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HomeMy WebLinkAboutRBPR-07-2015-21855.TIFApplicant Contractor THIS IS NOTA PERMIT Case # RBPR-07-2015-21855 CATAWBA COUNTY HEALTH DEPARTMENT PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES Residential Building Plan Review - Building New AUTH CONST - NEW WELL CALDWELL CONSTRUCTION, LLC., STEVE (STEVE CALDWELL), 6820 LOCKE DR. SHERRIE] FORD NC 28673 B:828-312-5787 MOBILE 0:8283125787 SWCBUILDER(a),YAHOO.COM CALDWELL CONSTRUCTION, LLC., STEVE (STEVE CALDWELL), 6820 LOCKE DR, SHERRIE] FORD NC 28673 8:828-312-5787 MOBILE 0:8283125787 SWCBUILDER@,YAHOO.COM Owner SAMUEL WHITE, 7025 LOCKE DR, SHERRILLS FORD NC 28673 0828896549 NAME TO APPEAR ON PERMIT Samuel White SITE ADDRESS: 7227 LOCKE DR, SHERRILLS FORD NC 28673 PIN # 460803103967 NAME of SUBDIVISION: Lot # 1 Section/Block PROPERTY SIZE: Square Feet Acres 1 14 DIRECTIONS: Hwy 16 South, Hwy 150 East left on Mt Pleasant RD, Approx 3 mile pass Camp Dogwood Left on Locke Dr, 1/4 mile on left PRIMARY CONTACT: Contractor SEWER TYPE: Septic Tank GALLONS PER DAY: 360 WATER SUPPLY: Private Well DESCRIBE WORK: 56x62 Single Family Dwelling with basement with attached garage SITE INFORMATION Do any of the following apply to the property for which this application is applied? It 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? No APPLICATION FOR: STRUCTURE TYPE: FACILITY TYPE: Single Family Residence DESCRIPTION OF vacant lot EXISTING STRUCTURES ON SITE (IF ANY DIM EXISTING STRUCTURE: NUMBER OF EXISTING BEDROOMS: New Structure PRIMARY RESIDENCE OTHER DESCRIPTION: # OF OCCUPANTS: 2 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 58x62 # OF NEW BEDROOMS:: 3 BASEMENT? Yes BASEMENT FIXTURES? Desired system types (Improvement Permit or Authorization to Construct): ACCEPTED. ALTERNATIVE. OTHER: INNOVATIVE, Other described: PLUMBING REQUIRED? CONVENTIONAL ANY: YES APPLICATION FOR WELL CONSTRUCTION PROPOSED WELL TYPE: Individual Well REPLACE WELL?: NO E9 - chappii�auon 07/01/2015 09 50 Pwe 1 of 4 $a CATAWBA COUNTY Case # R13PR-07-2015-21855 2 Public Health Department Subdivision Environmental Health Division PIN# 460803103967 PO Bos 389, 100-A Southwest Blvd, Newton, NC 28o58 Ig 2 sw NAME ON PERMIT: (SAMUEL WHITE), 7025 LOCKE DR, SHERRILLS FORD NC 28673 ( Samuel White) Site Address: 7227 LOCKE DR, SHERRILLS FORD NC 28673 Property Size: Square Feet Acres 1.14 Directions: Hwy 16 South, Hwy 150 East left on Mt Pleasant RD, Approx 3 mile pass Camp Dogwood Left on Locke Dr, 1/4 mile 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 accessible so that a complete site evaluation can be performed Date: %- / - / S— Signature of Applicant or Aoent An Environmental Health Specialist will contact you within 5 working days of application date. If you need further information or assistance please call 828-466-7291 AREA1 ############################################################################################################ FEENAME Authorization to Construct Fee (New/Expansion) Fee Well Permit & Inspection Fee TOTALFEES DATE FEE AMOUNT 07/01/2015 5150.00 07/01/2015 $300.00 $450.00 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) E9 - ehapplicauon 07/01/2015 09 50 Page 2 of 4 Ct ,��, THIS IS NOT A PEnRT cO-usTy �� CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services Page 1 Improvement Permit ❑ Authorization to Construct <v] Septic Repair ❑ Septic Malfunction ❑ Septic Expansion ❑ New Well Permit VReplacement Well ❑ Well Abandonment ❑ Well Repair ❑ Existing System Inspection (Pre -Approval Required) ❑ Application is for New Construction ❑ Existing Facility ❑ Property Address Jl % 4� f114 c i/ Subdivision 7. .r <I IV,, 1.5! 7, Lot# A Acres /, I(4c-) WHO WILL BE THE PRIMARY CONTACT? ❑ Owner ❑ Applicant ©-Contractor Description of Existing Structures on Site /Y.- )I < # of Bedrooms *I Structure Dimensions of Occupants Basement ❑ Yes ❑ No Basement Fixtures 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. 0 Yes C No Does the site contain any jurisdictional wetlands? El Yes A No Does the site contain any existing wastewater systems? 0 Yes ,K No Is any wastewater going to be generated on the site other than domestic sewage? Yes *No Is the site subject to approval by any other public agency? ® Yes Jb No Are there an), easements or right of ways on this property? Describe Existing water supply in use JZIndividuai 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 ❑ Alternative Conventional 0 Innovative 0 Other YAny Section/BIOcWPhase Driving Directions toProperty /<x�/., CZe Lw NAME TO APPEAR ON PERMIT? �2/Owner❑Applicant Q -Contractor Applicant Contact Information Name, j.f�. Address G,3Z J ��� kms. 7r 7hrry its �� r tl Il)< 1 S-6� 3 Phone :2 S; - Owner Contact Information owner Name Jim I, j)I c (Address /�3�� 4�<ez. •_� ✓ e (7 hL 1U c- ? G G 7 Phone L _ yd — 3 6%S `- "-- -'1 Cell Phone Contractor Contact Information Name .5-7', ,'z c_._) /c (w r I I Address 2 C3 c "Vl 2k4 "t Phone z _ j' 7 3 7 I Cell Phone WHO WILL BE THE PRIMARY CONTACT? ❑ Owner ❑ Applicant ©-Contractor Description of Existing Structures on Site /Y.- )I < # of Bedrooms *I Structure Dimensions of Occupants Basement ❑ Yes ❑ No Basement Fixtures 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. 0 Yes C No Does the site contain any jurisdictional wetlands? El Yes A No Does the site contain any existing wastewater systems? 0 Yes ,K No Is any wastewater going to be generated on the site other than domestic sewage? Yes *No Is the site subject to approval by any other public agency? ® Yes Jb No Are there an), easements or right of ways on this property? Describe Existing water supply in use JZIndividuai 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 ❑ Alternative Conventional 0 Innovative 0 Other YAny l TAWBA THIS 1S NOT A PERMIT ctUNTY - = CATAWBA COUNTY HEALTH DEPARTMENT h ,nn Application for Enviromnental Services Page 2 Proposed Facility Type rtmary Residence 0, New Residence ❑ Addition to Residence # of New Bedrooms * j Project Description /vim &-n-a.l Structure Dimensions S(„ ✓ /„ L # of Occupants o. Basement ® Yes ❑ No Basement Fixtures Yes ® No ❑ Accessory Structure(s) Describe ,d„�a r # of New Bedrooms *j if applicable Structure Dimensions # of Occupants Accessory Dwelling ❑ Yes ❑ No Plumbing ❑ Yes ❑ No Describe Plumbing Needed ❑ Multi -Family Residence # Units #Bedrooms per Unit' j Total # Bedrooms *j 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 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 ❑ Unlmown Well Repair Requested ❑ Yes ❑ No Describe Calculated Design Flow, Commercial f 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. f 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 maybe 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 malting the site accessible so that a complete site evaluation can be performed. Signature of Owner or Agent !.-2' ��l ��G�_.. Date % / / 5— Printed Name of Owner or Agent 75 to rz. CATAWBA COUNTY a Public Health Department Environmental Health Division PO Box 389, 100-A Southwest Blvd, Newton, NC 28658 `-t Case# IMPV-02.2015-057913 Subdivision PIN# 460803102887 LOT# NAME ON PERMIT: SAMMY L. & DAWN M. WHITE, 1839 LOWRANCE RD, CATAWBA NC 28609 Site Address: 7227 LOCKE DR, SHERRILLS FORD NC 28673 Property Size: Square Feet 48,220.92 Acres 1.107 Directions: HWY 150_LEFT ON MT PLEASANT RD, LEFT ON LOCKE DR, LOT ON LEFT BEFORE CURVE Improvement Permit Facility: Primary Residence Permit Category: New Septic Bedrooms WATER SUPPLY: Private Well Basement? No Basement Plumbing? No ----------------------------------------------- INITIAL SYSTEM SPECIFICATIONS _ ------------ --------------- Permit Valid: Expires In Five Years: _X_ No Expiration: Projected Daily Flow 360 g,p.d Proposed Wastewater System: 25% REDUCTION Type: IIIB - SYSTEM W/SINGLE EFFLUENT PUMP PUMP REOUIRED Permit Conditions: Permit issued to allow for subdivision of property. Keep all parts of septic system and repair 25' from home(up slope) 10' from property lines, 50' from any creek, 100' from any well. Lines to be installed on contour. Do not grade drive or fill over system or repair area. Small berm in front of proposed — — — — — — — _ home may be removed, approximate 1- _ _ --------------------- _ REPAIR SYSTEM SPECIFICATIONS -------- --------------- Repair System Required? Required Proposed Wastewater System: 25% REDUCTION Type: IIIB - SYSTEM W/SINGLE EFFLUENT PUMP PUMP REOUIRED Landscaping or other she alterations that potentially divert groundwater or surface water toward the septic system, or prevent proper drainage away from the septic system, including the direction of gutter flows or foundation drains, is not awroved, and may result in failure to approve the initial system installation, or the susoensioNrevocation of exisbnn permits. The issuance of this permit by the Health Depattrecnt does not guarantee the issuance of other permits. It is the responsibility of the epplicant/propeny owner to insure that all Catawba County Planning/Zoning and Building Inspections requirements are met. This Improvement Permit is subject to revocation if the site plan, plat or the intended use changes, or if site conditions are altered. The Improvement Permit is not oRected by a thange in ownership of the property. This permit was issued in compliance with the provisions of the North Carolina 'Law.f and Rafts lm,Sewaee Treatmrnt and Dirpoml Svrtemf' (15A NCAC 18A .1900). Neither Catawba County nor the Environmental Health Specialist warrants that the septic tank system will continue to function satisfactorily for any given period of time. Jason Boyd 02)1912015 AUTHORIZED STATE AGENT APPROVAL DATE Permit Expiration Date: 02/19/2020 No grading or consiraciion activity is allowed in areas designatedfor system and repair without approval of the Health Department. ehpcmtit 02232015 14:18 Page [,of 3 CATAWBA COUNTY I Permit N EHPR-1.15-20794 Public Health Department I Name Sammy L and Dawn M White Q �p, I Address 7227 Locke Dr Sherrills Ford NC Environmental Health Division 4a PO Box 389, I OOA Southwest Blvd, Newton NC 28658 I PIN71 460803102887 y (828)465-8270 Fax (828)465.8276 T1)D(828)465.8200 Site Plan Improvement Permit �, c- 4- 0 l � Ra/` .r rM Lo L s I a4m)- I; � e• Tr`�c L6 ear ti r Scale - 60 n� r ( Nom•.., 5r0' i (00' Sr PT 13-1 7 3' Parcel Report Parcel Report- Catawba County NC Parcel Information: Parcel ID: 460803103967 Parcel Address: 7227 LOCKE DR City: SHERRILLS FORD, 28673 LRK(REID): 803899 Deed Book/Page: Subdivision: Lots/Block: 1/ Last Sale: Plat Book/Page: 74/145 Legal: PLAT 74-145 LOT 1 Calculated Acreage: 1.140 Tax Map: Township: MOUNTAIN CREEK State Road #: 1932 Tax/Value Information: Tax Rates(pdf) City Tax District: All in County County Fire District: SHERRILLS FORD Building(s) Value: $0 Land Value: $0 Assessed Total Value: $0 Year Built/Remodeled: / Current Tax Bill Miscellaneous: Building Permits for this parcel. Building Details Watershed: WS -IV Critical Area Voter Precinct: P31 Parcel Report Data Descriptions List all Owners Deed History Report Page 1 of 1 Owner Information: Owner: WHITE SAMUEL LOCKE AKA WHITE SAMMY LOCKE Owner2: WHITE DAWN M Address: 7025 LOCKE DR Address2: City: SHERRILLS FORD State/Zip: NC 28673-7778 School Information: School District: COUNTY Elementary School: SHERRILLS FORD Middle School: MILL CREEK High School: BANDYS School Map Zoning Information: Zoning District: COUNTY Zoningl: R-30 Zoning2: Zoning3: Zoning Overlay: Small Area: SHERRILLS FORD Split Zoning Districts: / Zoning Agency Phone Numbers Firm Panel Date: Firm Panel #: 2010 Census Block: 2026 2010 Census Tract: 011501 Agricultural District: Assessment Report This map/report product was prepared from the Catawba County, NC Geospatial Information services. Catawba County has made substantial efforts to ensure the accuracy 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 contained 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/repos product or the use thereof by any person or entity © 2015, Catawba County Government, North Carolina. All rights reserved. 3ZOrLw's dA http://gis.catawbacountync.gov/nomap/parcel_report.php?key=460803103967&typ=P 7/1/2015 Catawba County Environmental Health Parcel: 460803103967, 7227 LOCKE DR 1 in=50ft SHERRILLS FORD, 28673 This map/report product was prepared from the Catawba County, NC Geospatial Information Services. Catawba County has made substantial efforts to ensure the accuracy 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 contained 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 07/01/2015 %N 2/ PROPOSED / HOUSE / / / 1.326 AC.+- �/ 1.134 AC.+- CLEAR R/W #4 PIN O \ R/W 11 s- 7.9 ac. +— REMAINING SAMMY L. & DAWN M. WN DEED 28841653 PIN 4608-0310-2887 LOc� \ — — — — _ POINT S\ � \ l— Y NAD 88 SPC 12 Northing Sg2g1 \ 681064.1600 N MAG NAIL v(t+ BENT (/4 PIN N \ \ � Fasting 1401502.7400 _ _ N 89'09'41E #4 PIN " \ / 73.25' \ 171 0 \ / \ 00' \ \\ POINT SSSS \\ l � \ MAG NAIL \ i V. M \ FFp �i� CORNER �K N4 PIN \ \ %N 2/ PROPOSED / HOUSE / / / 1.326 AC.+- �/ 1.134 AC.+- CLEAR R/W #4 PIN O \ R/W 11 s- 7.9 ac. +— REMAINING SAMMY L. & DAWN M. WN DEED 28841653 PIN 4608-0310-2887