The URL can be used to link to this page

Home My WebLink AboutWV0800237_Application_20200327 (3)CARTERET COUNTY HEALTH DEPARTMENT EVIRONMENTAL HEALTH ON -SITE WATER PROTECTION PIDN: SITE EVALUATION for WATER WELL OWNER: Dawn L&,4-z- TIME OF VISIT ADDRESS: DATE EVALUATED: �zr, LOCATION OF SITE: j C)a .�� V a i„/ S-- PROPOSED FACILITY: k�.n_ �4 .��,,� PROPERTY SIZE: TYPE WELL: ❑ Individual Drinking Water Ll Shared Drinking Water irrigation ❑ Geothermal (siting confirmation only) ;New Well ❑ Replacement Well Cl Repair (as specified by certified well driller) TYPE OF WASTEWATER: ❑ Onsite Septic installed not installed xMunicipal or Community Sewer EVALUATED BY:. Ly [,f/1__ OTH ER(S) PRESENT: 0 Vj r,� C COMMENTS Show profile locations and other site features (dimensions, reference or benchmark, and North). Fee Received �Q� CARTERET COUNTY HEALTH DEPARTMENT Check#CL or Cash 3820 Bridges St Morehead City, NC 28557 Area 3 Date Received 01a0 Phone: 252-728-8499 Fax: 252-222-7753 Priority oL Received By: APPLICATION Date Stakedtaff Initialdil- Well Construction Permit �J IF INFORMATION IS FALSIFIED, CHANGED OR� Iron AAL,q�BE AUTHORIZATION TO CONSTRUCT PERMIT SHALL BECOME INVALID. PERMIT IS VALID FOR 60 MONTHS. Pazcel ID: 7310 026-9 la 9</3006 Type of Well: Private Drinking Water Shared Drinldng Water Irrigation Other Type of Applicatio New Construction Replacement Repair _Abandonment Proposed Use: Residential _ Commercial (Design Capacity < 100,000gpd) Owner Name: First DO.uln Last Lae&z Mailing Address /O.J Saau;e SI. City Sgoacoc+ State /VC zip ,Z9L y(,� Phooe: Home jf/f-g6G-02-`i3 Work Mobile Fax Email wLRNtz c+-tws�kN o Al' n� nn Organization Applicant If same as owner: - Yes If no, complete this section and provide owners statement Name: First Mailing Address Phone: Home State Work Mobile Email Otganzation Zip Parcel Address: IDP Seuule-u-� City: Relyu�o4 Subdivision: Lot i�Ig3 Phase /_ Section Block # of Acres Type of Facility: Y Residential —Multifamily Nan -Residential (describe 1 Improvement Permit for Wastewater System Issued: _yes —no _N/A Applicant must inform Loral Healt�epartment if any of the following apply. Check all that apply: _ Existing well on property Buried Utility Lines Right of ways _ Existing or proposed septic tank system Additional structures on property _Stump holes/buried debris _Underground Fuel Tanks _Easements _Other potential sources of groundwater -pollution - list _Current or pending groundwater restrictions -describe Are there any variances associated with this application? Yes No Additional Information: R Arr' d L-.P T- -ak Any proposed development must be reviewed by the local jurisdiction for compliance with local ordinances and regulations. Additionally, you must consult with any state or federal agency with jurisdiction over the proposed development Page 1 of 3 CARTERET COUNTY HEALTH DEPARTMENT 3820 Bridges SL Morehead City, NC 28557 Phone: 252-728-8499 Fax:252-222-7753 APPLICATION Well Construction Permit Owner v.w n L._o��'� Z arcel ID: D 5 Site Sketch: Provide an accurate diagram of property with dimensions, proposed or existing building location(s) with setbacks to two property lines, proposed or existing wastewater system location, existing and/or proposed water source location, potential sources of contamination, driveways and any other characteristics or activities on the property or adiacent nroaerty that could impact Groundwater quality or suitability of the site for well construction. (Initial) Property is staked Applicant wiu cau when property is staked A re -inspection fee of $30 is required if the lot is not accessible and/or staked. Application will be returned after sixty (60) days if Carteret County Environmental Health has not been notified that site -is staked and accessible. Fees paid for application are forfeited when application is returned to applicant or agent. MIN The site evaluation is performed based on the information contained in this application. Any changes to the site or structure locations, the property lines, proposed or existing waste water system location shall be cause to revoke the Well Permit. I have read this application and certify 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. 1 understand that I am solely responsible for the proper identification and staking of aII pro erty lines and corners and making the site accessible so a complete site evaluatio can be per 11 Property owner's si afore or authorized agent (REQUIRED) Date Page 2 of 3 PC-o?a5,ecA wet) Sea Yew Drive - I 1 120'-0" SAL µEpLTH E0VIROM BRIDGES ST 3820 A CITY, NC 28557 MORE 52�728-8550 SALE 4053 Term: 1102 2590 Store: REM 00000002 Cf11O. 007113600755 # Batch RRN' 09:50:12 03111f201� 460071498122656 Trans CODE: 00384C Clip pPPR **�** VISA **-*5748 ��oo.00 A00"N"T APPROVED r NTZI L SE VISA AOp000 00 so000180 00 TVR; Tsl: F8 00 autS, 1 AGREE jG 4A1 ABGVE jG[Al IN ACC4ADP�ICEGREE�ENIR4 1SSUEQUCHERj a CREDIZ tl �khl A1N t 1 u10? low SS A�E>iEHj mil1CA11014 THANK \(Ou MERCHANT COPI Tax Parcel Information: C a r t B r e t C o u n t y, N C f t "� f �. •I Owner: LANTZ,WENDELL R ETUX DAWN _I _ CurrentPlN: 730507586943000 19; qa 1 I I 1 �J`0 I" Site Address: SEAVIEW ST f.7 r 3''1 7412 ; a, ".: a; , 1o2 BEAUFORT (43 �348 5yy'D7��jr :I Mailing Address: I1 117D 26845 SOUTH HIGHWAY 2 j aq 5r STRYKEROH 43557 tilm 6295 m a° ' j �i li Legal Description: I' a^ 1�iRi 7282 H 922 •42d21,Ir5�253' 1211 "{ to L62 63 B4 OCEAN BREEZE PARK TOWN OF BEAUFORT 62-- G{t 11 � U269�cr6t� R5 Prior PIN: 11007FO102 City Limits: BEAUFORT Q�t Rescue District: BEAUFORT RESCUE Fire District: 9q7 Tax District: 1159 ro Township: BEAUFORT Use: RESIDENTIAL m Land Value: $253,285 NBHD: 5900o6 IM Bldg Htd Sq Ft: 416 Bldg Value: $25o,633 t Bldg Tot Sq Ft: 526 Other Value: $46,387 Year Built: 2011 17Z0 Total Value: $550,305 Noise Level: Sale Price: $400,000 AICUZ Zone: 1 Deeded Acres:0.347 GISAcres: 0.349 Plat Ref: / Roll Type: R wr: Deed Ref: 1173 / 295 Deed Date: 20o6O526 'Bedrooms: 1 Bathrooms: 1 i6 11: Printed Marchlt, zozo The information displayed by this webshe is prepared fort he irrventory of real Wopertyfound within thisjurbtlictien end Is compiled from recorced deeds, plats, and other pudic records and di la. Users of this information are hereby notified that the aforementionad publb prirrery hformation sources should be consuled forvedficatbn of the information mntalned on this site. Carteret County asurnes no legal responsibility for the Information conlahed on the site. Carteret Countydoes not 9t a anlee that the dola and map services wll be available to users withouthtlerruotionorerror.Furthermore. Carteret Ca Nmayrnodfvorremovemooservicesmdareasmethodsetwil.