HomeMy WebLinkAboutWLS2009-00256~gA
1842 s~
THIS IS NOT A PERMIT Case #
CATAWBA COUNTY HEALTH DEPARTMENT
Application for Environmental Services
Improvement Permit? NA
Septic Service Type: N/A
Well Service Type: NEW WELL
Water Supply Type: Individual Well
OWNER
SUSAN SNYDER
2974 9TH TEE DR
NEWTON NC 28658-8575
NAME TO APPEAR ON PERMIT CARRETT SNYDER
Well Use
CONTRACTOR
SITE ADDRESS: 2974 NINTH TEE DR NEWTON NC Pin#: _
DIRECTIONS: HWY 10 W/ RT ON ROBINSON RD/ LFT ON NINTI I TI:L' DR/ ON L177'***original well over property line***
NAME of SUBDIVISION: COUNTRY CLUB ACRES Lot fl I5-16
PROPERTY SIZE: Squire Sect Acres 1.11 Date Plumed/Recorded
TYPE OF FACILITY: House X Mobile Home Dimension of structure 64 X 48
Basement: Y Water Using Fistures in Basement:
Whirlpool Tub : N Gal. Capacitv:
MULTIPLE FAMILY RESIDENCE: Units
DAYCARE: Number t Children
RESTAURANT: Seats
TYPE OF BUSINESS:
Square Feet Dining Area
Number of I:ntplovees
OTHIAI: (Specify)
Do you aniticipate any additions to Facility?
If so, describe:
Has any grading, removal, or addition of soil been done to this property? N
If so, describe
Are there easements/ii=ht- -of-Ways recorded on this property? N
Type of Water Supply' Individual Well X Community Wcll
Monitoring Well Request: N # of wells- Name of Sitc
Square Feet Foodstand/Meat Market Floor Space
Is( 2nd 3rd
Municipal Semi-public
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 non-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 pnainy iepresentati ni byyou Of house or structure
location should conform to applicable setbacks.
Date: S ~ 09 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
ASSIGNED TO : AREA 2
(FOR OFFICE USE ONLY)
Zoning Approval: -Yes No Zoning Approval g
Mininnrm Setbacks
Front
30
Side
15
Rear
30
Max I-Ight
45
*If a permit has
UDO Zoning R-20 Form A
FEES
Type Description Date Received Amount
By
SIR Neo Well Peunit 05/07/2009 EDH $300.00
Total: $300.00
to be redesiened and / or RI?TRIPS matte to (lie pronerhv, there is an additional S60 ch
W LS2009-00256
372017014455
Section/Block/Phase
Bedrooms 5
N No. in Family 3
Total Number of Bedrooms
argc
.:Ind,.kv:~ru.Jjlr[sapQ.,r„ 05/07/09 09 :23
CATAWBA COUNTY
2 'Public Health Department
Environmental Health Division
PO Box 389, I00A Southwest Blvd, Newton NC 28658
1842 stt (828) 465-8270 Fax (828) 465-8276 TDD (828) 465-8200
Applicant/Owner
Susan Snyder
Site Address:
2974 Ninth Tee Dr Newton 28658
y Size:
Propert
1.11 Acres
,
Directions:
WELL PERMIT
Proposed use:
Public ❑ Semi-Public ❑
GROUTING DEPTH: MINIMUM 20 FEET
SETBACKS:
1. BUILDNG FOUNDATIONS
25 PT
5. UNDERGROUND STORAGE TANKS
100 FT
2. EXISTING & PROPOSED SEPTIC SYSTEMS
MIN. 50PT
6. STREAMS/BROOKS/CREEKS
50 FT
3 EXISTING & PROPOSED SEPTIC REPAIR AREA
MIN. 50 F1
7 LAKESTONDS RESERVOIRS
50 FT
4. SEWAGE PUMP SUPPLY LINE
50 FT
ALL OTHER POSSIBLE SOURCES OF GROUND WATER CONTAMINATION 100 FT.
The well driller must verifil all separations are adhered to before drilling the well.
If the wedrlle above separations, contact the Health Department at (X28) 465-8270 before drilling the wellLAN R PERMITTED WELL LOCATION
S- 13- b q
ISSUED BY2 iJ PERMIT ISSUANCE DATE
SIGNATURE
DATE
WELL INSPECTION:
GROUTED DEPTH: 20'
APPROVED CASING: PVC ❑ STEEL
CASING HEIGHT 12' ABOVE LAND SURFACE
WELL COMPLETION REPORT RECEIVED
WELL HEAD APPROVED
DATE. (0IS
DATE:
Ci
DATE:
L_LlS
DATE:
Z?
DATE:
Other
INITIALS:
INITIALS:
INITIALS:!
FNITIALS:)
INITIALS:
WATER SAMLES TAKEN: BAD 10 ❑ N/N ❑ DATE:
?C C_
WELL DRILLER V
INITIALS:
\\-oq
DATE'DRILLED
Well permits are valid for 5 years from the date of issuance and are subject to suspension and/or revocation for non-compliance with appropriate
state and local rules and regulations, or if false information was given in order to obtain a permit. Wells shall be constructed in accordance with
all state and local regulations and rules. The Well Completion Report must be submitted to the Health Department within 30 days upon
completion of a well.
CERTIFICATE OF COMPLETION
AUTHORIZED STATE AGENT
7 21 -"o°I
APPROVAL DATE
Case #
Wls2009-256
Subdivision
Country Club Acres
Sectional/Ph/Lot#
15-16
PIN#
C.~ ...,.d,etl,g,1;,,g ,hT.. sea,6,1T<m,ora~ Internet Files\Content.Outlook\C9H5VVQQ\Snyder_Well-Permit 09-00256.docs
SBA ~
y CATAWBA COUNTY
Q Public Health Department
C Environmental Health Division
Ig 2 sn PO Box 389, I00A Southwest Blvd. Newton NC 28658
(828) 465-8270 Fa< (828) 465-5276 TDD (828) 465-8200
Case #
Subdivision
SectionBl(Ph tot#
PIN#
A llcanUOWner
Site Address:
Property Size:
Directions:
Improvement Permit ❑ Authorization to Construct ❑ Well Permit
SITE PLAN
,goods
Id a~~,\
1~ o ~ S e,
System componen epre n[ appr< im a contours c~ , The contractor must flag the system prior to beginning the installation to ensure that proper grade is maintained. Do not
ins [emu er w onditions. T s permit is 5alyecl to revocation if the site plan or site conditions are altered.
'S, 13-O
A ORIZED STATE AGENT DATE
1V
l
C N..m .ms end SeninysNjen,iishT.I Seninbs\Tc,.,orery Internet Files\Content.Outlook\C9H5 V V QQ\Snyder_W ell-Permit_09-00256.docx
Snyder
09-000256
TRACKING INFORMATION
Date Calls
5/8/09
1" Contact - Discussion Only
.5/7/09
Site Ready to be Flagged
na
Site Flagged
na ~J
Site Ready to be Evaluated
5/8/09
Site Evaluated
5/8/09
Approved for Issuance
Other
Date Comments/Field Notes
THIS IS NOT A PERMIT WLS # A,~0 9 _0025-6
CATAWBA COUNTY HEALTH DEPARTMENT
Application for Environmental Services
Improvement Permit E]
Authorization to Construct ❑ Septic Repair E] Septic Expansion El
Existing Tank Check ❑
New Well Permit
Replacement Well ❑ Well Abandonment ❑
1. Name to Appear on Permit
GAlRac 5,vy0f e
2. Permit Requested By Same
.
Business Phone '3a6- 2-t? L)
Address Z`l N,w~
'!~V y - A4w1,,
a Z0(5-8 Home Phone V(oS' 26.YI
I Property Owner Gge,2f jr r
S4 5,q ~y dew-
Business Phone -5
Address 2q?y A444; vze
/
Home Phone
4. Name of Subdivision (ow,~
C4~ 19r4eu-
Lot# Section/Block/Phase
Property Address z 174
N%ti~.
Directions to Properly: ~6~
L oti
V' ti r~~ 10
F~~acr-< <G
5. PropertySize: Square Feet 3 c
M -3 Sa~l Acres
Date Platted/Recorded
6. TYPE OF FACILITY: House Mobile Home
Dimension of Structure ? Bedrooms* 5
"~..-v,
*Anv roost<thabwtll tie inter ded.fotslecoinP at tlie;dine,of.construetion,or.fiir,;fuhtre consideration shoitld;be ix ted'as a
Basement ye /no Water Using Fixtures in Basement: yes/to No. in Family
Whirlpool Tub ye no Gallon Capacity
MULTIPLE FAMILY RESIDENCES: Units Total Number of Bedrooms
DAY CARE: Number of Children
RESTAURANT: Seats Square Feet Dining Area -Square Feet Food stand/Meat Market Floor Space
TYPE OF BUSINESS: Number of Employees I st 2nd 3rd
OTHER: (Specify)
7. Do you anticipate any additions to Facilitv? Yes No
If so, describe-.
8. Has any grading. removal, or addition of soil been done to this property? Yes No
If so, describe-
9. Are there easements/right-of-ways recorded on this property? Yes X~o
10. Is a public water supply available on or adjacent to the above property? Yes / No
Check type that is available: [ ] Community well [ ] Semi-public well ] County/City/Township water line
**IfNo, a Well Permit must be issued with the Septic Permit.**
11. Well Type Applying For: individual well [ ] Community well [ ] Semi-Public well
3
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 valid for 5 years or may be non-expiring under certain specified conditions. Improvement Permits and Well
Permits are transferable, but may be revoked if this information, site plans or intended use changes for the proposed facility. An 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.
**IF A PERMIT HAS TO BE REDESIGNED AND/OR RETRIPS MADE TO TH P OPERTY H RE IS AN ADDITIONAL CHARGE..**
Date Signature of Owner or Agent
Catawba County, North Carolina
This map product was prepared from the Catawba County, A'C, Geographic Information System.
N Catawba County has made substantial efforts to ensure the accuracy of location and labeling information
contained on this map. Catawba Count 'v promotes and recommends the independent verification of arty
data contained on this map product by the user. The County ofCataiwba, 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. Legend
01 Selected Parcel Number: 3720-17-01-4455
1 inch = 60 feet 1-7109 Prepared for:
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THIS IS NOT A LEGAL DOCUMENT
Thursday, May 07, 2009 09:
40,
627
ij
co
.
8 AM
CAT9W13A C.GUNTY NC - Parcel Report
Information Regar
ding Selected Parcel(s)
Parcel ID
3720-17-01-4455
Name:
SNYDER GARRETT C
Name2.
SNYDER SUSAN T
Address:
2974 9TH TEE DR
Address2:
City
NEWTON
State:
NC
Zip:
28658-8575
Account:
65473000
Calc Acreage:
1 11
Tax Map:
048N 07004
LRK.
31070
Deed Book:
1998
Deed Page:
1281
Subdivision Name
: COUNTRY CLUB ACRES
Subdivision Block:
C
Lots:
15-16, PT 14
Plat Book:
13
Plat Page:
31
Building Number:
2974
Street Name.
NINTH TEE DR
Site Zip:
28658
Township:
NEWTON
Fire Code:
NEWTON RURAL
City Code:
COUNTY
State Road:
Total Bldgs Value:
$294,200
Land Value.
$36,300
Total Value:
$330,500
Year Built:
1997
Year Remodeled:
Last Sale Date
08/01/1996
Last Sale Amount:
$29,500
Neighborhood:
95
Watershed:
Watershed Split:
Voter Precinct:
P34
E911 District:
COUNTY
Matrix:
Zoning:
R-20
Zoning2:
Zoning3:
Zoning Split:
N
Zoning Overlay ED-0
Zoning District:
COUNTY
Split Zoning Dist:
N
Split Zoning Dist(1
0
Split Zoning Dist(2
0
School District:
COUNTY
Elementary Schoo
l: STARTOWN
Middle School:
MAIDEN
High School:
MAIDEN
School Split:
NO
P&Z Case Numbe
r
Census Tract 2010 011701
Census Block 2010: 2024
Recorded Date:
Lot Type.
Small Area Plan:
STARTOWN
Printed: Thursday,
May 07, 2009 09:08 AM
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� : �. � CATA�V�A COiTl�
c� , y� '`� P O Box 389 - Newton, North Carolina 28658 -(828) 465-8270 - Fax (828) 465-8276 - TDD (828) 465-8200
1842 SM public Health — Environmental Health Division
Niemorandum
June 8, 2011
To: Garrett Snyder
From: Michael Cash, Environmental Health Supervisor
Re: Well Samples Required: WLS2009-00256, Site Address: 2974 Ninth Tee Dr
Since July 1 2008, a program mandated by the State of North Carolina to regulate private
drinking water wells required all county well programs to sample new wells constructed after
that date. According to Rule .3801 of the North Carolina Administrative Code (15A NCAC 18A)
all wells must be sampled for bacteria, nitrate, nitrite, pH, and a number of naturally occurring
inorganic minerals.
Our records indicate that we have not taken the required samples for your new well. In order
to satisfy our obligation in this regard, we are planning to visit your property the week of
6/13/11 to collect these water samples. The fees normally charged for these samples were
included in the cost of your well permit, so there is no additional charge for this service. The
samples will be taken from an outside source, so there is no obligation for you to be present.
The sample test results will be sent to you when they are received by our office. Please allow
6-8 weeks for processing.
Please contact our office if we can answer any questions or provide additional assistance. You
may reach our office at (828) 465-8270, or by e-mail at:
EHAdministrativeAssistants(a�catawbacountvnc.qov.
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