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HomeMy WebLinkAboutEHPR-06-2023-44580.TIF catawba county public health AUTHORIZATION OF REFUND Date: 6/21/2023 Case#: EHPR-06-2023-44580 Applicant: Crisandra Ashley Refund Amount: S150 Refund Reason: application withdrawn Authorizing Signature: \\—Q-&-i — Received By Staff: EiNt/OL Date: to l )'' )-3 catawbacountync.gov Environmental Health Catawba County Government Center 25 Government Drive I PO Box 389 I Newton NC 28658 1828.465.8270 MAKING. LIVING. BETTER. Catawba County, North Carolina - Disbursement Voucher Vendor No. Date: 6/21/2023 Make Payment To: 4)A c06 Voucher No(s) Crisandra Ashley EZ. t t Z 108 1st St SW rt jPA Hickory, NC 28602 iP j84'L ATTACHMENT Prepared by: Julia English Description Amount EHPR-06-2023-44580 application withdrawn $150.00 Sub-Total Food Tax Sales Tax Total $ 150.00 For Accounting Use Fund Cost Center Object Project Amount Only 110 580200 663000 Total The undersigned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) . A CATAWBA COUNTY �" a 100A SOUTHWEST BLVD ` 1-1 NEWTON,NORTH CAROLINA 28658 RECEIPT PHONE: 828.465.8399 V Wednesday,June 21,2023 1842 sM www.catawbacountync.gov PAYOR: Ashley,Crisandra PAYMENTS TRANSACTION NUMBER: TRC-6683 1 780-2 1-06-2023 PAYMENT DATE: 06/21/2023 PAYMENT TYPE: DV INVOICE NUMBER ACCOUNT FEE NAME FEE AMOUNT 06-23-423812 110-580200-663000 Improvement Permit Fee (S150.00) TOTAL PAYMENTS: ($150.00) EHPR-06-2023-44580 CASE TYPE: Environmental Health Plan Review WORK CLASS: OSWP SITE ADDRESS: 6260 BUENA VISTA DR,CLAREMONT NC 28610 Applicant CRISANDRA ASHLEY, 108 1ST ST SW,HICKORY NC 28602 C:8282917231 CRIS@CRISASl1LEYREALESTATE.COM **NO PEOPLESOFT ACCOUNT ASSIGNED** Owner CLIFFORD&DEBORAH COOPER, 107 BUCK SHOALS CIR,HUDSON NC 28638 C:8287293220 receipt 06/21/2023 13:54 Page 1 of 1 4411 ,.6 THIS IS NOT A PERMIT Case# EHPR-06-2023-44580 Q r., H CATAWBA COUNTY HEALTH DEPARTMENT PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES L842 ski Environmental Health Plan Review- OSWP IMPROVEMENT Applicant CRISANDRAASHLEY, 108 1ST ST SW,I IICKORY NC 28602 C:8282917231 CRISVuCRISASIILEYRF.ALES'I'AfE.COM Owner CLIFFORD&DEBORA'I COOPER, 107 BUCK SIIOALS CIR,IIUDSON NC 28638 C:8287293220 NAME TO APPEAR ON PERMIT Clifford & Deborah Cooper SITE ADDRESS: 6260 BUENA VISTA DR.CLAREMONT NC 28610 PIN# 375501254828 NAME of SUBDIVISION: BUENA VISTA REVISION tot# 48 Section/Block PROPERTY SIZE: Square Feet 78,843.60 Acres 1.81 DIRECTIONS: NC 16,right onto River Bend Rd,left onto Buena Vista Dr,property on the rifht PRIMARY CONTACT: Applicant SEWER TYPE: Septic Tank GALLONS PER DAY: 480 WATER SUPPLY: Private Well DESCRIBE WORK: IP only 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? No 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? Yes Property Easements Description: Duke power line APPLICATION FOR: New Structure STRUCTURE TYPE: PRIMARY RESIDENCE FACILITY TYPE: Other OTHER DESCRIPTION:Doublewide DESCRIPTION OF EXISTING STRUCTURES ON SITE(IF ANY) DIM EXISTING STRUCTURE: NUMBER OF EXISTING BEDROOMS: #OF OCCUPANTS: 4 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 32x76,6x6 front and back decks #OF NEW BEDROOMS:: 4 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: ehapplicauon 06/09/2023 10:53 Page I or 3 CATAWBA COUNTY(7-1,./, Case# EHPR-06-2023-44580 Public Health Department Subdivision BUENA VISTA REVISION Environmental Health Division PO Box 389, 100-A Southwest Blvd,Newton,NC 28658 PIN# 375501254828 j NAME ON PERMIT: (CLIFFORD&DEBORAH COOPER), 107 BUCK SHOALS CIR,HUDSON NC 28638 (Clifford&Deborah Cooper) Site Address: 6260 BUENA VISTA DR,CLAREMONT NC 28610 Property Size: Square Feet 78,843.60 Acres 1.81 Directions: NC 16,right onto River Bend Rd,left onto Buena Vista Dr,property on the ritht 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: (cjq ja ? Signature of Applicant orAgentCyl,t ( 4 al, Cc,/l--� If you need further information or assistance please call 828-46 -8270 U AREA3 FEENAME DATE FEE AMOUNT Improvement Permit Fee 06/09/2023 $150.00 TOTAL FEES S150.00 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 06/09/2023 10:53 Page 2 of 3 catawba county ' Application for Environmental Health Services THIS IS NOT A PERMIT Application is for: Ef New Construction ❑ Existing Facility improvement Permit ❑ Authorization to Construct ❑New Septic ❑Septic Repair/Malfunction ❑ Septic Relocation ❑ Septic Expansion ❑Existing System Inspection or Reconnection ❑New Well ❑ Replacement Well ❑Well Abandonment ❑Well Repair Property Address to (p 0 e u t r,a VC 64-a. Tr. CI alt71Yla-N-1-,kw. a t 10 10 Acres 931 Subdivision btio nQ Lot# 1.`B Driving Directions to Property Describe work peir_ itesi t .Q r1 S t,c r t po t,�.r Li tiu'S Q.r { c U 'n 3 -6 be an i 5 s e. Applicant Name CA',5GU- 'k& ; ( ? aI-for') Applicant Address ko (s(- s4- SW k_vni , NG c g(o0 01� Phone Bag (Q q► - n a 3 i Email C. Pr i 5 a Ne r.e14p 5 eo n-1 Owner Name C1►'F{,Yd +-r)LbcyrQ.h Coo V Owner Address 101 B,A_ck shy 5 C . son NC a to 3 v Phone gag— - 3 as o Email Contractor Name Contractor Address Phone Email Name to Appear on Permit? igOwner L Applicant ElContractor El will be the Primary Contact? Owner Applicant ❑Contractor Proposed New Construction-Residential Primary Residence OEI New Residence ❑ Addition to Residence #of New Bedrooms*t 4 #of Occupants Li Project Description Non( DNA bl¢wid,v rrlf. horn -fro be &up Structure Dimensions,also specify dimensions of decks&porches 3a of ( _ (Choose One) ❑ Basement FiCrawl Space ❑ Slab If Basement,Will There Be Water Using Fixtures In Basement ❑Yes ❑ No Retaining Wall>2' 0 Yes ❑ 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 ❑ 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 ❑ Drilled ❑ Bored ❑ Dug ❑ Unknown Well Repair Requested ❑Yes ❑No Describe Will Certified Well Contractor Install Water Line or Electrical Line from Well I lead 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 , 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 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 0 Yes 0 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 1- (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 ls(No Does the site contain any jurisdictional wetlands? ❑ Ycs 2'No Does the site contain any existing wastewater systems? ❑Yes lI'l o Is any wastewater going to be generated on the site other than domestic sewage? ❑yes El''lo Is the site subject to approval by any other public agency?KO Knowh t�d'Yes El No Arc there any easements or right of ways on thisproperty? DAl RcAnt- If applying for an Improvement Permit or Authorization to Construct, Please Indicate Desired System Alar. Li T pe(s): (systems can be ranked in order of your preference) ❑ Accepted 0 Alternative 0 Conventional 0 Innovative 0 Other ree I2/ f 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 he 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 arc valid for a period of 2 years. Improvement Permits arc 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 he 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 arc 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. Signature of Owner or Legal Agen Date s/7/A71--? Printed Name of Owner or Legal Agen , ep Y a (c ( (Afj 1 ( ilj I4fP . -- -- -_ SURVEY NOTES: SITE `t Type of Survey I TMS SURVEY WAS PREPARED WITHOUT TH BL#9 'i' ''1 . 1pY plal rap..aarrrs a OF A TITLE REPORT WHICH MAY REVEAL A WTI II "•47.- I aann al •••••a pawala old CONVEYANCES,EASEMENTS,RIGHTS OF W ;,OR = Vicinity In a coolly IM ea an erdin.00114..9ylde wmoars d land 1 lease BUILDING RESTRICTIONS ONES NOT SHO: Map Rr 3.AMAMI LM4DOWNERS WERE DETERH!NEO win I nrad s umWq larsbo .:y ua k n.n.r k.onefd36 6 Pg.Map 3.A"RCM'HORIZONTAL CONTROL MONUMENT WASI ¢p k.359/.Pp.B31 NOT TIED DURING THIS SURVEY ` \ br(a0asabw — 1L 11k I \ \ RM60 DO t4•WO L1769n' 7F .. LG/-N 39'0T3a'W `e i /'/ s Rey O.Munger.St I, ' { Dbk,INN.Pq.144 \ � \ WWI f AO Jeffrey Rey Bowmen 1\ _ ` 1e. \r_ 1 4 Dbk.2212.Pp.1472 i. s62y '9b �N \, LOON661931•E 1 1 R • 11 1 t VII I — _ ^ ` a•,-._.. -, \ iN 4\ Ann St• t t a, N 1C_• a � ry v� $ I Nancy 0.Stewart vat �- { Dbk.3036,Pg.6901 Be (�1r �_`� 'I + Ih'eM "in _.—�se9•: w 20051 W.F., Lawrence G.Holler • 006.2336.Pg.1330 1 TOnotby O.Hefner i I Dbk.3062,Pg.1106 • Buena Vista Drive I,- 47 RW 1 1 R%VE1r q�3 — _ — _ J _ — — — -- - — -- -- —1 - - LEGEND .--SR-Ty. i-Rd-- — ` Poe Point of 8eginning cp'AmwA • Point C. kon Pin Set Preliminary Boundary Evidence Survey * R.ta•nnw Trees • Iron Pal 0oAndlo.Cm Cb.Land feral kW r1 a.Pen kart, 3r6t0115.62e Iron Pin Found o,d r.Tewnanp Catawba ba Caunry urt,C.•Mnn ' set 9,Oonpet6 19E0 91426 • Found NM6oNp O..w.an...a Slone ",ti= Clifford Earl Cooper ' •r rani*A+de ... ua Buena Von a "3 ConcreteMollun.M a CO.emcnI AC 2961u R Power Pol. Surveyors Certification — Survey Boundary 01 Parent .... 1.bw.tl G.eau Prot. Lend Damon•artily nul eVaspa l as W Ir a Act nano Traci drown war my arpeMabrm no,.n.m on actualauwy mods gnaw'r.r'u..'.nnron. .. Mr me w..a•mr.nalmonomer r•own•alrAna..ono.a.n.aen..v. Jonathan Blankenship ,—Fence line In...In Ill relrr,lw snow nw.w,not R.tiro a►xYr...as.S1.d CeMaAq e F nova al1119e11,.dn.uh.r.wr.01 0 Ma Map nears!r•.•awaw.r•• my a I To Lea Wow elMer r..refele..cnra tar lard ronq Iy North Correa,Ill NCAc Da MO:. Det•: 4166?023 Area by D.M-.D. Rond Wry Lkm•f . r'M..el epuw.llama a mum•r arm.W VW 1 —.—�ara 20nAC 5 vayd by Sayw Donald G.Bolick I.oraubnelt era Sonar. ..Jose ill Lawman Or..SE Whim,N.C.21600 — T• — ---- ..1 1,•mars 61.16*r.non 47 Pr Inch•F Feel Pafeelnal land Surveyor L•1621 1 40 20 0 40 110 120 160 Catawba County Environmental Health i N 1---- 245,16 56.88 53.01 50.82 200. 56.61 1 03.9; 245.44 200 , • • to •627.E • cn 78,54 33.74 co • ry • • r 6160 1 . [. zoo •6259 55.2 45 �._ 0 ANN ST ca . 20a • 277.6S 03 w c Z G N 2'00.15 6 ,..,.. E1 -CO r--1 r:4 n, ' •6253 u, a •6244 `� 200 Mn1 Parcel: 375501254828, 6260 BUENA VISTA DR 1 in=80ft CLAREMONT, 28610 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 06/09/2023 Parcel Report - Catawba County NC Parcel Information: Owner Information: Parcel ID: 375501254828 Owner: COOPER CLIFFORD EARL Parcel Address: 6260 BUENA VISTA DR Owner2: COOPER DEBORAH S City: CLAREMONT, 28610 Address: 107 BUCK SHOALS CIR LRK(REID): 91426 Address2: Deed Book/Page: 1918/1151 City: HUDSON Subdivision: BUENA VISTA REVISION State/Zip: NC 28638-9135 Lots/Block: 4B/ Last Valid Sale: $9,300 on 1994-08-01 School Information: School District: COUNTY Plat Book/Page: 30/180 Elementary School: OXFORD Legal: LOT 4B PL 30-180 Middle School: RIVER BEND Calculated Acreage: 1.810 Tax Map: 0901 01014 High School: BUNKER HILL Township: CLINES School Map State Road #: TaxNalue Information: Tax Rates Zoning Information: City Tax District: All in County Zoning District: COUNTY County Fire District: OXFORD Zoningl: R-40 Building(s) Value: $0 Zoning2: Land Value: $14,700 Zoning3: Assessed Total Value: $14,700 Zoning Overlay: WP-O 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 828-465-8436 Current Tax Bill Miscellaneous: Firm Panel Date: 2007-09-05 Building Permit Address Search for this parcel. Firm Panel #: 3710375500J If available, Building Permits for this parcel. Septic 2010 Census Block: 1005 links are not permits. 2010 Census Tract: 010101 Septic Final Permits prior to 08/2018, contact Agricultural District: PROXIMITY Environmental Health. Building Details WaterShed: WS-IV Protected Area Voter Precinct: P27/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. ©2023, Catawba County Government, North Carolina.All rights reserved. .4iirj t ,. i 0 '1 ( '' • 1 ::.;;i:Icr, l 1 y 4 i 4 Fil itaO kiibil —L 1 ON a;e a ��i�qi a N.riti • a 11?' 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