erter Inon,pair aID mdmted o,nrolA ono not I cps Q Lip N 5T179'Marti rl 3' (Oa)eel mn1r.h ad wen owe ant,ern•err of dndkat+an la 1 LIQ N SB eta 55.9 ° accepted by foe ePra a pie o...Monty ./propel,Mort an E ll N�s§§ QahRitrlii''--rr 25.1' pO. this plot l•lkaled Icy a park used Mal be deemed fa ha L1• N S� f }r. der$.... NOT 70 SCALE ]7' eekefN M my*MY puelte uw...Med by low man rem e �2y__.•1__� ._LINT SURvn[o ',Z.-8 other*vv.M •a..e by cere.ee Count" a LI. N 3 S m. 11E UNE SUR0TVE0 dA,A9 1� fJ f7 11ITr 1 ---_UNE NOT SURYETED O !'14!//R <e ��a�f t!u ANtIng A.w r4 Iwv OM �r-i 6 1'� �3T.1 e. e- Rlctrl-Or-WAr UN( - Nam of 1 s.G Non-groin) Camera Roe.• L •^90. chid cNrd seer. -oE-OVERHEAD U11Un'LANE ,.964$4/4.9.v r A 7 atZ cI ,7s.ca 190.w 161.64• II 67011r C trot•: iy lPreede t'a agban) �/'. to 80 o eo 160 240 Mdicdual driveway easements an 10'wide and eafend bolo Cenler6n• . -- - el rood to 20'post R/ls One or shown. ''''2' am newt(9•aletry re,aw..) den GRAPHIC SCALE - reel a' - Kr Shared aNvs.oy...sent*ere Major Subdivision a..' 10'wide 10'on roan MA*of property Notary Spring Farms lino and extend from the eenfertinr 1/2•OR N cal err..*Cer.,.pe*dually of rood to 20'parr R M show./here as show. TED %t1.GlsSP5LClA7TEIttA2;,a Nelry wee w,ea Clines Township, Catawba County, NC lip and same dal hr.ey rrny mot e.. Owners of Record: MortinRoy Holding. LLC BWi�B0w -D11511nL_MiCLuPe uarya Deed Reference: D.H. 3736, Pg. 782 owner(*)p.n.s opp.rad PA.me MN clay and ennowenbe OT.A �4. Plot Reference: N/A >�,,� Me a*ewe tan the foregone notn mn1. N Ry n Lf"'p� �� Zoning � PIN: 3734-1175-2155 Proudly Surveying lredN/Count' ro1INO R-20(Calowbe County) M1m•r•my hand and o111<a•sal Job Number:2111380S3.DWG (3111J80.CR0) Since 1989 thiffo p Setback* ma the t��alas f-gy.4115f 2017. $ Feld Work: 12-2-2021 630 SIGNAL HILL DRIVE EXT.,STA tESNLLF,NC 28025 Front-30. PHONE(70e)87e-9661 Sae_ IS' __L o pLrel/on --` n01 1 111".o "*E woe' Plat DrawD t 8-29-2022µS eanaboundorydevelopment.com Rear 30' wyf commission mei.e .`fhvO-WO gU 2'1 ' By: FILED Sep 06.2022 10:15 an, BOOK 00064 CATAWBA COUNTY NC l//�ij PAGE 0197 DONNA NICKS SPENCER8fif v{ 7 REGISTER OF DEEDS INST a 19520 4 e A C•G C OA SOUTHWEST COUNTYA THWEST BLVD • NEWTON,NORTH CAROLINA 28658 INVOICE/RECEIPT Ar, ►i PHONE:828.465.8399 V4►� Thursday,April 27,2023 18 4 2 SM www.catawbacountync.gov Invoice Number: 04-23-421801 Invoice Date: 04/27/2023 RBPR-04-2023-44176 CASE TYPE: Residential Building Plan Review WORK CLASS: Building New SITE ADDRESS: 4496 SPRINGS RD,CONOVER NC 28613 Applicant LARRY THOMPSON,LSS,PO BOX 541,MIDLAND NC 28107 C:7043014881 LARRY@THOMPSONENV.COM Contact Person CENTURY COMPLETE,9325 CENTER LAKE DR SUITE 160,CHARLOTTE NC 28216 B:7044881100 KATIE.DYESS@CENTURYCOMMUNITIES.COM Owner *WJH LLC,9235 CENTER LAKE DR STE 160,CHARLOTTE NC 28216 B:3362823606C:7044881100 KDYESS@WADEJURNEYHOMES.COM WADEJURNEYHOMES.COM ACCOUNT:7554 PAYOR: `WJH LLC FEES RBPR-04-2023-44176 FEE AMT DUE AMT AOWE 110.580200-663000 04/27/2023 $135.00 $135.00 FEES: $135.00 $135.00 TOTAL FEES: $135.00 $135.00 invoicereceipt 04/27/2023 10:11 Page 1 of Robert Phelps From: Robert Phelps Sent: Wednesday, April 26, 2023 10:17 AM To: 'Larry Thompson' Cc: Katie Dyess Subject: lots 9,10,11,12, and 13 of Spring Farms subdivision Attachments: Spring farms plat.pclf Larry, The AOWE submittals for lots 9-13 are incomplete because page 1 of the NOI form is marked as a repair of an existing system. Please resubmit page one with the boxed checked as NEW. And just a heads up there is a zoning requirement about the number of driveways allowed entering a main road without having an internal road. The previous developer got around this by sharing the driveways for this subdivision. Our zoning department will hold up the building permits until the driveways are shown to be shared on any site plan. The attached plat shows the driveway easements. Thanks Robbie Phelps, REHS Environmental Health Supervisor, OSWP Division 25 Government Drive, Newton, NC 28658 (828) 320-3077 cell https://www.catawbacountync.gov/county-services/environmental-health/ seat awba county Confidentiality Statement:The information contained in electronic transmissions is confidential and may be subject to protection under the law,including the Health Insurance Portability and Accountability Act(flIPAA).An electronic transmission is intended for the sole use of the individual or entity to whom it is addressed.If you are not the intended recipient,you are hereby notified that any use,distribution or copying of the message is strictly prohibited.If you received a message in error, please contact the sender immediately by replying to the e-mail and delete the material from any computer. 1