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Home My WebLink AboutRBPR-07-2013-17694.TIFApplicant Contractor THIS IS NOT A PERMIT Case It RBPR-07-2013-17694 CATAWBA COUNTY HEALTH DEPARTMENT PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES Residential Building Plan Review - Manufactured Home IMPROVEMENT -NEW WELL 20m ELIZABETH BAILEY, 3535 MELDONNA DR, MAIDEN NC 28650 ot '� 1 WA - �U H:8288555119 HOME:8288555119 CLAYTON HOMES OF CONOVER, 1230 W CONOVER BLVD, CONOVER NC 28613 OTHER:828-465-3450 Owner MOSER BROTHERS ENTERPRISES INC, 2828 ROHRER RD, WADS WORTH OH 44281 NAME TO APPEAR ON PERMIT Elizabeth Bailey SITE ADDRESS: 3535 MELDONNA DR, MAIDEN NC 28650 PIN # 366703320684 NAME of SUBDIVISION: GEORGIA PARK Lot# 3 Section/Block PROPERTY SIZE: Square Feet Acres 0.46 DIRECTIONS: Hwy 16S/right on Buffalo Shoals Rd/right on Meldonna Dr/lot 3 on left PRIMARY CONTACT: Contractor SEWER TYPE: Septic Tank GALLONS PER DAY• WATER SUPPLY: Private Well DESCRIBE WORpC Revised 3248 with 2 6x6 decks 12/23/14 (es 28 x 60 Doublewide with 3 —bedrooms &-2 bathrooms 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? Yes 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? Yes Are there any easements or right-of-ways on this property? No APPLICATION FOR: STRUCTURE TYPE: New Structure PRIMARY RESIDENCE FACILITY TYPE: Mobile Home OTHER DESCRIPTION: DESCRIPTION OF I SINGLEWIDE REMOVED EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: NUMBER OF EXISTING BEDROOMS: 0 # OF OCCUPANTS: 2 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: C 44xx 5B INCLUDING (2) 6X6 DECKS # OF NEW BEDROOMS:: 3 Desired system types (Improvement Permit or Authorization to Construct): ACCEPTED: ALTERNATIVE: CONVENTIONAL: OTHER: INNOVATIVE: ANY: YES Other described: APPLICATION FQR WF' '-�-�"1CT N CROPOSED WELL TYPE: Individual Well REPLACE WELL?: NO 1:9-eliapplica1100 12232014 13:55 Page I of CATAWBA COUNTY Case # RBPR-07-2013-17694 Public Health Department Subdivision GEORGIA PARK Environmental Health Division PIN# 366703320684 PO Box 389. 100-A Southwest Blvd. Newton. NC 28658 NAME ON PERMIT: ( ELIZABETH BAILEY), 3535 MELDONNA DR, MAIDEN NC 28650 ( Elizabeth Bailey) Site Address: 3535 MELDONNA DR, MAIDEN NC 28650 Property Size: Square Feet Acres 0.46 Directions: Hwy 16S/right on Buffalo Shoals Rd/right on Meldonna DrAot 3 on left Improvement Permits issued as a result of this information are valid for 5 years or may be non -expiring under certain specified conditions. An Authorization to Construct issued by this department is valid for (5) five years from the date issued and is not transferable; Improvement Permits and Well Permits are transferrable. Permits may be revoked if the information on this application, site plans or intended use changes for the proposed facility. 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 accessibl so that a complete site evaluation can be performed. Dater -) � JJ Signature of Applicant or Agent ;! �) ,;c, [ 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 +++»++++***+++*+*»+»**++»++»+++»»+*+*+»»+•r****+r»»»»»»»»•r»»»»r»*r******»»»rrrrr»rr»***rrrrrr*+»»rrrrr»rrr* FEENAME Improvement Permit Fee Well Permit & Inspection Fee Re -Trip or Redesign Fee TOTALFEES DATE FEEAMOUNT 07/18/2013 $150.00 12/23/2014 S300.00 12/23/2014 $70.00 $520.00 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) 1:9 - chapplicahon 12232014 13:55 Page 2 of 4 a�'��]R� THIS IS NOT A PERMIT coU." r 1 CATAWBA COUNTY HEALTH DEPARTMENT ,.. �.,,.. Application for Environmental Services Page 1 Improvement Permit ❑ Authorization to Construct ❑ Septic Repair ❑ Septic Malfunction ❑ Septic Expansion ❑ New Well Permitt Replacement Well ❑ Well Abandonment ❑ Well Repair ❑ Existing System Inspection (Pre -Approval Required) ❑ Application is for New Construction X Existing Facility ❑ Property Address MEI W4N A DR • Subdivision Ae=6iA P IL Maid wi, )dc, Rt"t Lot # 'i Acres 0, 4Co s s iV3iEI�Z+.!1:1�7NiTr47MLMf �i7�1�Tf.� J►.�:1^!. s,. ♦� �_ i . ., NAME TO APPEAR ON PERMIT? ❑ Owner ❑ Applicant ❑ Contractor Applicant Contact Information Name AQ6 /Cla.�r-4AC# GS C0tWUE12, Me— Address ILAddress 11 W. PhoneCell Phone &6-717_31lpJ9 Owner Contact Information Name EL.t?AI IM % ,W Address -Ati B6 MELplV%SA DR . Ih%WFMT t Nri 2&O5p Phone f3,2J — 95;:Z-tc:3 Iq I Cell Phone N/A m Contractor Contact Inforation Name Ru 55el l W EI 1 Diet 11 fMi Address —Jy tJ( ., Phone r _ L Cell Phone WHO WILL BE THE PRIMARY CONTACT? ❑ Owner )KApplicant ❑ Contractor Description of Existing Structures on Site # of Bedrooms *t Structure Dimensions # of Occupants Basement ❑ Yes ❑ No Basement Fixtures Q Yes ® No 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. 13 Yes XNo Does the site contain any jurisdictional wetlands? JWYes 0 No Does the site contain any existing wastewater systems? 13 Yes WNo Is any wastewater going to be generated on the site other than domestic sewage? 17 Yes XNo Is the site subject to approval by any other public agency? 13 Yes KNo Are there any easements or right of ways on this property? Describe Existing water supply in use ❑ Individual Well ❑ Community Well ❑ Semi -Public Well ❑ County/City/Township Water Line Is a public water supply available? ** ❑ Yes VNo If applying for an Improvement Permit or Authorization to Construct, Please Indicate Desired System Type(s): (systems can be ranked in order of your preference) 0 Accepted 13 Alternative 0 Conventional 11 Innovative 0 Other 0 Any rl qt's:&I ]y� A THIS IS NOT A PERMIT CUU TTY `_y CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services Page 2 Proposed Facility Type Primary Residence 1k New Residence ❑ Addition to Residence # of New Bedrooms *t Project Description DrAINF.wlnE (lnxl_u cRec(LS Structure Dimensions 44v EaU # of Occupants — Basement [:]Yes W No Basement Fixture's ® Yes JQ No Ary e(s) Describe Structur -- # of New Bedrooms *t if applicable Structure Dimensions # of Occupants Accessory Dwelling ❑ Yes ❑ No Plumbing ❑ Yes ❑ No Describe Plumbing Needed V Multi -Family Residence # Units''-- nits#Bedrooms per U .. .... nit*t Total # Bedrooms *t Structure Dimensions Food Service Specify Type # Seats Floor Space -Entire Food Service Facility (Sq Ft) # Employees per Shift # of Shifts Dining Area (Sq. Ft) U Business Specific Type of Business Retail Floor Space # of Employees per Shift # of Shifts LJ Other Facility Type Specify If Church # of Seats Kitchen ❑ Yes ❑ No If Daycare Specify Occupancy Application for Well Construction/Abandonment/Repair Proposed Well Type X Individual Well ❑ Semi -Public Well ❑ Community Well Abandonment Type ❑ Drilled ❑ Bored ❑ Dug ❑ Unknown Well Repair Requested ❑ Yes ❑ No Describe Calculated Design Flow, Commercial t 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 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. t 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. SYSTEM REDESIGN AND/OR RETRIP WILL INCUR AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) Improvement Permits issued as a result of this information are valid for 5 years or may be non -expiring under certain specified conditions. An Authorization to Construct issued by this department is valid for (5) five years from the date issued and is not transferable; Improvement Permits and Well Permits are transferrable. Permits may be revoked if the information on this application, site plans or intended use changes for the proposed facility. 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 comers and making the site accessible so that a complete site evaluation can be performed. Signature of Owner or Agen �_ , �� Date I Printed Name of Owner or Agent GI�Y l L.ft S f!T1 Mr� 206.12 Catawba County Environmental Health 103.58 146.11 4F4 �N 183.58 Parcel: 366703320684, 3535 MELDONNA DR MAIDEN, 28650 5YA 3w0 1 � IP 65--X*I SyS�Lr� Ke 1, 160.39 114.80 1 153.50 167.44 1 in=40ft p,j ,, -$ 76 300 This map/reportproduct was prepared from the Catawba County, NC Geospatial Information Services. Catawba County has made substantial efforts to ensure the accurecy 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 contamed 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 2014 Catawba County NC 12/23/2014 Invoice Number: 12-14-313096 RBPR-07-2013-17694 CATAWBA COUNTY I OOA SOUTHWEST BLVD NEWTON, NORTH CAROLINA 28658 PHONE: 828.465.8399 www.catawbacountync.gov INVOICE/RECEIPT Tuesday, December 23, 2014 Invoice Date: 12/23/2014 CASE TYPE: Residential Building Plan Review WORK CLASS: Manufactured Home SITE ADDRESS: 3535 MELDONNA DR, MAIDEN NC 28650 Applicant ELIZABETH BAILEY, 3535 MELDONNA DR, MAIDEN NC 28650 H:8288555119 O%%mer MOSER BROTHERS ENTERPRISES INC, 2828 ROHRER RD, WADSWORTH OH 44281 Contractor CLAYTON HOMES OF CONOVER, 1230 W CONOVER BLVD, CONOVER NC 28613 ** NO PEOPLESOFT ACCOUNT ASSIGNED ** PAYOR CLAYTON HOMES OF CONOVER CLAYTON HOMES OF CONOVER FEES RBPR-07-2013-17694 Re -Trip or Redesign Fee Well Permit & inspection Fee FEES: TOTAL FEES: PAYMENTS FEE AMT 12/23/2014 570.00 12/23/2014 $300.00 5370.00 $370.00 INVOICE NUMBER FEE NAME TRANSACTION NUMBER: TRC -411833-23-12-2014 PAYMENT DATE: 12/23/2014 PAYMENTTYPE: Check 4616685 BOBBI LASAGE NCDL 29027263 DOB -3/22/73 XP- 3/22/16 12-14-313096 Well Permit & Inspection Fee DUE AMT SO.00 $0.00 $0.00 $0.00 FEE AMOUNT $300.00 TRANSACTION NUMBER: TRC -411834-23-12-2014 PAYMENT DATE: 12/23/2014 PAYMENT TYPE: Check 2157 BOBBI LASAGE NCDL 29027263 DOB -3/22/73 XP- 3/22/16 12-14-313096 Re -Trip or Redesign Fee $70.00 TOTAL PAYMENTS : $370.00 invoicemecipt 12232014 13:52 Page I or I THIS IS NOT A PERMIT Case # RBPR-07-2013-17694 CATAWBA COUNTY HEALTH DEPARTMENT 0"y0 C:;,• PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES Residential Building Plan Review - Manufactured Home �• T IMPROVEMENT Applicant ELIZABETH BAILEY, 3535 MELDONNA DR, MAIDEN NC 28650 1-1:8288555119 HOME:8288555119 Contractor CLAYTON HOMES OF CONOVER, 1230 W CONOVER BLVD, CONOVER NC 28613 OTHER: 828-465-3450 Owner MOSER BROTHERS ENTERPRISES INC, 2828 ROHRER RD, WADSWORTH OH 44281 NAME TO APPEAR ON PERMIT Elizabeth Bailey SITE ADDRESS: 3535 MELDONNA DR, MAIDEN NC 28650 PIN # 366703320684 NAME of SUBDIVISION: GEORGIA PARK Lot # 3 Section/Block PROPERTY SIZE: Square Feet Acres 0.46 DIRECTIONS: Hwy 16S/right on Buffalo Shoals Rd/right on Meldonna Dr/lot 3 on left PRIMARY CONTACT: Contractor SEWER TYPE GALLONS PER DAY: 360 WATER SUPPLY DESCRIBE WORK: 28 x 60 Doublewide with 3 bedrooms & 2 bathrooms 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? Yes Are there any easements or right-of-ways on this property? APPLICATION FOR: New Structure STRUCTURE TYPE: FACILITY TYPE: Mobile Home DESCRIPTION OF none EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: NUMBER OF EXISTING BEDROOMS PRIMARY RESIDENCE OTHER DESCRIPTION: Septic Tank Private Well 0 # OF OCCUPANTS: 2 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 28 x 60 # OF NEW BEDROOMS:: 3 Desired system types (Improvement Permit or Authorization to Construct): ACCEPTED: ALTERNATIVE: OTHER: INNOVATIVE: Other described: CONVENTIONAL: ANY: YES P.9 - chapplicalion 07/18/2013 15:30 Page I of 4 �yA CATAWBA COUNTY Case# RBPR-07-2013-17694 Public Health Department Subdivision GEORGIA PARK Environmental Health Division PIN# 366703320684 PO Box 389, 100-A Southwest Blvd, Newton, NC 28658 1� 2 SM NAME ON PERMIT: ELIZABETH BAILEY, 3535 MELDONNA DR, MAIDEN NC 28650 Site Address: 3535 MELDONNA DR, MAIDEN NC 28650 Property Size: Square Feet Acres 0.46 Directions: Hwy 16S/right on Buffalo Shoals Rd/right on Meldonna Dr/lot 3 on left Improvement Permits issued as a result of this information are valid for 5 years or may be non -expiring under certain specified conditions. An Authorization to Construct issued by this department is valid for (5) five years from the date issued and is not transferable; Improvement Permits and Well Permits are transferrable. Permits may be revoked if the information on this application, site plans or intended use changes for the proposed facility. 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 th t I am solely responsible for the proper identification and labelingof all property lines and corners and making the site acc ib , so at mplete ' e evaluation can be performed. Date: fJ / /Q /-�S 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: 30 SIDE: 15 REAR: 30 MAX HEIGHT: FEENAME Improvement Permit Fee TOTAL FEES DATE FEE AMOUNT 07/18/2013 $150.00 $150.00 SYSTEM REDESIGN AND/OR RETRIP WILL INCUR AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) 1:() - :hapl lication 07/18/2013 15:30 Page 2 of 4 CATAWBA nTHIS IS NOT A PERMIT COUNTY CATAWBA COUNTY HEALTH D EPARTM EIS T Narih Carolino Application for Environmental Services Page 1 Improvement Permit ❑ Authorization to Construct ❑ Septic Repair ❑ Septic Malfunction ❑ Septic Expansion ❑ New Well Permit ❑ Replacement Well ❑ Well Abandonment ❑ Well Repair ❑ Existing System Inspection (Pre -Approval Required) ❑ ? Application isforNew Construction [:1 Existing Facility ❑ Property Address J 53 ] �' A,, ( rho Meq Subdivision Cg ear ; y �� 1 Lot # 3 Acres �l6 Section/Block/Phase A Driving Directions to Property NAME TO APPEAR ON PERMIT? Owner Applicant Contact Information Name g`, �e I-- I i y -, ki-k Address 3 3 �" % V 1 w, d. n o C) ►^ Phone �- f l q Owner Contact Information Name Address Phone ❑ Applicant ❑ Contractor Contractor Contact Information IName C 1., 1140 -,14t) e^ ti j I Address /);L30 I Phone '?9 5� y G 3 1-1 S v Cell Phone Cell Phone CUK0✓t✓ Cell Phone WHO WILL BE THE PRIMARY CONTACT? ❑ Owner Q-Xp-plicant Description of Existing Structures on Site # of Bedrooms *t Structure Dimensions Basement ❑ Yes [a—No Basement Fixtures ❑ Yes ❑ No A • ontractor # of Occupants 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 El -No Does the site contain any jurisdictional wetlands? ❑ Yes El"No Does the site contain any existing wastewater systems? ❑ Yes C'INo Is any wastewater going to be generated on the site other than domestic sewage? El Yes E No Is the site subject to approval by any other public agency? -❑ Yes L"No Are there any easements or right of ways on this property? Describe Existing water supply in use F- Individual Well ❑ Community Well ❑ Semi -Public Well ❑ County/City/Township Water Line Is a public water supply available? ** ❑ Yes ❑ No If applying for an Improvement Permit or Authorization to Construct, Please Indicate Desired System Type(s): (systems can be ranked in order of your preference) 0 Accepted 0 Alternative 0 Conventional 0 Innovative 0 Other 0 -Any CATABA THIS IS NOT A PERMIT COUNTY \y y� �y CA TAWBA COUNTY HEALTH DEPARTMENT Nort, Application for Environmental Services Proposed Facility 'type ❑ Primary Residence New Residence ❑ Addition to Residence # of New Bedrooms *t Project Description Structure Dimensions X � 0 # of Occupants Z_ Basement❑ Yes 0 o Basement Fixtures ❑ Yes ❑ No ❑ Accessory Structure(s) Describe # of New Bedrooms *t if applicable Structure Dimensions # of Occupants Accessory Dwelling ❑ Yes ❑ No Plumbing ❑ Yes ❑ No Describe Plumbing Needed ❑ Multi -Family Residence # Units Total # Bedrooms *� ❑ Food Service Specify Type #Bedrooms per Unit*t Structure Dimensions 3 # 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 Church # 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 Describe Page 2, Calculated Design Flow, Commercial t 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 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. t 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. SYSTEM[ REDESIGN AND/OR RETRIIP WILL INCUR AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) Improvement Permits issued as a result of this information are valid for 5 years or may be non -expiring under certain specified conditions. An Authorization to Construct issued by this department is valid for (5) five years from the date issued and is not transferable; Improvement Permits and Well Permits are transferrable. Permits may be revoked if the information on this application, site plans or intended use changes for the proposed facility. 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. Signature of Owner or Agent Date 7//?i/ 5/ g g Printed Name of Owner or Agent C)a �, ; o% S>L�a FIM fMMMMIMM�ff Catawba County, North Carolina This map product was prepared from the Catawba County, NC, Geospatial Information System. Catawba County has made substantial efforts to ensure the accuracy of location and labeling information contained on this map. Catawba County promotes and recommends the independent verification of any data contained on this map 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 product or the use thereof by any person or entity. Selected Parcel Number: 3667-03-32-0684 I inch = 50 feet 3517 0 9735 Vis, Prepared for: V %J 1 ' ', O' who s� ina, 0_ 38 16 _ _ o THIS IS NOT A LEGAL DOCUMENT �° Date: 7/18/2013 3 ♦ Time: 3:11:53 PM �riai 52,765 2745` CATAWBA COUNTY NC - Parcel Report Information Regarding Selected Parcel(s) Parcel ID: 3667-03-32-0684 Name: MOSER BROTHERS ENTERPRISES INC Name2: STONE REAL ESTATE COMPANY LTD Address: 2828 ROHRER RD Address2: City: WADSWORTH State: OH Zip: 44281-9533 Account: Calc Acreage: 0.46 Tax Map: 008AK 01003 LRK: 8172 Deed Book: 2915 Deed Page: 0175 Subdivision Name: GEORGIA PARK Subdivision Block: Lots: 3 Plat Book: 52 Plat Page: 65 Building Number: 3535 Street Name: MELDONNA DR Site Zip: 28650 Township: CALDWELL Fire Dist: BANDYS City/Tax: State Road: Total Bldgs Value: Land Value: $10,700 Total Value: $10,700 Year Built: Year Remodeled: Last Sale Date: Last Sale Amount: Neighborhood: 113 Watershed: WS-II Protected Area Watershed Split: NO Voter Precinct: P9 E911 District: COUNTY Zoning: R-40 Zoning2: Zoning3: Zoning Split: N Zoning Overlay: WP-O 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: 011602 Census Block 2010: 4001 Small Area Plan: BALLS CREEK Agricultural District: Printed: Thursday, July 18, 2013 03:11 PM Applicant/Owner: GEORGE MOSER Site Address: 3535 MELDONNA DR MAIDEN NC Property size: SF .46 ACRES Directions: HWY 16 S/ RT BUFFALO SHOALS RD/ ON RT @ CORNER OF MELDONNA DR & BUFFALO SHOALS RD/ GEORGIA PARK, EXISTING SEPTIC SYSTEM INSPECTION REPORT Site/System Diagram 4 f)v no �' 1 l g rc� over S q s4 -v, pY n -P C r ..-b-, Rol- d ri ✓C Ov(,r ' S w i 1�(•� h ��z `` a e c k.s q.31-6 ed -Le - I p 0 3 Pact rr t 1�3.9a� RCnC' -h' � — rl o V1 si b)e, S1, )'LS Q� ►�, W itrr\va,�itct Type of Facility: House Mobile Home X # Bedrooms 3 Business Specify Other Specify Proposed Additions / Accessory Structures: Approved J ' Not Approved Reason Evidence of system malfunctti pn':nYES NO ✓ System Type/Description Authorized State Agent: ( ✓r�J( T �DL, DATE: v z NOT FOR LOAN APPROVAL , \Tid— AF V1VLSunu.r nr S-./)- -0b Form E CATAWBA COUNTY Public Health Department Case # WLS2008 00356 /K� Environmental Health Division Subdivision GEORGIA PARK \ PO Box 389, 100-A Southwest Blvd, Newton. NC 28658 SecdBL/Ph/Lot # 3 (828) 465-8270 FAX (828) 465-8276 TDD (828) 465-8200 PIN# 366703320684 Applicant/Owner: GEORGE MOSER Site Address: 3535 MELDONNA DR MAIDEN NC Property size: SF .46 ACRES Directions: HWY 16 S/ RT BUFFALO SHOALS RD/ ON RT @ CORNER OF MELDONNA DR & BUFFALO SHOALS RD/ GEORGIA PARK, EXISTING SEPTIC SYSTEM INSPECTION REPORT Site/System Diagram 4 f)v no �' 1 l g rc� over S q s4 -v, pY n -P C r ..-b-, Rol- d ri ✓C Ov(,r ' S w i 1�(•� h ��z `` a e c k.s q.31-6 ed -Le - I p 0 3 Pact rr t 1�3.9a� RCnC' -h' � — rl o V1 si b)e, S1, )'LS Q� ►�, W itrr\va,�itct Type of Facility: House Mobile Home X # Bedrooms 3 Business Specify Other Specify Proposed Additions / Accessory Structures: Approved J ' Not Approved Reason Evidence of system malfunctti pn':nYES NO ✓ System Type/Description Authorized State Agent: ( ✓r�J( T �DL, DATE: v z NOT FOR LOAN APPROVAL , \Tid— AF V1VLSunu.r nr S-./)- -0b Form E CATAWBA COUNTY HtALTH DEPARTMENT NEWTON, NORTH CAROLINA COMPLETION PERMIT FOR SEPTIC TANKS OWNER BUILDING CONTRACTOR LOCATION_,_) PERMIT No DATE: ADDRESS SUBDIVISION LOT # LOT SIZE BLO OR SECTION HOUSE ( ) MOBILE HOME BUSINESS ( ) OTHER ( ) FHA -VA LOAN ( ) SEPTIC TANK: (SIZE /Q Cl O GALS) WATER SUPPLY: NO. BEDROOMS NO FIXTURES INDIVIDUAL PUBLIC GARBAGE DISPUSTE UNIT:YES (-Y—N0 ( ) IF WELL, TYPE: BORED DRILLED DUG AUTO WASHING MACHINE: YES ) NO ( ) DISTANCE FROM SEPTIC TANK OR NEAREST NITRIFICATION FIELD: SQ. FT. POLLUTION: FT. 1) NUMBER OF LINES SEPTIC T ALL B i 2) LENGTH AND WIDTH OF -LINES .e. J�- r D /rl� PERMIT FEE $ IJ 0 HCl6 a) BED SYSTEM (� CERTIFICA OF MPLE ON B' b) TRENCH SYSTEM ( ) p � �fn t 3) DEPTH OF STONE IN LINES /2 REMARKS: ADEQUATE FALL (GRADE) ON: y 1) BUILDING (HOUSE) SEWER LINE: YES ( ) NO ( ) 2) NITRIFICATION LINES: DATE INSTALLED:/9— YES ( ) NO ( ) SEPTIC TANK LAYOUT w { H � O o / a 0 HEALTH DEPARTMENT COPY C Q PERMIT PERItff NO. FEE: G/ate PERMI-r' VOID AFTER 36 MONTHS CATAWBA COUNTY ET DEPARTMENT IMPROV T PERMIT OWNER OR CONTRACTOR: ` LCr DATE: C2 PHONE: ADDRESS: LOCATION: SUBDIVISION: LOT 46 _ SECTION OR BLOCK: LOT SIZE:-) Notified to check w h Zoning Y ) No ( ) Zoning Approval # - 73 Y House ( ) Mobile Home ( Business ( ) Other ( ) Flow Ra�te: gpd Bedrooms: Bathrooms: Special Fixtures: Other: Basement - Yes ( ) No ( xtures in Basement - Yes ( ) No (L-�P'ump System Yes( ) No (� ------------------------------------------------------------------------------------------ Garbage Disposal Un't Yes ( ) No (�-)� Water Supply. Private ( ) Public (� TANK SIZE:9 p gallons Comments/Special Instructions: NITRIFICATION FIE D: Number of Lines Length and width of Li es System must be installed as shown. Any (a) Bed System 79 X, � changes will be made only with prior Health (b) Trench System 36" X Department approval. If unforeseen problems or Trench System 30" X arise duringinstallation contractor must Total Square Fontage _T)egt,,,_gf Igne_! /call -Health Department__ Total --------- y/ I RTIFY THA ED AND AGREE TO THE PROV;SIO/C��i`,'yl ON r P r/Agent Sanitari Final approval of this septic tank system shall in no wa be taken as a guarantee that the system will function satisfactorily for any given period of time. SITE AND SEPTIC TANK PLAN Site Factor: Slope and Landscape Position Soil Drainage Soil Depth Restrictive Horizon Available Space Other (Specify) Soil Characteristics: Repair.Area Required: Yes Health Department Copy bozi Croup Soil Texture Class Application Rate S - PS - U S - PS - U S - PS - UIII Fine S - PS - U Loams S - PS - U S - PS - U S - PS - U IV, Clays No ( ) icRori cvctnmc Sandy Clay Silt Loam 0.6-0.4 Clay Loam Silty Clay Sandy Clay Silty Clay 0.4-0.2 Clay arP allowed onlv in soil Gt0UD III.