HomeMy WebLinkAboutEHPR-3-11-10139 (2).TIF � g ' A � THIS IS NOT A PERMIT Case # EHPR-3-ll-10139
� � CATAWBA COUNTY HEALTH DEPARTMENT
c� ,:�°: '�` Plan Review Application for Environmental Services
I842 sM Environmental Health Plan Review - OSWP
ey �� � . I- - � .� IMPROVEMENT
D�I �IC1�-7Fnn � �nPS u� D�+rJ,�� NAME TO APPEAR ON PERMIT
��� CLAYTON HOMES CLAYTON HOMES
SITE ADDRESS: ZION CHURCH RD Hickory, NC Pirr�: 370016842737
NAME of SUBDIVISION:BARBARA ANN GRAY Lot # 2 Section/Block/Phase
PROPERTY SIZE: Square Feet Acres 3.33
DIRECTIONS: HIGHWAY 10 W- TURN RIGHT ONTO ZION CHURCH RD - PROPERTY ON WGHT BEFORE PITTSTOWN
RD
APPLICANT OWNER CONTRACTOR
CLAYTON HOMES CLAYTON HOMES BARBARA GRAY
1230 CONOVER BLVD W 1707 MENNONITE CHURCH RD
CONOVER NC 28613- HICKORY NC 28601-
(828)465-3450 (828)241-4935
PRIMARY CONTACT: Applicant APPLICATION FOR: Existing Structure
DIM EXISTING STRUCTURE: 34 X 60 EXISTING FACILITY TYPE: Mobile Home
NUMBER OF EXISTING BEDROOMS: 3 SEWER TYPE: Septic Tank
NUMBER OF EXISTING OCCUPANTS: 2 EXISTING WATER SUPPLY fN US . Public Water
CALCULATED DESIGN FLOW:
Public water IS available for this property.
PUBLIC WATER TYPE AVAILABLE: County/City/Township Water
DESCRIBE WORK: DNIDING PROPERTY INTO 2 LOTS - NEED IP
DESCRIPTION OF DOUBLE WIDE
EXISTING STRUCTURES
ON SITE (IF ANY)
PROPOSED FUTURE ADDITIONS NO
OR IMPROVEMENTS:
PROPERTY EASEMENTS: YES - PART OF DRAINLINES FROM LOT 1
PROPOSED CONSTRUCTION
I understand that this is a formal application for a well permit, Improvement permit or Authorization to Construct a ground absorption sewage disposal
system to serve the above described facility on this property and authorize Catawba County Health Department employees to go on this property for
evaluation purposes. I certify the above information to be correct and understand that an Improvement Permit issued as a result of this information is
transferable and may be eligible for a nor�expiring date, but may be revoked if this information, site plans or intended use changes for the proposed
facility. A Well Permit and Authorization to Construct issued by this department is valid for (5) five years from the date issued and is not transferable.
Note: You must obtain Zoning Approval prior to locating a home or structure on this property. Any representation by you of house or
structure location should conform to applicable setbacks.
Date: Signature of Applicant or Agent
An Environmental Health Specialist will contact you within 2 working days of application date.
If you need further information or assistance please call 828-466-7291
AREA2
*****************************�*�******************�*******************************************************************
Minimum Setbacks Front: 30 Side: 15 Rear: 30 Side St: Max Height:
FEE NAME DATE AMOUNT BALANCE DUE
Im provement Permit Fee 03 /30/2011 $15 0.00 $0.00
TOTAL FEES $150.00 $0.00
04/13/ll 08:09
. _ . .,
ypr. 4. �011 1:5iPNi (;l,:,y�ton Horr�:;—C�naver PJo. fii;i�Q P, 1
RECEIVED
'�`�' �P� 0 4 2011
� �
homes �r�w� courmr
9 230 Conover Bivd. West ��Ta� t��,�
Conover, NC 28613
(828) 465-3450 (828) 464-0261 (Fax)
DATE � � ll
TO /�/( �� �,
FAx# �Z�-c{��_ �5 2�?�
FROM � .• ��-,L
# PAGES (including cover sheet)
MESSAGEa
_ P 1� C �i4t � jn,'�' �✓
� t� x► �• C��..f r c.�r �� - _
1 � I ^�1 1 � � I I %� 1 �I '� "I �� n
y��r. 4. tr�ll 1:51?i��i �:I,;.yi��r ror��;-�,onov�r id�;. (i,i,i, r. [
FlLED C2lar�b,e Gots�
�� � an S�iar �U, �Oi9 s� b1:a2:44 psn
�p
� �15e �cx �`il-GQ i P
� �
��{vT..�`r �.1J�J�3
.�/ C, q h �� � �^1. 4'�kA t�LIG�G ��@i�fER,
�z 3 0 � e n avc � a�V� �• ���a� �s [�cts
c�o�� Nc����
3, CK�;t'17O F� �6?C1�-'����
NOR�'H C:AROLINA
EASENiENT �'OR SEPTIC TA.�rK LLti'E
CATA�'4�A COUNTY
THIS AGREEIvLENT, made this the 28th day of March, 2011, by and between BARBARA A?v�i
GRAY and CAROLYI� CA1�E, T?arty of the First Part, and E�RBARA A��i 1 GRAY and CAROLYI�T
CA1'��SPE, Party of the Second Part.
�'VITNES SETH
V�'HEREAS, the parties hereto own a cerr.ain tract of land i.n Hickory• Tow�ship, Catawba County,
!�orth Caroli.na, the sazae being the land con�•eyed to them by deed recorded in Book306�, Page 1412, of
the Catawba Counry Re;is�y; and
bVI3EREAS, the parties desire to ditiide the propezty into tu-o lots, �ne of which �rill bave a septic
tank installed (new lot), a.nd the lines to the sepric t,ink will nw onto the remaining lot (p4ent tract); and
�VHER�AS, the parties hereto desire that a definite agreement be made as to the use and
maintenance of said septic tank; and
NO�V, THEREFORE, in consideration of the mutual rights and adva.nrzges herei.n set out, tbe said
parties hereto mutually a�ee as follows: -
Party of the Second Part herein agrees to allo«% Pazty o� the Fizst �art berein to install and matntain
a septic �ank line on the propercy ofthe Party of the Second Part (the pazent tcact) for a septic tank tlialwill
be installed on the property of the Pa.rty of the First Part {new� lot from parent t�act); for tbe puzpose of
pro�•iding sewer services to a residenrial dwe? ling located on property of rhe Pazry of the �irst Part (Aew 1ot
from pazent tract).
II� TESTIMOI�Y VJHEREOF, the parties hereto ha��e set their hands and seals the day and year first
above �vritten.
(SEAL)
Barbara Ann Crray
( S�AL)
Carolyn anipe
�
, p � ..
� , ���If. �t. ��il� �:���IY�I (.��'.VI'Jil IiOf�i��: I��O. ��Irl�l� '. J
�.
STATE OF NORTH CAROLINA � `�
�at,�'etvJ b� COUNTY.
I, V Q n G SS G� �. • Gl rn d f , a Notary Public of the County and state aforesaid, certify that
B�1RB:i�ZA !LI`'N GRAY and CAROLY�1 CANIFE personally appeared before me this day and
acknowledged the execution of the foregoing i.nstrument.
�4Yitaess my hand and official stamp or seal, this ��'day of � Gl r�� , 2011.
` ' ' ��= \ � I � %>�i.�.
�/ � . `.^i - ``,`,\f✓ . l'
o l��� � �' � •',, n n �n �
_� = ' _,.,�.1 -,�_
Nota�ubli� � � :.�_ _
My commission eapires: 0 3 0 � n : �_
��s A� ��� _:� �
% �`'• :
�
STATE OF NORTH CAROLIN.4 ��'���� 4 C O ����`�'
� ��//l; l ll lllll\U
B�L�.KE COUNTY. � -
I, , a Notary Public of the County and state aforesaid, certi�y that
personally appeare� betore me this day and acl�owledged
the execution of the foregoing instrument.
Wibness my hand and official stamp or seal, this day of , 2011.
Notarv Public
My commission expires:
!
'� �t [Q'1 1Q:lif�Ni C1=y't+�n Ho����:—f.onov�r No, (O�;i; �. 1
.I'��,
GI� n
�
homes
1230 Conover Blvd. West
Conover, NC 28613
(828) 465-3450 (828) 464-0261 (Fax)
DATE � t
� �i�
TO � � �n - -
FAX# � ZSr -�{ l� Sr-- 2�-� �
FROM _�vS�I�in ��,��
# PAGES (including cover sheet)
MESSAGE: f
( o r� u f�` � r��
� I. Lll� I �i;. 1 jANi �;�-.yron Hs� .. �d�. Gi,'`�(I �. �
�mall.fv�,.., ,..., ....._.,...ir, .,_.. /
Sgt,�ae� u�rements ,'
�rarrt - 30' /
:..�e - �5' ,
�,t�ar - 30' '
�
,'
�
' /
./ � �
� �.
,� �tl�� ��c k
, � �4c. ��4, �. �� � ��
/ �
,
\ ��a�t �..
.
.
, - �
�� � � �a�►��++°��r �,� �
,./ � �a+�� �� � �,
�
1 �
i �
��/ �n��r �f ��
,
/ �k• �, Pg. 1 �8q �'
' s �'� � �� �
� !��� �i�?L� - '�j �. �V�"�
� „
�/ ��� � � �. 1 J�y�q�ere � 3B�&s �
.
, ,Slf�� �'� �f �Q����� � 2�.08'
,/ nb94 ��fi / �: �' r � , � Re��f# �
� � �` �, ��k. ��
��'�'�'' � �'�� � �.� � � ti�
, a , \
� �°' � � '�S' �� �(� � � �
� ',
' � ,.� �a.� .� �� � � ���
,����" �'i� �'� � ,� � � \
. a � � "�'�� ���� � ,
\ \\ w�� • ,�ti, � � ^N �/� � S / � \
\� , �ontrol
� � \ � ,� �' � _ �/�"� �s�1��fe ��
�==-
2a� — � – `� �~,� �1/2"��� � ,,
� � �a �
N a3•�h2'�� �, � _ �
i �'�� �p/ � �
� � � �, I►��_ \
rv 5s�2s.�^ - '� �• �A. 1 �@0
� �`� �. _ , eA: 14�
.- q � r � ' . ` r � ,�
� �n 4��"�� ��• • 1 , Mli+��l L, M�r�l
� � r � Q � �{/� � ��k. gQ93, �fl, ��
�� ` � �,� , ��:7�� `��'�R�
►r��� � �li�� �0��.. \
��Q�� � �� ��' ° , /
�.� �� �
-- -- � �
i � ;Stone � �
.,
� �
i�'t�l'�.�t � . •
�c,4� ` �
��� i ���� �
�� � _ ,. . .
�� � _'►,��� a�� �
` k;�r.�' �. (i;i i �i,:'� iH�ii �: .,V��)n r;��,;�_—;;:�nov:�� i"V;. f,i;,�i? . j
Description for tf��e Barbara Ann Crray and Carolyn Canipe survey - Septic Easement
An Easemerrt Area is reserved for the Sepfiic Draina�e and is described as follows:
Commencin� at the 3/4" Iron Pipe v�zth in the NE portion of the right of way for Zion
Church Road, (SR 1008), and in the division ]ine for Lot Z and the Citifinancial Services,
Inc. parcel as shown by sun•e}� plat for a�finor Subdi�lsion surveyed for Barbara rinr►
Gray and Caroly�n Canipe, surveyed and platted by Donald G. Bolick, L-3638, 3/16/201 l,
and proceedin� thence N?5'16'�8"E. a distance of 162.45' to the POI'�1T OF
BEGINNII� G;
The Point of Beginnin� being an unmarked point in the aforementioned division line,
thence rurulin� through the Lot 2 a.rea, I�$5 1"�', a distance ot 80.26' to an unmarked
point in the division line for Lot 1 and Lot 2 as showm by the $arbara Ann Crray and
Caroljm Canipe plat; thence u�ith said division line I�T31 °26'31 "E, a distance of �0.00' to
an unrnarked point; thence crossin� through the Lot 2 area, S86`51'�1"E, a distance of
15.36' to a 1 i2" Iron Pipe; N`V comer of the Citifinancial Ser�ices, Inc. pa.rcel: thence
S25°16'38"��1, a distan.ce of 50.00' to ihe pO1NT' OF BEGI'�'_�1NG;
Said described Area bein� 0.08 Acres (3538.02 Square Feet), more or less, as
computed from the :vlinor Subdi��ision plat b_y Donald G. Bolicl� L-368S, 4/03/201 l.
!/�"
��° S�
�
��
�� ��
l �� .�� g ��o
a �� �
�
�f �
�om�es
1230 Conover Blvd. West
Conover, NC 28613
(828) 465-3450 (828) 464-0261 (Fax)
DATE � - 9 ll
TO /!�( /v(G <'
FAX# � 2. �- c{ ��- i5 �� 6
FROM J v � r` �- �
# PAGES (including cover sheet) �
MESSAGE:
�C � t ✓ �
�_ l r �� GI�. v r c.�- �� •
� � s -� G �� � � ,� ,� � �.v� Gc S
�v o w �(.. � �- c� i ,'�� c ��
��f
� •d �,����� •� ��nouo:)—s;u�o� uo�h.IJ �Nd��i)�c 110� �ll '.�r��;-
� � ,
/� �� yl���,� n� ,,/ '�/
, � � �,
• j !� , .
/ �� � /
'� /�`� /i
� Carmie Carlos Cook y
,\ Dbk. 870, Pg. 210 �.�"'� I '1 ` Ava J. Co�
'� , �'� /,� � Dbk.2057,
� s '/ �
� /
\ j �� �
� eptic Easement , � \
,, Id Bearin Distance � '� �
36 50.00' �� \
s � \
N 65°13'31" W 80.2G j ,/
, L3. N 31°26�31" E 100.00� �
?5'1��� F 67 87'.' LOt 2 �� �
� � Remainder of � Ashley S. Lindler
'� � Dbk. 3046, Pg. 1380 Dbk. 2243, Pb. 1513 '
,� �
, 2168 Zion Church Rd ,
� Lot 1 includes S �',�,��� 3/6"Rebar _ _ � - - --� - � '� r - �
,� 0.06 acres ,�, F 1��IPf/square S 30'Q4'ST' W �
/ 3565.70 sq ft LOt 1 `
at street R/W Pa�t of �'i011�r0{ � z�'os' �
�,sa' NW of Dbk. 3046, �, �� Robert E. Johnson, Sr. '�
properry line a .; � Pg. 1380 ��h %� �� Dbk. 2449, Pg. 704 ��
s�a°�� ��� 1,0o acres ,� , ry � '
�� 43560.00 sq ft � .� �� ,�
1.56' NW of ,��'` Removed home,� / Septic Easement �� �
property line a'� sap�r., site o :;, � � �
�
1/2"IPf � vv��rrapCid. � ti�' ` � �, ,
E�ec ;� 1/2"IPf � /'
�� ` ,
�,� � `�:� � ��� �� Gontrol �, ,
'�`��'' , . ���� �?� : �1l2"IPfis uare �
� a• . Possible ;.;:;:: � � 4g q
� �' � Overlap � � ���,'.` �cc ��e � 1/Z'Rebar \��/
Area Bld � �
p 38,21 g ,�ry'
,�i� � 59"04'CO" W `ti �� �
_ �� ���' yCitifinancial S rvices, Inc. \
� 1 ��o� �'�� e�l�n �,� Dbk.3046�Pg. 1380 �
s�� ` ' � Pbk. 23� Pg. 143 �
_ p� �,,
� 2a�' - � �Axle \
�'� � � ' INlichael L. Henry �
33 � � �
N so°s2�4s'� w °• sT Dbk. 2873, P 83 �\
\s „ 1Pf/base � 9 '
, " Sn ° S 25'16"36" W �
� w � , 17.79' � /z'Rebar �\
Dn Church Road \ ag ' � \
SR 1008 �so� �''�'� .
25.23 � , � ,'
' `�\ /
�,� ��
`� \
Surveyors Cert� c �'o
"I, Donald G. Bolick Professional Land Surveyor, certify that this plat
was drawn under my supervision from an adual survey made under my :
That the boundar�es'not surveyed are clearly indicated as drawn ftom infi
found in the references shovm hereon; That the ratio of precision as calc
is in excess of 1/10000 unless otherwise noted; 7hat this plat was prepa
in accordance with G. S. 47-30 as amended, any exception is duly noted
- Witness my ori inal signature, regi tion n mber and seaf this
�" = 100 Graphic S _ , , �_, day of �� , 2011 A
_ ��� �c���'i?9'°N� ,.i�nouo,�_:.��uo� u�:�.�'.�IJ��"�'�;Nd6�?�� � 110� 'll '.io�
Description for tahe Barbara Ann Gray-Caro�yn Cazu.pe Survey - Septic Easement 0.12 ac
An Easement Area is reserved for the Septic Y}rainage and is described as follows:
Commencing at the 3/4" Iron Pipe with in the NE portion of the zigkit of way for Zion
Church Road, (SR 1008), a.nd in the division line for Lot 2 and the Citifinancial Services,
Tnc. parcel as shown by survey plat for a Minor Subdivision surveyed for Barbara Ann
Gray and Carolyu Canzpe, stweyed and platted by Donald G. Bvlicl� Ir3688, 3/16/2011,
and proceeding thence N25°16'38"E, a di,stance of 162.45' to the POINT OF
BEGINNINCr,
T'be Point ofBeu�inning beivg an u.nr.�.arked �oirrt in tl�e aforementioned division liuoe;
thence z'unning through the Lot 2 are� N85°13'31 "W, a distance of 8026' to an unmarked
point in the division liz�.e for Lot 1 and Lot 2 as shown by the Barbara Anu Gray and
Carolyn Canipe ptat; thence wi�th said divi�sion line, N31 °26'31 "E, a distance of 100.00' to
anunmarked poim; thence aossing through tbe Lot 2 area, S46°25'13"E, a disr.ance of
68.87' to a 1/2" Iron Pipe; NW corneK of the Citifinancial Services, Inc. parcel; thence
S25°16'38"W, a distance of 50.00' to the POINT OF BEGINNII�IG;
Said descnbed A.rea being 0.08 AcTes (3538.02 Squaze Feet), more or less, as
computed from the Minor Subcli�vision plat by Donald G. Bolicl� L-3688, 4/08/2011.
� � ��
�P � o ,��
� �,a�'�``�� � � �-� 69 D
�33 Q �� �
��
� •� �����;iy �oN ii.nouoJ-=��.uoH uc��:l:) !Nd6(!�� lli)� 'll '.i��h�