HomeMy WebLinkAboutRBPR-06-2023-44508.TIF 1 f
catawba county
public health
AUTHORIZATION OF REFUND
Date: 6/9/2023
Case#: RBPR-06-2023-44508
Applicant: _ D& M Construction of Denver
Refund Amount: $80
Refund Reason: Revised to remove EH from review. Applicant requested to
withdraw EH application and submitted EH Acknowledgement of
Optional Services.
Authorizing Signature: '/41//
Received By Staff: -Attic flk e/IL
Date: — ( (l )3
catawbacountync.gov
Environmental Health
Catcwbo County Government Center
25 Government Drive PO Box 389 Newton NC 28658 828.465.8270
MAKING. LIVING. BETTER.
Catawba County, North Carolina - Disbursement Voucher
Vendor No. A Date: 6/9/2023
Make Payment To: .l,� __ Voucher No(s)
D & M Construction of Denver Inc IIIQ t r (:•ZPO Box 934 IQ ��r� y
Denver, NC 28037 v ����
184'L
ATTACHMENT
Prepared by: Julia English
Description Amount
RBPR-06-2023-44508 Revised to remove EH from review. Applicant requested to withdraw EH $80.00
application and submitted EH Acknowledgement of Optional Services
Sub-Total
Food Tax
Sales Tax
Total $ 80.00
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)
1 1
47'A C CATAWBA COUNTY
Ga 100A SOUTHWEST
NEWTON,NORTH CAROL NAD28658 RECEIPT
V0 PHONE:828.465.8399 Friday,June 9, 2023
18 4 2 sM www.catawbacountync.gov
PAYOR: "D&M Construction of Denver, Inc.
*D&M Construction of Denver,Inc.(Davis,Andrew)
PAYMENTS
TRANSACTION NUMBER: TRC-65922579-09-06-2023
PAYMENT DATE: 06/09/2023
PAYMENT TYPE: DV
INVOICE NUMBER ACCOUNT FEE NAME FEE AMOUNT
06-23-423543 110-580200-663000 Existing Tank Check Fee ($80.00)
TOTAL PAYMENTS: ($80.00)
RBPR-06-2023-44508
CASE TYPE: Residential Building Plan Review WORK CLASS: Swimming Pool
SITE ADDRESS: 1165 SHILOI l RD,CLAREMONT NC 28610
Owner JASON&LESLIE HICKS, 1165 SHILOH RD,CLAREMONT NC 28610
C:828-514-6162
Contractor *D&M CONSTRUCTION OF DENVER,INC.,PO BOX 934,DENVER NC 28037
B:7049661996C:7044375446 DMCONSTI5@YAHOO.COM
**NO PEOPLESOFT ACCOUNT ASSIGNED**
receipt 06/09/2023 09:I I Page I of'I
,� '" Acknowledgement of Optional Environmental Health Services
, t.; ttawba tui ily I._nvironme.ntal HenIth
25 Government Drive i P.O. Box 389 I Newton. NC 28658
Phone 8213.465.8270 I lax: 828.465.8216
�~ 1-HAdmintfuCatawbaCotantyNC.gov
Property Owner. —4 OI.3G fl k i.c,k.co,
Phone Number 0 li — S 14 -()/ Email a
JtScri.hia_S 4il.',cc:.f7on(L'Y'd''7 /• (u"7-7
Project Address: //�, S $/1//G/j /'cl C l4 .rr2d.-7 f /l/C- 21 A)
Project Description: J e.. y(2, 1 (ALfl-S- /I.A.L_f R tm
Required Setbacks for Wells
Building foundations:home addition,deck,carport,pool,accessory structure 125 feet
Required Setbacks for Septic Systems&Septic Repair Areas
Deck, Patio 5 feet
Swimming pool 15 feet
Building foundation on crawlspace or slab 5 feet
Building foundation with basement located: uphill of septic/repair 10 feet
beside septic/repair 15 feet
downhill of septic/repair 25 feet
Retaining wall,foundation drain located: uphill of septic/repair 10 feet
beside septic/repair 15 feet
downhill of septic/repair 25 feet
* No grading,cutting,or filling is permitted within 15 feet of septic system or repair area
* No vehicular traffic,driveways,or sidewalks are permitted over septic system or repair area
* Do not divert surface water over septic system or repair area
I understand that Environmental Health can field review an existing well,septic system,and septic repair
area for required setbacks,and the County recommends this optional service.Structural additions,
swimming pools,decks,and other accessory structures constructed on septic systems or in septic repair
areas,can irreversibly destroy the area and may result in an inability to install a septic repair system. If
the undersigned is an agent for the property owner,the undersigned is responsible for informing the
property owner of this optional service. An Environmental Health inspection and permit are required if
building a new house or adding a bedroom to an existing house.
I want the well/septic review and inspection
I do NOT want the well septic review and inspection
f)\'''f"--e---;' _6_
�Owne /Agent Signature_ Date
MK_ 1)6_,/s-s
Printed Name
qr OFFICE USE
Zil A copy of the septic permit was provided to the owner/agent
No septic permit was found on file
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