The URL can be used to link to this page

Home My WebLink AboutEHPR-6-11-11152 (2).TIF �$ C G THIS IS NOT A PERMIT Case # EHPR-6-11-11152 �" ��:�� r CATAWBA COUNTY HEALTH DEPARTMENT v , o ''4' Plan Review Application for Environmental Services I842 sM Environmental Health Plan Review - OSWP SEPTIC MALFUNCT/OIV NAME TO APPEA O PERMIT MELISSA DUSTIN SITE ADDRESS: 22gS ARBOR LN Newton, NC Pin#: 365914239960 NAME of SUBDIVISION:CRESTVIEW DEV Lot # 39-41 PT 3 Section/Block/Phase B PROPERTY SIZE: Square Feet Acres 0.43 DIRECTIONS: HWY 16 S, R[GHT ON CRESTVIEW DR,LEFT ON ARBOR, 2ND HOUSE ON RIGHT APPLICANT OWNER COIYTRACTOR MELISSA DUSTIN MELISSA DUSTIN 2285 ARBOR LN 2285 ARBOR LN NEWTON NC 28658 NEWTON NC 28658 PRIMARY CONTACT: Owner APPLICATION FOR: Existing Structure DIM EXISTING STRUCTURE: 68 X 29 EXISTING FACILITY TYPE: House NUMBER OF EXISTING BEDROOMS: 3 SEWER TYPE: Septic Tank NUMBER OF EXISTING OCCUPANTS: 2 EXISTING WATER SUPPLY IN USE: Community Well CALCULATED DESIGN FLOW: 36Q Public water IS available for this property. PUBLIC WATER TYPE AVAILABLE: Community Well DESCRIBE WORK: SEPTIC MALFUNCTION DESCRIPTION OF PRIVATE RESIDENCE AND 10 X 12 OUTBUILDING EXISTING STRUCTURES ON SITE (IF ANY) PROPOSED FUTURE ADDITIONS NONE OR IMPROVEMENTS: - PROPERTY EASEMENTS: NONE PROPOSED CONSTRUCTION I understand that this is a formal application for a weli 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 non-expiring date, but may be revoked if this information, site plans or intended use changes for the proposed facility. A Weil 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 ho or structure location should conform to applicable setbacks. . Date: �o '�' � I 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 AREA1 ******************�***********�**********�*�**�*********��************�*************************************�********* Minimum Setbacks Front: Side: Rear: Side St: Max Height: FEE NAME DATE AMOUNT BALANCE DUE Authorization to Construct (Repair Fee 06/03/2011 $300.00 $0.00 TOTAL FEES $300.00 $0.00 06/03/I i I5:24 ��A CATAWBA COUNTY Case # EHPR-6-11-11152 � $ G Public Health Department 2 Subdivision CRESTVIEW DEV d .; Environmental Health Division - Plan Review '��- �� .'s' PO Box 389, 100-A Southwest Blvd, Newton, NC 28658 Lo� 39-41 PT 38 &42 !g 2 sw ' PIN# 365914239960 Applicant/Owner MELISSA DUSTIN, 2285 ARBOR LN, NEWTON NC 28658 Site Address: 2285 ARBOR LN, Ne�vton, NC Property Size: SF 0.43 ACRES Directions: HWY 16 S, RIGI-IT ON CRESTVIEW DR,LEFT ON ARBOR, 2ND HOUSE ON RIGHT CHANGE WORK ORDER REQUIRING REDESIGN AND/OR RETRIP WILL INCURE AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) ' 06/03/11 1524 ` ,��A THIS IS NOT A PERMIT �?' �4 ;� CATAWBA COUNTY I�EALTH DEPARTMENT �' �� -� Application for Environmental Services Page 1 1 I�jQ2 SM Improvement Permit ❑ Authorization to Construct ❑ Septic Repair Septic Malfunction ❑ Septic Expansion ❑ New Well Permit ❑ Replacement Well ❑ We 1 Abandonment ❑ Well Repair ❑ Existing System Inspection (Pre-Approval Required) ❑ Application is for New Construction ❑ Existing Facility ❑ Property Address �.��5 /�; �� UV. . 5ubdivision Lot # Acres � � � tionBloc ase Driving Directions to Property c1 �Do�l �r� � d 1�0 -� 0 � � W � a NAME TO APPEAR ON PERMIT? �Owner ❑ Applicant ❑ Contractor � Applicant Contact Information V Name /� W Address 22 � m � Phone g, �Q Cell Phone � Owner Contact Information � Name Z Address � Phone , Cell Phone �ptiL�- � Contractor Contact Information 4 Name � Address � = Phone Cell Phone � z WHO WILL BE THE PRIMARY CONTACT? �;Owner ❑ Applicant ❑ Contractor � Description of Existing Structures on Site �/ � Q Q # of Bedrooms *�' Structure Dimensions �OK l2. # of Occupant 1� Basement ❑ Yes No Basement Fixtures ❑ Yes �} No �-��(�� (�,�� `j� � Planned Future Additions or Improvements (Building Permit NOT requested at this time) � 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 avai ble on or adjacent to the above property ** Yes o Check type available Community Well ❑ Semi-Public Well ❑ County/City/Township Water Line Existing water supply in use ('� Individual Well Community Well ❑ Semi-Public Well ❑ County/City/Township Water Line ❑ I WOULD LIKE TO SCHEDULE A COMBINED FLAGGING AND SOIL EVALUATION (SEE COMBINED EV ALUAT.ION PROCEDUES)' . . _ i �,�� `� THIS IS NOT A PERMIT `� � �'� CA'I'AWBA COUNTY HEALTI� DEPARTIVIENT � n, . �� Y Application for Environmental Services Page 2 1$42 sM • . Proposed Facility Type ❑ Primary Residence ❑ New Residence ❑ Addition to Residence # of New Bedrooms *`; Project Description Structure Dimensions # of Occupants Basement ❑ Yes ❑ No Basement Fixtures ❑ Yes ❑ No � ❑ Accessory Structure(s) Describe ' • • - " � ' �° � � ' � # of New Bedrooms *�' if applicable Structure Dimensions # of Occupants, Accessory Dwelling .� Yes, ❑ No . ', P.luinbing Q,Yes ❑ No :Descr`ibe Plumbing Needed 4� " ❑ Multi-Family Residence.# Units: � � � � ° #Bedrooin's per Un`it*� � ' � . . : . Total # Bedrooms *�' 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 Daycare Specify Occupancy ' � � � Application for Well Construction/Abandonment/Repair • ._ ti' Proposed Well Type ❑ Individual Well ❑ Semi-Public Well , 0�•.Community Well Abandonment Type [] � Drilled ❑ Bored ' . . , ❑ Dug ' `. � Unknown Well Repair Requested ❑ Yes ❑ No Describe � � Calculated Design Flow, Commercial j Additional information may be required to determine design flow from certain facilities. This value will be determined during consultation with on- site staff. *Any room that;will be intended;fo'r sleeping at the time of const'ruction 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 SCHEDULE) � I understand that this is a formal application for Environmental Services and authorize Catawba County Environmental a � 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 U specified conditions. Improvement Pennits and Well Permits are transferrable, but may be revoked if this information, site W pians or intended use changes for the proposed facility. An Authorization to Con ct issued by this department is valid for m � (5) five years from the date issued and is not transfer�ble � Signature of Owner or Agent � Printed Na e of i wner or Agent � Date • � •.j ' � Catavvba County, North Carolina N This map produc! wns prepared fi an the Catawba Counry, NC, Geographic Informatron System. Catawba Co:mty has made substantia] eJforls m ensure the accuract� of location and labeling injorn:ation contarned on d�is map. Catawba Counry promotes and recomn�ends the independent verifrcation of any da�a contained on dris mnp product by the t�ser. The Coimty of Catmvba, its employees, agents and personne! disclaim, and shall not be held liable for unv and all damages, loss or Irabiliry, whether direct, indirect a� consequential tivhich nrises or may arise fi�om this map product or the use thereojby any person or entity. Legend Selected Parcel Number: 3659-14-23-9960 1 inch = 40 feet Prepared for: ' � _ l ` ' 41 �� ; � � _ _ ___ f , t ^,-- t � g � � _ , , , ,o ; � J f ! 1 1 1 `,� °�' ��d�� ,� r � �� ... �I r�llli��l� I�.'� � 1 `� � , ; f x� � � g � �� , � �f ` '�£' I�-� r t "�I�.._� . `''7 ,rJe x � � �^ � : ^� / � t� �sa � � � �3t ( � � 'r ,� . � �� `+ :L � ,u �.'' � ' � �u' + , 1 � , �L } I � i �� F� �ty`�� .'� �� t� '�,� � � j � '' �pr �'� I 1 ��. i � / ,'€ k �s ( ,�. � � ! \_ � + fi � d` '', sr� `' �' I 1 1�� J '�/ ��'" t � a v�( k � s i -� � � � sm x � / ��. z � ) � ` Ir � � � � �� 1 I � r � � h �� ' � � � rf � � �t � u4 � x �f�' � ��. � `: f I i.�. I r �� kk '. `� � F 3 � � ,' � ^ ^ � r �� f � f ti J, � � P � J 0 f '� r�,� ', ��;� • � r ,, , ��i �,; � ; / J i � ( ' .�" � r � i ;y � � r � i i� a i Sm� � � � ,,��;: � ( J J � � ` 8963 �' � �� ! , � : r�� ,:� � r �¢ �, � 1 'L� 3sa, ' p # y ll�i R I y,� J ( t J � t) " .� t .; r ViV� clli )j h �, O j f ¢ j z � '� wt � � � ; I h � � p i f � "'} — „� I I /T � Y \ } � / � { � p I � '� `S � � . \ \ `�J I � r 4 i $' # {� 4 { d $ B i � ) � v' y �s i � ..� �"' i I � � ��'� I �� i � I � a�� ' � �"�� a�> � T' ' - Y `�„ � ' �� / f ,�^�` `'� \�'`. 1 x ,, r # .. / , ` Q l � � � � 1 `E '� a �'�� ' `�A � l � / / f / / i'�� `"� ° � � , r �� , � �r aa'�� :� �� '� �; �° �� ' � 09�a 1 1 � , �� , , ��,� � 99 0 ��_�� _� � t �� n � � r '-��_ ti ' � � � � r � , �� ' �'' ' Q� "� ' � � , ;\ 1 �„� � r �u� , f i � 3 5 ' , �,�, , ,; t��r u � � � c�. ; � , � " x � , � ` r 4 J V � d l �� ! � �' � � y� '�" i k� �� 1�� " J 1 � � C 36 i / ( ( � " Tt � � " '�l r �� 1 f J �� ' i ' ' f 37 �� .;�� x 3 ` � : �� '� � It ,� < � r � j � � I ;� �� t ,� x �,� � �'�, � r �! � j • �� ! 1 �/ u I � c. �..a r� �, r� .;+ +�' i 1 3 14 � 38 �, � n� � � �� , � � ��U� ; ; , � 9 � � � � , , � �p , �� , � � ,� � �� cv , t�a a aa r ., .�? ` , r ' � ( 1 / �/ ( ( � � �'r b i d "n��, � � � r illiir^�� r ; I � � , , � , � � q,p,a �� , , , � u � 4 0 � �----�� t � � ,� �, r �� r �. z � u �,,� �,�. � �� ` o r -- � / � r , �� ! i: i 1 1 � � .-vi�r�qo ui � ( 1 � 2 , �� , � �s�� , ,� 41 �� ,, �� , � , � � �� a �142��4 1 � , o� r�� 6 � � ;� x,� , t a871 � ' ' 13 �� xt - �� ; , t t �� ,{ � � �� : 43 � --� � .� � �� , � 4 , 1 � �� u�� ,� a 44 , 45 �� , � 1 � � I j ' �-�� 15 ,' � 6 � 10 p � ' �� ' 46 � ; � 1� � � �,. �,; , ,� • �� ,-.�=__ ,' > �.. ' ; 47 THIS IS NOT A LEGAL DOCUMENT � 7 � � Q Friday, June 03, 2011 03:13 PM � � � � � v ! , � � , f � � J CATAWBA COUNTY NC - Parcel Report Information Regarding Selected Parcel(s) Parcel I D: 3659-14-23-9960 Name: , , .DUSTINMELISSASUE Name2: Address: 2285 ARBOR LN Address2: City: NEWTON State: NC Zip: 28658-8635 Account: 159755938 Calc Acreage: 0.43 Tax Map: 040N 06001 C LRK: 28734 Deed Book: 2009E �S�p(l �,�l, (fi��pu.��. � Deed Page: 0754 CPS � C Subdivision Name: CRESNIEW DEV p Subdivision Block: B /„ 7_ ��( l(�� I(�'�,� D� Lots: 39-41 PT 38 &42 �y Plat Book: 8 Plat Page: 95 Building Number: 2285 Street Name: ARBOR LN Site Zip: 28658 Township: NEWTON Fire Code: NEWTON RURAL 1 City Code: COUNTY � Q �CK�,iI. �12 ,� State Road: / Total Bldgs Value: $81,600 Land Value: $10,300 Total Value: $91,900 Year Built: 1967 Year Remodeled: 1978 Last Sale Date: 9/1/1989 Last Sale Amount: $50,000 Neighborhood: 117 Watershed: Watershed Split: Voter Precinct: P32 E911 District: COUNTY Zoning: R-40 Zoning2: Zoning3: Zoning Split: N Zoning Overlay: Zoning District: COUNTY Split Zoning Dist: N Split Zoning Dist(1): 0 Split Zoning Dist(2): 0 School District: COUNTY Elementary School: TUTTLE Middle School: MAIDEN High School: MAIDEN School Split: NO P&Z Case Number: Census Tract 2010: 011600 Census Block 2010: 1017 Small Area Plan: BALLS CREEK Agricultural District: PROXIMITY Printed: Friday, June 03, 2011 03:13 PM .�$A Cp� CATAWBA COUNTY, NC � � � 100-A South West Blvd �/ /� A► /��° Newton, NC 28658- `I�1 /Y I� I i v °=� '� �� ' (828)465-8399 Friday, June 3, 2011 �� j84?, sM www.catawbacountync.gov P�an case: EHPR-6-1 1-1 1 1 52 �nvoice Number: INV-6-11-276040 Environmental Health Plan Review Invoice Date: 06/03/2011 Site Address: 22g5 ARBOR LN, Newton, NC APPLICANT OWNER CONTRACTOR MELISSA DUSTIN MELISSA DUSTIN 2285 ARBOR LN 2285 ARBOR LN NEWTON NC 28658 NEWTON NC 28658 Fee Name Fee Amount Authorization to Construct (Repair) Fee Adjustable $300.00 Total Fees Due: $300.00 PAYMENTS PAYER: MEL[SSA DUSTIN Date Pay Type Check Number Amount Paid Change 06/03/2011 Check 1002 $300.00 $0.00 Total Paid: $300.00 Total Due: $0.00 pl�m reccipt 06/03/201 l 15:23 I