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HomeMy WebLinkAboutRBPR-07-2015-21861.TIFApplicant Contractor Owner THIS IS NOT A PERMIT Case # RBPR-07-2015-21861 CATAWBA COUNTY FfEALTH DEPARTMENT PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES Residential Building Plan Review - Building New AUTH CONST - NEW WELL KINI TURNER, 711 E BOYD ST B, MAIDEN NC 28650 H:8284286008 C:8284857286 HOME:8284286008 MADISON HOME BUILDERS (RYAN PRUITT ), 301 LOTH ST NW SUITE F-105, CONOVER NC 2 6:8284648870 0:8282440968 M&B LAND CO INC (JEFF "TURNER), 1236 BUFFALO SHOALS RD, CATAWBA NC 28609 NAME TO APPEAR ON PERMIT Kim Turner SITE ADDRESS: 2454 OAK VALLEY LN, MAIDEN NC 28650 NANIE of SUBDIVISION: OAK VALLEY PROPERTY SIZE: Square Feet Acres 0.57 PIN # 365806488654 Lot 9 8 Section/Block DIRECTIONS: From 100 SW Blvd in Newton, Right 321 Business to Maiden. Left Main Street, Left Providence Mill R D, Left Bud Arndt Rd, Right Oak Valley Ln, Lot #8 is on the right. PRIMARY CONTACT: Contractor SEWER TYPE: Septic Tank GALLONS PER DAY: 360 WATER SUPPLY: Private Well DESCRIBE WORK: New Single Family dwelling 46x31, no basement or garage 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? No APPLICATION FOR: New Structure STRUCTURE TYPE: PRIMARY RESIDENCE DESCRIPTION OF EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: NUMBER OF EXISTING BEDROOMS: # OF OCCUPANTS: 1 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 46x31 # OF NEW BEDROOMS:: 3 BASEMENT? No BASEMENT FIXTURES? No PLUMBING REQUIRED? Desired system types (Improvement Permit or Authorization to Construct). ACCEPTED: ALTERNATIVE: CONVENTIONAL: OTHER: INNOVATIVE: ANY: YES Other described: APPLICATION FOR WELL CONSTRUCTION PROPOSED WELL TYPE: REPLACE WELL?: NO E9 - chapplication 07/02/2015 08 34 Page 1 of 4 eA CATAWBA COUNTY Case # RBPR-07-201 5-21861 y 2 Public Health Department Subdivision OAK VALLEY y Environmental Health Division PIN# 365806488654 PO Box 389, 100-A Southwest Blvd. Newton. NC 28658 tg w NAME ON PERMIT: ( KIM TURNER), 711 E BOYD ST B, MAIDEN NC 28650 ( Kim Turner) Site Address: 2454 OAK VALLEY LN, MAIDEN NC 28650 Property Size: Square Peet Acres 0.57 Directions: From 100 SW Blvd in Newton, Right 321 Business to Maiden. Left Main Street, Left Providence Mill R D, Left Bud Arndt Rd, Right Oak Valley Ln, Lot #8 is on the right. 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 accessii Ij� so that 9 complete site evalua n be performed Date: 7^�^�J� Signature of Applicant or Agent 9�/� l4Z4 A • ZAZ'J 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 _ _ DATE _FEE AMOUNT Authorization to Construct Fee (New/Expansion) 07/02/2015 $150.00 Fee Well Permit & Inspection Fee 07/02/2015 $;00.00 TOTAL FEES $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 - ehapplrention 07/02/2015 08.34 Page 2 of 4 CAT k ik THIS IS NOT A PERMIT gyt�-- Oq _ a� `J ^ O l co :�rsC7 CATAWBA COUNTY HEALTH DEPARTMENT `�„ �,;,a Application for Environmental Services Page 1 Improvement Permit ❑ Authorization to Construct Septic Repair ❑ Septic Malfunction ❑ Septic Expansion ❑ New Well PermittReplacement Well ❑ Well Abandonment ❑ Well Repair ❑ Existing System Inspection (Pre -Approval Required) ❑ Application is for New Construction Existing Facility ❑ Property Address Subdivision Oak VAI(Ao Lot# 4K Acres v tD rT i lection/Block/Phase Driving Directions to Property ROM PJM oo j � ! (J2S31 A k VA 61_1aLl).eA (,b2_(AAJJ-n) L ��R-f (^M t to si r/a . LP P Eirr�c Ree EP'+ go af-Rd+",_RL& ont Ila lieu i anz, j le)f` $ is On rl# O)ll� NAME TO APPEAR ON PERMIT? Owner X Applicant ❑ Contractor Applicant Contact Information Name I/ 7H �v� Address�Cl,l en13 SStn/Oj `"T A (J" 11)('.- OZ R& �g.-- Phone �t}� � /n R I Cell Phone gap,— C� ._'7,.a W, Owner Contact Information Name Address 1 Phone Cell Phone$ Contractor Contact Information Name GI/ALzgn H,,Aro 0d o+s — Rt-tAYld-f -� 144+ Address c i-, norOJ `_fit 1x�P �^i© (l��/rN o]r Phone�� %� S� 7D Cell Phone�� WHO WILL BE THE PRIMARY CONTACT? ❑ Owner ❑ Applicant E�,ontractor Description of Existing Structures on Site # of Bedrooms *j' Structure Dimensions # of Occupants Basement ❑ Yes ❑ No Basement Fixtures 0 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. ® Yes &1Jo Does the site contain any jurisdictional wetlands? ® Yes 951<o Does the site contain any existing wastewater systems? kYes 0No Is any wastewater going to be generated on the site other than domestic sewage? es di&o Is the site subject to approval by any other public agency? ® Yes C11110 Are there any easements or right of ways on this property? Describe Existing water supply in use f/A Individual Well ❑ Community Wel] ❑ Semi -Public Well ❑ County/City/Township Water Line Is a public water supply available? ** ❑ Yes Ej,Qo 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 0 Conventional 0 Innovative 0 Other C3�Any (-IATA 7� THIS IS NOT A PERMIT COUNTY - ,�1 �-�_� CATAWBA COUNTY HEALTH DEPARTMENT „ -,o, Application for Envirotnnental Services Page 2 Proposed Facility Type [✓Primary Residence R/Nemv Residence ❑ Addition to Residence # of New Bedrooms *I Project Description Cut,( rl 7 NYL& Structure Dimensions L{ UZ X 91 # of Occupants Basement ❑ Yes ['No Basement Fixtures ® Yes �o ❑ Accessory Structure(s) Describe # of New Bedrooms * I if applicable Structure Dimensions # of Occupants Accessory Dwelling ❑ Yes ❑ No Plumbing ❑ Yes ❑ No Describe Plumbing Needed ❑ Multi -Family Residence # Units #Bedrooms per Unit*I Total # Bedrooms *I 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 &Kndividual Well ❑ Senr-Public Well ❑ Community Well Abandonment Type ❑ Drilled ❑ Bored ❑ Dug ❑ Unknown Well Repair Requested ❑ Yes ❑ No Describe Calculated Design Flow, Cotntnercial I 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. I 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 corners and making the site accessible so that a complete site evaluation can be performed. Signature of Owuer or Agent GGGl41,et2 Date /67 Printed Name of Owner or Agent 6"Zo"X� ,$A CATANVBA COUNTY � T Public Health Department 4 -, �� M Environmental Health Division PO Box 389, 100-A Southwest Blvd, Newton. NC 28658 lg.p2 :m D Case # IMPV-05-2015-060662 Subdivision Oak Valley PIN# 365806488654 LOT# 8 NAME ON PERMIT: KIM TURNER, 711 E BOYD ST B, MAIDEN NC 28650 Site Address: 2454 OAK VALLEY LN, MAIDEN NC 28650 Property Size: Square Feet 24,82920 Acres .570 Directions: From 100 Southwest Blvd In Newton. Rt 321 Business to Maiden, Left Main Street, Left Provindence MITI, Left Bud Arndt Rd, Right Oak Valley Lane, Lot #8 Is on the right Improvement Permit Facility: Primary Residence Permit Category: New Septic Bedrooms 3 9 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: IIIG -OTHER NON -CONY TRENCH SYSTEMS Permit Conditions: Keep all parts of septic system and repair system minimum. 50' from any well,10' from property lines, 5' from home including decks. Lines to be Installed on contour. Do not grade drive or fill over _ system or repair area. REPAIR SYSTEM SPECIFICATIONS Repair System Required? Required Proposed Wastewater System: 50% REDUCTION Type: IVA- ANY SYSTEM WITH LPP DISTRIBUTION PUNIP REOUIRED "' OPERATOR REOUIRED Landscaping or other site 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 approved, and may result in failure to approve the Initial system Installation, or the suspenslontrevocahon of exisbnq permits The issuance of this permit by the Health Department does not guarantee the issuance of other permits. It is the responsibility of the applicant/property 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 affected by a change in ownership of the property. This permit was issued in compliance with the provisions of the North Carolina 'Laws and Rules for Selvage Treatment and Disposal Sl -stems' (InA 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 05119/2015 AUTHORIZED STATEAGENT APPROVAL DATE Permit Expiration Date 05/18/2020 No grading or construction activity is allowed in areas designated for system and repair without approval of the Health Department ell PQ) m 11 05/19/2015 09.50 Page I of vJ4 A C� CATAWBA COUNTY Permit # `Q G Z Public Health Department Name Environmental Health Division Address ° PO Boa 389, 100A Southwest Blvd, Ne,gon NC 28658 18 d `L sM (828) 465-8270 Fax (828) 465-8276 TDD (828) 465-5200 I PIN# Site Plan Improvement Permit 1b 2 -3S I �d � (, L A 17fA as. 1��k•�7' �"A� 313�N° k 31 , a S YS+_ W ID 7/T EHPR-4-15-21395 Kim Turner 2454 Oak Valley Lane Maiden NC 365806488654 Scale v Department of Environment, Health, and Natural Resources Division of Environmental Health On-site Wastewater Section Owner: Address' Proposed Facility' Location of Site Water Supply Evaluation Method. Type of Wastewater: SOIL/SITE EVALUATION for ON-SITE WASTEWATER SYSTEM Sheet' Property ID. Lot #. File # AppID. EHPR-4-15-21395 Kim Turner Applicant, 2454 Oak Vallev Lane Maiden NC Date Evaluated: 511 412 01 5 3 BR home Design Flow (.1949) 360 and Property Size' Property Recorded' pvt well [ ] Spring [ ] Other 3 4 I M 0 tl Description (Available Space ( 1945) (System Type(s) ISite LTAR pits by Mike Benfield �R G Ip• z. i. F r' IVA . I..r,t_.dsca (L' I ,.., ;Landscaper Horizon, IE � I'�,P9silion_l, Site Evaluation By ISOILlMORPHOLOGY '. 1 LL 4-6% 0-6" I 6-30" PROFILE,FACTiORS 30-48" 2 I 3 4 I M 0 tl Description (Available Space ( 1945) (System Type(s) ISite LTAR pits by Mike Benfield [ ] Cut I Other Factors ( 1946) PS X Sewage [ ] Industrial Process [ ] Mixed IIIG IVA Others Present Rvan Pruitt Madison Home Builders 3 3 I Site Classification (.1948) PS Site Evaluation By ISOILlMORPHOLOGY '. Others Present PROFILE,FACTiORS -,r7,,7 17-'19421L-17 !^ •--1941„ ; n rte, g t%,*•;:-3� - •(Soill,�, ,, ��',�,;1943t :[1956 ,1944; ' ',Profle' L•1.19,41 I'�Structure/,;1 -_, ,,-,consistencel '`•„;, "'ti Wetness/;,-• Soilt•,;j ?: tsapro,., f•, Res Class �Teztu�eon z(_ '�_. 8 LTAR, -- , topsoil I SCL SC SS SP SEXP FR 48” PS 3 same as 1 same as 1,2 Initial System Repair System I Other Factors ( 1946) PS PS ` Soil Evaluation By. Jason Boyd IIIG IVA Others Present Rvan Pruitt Madison Home Builders 3 3 I Site Classification (.1948) PS Site Evaluation By Others Present COMMENTS: Landscape Position Group Texture R -Ridge I S -Sand SS -Shoulder Slope LS -Loamy Sand LS -Linear Slope FS -Foot Slope II SL -Sandy Loam NS -Nose Slope L -Loam HS -Head Slope CC -Concave Slope III SI -Silt CV -Convex Slope SICL-Silty Clay T -Terrace Loam FP -Flood Plain CL -Clay Loam SCL-Sandy Clay Loam IV SC -Sandy Clay SIC -Silty Clay C -Clay Consistence Moist VFR-Very Friable FR -Friable FI -Firm VFI-Very Firm EFI-Extremely Firm Consistence Wet NS -Non -Sticky SS -Slightly Sticky S -Sticky VS -Very Sticky NP -Non -Plastic SP -Slightly Plastic P -Plastic VP -Very Plastic .1955 LTAR 1.2-08 1 : 1 [1I=1111R' 04-01 Mineralogy SEXP-Slightly Expansive EXP -Expansive Sketch of Soil Evaluation Locations Sheet FILE #. Structure SG -Single Grain M -Massive CR -Crumb GR -Granular SBK-Subangular Blocky ABK-Angular Blocky PL -Platy PR -Prismatic Parcel Report Parcel Report- Catawba County NC Parcel Information: Parcel ID: 365806488654 Parcel Address: 2454 OAK VALLEY LN City: MAIDEN, 28650 LRK(REID): 200774 Deed Book/Page: 2134/0984 Subdivision: OAK VALLEY Lots/Block: 8/ Last Sale: Plat Book/Page: 48/26 Legal: LOT 8 8 PL 48-26 OAK VALLEY PL 48-26 Calculated Acreage: .570 Tax Map: Township: CALDWELL State Road #: Tax/Value Information: Tax Rates(pdf) City Tax District: All in County County Fire District: BANDYS Buildings) Value: $0 Land Value: $11,700 Assessed Total Value: $11,700 Year Buill/Remodeled: / Current Tax Bill Miscellaneous: Building Permits for this parcel. Building Details W aterS hed: Voter Precinct: P20 Parcel Report Data Descriptions List all Owners Deed History Report Owner Information: Owner: M & B LAND CO INC Owner2: Address: 1236 BUFFALO SHOALS RD Address2: City: CATAWBA State/Zip: NC 28609-8022 School Information: School District: COUNTY Elementary School: TUTTLE Middle School: MAIDEN High School: MAIDEN School Map Zoning Information: Zoning District: COUNTY Zoningl: R-40 Zoning2: Zoning3: Zoning Overlay: DWMH-O Small Area: BALLS CREEK Split Zoning Districts: / Zoning Agency Phone Numbers Firm Panel Date: 2007-09-05 Firm Panel #: 3710365800J 2010 Census Block: 1000 2010 Census Tract: 011601 Agricultural District: PROXIMITY Assessment Report Page I of 1 This mapheport product was prepared from the Catawba County, INC 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 venhcation 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. http://gis.cataNvbacountync.gov/noinap/parcel_report. php?key=365806488654Rtyp=P 7/2/2015 Catawba County Environmental Health Parcel: 365806488654, 2454 OAK VALLEY LN 1 in=50ft MAIDEN, 28650 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 07/02/2015