HomeMy WebLinkAboutEHPR-6-11-11119 (2).TIF ys C THIS IS NOT A PERMIT Case # EHPR-6-1 1-1 1 1 19
� < �
H �� �
_���` y C�ATAWBA COUNTY HEALTH DEPARTMENT
c�.� ;.��v ^C Plan Review Application for Environmental Services
1842 5M Environmental Health Plan Review - OSWP
IMPROVEMEIVT
NAME TO APPEAR ON PERMIT
Reginald Henkle
SITE ADDRESS: 4Eg9 MCCORKLE LN Sherrills Ford, NC Pin#: 369602763719
NAME of SUBDIVISION: Lot # Section/[31ock/Phase
PROPERTY SIZE: Square Feet Acres 0.46
DIRECTIONS: 16 S/ 150 EAST / RT MCCORKLE LN / INTO CUL-DE-SAC - PRNATE DRIVE - LAST HOUSE
APPLICANT OWNER CONTRACTOR
Reginald Henkle Reginald Henkle Avision2, INC
117 E Charlotte AV 117 E Charlotte AV 5020 Currituck DRCharlotte NC 28210-
Mount Holly NC 28120-2209 Mount Holly NC 28120-2209 (704)604-0293
704-913-7922 704-913-7922 avision2@ymail.com
PRIMARY CONTACT: Contractor APPLICATION FOR: Existing Structure
DIM EXISTING STRUCTURE: 22 x 22 EXISTING FACILITY TYPE: House
NUMBER OF EXISTING BEDROOMS: 2 SEWER TYPE: Septic Tank
NUMBER OF EXISTING OCCUPANTS: 2 EXISTING WATER SUPPLY IN USE: Private Well
CALCULATED DESIGN FLOW:
Public water is �*NOT*" available for this property.
PUBLIC WATER TYPE AVAILABLE:
DESCRIBE WORK: 12 x 14 Kitchen Extension with 8 x 8 uncovered deck on side of house
DESCRIPTION OF A Frame 2 bedroom Home
EXISTING STRUCTURES
ON SITE (IF ANY)
PROPERTY EASEMENTS: none
PROPOSED CONSTRUCTION
PRIMARY RESIDENCE
NEW RESIDENCE? AddlAit to Residence
# OF NEW BEDROOMS: 0 # OF STRUCTURE OCCUPANTS:
PROJECT DESC: Kitchen Extension and uncovered deck
PROJECT DIMENSION: 22 x 12
BASEMENT? No BASEMENTFIXTURES? No
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 norrexpiring 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 re esentation by you of house or
structure location should conform to applicable setbacks.
Date: �`�' L� Signature of Applicant or Agent ��
An Environmental Health Specialist will contact you wi ' 2 workm days of plication date.
If you need further information or assistan please call 828-466-7291
AREA1
****************************************�******************�*********�**********************************�***�*********
Minimum Setbacks Front: 30 Side: 15 Rear: 30 Side St: Max Height:
06/03/11 14:54
��,A CATAWBA COUNTY Case # EHPR-6-11-] 1119
¢ � l Public Health Department Subdivision
..; Environmental Health Division - Pla� Review
�' �`�' PO Box 389, 100-A Southwest Blvd, Ne�vton, NC 28658 Lot#
r�42 sw P[N# 369602763719
Applicant/Owner Reginald Henkle, I 17 E Charlotte AV, Mount Holly NC 28120
Site Address: 4689 MCCORKLE LN, Sherrills Ford, NC
Property Size: SF 0.46 ACRES
Directions: 16 S/ 150 EAST / RT MCCORKLE LN / INTO CUL-DE-SAC - PRIVATE DRNE - LAST HOUSE
FEE NAME DATE AMOUNT BALANCE DUE
Impro Permit Fee 06/02/201 1 $150.
TOTAL FEES $150.00
CHANGE WORK ORDER REQUIRING REDESIGN AND/OR RETRIP WILL INCURE AN ADDITIONAL CHARGE
(SEE FEE SCHEDULE)
06/03/11 14:54
��A THIS IS NOT A PERMIT /// �
� � CATAWBA COUNTY HEALT�I DEPARTIVIENT �; �/�� � -�f % �
;, , �- Application for Environmental Services �� Page 1
18 w
Improvement Permit Authorization to Construct ❑ Septic Repair ❑ Septic Malfunction ❑
Septic E�pansion ❑ New Well Permit 0 Replacement Well ❑ Well Abandonment ❑
Well Repair ❑ Existing System Inspection (Pre-AQproval Required) ❑
Application is for New Construction ❑ Existing Facility ❑
Property Address ur�� � �� � � Subdivision
• �r�, l - (� Lot # Acres
Section/Block/Phase
Driving Directions to Property �?� �/02,�'IG' /S � N' ��= � C�
0
�
�u
a NAME TO APPEAR ON PERIVIIT? Owner ❑ Applicant ❑ Contractor
- O Applicant Contact Information
U Name ` ����� �r
W Address
m
p� Phone Cell Phone
� Owner Contact Information
� Name c l� � � L'-
Z Address
� Phone � ;, �� Cell Phone
U Contractor Contact Information
� Name ��G� e,C�,lf.�.
� Address -r �2.�t� � u.vv'� � C� �rt.- C L7� c 1 o�J e.. r?`�c�, t O
= Phone `�d � o Cell Phone D o 1 Q�'y�-3
�
Z WHO WII,L BE TFIE PRIMARY CONTACT? ❑ Owner ❑ Applicant Contractor
� Description of Existing Structures on Site =�1ryPC,= a o��'� �
� # of Bedrooms *�'� Structure Dimensions �-�-y(� # of Occupants �
!► Basement �Yes _� No Basement Fia�tures ❑ Yes ❑ No
�
Planned Future Additions or Improvements (Building Permit NOT requested at this time)
OG Describe
� Proposed Future Structure Dimensions # of Bedrooms *�' if applicable
� Are there easements or right-of-ways recorded on this property ❑ Yes No
Describe
Is a public water supply available on or adjacent to the above properly **❑ Yes No
Check type available ❑ Community Well ❑ Semi-Public Well ❑ County/City/Township Water Line
E�sting water supply in use ""�dividual Well ❑ Community Well ❑ Semi-Public Well
❑ County/City/Township ater Line
❑ I WOULD LIKE TO SCHEDULE A CONIBINED FLAGGING AND SOIL EVALUATION
(SEE COMBINED EVALUATION PROCEDUES)
I
� a G THIS IS NOT A PERMIT
� � CATAWBA COUNTY HEALTH DEPARTMENT
" � Application for Environmental Services � � Page 2
18 w
� Pro osed Facility Type
rimary Residence ❑ New esidence Addition to Residence # of New Bedrooms *�'
ProjectDescription �/�C�IPi�J E�'` ���iOn) - /�C�✓�►�'�d� �'G1�-
Structure Dimensions 6 �- X(�_ # of Occupants
Basement ❑ Yes �To Base Fixtur ❑ Y es ,� No
❑ Accessory Structure(s) Describe
# of New Bedrooms *-� if applicable Structure Dimensions
# of Occupants Accessory Dwelling ❑ Yes ❑ No
Plumbing ❑ Yes ❑ No Describe Plumbing Needed
❑ Multi-Family Residence # Units #Bedrooms per Unit*�
Total # Bed *� Structure Dimensions
❑ Food Service Specify Type
# Seats Floor Space -Entire Food Service Facility (Sq Ft)
# Employees per Shift # of Shifts Dining Area (Sq. Ft.)
❑ Business Specific Type of Business Retail Floor Space
# of Employees per Shift # of Shifts
❑ Other Facility Type Specify
If Chu rch # of Seats Kitchen ❑ Yes ❑ No If Daycare Specify Occupancy
Application for 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 Desc
Calculated Design Flow, Commercial �' Additional information may be required to
determine design flow from certain facilities. This value wilt be determined during consultation with on-
site staff.
*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 house plans as a
bedroom at the time of building permit issuance. This may prevent the need for septic system size increase in the future. �'If
structure is plumbed but no bedrooms, calculated design flow is required.
** If No, a well permit must be issued with the Authorization to Construct.
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.
� CHANGE WORK ORDER REQUIRING REDESIGN AND/OR RETRIP WILL INCURE AN
� ADDITIONAL CHARGE (SEE FEE SCFIEDLTLE)
a I understand that this is a formal application for Environmental Services and authorize Catawba County Environmental
� Health 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 valid for 5 years or may be non-expiring under certain
V specified conditions. Improvement Permits and Well Permits aze transferrable, but may be revoked if this information, site
W plans or intended use changes for the proposed acility. An Authorization to Construct issued by this department is valid for
m (5) five years from the date issued tra erab�
� � �� r t /� �
= Signature of Owner or Agent �` � �
� Printed Name of Owner or A e '�I�'�C� � ~ L L
Date l� -
��A �o ca�raw�a co���� p��i�
�, �. � ��. � � w� � �� �'� � � )
�, _ � � � Addit�on �
�' �,� ��� PERNIIT NO: ZONR-6-11-18563
(� �", ���� � P.O. Box389 Phone:828-465-8380 APPLIED: 06/02/ZO11
100A Southwest Blvd P�1X: 828-d6�-8484
Newton, North Carotina 286�8 [SSUED: 06(02/2011
1 g L�� SM � w�vw.cata�vbacountynagov EXPIRES: 11/29/20( l
Catawba County Internet Citizen Access Portal: enerbov.catawbacounrync.gov/cap/
APPLICANT OWNER COIYTRACTOR
Re�inald Henkle Reginald Henkle Avision2, INC
1 17 E Charlotte AV � 1 17 E Charlotte AV 50?0 Currituck DR
� Mount Holly NC 28120-2209� � Mount Holly NC 28120-2209 Charlotte NC 28210-
P. 704-913-7922 P. 704-913-7922 P. (704)604-0293
� EMA1L: avision2@ymaiLcom
.'i::t:�: _ . . � . . .Y.� .�. ..__._.,..,...._ �._., �_.
Pr�oPERTY ID�: 369602763719
STFZEET f1DDRESS: 4689 MCCORKLE LN, Shenills Ford, NC LOT�
` PROJECT DESCRIPTION: 12 x 14 Kit�chen Extension with 3 x 8 uncovered deck on side of house ** see Deed 1 159 / 984 for access�easement to property
COMMENTS:
�� �FLOOD ZONE? OWNER TYPE: IZesidential (Private)
100 YEAR FLOOD ZONE PLAIN? Yes LAND OWNER:
FLOOD PLAIN, STRLJCTURE? No
REQ(JIRED SETBACKS FRON"I�: 30.00 REAR: 30.00 CORNER: SIDE: 15.00 MAX HEIGHT: 4�
FEE DESCRIPTION DATE FEE°AMOUNT `
Residentia Zoning Fee 06/02/201 1 �25.00
TOTAL FEES $25:00
The �qlicant hereby certifies that all information and attachments to this Certificate of Zoning Compiliance are true and correct, and
acknowledges that this permit was issued on the basis of the information reauired herein. The applicant further acknowledges that any construction,
alte�•ation or addition which differs from this application shall be sub_ject to removal or alteration so as to bring said structure into conformance �vith the
specifications and standards of the Catawba County Zoning Ordinance. Such corrective aetion shall be at the expense of the applicant.
; t .,.
�. lt.is the responsibility of Appiicant to comply w�ith all existing deed restrictions pertaining to the property. Issuance of this permit is not certitication of
such compliance and.dozs not relieve Applicant of thc duty to comply.
.. ""This Zoning Authorization (R) Permit shall expir ' montFt�fro e date of issuance unless a building permit is secured and remains activ
� � (� � -� �,
rrc'.�r �'ti��_ �-� ��` � t �/ —'' ��� `���-�-E-�-1�
���.-APPLICANT NAME (PRIN1 D) AI' LI � ANT SIGNAI ZONING APPROVED L3Y �
� V�S� 01�, t��?� ***** 'LONING FEES ARE NON-REFUNDABL� *'`***
CO?�4PANY NAME
� t��-r,uit 06/02/20I t 16:1 � Page l of ]
,.�.,.�:Mti.,�,..�.,,��.-.� .ns�...�r �,.n�,�,����:�-„_,.�.�,,.�.�.. a.,..��-,.:.�.q���-�..�.� .._,,,..r�,-.�.-:�„.�.�__,�s.,.,,-.-.�u.,..�:,.�,M.�......,......�,
-_ �
� s
� , s '`s s , ! f
` �`�' �I�' F ��, � 14 �:�� ' `'�c � ,� s k � ', S�� e < L �r k 5' L 4' ? ��� ��
2 �
� �
.. . � . .
� .. . . . . . . .- . . �
� � . . . . , � . . - . . . �
� *�. I I •♦ I I I I I '/ I' I j
� E y: / , / / ' / I ' / / I / I • I I "
� � � � �
(� I I I/ I / / / ��' •
� ti
# � 1' 1� 1 � 1 � �
�
R �
$ � ' . 1 . ' 1 1 `t
e �
� _ ... .. .-- a ..m�f - .'t`iar�-__ ..._ . . . _ _' _ ' '_ _ - _ _
., ^ � � � ., _ _ _
�' ��'_ Y " - , y , .. st' � . ��l` ".�,� ..
' � ,- .rrfa � �._� ; ���� �•� axbM: J � �} �•�
a"'ti eL �'24am F Cf'. � v.:F'-J4'iA �.�+� �°�?a� t 4E
:�. � ���
� ���'
Y -
r , d .� ^.,°�� a n : ='��
'$w... A a" �.1 fi �..w �
�t �
.. � p �•� � F, T
E "` y '"�„
� � ,<" +' f R+ �. ^ z ;��T" � -�,,r-'.
i�'.-+.t'*3.'? A�� � � t�'� i . �P��`iCi �F.
f�� ':tV,�tso-"� ' ,W,i �4L�:
i � ,� � �
[�µ i
� f �`` t •
� 9.Y �..i• � ��•/
r.z...�-` ��, E�.._ y _
,�,
'4i ri�yp3 ".`
ti J u � ..,h , r``` ' aL
{` �� 1
; F �`
,.'' ..,,,,, . S �� �, � Y7� w :r m :r@, ,:*^. � Y,rr.� _,
,+". ;3 . � ..a'� F � a '� � .�r i � ";��' '� '4 x �
< .
t��_�, P s�� . � f �` `� ,. ?" � r�,<-,,� „
< ,.
. �� . i �� . ?... z � � �•�,' } � Fry .� .
' "' f9 .� g a�" �r � yy f "F � � a�. F y '""��
t s ..a�' � ,r� �+° �.,�.:� ,a"
+`: ..�� r s� ` �� '�^�'�
� � ' .fi.+ � � . � � ���s °` ;�'+�^� � {� .'
I � ���s ta °'.;` t � ��l�v� ' � �a ,
t a .n�-,�' : �-�' : � • £ z , ; ,. ti ' �. Et T' � . 3 � � ..
r � � � -°r. �.�r 4, � ,, 1 � u � � i
° �,x �!• � � � �;�` � � � � . 1 J' �r . ,.wg �
� ' � �...,.�'� �. ' . " �.. 3.. r r . E,.: ,,' � � .-,.�' . � . ,�A , � �� �� � r ;
�-...:<' � '�r'' r �r�"--� _ �' � :., y qx �;�:r 8- �� r ,�� f � �`
� rf �,ik ' '� "�. j� � �,
� n ` �� r v. ,� y ;«� � ° � i 3�`4% s. " ,;.1�r. r."�� p .
' .. a� a3 '�f ,� . �, $ •.. . f �' ,� .... u �. vi k � " �`� r � � `5f r ur'3�Yi�Y . �^`' . .
{� Y i , . � � , � ."a'� ,I. . � i .-: t � , �� .. , a�� � 1� ,
_ �"' �r� � • 1'A ' � T'm� � e . . � r u i. - 3, - t
� � z � `� �' .�.,� � �� �i r a� ,t"s '� S > F"�� ae. � 1r�' >-s .
ti � � ��� � ��I I � I �' :
� J' �++ r �,� `x i �'' r �
(:4 � ��,r;. '�''�c�r�, yr �``�'���,� h V � ' W�, � �� �� y r r �� xa a �`� .: �� a,
r , s !� �'.'�'� .3 f � 3 _ "' w k'� '
�lr � ,�' 'p x- -i"
r� i•. '+i�'�,�- ' +f' _ a F, ,,,5�.�`h i� i.�, zi Y��.��,� i.
• V �'' . � i� 3�. fi h ."' ? r� ��,'3a„�. �
� � V i h �� Y � .Y .,� �' h '�"" �y �� ��,: �'h"' �' s�` ;.
+ �, � —�. ` x`"�'p. � `' a� � �j .r �T t�,c
` � �. �, � + ;t w� � �� x��� � ��� �. �� ,, � -y,,� s y
. :.st .�� � f " a c. •: ['�, ,; � � '�7�"" ��� � . � S
. ��z.a. .T';� r R`�� . ` - C �s � � �^ �s,s�s'�t n �,
��.„ � 1, �,�: i : r ,�f.1. �, "r,�e h �.: " i �� �J" � r' g,F� 9,
.� �.�' - � �� ,�e . � > a�'���` '�� �av �,�� 5 � �� r *�t� '
� � �,s'��. .� ^�.3--�a< '� '�r" i-, t,-'-a "t�' a..,'� � .
�.�.� ` `^,,.^"� . •d � � � a"r° T `�� d�..�.�. �" -;'� ��" . r'���`� �. �v � � v
y � .,z � '�m.r � . n ; r ��� "' r�,y�,��� ' S �.� � �����,.� -� x �yi'' ���' "��.
l s ,�uE, _`°:, a,ac..-�cnb � Rr.�. ,a � � . ' � ' � .� •'f �� . ; �YJ ��'1�,� � �' � N'r ���r�-rf�rY 7" t T � t�'"�^' ` ,v� '
�; �'" ... � �' " .' � � � � n ,�5� . � ax e- .,.r`�'� f S �?� 7 ' - -�" W ^ �' a 'N.- i .'^e� V '�' 't 5 mc ' _ n� i
�' �- � � ,r� ' � c . -�3 ,�+`,�4� �, . . � "' �..l���r'��^ + ""� y �,; t S �:: � ,1 F $?� "`1t�}.a '� §�� .:
�� � �. �a���i� ' �',.• � �.�'.*• ��q�� X x t �"Y�a� '`,�..�' ,r` . �� a^ �� x S .
a z: *F; t . F v- �t '�f c� 4�': r + � �°---'Tyv rt"� �� d
s� R,�, r � '� ,�`' �« ` $ °` T!� � ��������' � � � k,,� �'s."xT `�'� r ��'�-� i
. i r . dTY;�Y'� ��� �"k� .� �S a'```'��.-,,��'2��-�`,��+. .�. ��t�..y; �. � ?y��"''��
t � '� �,� �-��Y��' ,.f ` M1 a "'�}-� f �Fr ���E`+ : ,�E a � �.yi �a
� ` v fY 3
�k Ea t3, � V �� z�p ?y� ''� � xt �„ �: ,fi t � r$^�'� ���� ��c�t� �
$ ; 3�R q S�^�i ''D`"+S` � � n � }.#�` 'k 'k � T W a 'h3 � .� T�' �.
s'� _�.. ,�.g S'` � �'h�" '"" a.=r.�' .t �a �I,n �'"Jt s '' d . "� �� i � ��c 'P" ( '� 's a y W.,.� ..
a��.3 �ft�,��.i{� ^+' �' '�`� 'u,' F �+�'��i,����'.�,+,3 G 'i� ��� s*.�'� ..33�'w`' '� �X�c+ .n���s�;
�� 4 j 3' .� 4+` a . � - -,� y�� 9 t �" "�.4+ , n k D�t� �` 5 d� x �, ^;� - `�
... `�-,� ,3' i r � . �'� �+ a �' s'� u � �,g $-�t -r"1»� ��-�s'�7 ..�`+' s, '� ^s +� � t �
' ¢..� �3 y p , tr.� . r� ^,#r'Y.�� �� > E c. 3�' � ,,.g w� 1 r f'.yx �•,ka,,• S 7�, R. r ° � .
t� ��,. � ff��?�'� �W. 4 . � C. �MN',t" 3�\� � � Ws� d.�' k}�.�� �5�'S 'SM . h ^;� .
�R',. .,�a '1„ - "� � �.�.�„� aP � �' v � ��,, � 3 � ��'���.*� +`� .���� � � �, � y ���
�+� ''b ,x �.r�a7 . .F,� 3�, z�' ;za i^a�s*"�� � � � c �1,.---t� s�r a3J� y ,� � y Y.
`4 � 'a : `" "F?if �. .h �..�.� ar yr x� �f w ��,�'�°� :Js rn � +t �'#
'+ti. .�' } �8 �'y. : � � 1 , �'�,e�'� k �`�+ �'' � �'N ��.a� � � � `�`x' 4 t,. r �& �� 1� ,+ � � '.
c # $� f"'9. .F✓�'���•�3x�s��- ty 'f��"�(.,,,"'�i�x„`� a ` ��."51,a �` f:i.� "�.srs,�+q.-u.� �. -. e xa' '� a,i�. �'�',
��•` i. ""� '� s r�, .��•> � c i a} 5' r. •.�ws:��. �.a',�:��e.C�.Ze7�,.t�:ar.rr.rak w x 3 '� .,�,�'�
5" �� v � a j � , ' � dh $
� ` � � � �"q,�� 'i"'^TM��� �v ° .3 �� -�j�{n� 4.�i 1 � ( � � ak �-t-T � `-
..r t S�'a� � ' i. ' L 3t. / ,�, ,.
i � r z � „ �g,,, .� p?.r p i �w� t � � `d �xtt+�,� t5. �� _ , °t`�'' -,� �`GM�
'� � �' � � `' '�`� � �. � '�`, °s �.��"� �, r + � �.F ��a �;�• r a. + a �v � "�- a z �'
4.�..Q. .,....1�..�, e�xi�"'.'" �a ���- ..�a�c.�fi '�'-�.a � _aw`� t;".�`-.`� "r M�. � arw.v�ira�.. �`p`� y,1.s+a� -w�,�,c.
- z;_. -
CATAWBA COUNTY NC - Parcel Report
Information Regarding Selected Parcel(s)
ParcellD: 3696-02-76-37i9' ' `
Name: HENKLE REGINALD A
Name2: HENKLE DOROTHY
Address: 117 E CHARLOTTE AVE
Address2:
City: MOUNT HOLLY
State: NC
Zip: 28120-2209
Account: 156808000
Calc Acreage: 0.46
Tax Map: 017 X 02001 E
LRK: 17765
Deed Book: 2856
Deed Page: 0989
Subdivision Name:
Subdivision Block:
Lots:
Plat Book:
Plat Page:
Building Number: 4689
Street Name: MCCORKLE LN
::.1,; Site Zip: 28673
_�°'•`;;-, Township: MOUNTAIN CREEK
Fi�e Code: . SHERRILLS FORD
City Code:. COl1NTY t ,� � -�-� 'U���'� ��r�r�,-�
State Road: �t
Total Bldgs Value: $196,400
Land Value: $114,100 (1 �� C` ��
Totai Value: $310,500 � � J
. Year Built: 1982
Year Remodeled: �� _ � � a �''
Last Sale Date: 8/9/2007
Last Sale Amount: $480,000
Neighborhood: 129
Watershed: WS-IV Critical Area
Watershed SpVit: NO
Voter P�ecinct: P41
E911 District: COUNTY
Zoning: R-30
Zoning2:
Zoning3:
Zoning Split: N
Zoning Overlay: CRC-O,WP-O,FPM-O
Zoning District: COUNTY
Split Zoning Dist: N
SplitZoning Dist(1): 0
Split Zoning Dist(2): 0
School District: COUNTY
"�'�:-�:� Elementary School: SHERRILLS FORD
Middle Scbool: MILL CREEK
High School; BANDYS
School Split: N0
P&Z Case Number: LOMA 11/20/2003
Census Tract 2010: 011502
Census BIocK2010: 4049
Smali Area Pian: SHERRILLS FORD
Agricultural District:
Printed: Thursday, June 02, 2011 02:48 PM
X � - _� - ,_�-,_..-�. - . � � ,
f � ` !` . * . .
'b
� CATAWBA COUNTY HEALTH DEPARTMENT
NEWTON, NORTH CAROLINA
COMPLETION PERMIT FOR SEPTIC TANKS
PERMIT �� C - � '� 6 4 �
� DATE : �-� �7� �� f
OWNER ��j�/,�l�S 1��/t l''��,�0 0�l ADDRE S S
BUILDING CONTRACTOR SUBDIVISION
LOCATION ��� �' �° LOT �k
LOT SIZE BLOCK OR SECTION .
HOUSE () MOBILE HOME ( a� BUSINESS () OTHER () FHA-VA LOAN ()
SEPTIC TANK: (SIZE ��C�C�' GALS) WATER SUPPLY: /
N0. BEDROOMS�_NO FIXTURES v NDIVIDUAL !/ PUBLIC
GARBAGE DISPOSAL UNIT:YES (�0 ('� IF WELL, TYPE: BORED DRILLED DUG
AUTO WASHING MACHINE: YES (�0 () DISTANCE FROM SEPTIC TANK OR NEAREST
NITRIFICATION FIELD: CI�1� SQ.FT. POLLUTION: FT.
1) NUMBER OF LINES SEPTIC TANK IN BY:
2) LENGTH, AND WIDTH OF LINES C��/'�-E: �CQ �ll�l���
(�(� x I� �- PERMIT FEE _�c1
. a BED SYSTEM CERTIFICATE OF COi�IPLETION BY:
. , , F _ b) _TRENCH SYSTEM ( ) . � � yjh �.�3''
�� � 3) DEPTH OF� STONE�IN L'INES� T lQ`� - "`�REMARKS :` �T - ��'r "- -�°�=� �-
ADEQUATE FALL (GRADE) Oi�: y
1) BUILDIN (HOUSE) SEWER LINE:
YES ( � NO ( )
2) NITRIFI TION LINES: DATE INSTALLED: - —
YES ( �NO ( ) ,
SEPTIC TANK LAYOUT
� �
� �' ` �
I.� � N
H � �
o �
� �
w
H
. o
a a
.
J,
�HEALTH DERARTMENT COPY -
,,.�,�_ �` , -
. _ . . � _. . ___ . ... .
. � ,�\ , ' .' � �� �
� ��;.. .. '. + N' � ' \ r /� �� � i� -
' i ����� �� CATAWBA COUIv'TY HEALTH DEPARTMENT
II�'ROVEMEDTT PERMIT FOR SEPTIC TANKS Permit No. � O 7'2'O
tvTAME OF OWNER �E'��L?� �'�°1 �'���� � DATE �- � / - ���
ADDRESS OF OWNER � PHONE
NAME OF CONTRACTOR ADDRESS
�
LOCATION � .��'� �72. ��J c��c'./� r�� `d, /l. #--� �V �� c-� �S' �-(L-s��„ ��-��.,R
� .
/r� r� �-�'il�. —�' �i.v � -f'-v2 c� D � , f'"c�� � �
SUBDIVISION LOT N0. SECTION OR BLOCK
LOT SIZE FHA, A L0�1N '
HO,USE O MOBILE HOME (�SINES,S O OTHER O SEPTIC TANK LAYOUT
N0. BEDROOMS �) N0. FIXTURES (�- � y
GARBAGE DISPOSAL t?NIT : YES O bT0 .( � ti�'
EIaUUM$iNG UNDER BASEMENT FLOOR: YES () NO (tY '
M
SIZE OF TANK �UQ (� LIQUID GALLONS
NITRIFICATION FIELD ° �`S �
l. Number of "lines � � -�'
2. Length and width of lines: �
a. Bed System C� ��� ft. �� �
b. Trench system ft. �b
3. Total Depth of stone l c� inches
GROUNDWATER INTERCEPTOR DRAIN: �
(IF REQUIRED)
�WTiTER SUPPLY: - - PRIV?.TE — ( — PUBLIC ( ) — � � - — - - �" -- - - " � _
OWNER NOTIFIED TO CHECK ZONING: YES (�NO O
�OWNER.AGREES WITH LAYOUT: YES (►a�NO ( }
OWNER AGREES WITH SPECIAL INSTRUCTIONS: YES (B� NO O
OWNER OR CONTRACTOR SIG TU
PERMIT FEE $ 1 , -��'
PERMIT VOID AFTER 36 MO THS
I92PROVEMENT PERMIT ISSUED BY SEPTIC TANK CONTRACTOR MUST FOLLOW ALL
�
� DETAILS OF THIS PERMIT (LAYOUT)
SANITARIAN � /� r► C S�
HEALTH DEPARTMENT COPY
SOIL CLASSIFICATION: SUITABLE O PROVISIONALLY SUITABLE:( ) iJ?�1SUIT!�BLE O
SITE FACTORS
1. SLOPE (%) S- PS - U 7. SOIL PERMEABILI�Y S- PS - U
2. SOIL TEXTURE (12-48 IN.) S- PS - U UNDER 60 MIN. - OVER 60 MIN.
SANDY, LOAMY, CLAYEY ___ 8.. OTHER S- PS - U
3. SOIL STRUCTURE (12-48 IN.) S- PS - L' SPECII'Y)
4. SOIL DEPTH (IN.) S- PS - U 9. 50IL SERIES:
5. RESTRICTIVE HORIZONS (IN.) S- PS - U A. CECII: O B. HIWASSEE O
(IMPERVIOUS STRATA, ROCK) C. MADISON O D. APPLING O
6. SOIL n�tAINAGE - GROUNDWATER S- PS - U E. PACOLET O F. FLOOD PLAIN O
(EXTFRNAL - INTERNAL) G. 2-1 CLAY SOIL H. OTHER-SPECIFY
� .
~-0p~ CA'I'AWBA COUNTY
~ Case # WLS2007-00267
/ ~ ~ '1~~~\ Public Health Department
~ Enviromuen[aI Heal[h Division Subdivision
V~~\- 1'O Box 389, 100-A Southwest E31vd, Newton, NC 28658 SecCBL/Ph/hot #
~~,4d a (828j 465-8270 FAX (828) 465-8276 TDD (828) 465-8200 PIN#
369602763719
. Applic~?nt/Owner: JAMES CRISSON
Site Address: 4639 MCCORKLE LN S1~RRILLS FORD NC
Property size: SF .46 ACRES
Directions: 16 S / 150 EAST / RT MCCORKLE LN /INTO CUL-DE-SAC -PRIVATE DRIVE -LAST HOUSE
EXISTING SEPTIC SYSTEM INSPECTION REPORT
Site/S stem Dia ram
e~"
v~~
-v~
~,I'
~
,n
Mfr
~
Type of Facility: House X Mobile Home # Bedrooms ~
Business Specify
Other Specify
Proposed Additions /Accessory Structures: ~ (R ~ X ) 2' Ll2 a- ~nC~C. -~-c o~v~
~
Approved Not Approved Reason
Evidence of system malfunction: YES NO System Type/Description
Authorized State Agent: DATE:
i
NOT FOR LOAN APPROVAL Form E
r:\Ti demark\Porrn sV W1~Savv.mr