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HomeMy WebLinkAboutRBPR-07-2015-21866.TIFSte: North Carolina Department of Health and Human Services Division of Public Health Pat McCrory Governor Michael Cash Environmental Health Supervisor Catawba County Public Health PO Bos 389 Newton, NC 28658 September 3, 2015 Mr. Cash, Richard O. Brajer Secretary Daniel Staley Acting Division Director On September 3, 2015, you, and Robbie Phelps, FHS, accompanied me on a second opinion evaluation of 1165 Beagle Lane, aka Lot #52 Fos Chase Subdivision. This properrY has an existing three bedroom residence with a basement. The owners have applied to expand their existing system to accommodate a fourth bedroom. The local health department has denied this application due to insufficient space for septic system and repair (.1945).. We evaluated the lot with a backhoe pits to a depth of greater than 48 inches. The pit in the back yard had 12 inches of clay loam over clay with moderate, mechum, subangular blocky structure. The clay has slightly expansive clay mineralogy. The clay texture extended to 40 inches and then has a clay loam (BC) horizon with weak subangular blocky structure to a depth of 48 inches +. The landscape in the backyard was a head slope. Due to landscape position, texture and soil structure the LTAR of 0.3 is appropriate. The pit in the front yard had 31-38 inches of group INT (clay) fill material over the original surface. This pit is unsuitable due to depth of unsuitable fill material. The local health department will lay out the system in the backyard to determine if there is suitable available space fora four bedroom PPBPS (Panel Block System). Please feel free to contact me at 336-689-5380 if you have any further questions. R. Scott Greene, LSS, REHS Onsite Water Protection Branch Environmental Health Section wwcv.ncdhhs.gov • www.publichealth.nc.gov Tel 919-707-5874 • Fax 919-845-3973 Location: 5605 Six Forks Road • Raleigh, NC 27609 Mailing Address: 1642 Mail Service Center • Raleigh, NC 27699-1931 An Equal Opportunity / Affirmative Action Employer F ��JI i North earohna Publ:e Health August 13, 2015 John Turnipseed 1165 Beagle Ln Newton, NC 28658 Catawba County Public Health www.catawbacountync.gov/environmentalliealtli Environmental Health P.O. Box 389,100-A South West Blvd., Newton, NC 28658 Phone (828) 465-8270. Fax (828) 465-8276 Re: Application for improvement permit for John Turnipseed property site 1165 Beagle Ln, Newton, NC 28658 Health Department file number RBPR-07-2015-21866. Dear John Turnipseed, The Catawba County Health Department, Environmental Health Division on August 3, 2015 evaluated the above referenced property at the site designated on the plat/site plan that accompanied your, . . improvement permit application. According to your application the site is to serve a 4 bedroom house with a design wastewater flow of 480 gallons per day. The evaluation was done in accordance with the laws and rules governing wastewater systems in North Carolina General Statute 130A-333 including related statutes and Title 15A, Subchapter 18A, of the North Carolina Administrative Code, -Rule .1900 and related rules. Based on the criteria set out in Title 15A, Subchapter 18A, of the North Carolina Administrative Code, Rule .1940 through .1948, the evaluation indicated that the site is UNSUITABLE for a sanitary- system of sewage treatment and disposal for 480 gallons per day. Therefore, we must deny your request for an improvement permit. A copy of the site evaluation is enclosed. The site is unsuitable based on the following: Unsuitable soil topography and/or landscape position (Rule .1940) Unsuitable soil characteristics (structure or clay mineralogy) (Rule .194 1.) Unsuitable soil wetness condition (Rule .1942) Unsuitable soil depth (Rule .1943) Presence of restrictive horizon (Rule .1944) X Insufficient space for septic system and repair area (Rule .1945) Unsuitable for meeting required setbacks (Rule .1950) Other (Rule .1946) These severe soil or site limitations could cause premature system failure, leading to the discharge of untreated sewage on the ground surface, into surface waters, directly to ground water or inside your structure. The site evaluation included consideration of possible site modifications, as well as use of modified, innovative, or alternative systems. However, the Health Department has determined that none of the above options will overcome the severe conditions on this site. A possible option might be a system �j'�)� �l/"�'• "Leading the Way to a Healthier- Community" �Z I� U L✓ �J HAecNedAled(�� QZ) gg� `Neallh--'S 4e' Q0 /�/�'th '0 oeaaromem UU�i��06/rAlpl �y :ooeam: 'ff 21Page designed to dispose of sewage to another area of suitable soil or off-site to additional property. For the reasons set out above, the property is currently classified UNSUITABLE, and no improvement permit shall be issued for this site in accordance with Rule .1948(c). Note that a site classified as UNSUITABLE may be classified as PROVISIONALLY SUITABLE if written documentation is provided that meets the requirements of Rule .1948(d). A copy of this rule is enclosed. You may hire a consultant to assist you if you wish to try to develop a plan under which your site could be reclassified as PROVISIONALLY SUITABLE. You have a right to an informal review of this decision. You may request an informal review by the soil scientist or environmental health supervisor at the local health department. You may also request an informal review by the North Carolina Department of Health and Human Services regional soil scientist. A request for informal review must be made in writing to the local health department. You also have a right to a formal appeal of this decision. To pursue a formal appeal, you must file a petition for a contested case hearing with the Office of Administrative Hearings, 6714 Mail Service Center, Raleigh, NC 27699-6714. To get a copy of a petition form, you may write the Office of Administrative Hearings or call the office at (919) 431-3000 or download it from the OAH web site at llttu://hvww.ncoah.com/forms.html . The petition for a contested case hearing must be filed in accordance with the provision of North Carolina General Statutes 130A-24 and 150B-23 and all other applicable provisions of Chapter 15013. N.C. General Statute 130A-335 (g) provides that your hearing would be held in the county where your property is located. Please note: If you wish to pursue a formal appeal, you must file the petition form with the Office of Administrative Hearings WITHIN 30 DAYS OF THE DATE OF THIS LETTER. The date of this letter is August 13, 2015. Meeting the 30 day deadline is critical to your formal appeal. If you file a petition for a contested case hearing with the Office of Administrative Hearings, you are required by law (N.C. General Statute 15013-23) to serve a copy of your petition on the Office of General Counsel, N.C. Department of Health and IIuman Services, 2001 Mail Service Center, Raleigh, N.C. 27699-2001. Do not serve the petition on your local health department. Sending a copy of your petition to the local health department will not satisfy the legal requirement in N.C. General Statute 150B-23 that you send a copy to the Office of General Counsel, N. C. Department of Health and Human Services. You may call or write the local health department if you need any additional information or assistance. Sincerely,A" n 1. / 1 "� �' Robbie Phelps, REHS Environmental Health Specialist Enclosures: (Enclose copy of site evaluation) (Copy of Rule .1945) j4'hxfTtt7rniPrscFed,% �Env.,Ine 4 1 Postage $ OV�Y, /V lr�, *Y, Certified Fee U AUG CIO Return Receipt Fee X ark Cy� 0 PIHXe, CD (Endorsement Required) Restricted Delivery Fee 2015 (Endorsement Required) SPS Total Postage & Fees $ Sent To HBPR-() /-.Zul�-I 175611) .s67 ,ijF, -AiTrw -------------- John-Turnipsted -------------------------- or PO Box No. City State, 'ZfF;; 4 ------------ 1 -1 -65 -Beagle -Ln•------------------------------- Newton. NC 28658 Certified Mail Provides: ❑ A mailing receipt ❑ A unique identifier for your mailpiece ❑ A record of delivery kept by the Postal Service for two years Important Reminders: ❑ Certified Mail may ONLY be combined with First -Class Mail® or Priority Mail®. ❑ Certified Mail is not available for any class of international mail. ❑ NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For valuables, please consider Insured or Registered Mail. ❑ For an additional fee, a Return Receipt may be requested to provide proof of delivery. To obtain Return Receipt service, please complete and attach a Return Receipt (PS Form 3811) to the article and add applicable postage to cover the fee. Endorse mailpiece "Return Receipt TIj Requested". eceive a fee waiver for a duplicate return receipt, a USPS® postmark on y r9ertified Mail receipt is required. ❑ For an additional fee, delivery may be restricted to the addressee or addressee's authorized agent. Advise the clerk AWV the mailpiece with the endorsement "Restricted Delivery". (/ ❑ If a postmark on the Certified Mail receipt is desired, lea a )esent the anti- cle at the post office for postmarking. If a postma : on a Certified Mail receipt is not needed, detach and affix label with postage and mail. IMPORTANT: Save this receipt and present it when making an inquiry. PS Form 3800, August 2006 (Reverse) PSN 7530-02-000-9047 —T iA��.�IxflLya.Liii1� Y,��1�II II�� � i`IIIYIYII rlh�e ASi4/iLlI1.191%/I�u i�, ifi� ti Ul3Ry�°Il,,& a31/l riN�r!�/. i Vrnv(/r�Z ■ Complete items 1, 2, and 3. Also complete A. Signature item 4 if Restricted Delivery is desired. X_ 0 Agent ■ Print your name and address on the reverse 0 Addressee so that we can return the card to you. B. Receivedrinted Name) C. Date of Delivery ■ Attach this card to the back of the mailpiece, ^ / AV or on the front if space permits. D. Is delivery address different from item 17 0 Yes 1. Article Addressed to: If YES, enter delivery address below: 0 No John Turnipseed 1165 Beagle Ln Newton, NC 28658 3. Service Type Certified Mail 0 Express Mail Registered 0 Return Receipt for Merchandise 0 Insured Mail 0 C.O.D. 4. Restricted Delivery? (Extra Fee) 0 Yes 2. Article Number (Transfer from service label) 7008 1830 0004 6921 6180 PS; Form 3311,, February 2004 Domestic Return Receipt 102595 -02 M -1540 i I [ ]�'P !:ill; I III Iii dill UNITED STAfdiA56k, y.4,,$ '5ER66E First -Class Mail 19WV _ � Postage & Fees Paid AhjA7 ' t'S Permit No. G-10 ROP,AFOe7-2015-21866 • Sender: Please print your name, address, and ZIP+4 in this box Robbie Phelps, REHS Catawba County Environmental Health PO Box 389 Newton, NC 28658 flfllill"in„f' 11l,arflruin:ill;rriltjlfti1t+if!'l�'ff1 f �A C� CATAWBA COUNTY Case # Name Public Health Department Address 1 e®®A Environmental Health Division PO Box 389, 100A Southwest Blvd, Newton NC 28658 Lot# 184 L sM (828) 465-8270 Fax (828) 465-8276 TDD(828)465-8200 SITE PLAN f®r Denial RBPR-07-2015-21866 John Turnipseed 1165 Beagle Ln, Newton 52 *If the existing drain field is expanded to a 4 bedroom size the site will not have enough sufficient available space for a four bedroom repair area. �S S i Current 3 BR House with basement Beagle Ln Scale I "Lf 0 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: John Turnioseed 1165 Beaole Ln 4br SOIL/SITE EVALUATION for ON-SITE WASTEWATER SYSTEM Design Flow (.1949) 480 [ x ] Public [ ] Individual [ ] Auger Boring [ x ] Sewage [ ] Well [x]Pit [ ] Industrial Process Sheet: Property ID: Lot #: File #: AppID: 21866 Applicant: Date Evaluated: 8/3/2015 Property Size: Property Recorded: [ ] Spring [ ] Other [ ] Cut [ ] Mixed 1: ',;• ..�+ ,,4f,-_- ter ,y, s,,: ;t.i-. '.t, .rte ..s, .ct;'- �'•j..itT.,.,. ,-a•.,;.i ^ns'1 -.,qi •-r*,':,.r'„ :`2«.'.� ,1r :::}'' h lis' �'y ,j� �, }.. pp "� �, '�.ti•<,... .d' ;: �..:��`�' ,t ,^ �,; �';�' :-}'r�^�3>.,.s f'- "r ct •1 tv .Y+ 4 S /: 1`.t . 1 j.� t, SO�IL�MO�RP,HQ t. '>.•�•e O' h 't- k •Y � 'F.a..n^ •r; `�i, x ,i�hrr .,194'1d�:'� lV;',_ ,�,.. ,:9P,ROFI - FACTaORSiw I �,": 1 �.i„ ,s. �,Yy ��3? �ii�. •,i.{ Y�'�; - _-. .. .. `jr«°y ,�1, ''ir._ �S, "-rt`'- -- i. _ .� .-�- --� -- '-' -- - — '4. y'•t .1'940{ 4= �,^- ��, `,. ✓',:. 't 1.1942 :�_ ''r - t 'I '>;" :,-� � •..4` .•: z» ��r•k: ,Y [,ry�k,• - ''a. �=.., .t.,1 '.i•,., ryy�*^r i.`'' ,��4 I }a t 1 li' li :} � ', Soil :1943 :�1�956"'' .1'94`.4., I Profile' e� ,IHoiizon .i• r�1j941 ,,' S,' I �. `.e.n "1 0 'iste det' ,; Wetriesslr =Soili°' 11 'rSa ro. Restre, Glass, E= ::; r P„os`ition/r DeApth : c. ,Structure/'. C ns n ;3 �, ;,' i;;; '' , S ., ,p. r,6s 5 - ,t„/l:.r ,I, t..az`^.,1” ''i;e'y ', �� t .,�?: :'��• ,4.. _t_, '`) -:•'rf ' t. e% +: INk,i Texture) --mine Golorf` G , 4De`th, IN:i (Cla§sf': 'HbrizF• &LIAR+':• ., �_..:Y (. _)�. � . n.: � -_:' cr` _ ,., 9Y' _..:. , ��-,``:.•�': _;r._ t, .P 5(.. )! 1 0-33 fill/compacted 33-58 cl,sbk fr,ss,sp 25 0.3 2 1 0-10 L 10-40 cl,sbk fr,ss,sp 40-60 cl,sbk fr,ss,sp yellow with red/brown spots 60 0.3ps Description Initial System Repair System Other Factors (.1946): (Available Space (.1945) s u Soil Evaluation By: Robbie Phelps (System Type(s) 50% Others Present: Site LTAR 0.3 0.3 Site Classification (.1948): U Site Evaluation By: Others Present: COMMENTS: Landscape Position Group Texture R -Ridge I S -Sand SS -Shoulder Slope LS -Loamy Sand LS -Linear Slope CR -Crumb FS -Foot Slope 11 SL -Sandy Loam NS -Nose Slope L -Loam HS -Head Slope ABK-Angular Blocky 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 Sheet: FILE #: .1955 LTAR Structure 1.2-0.8 SG -Single Grain M -Massive CR -Crumb 0.8-0.6 GR -Granular SBK-Subangular Blocky ABK-Angular Blocky 0.6-0.3 PL -Platy PR -Prismatic 0.4-0.1 Mineraloay. SEXP-Slightly Expansive EXP -Expansive Sketch of Soil Evaluation Locations 15A NCAC 18A.1945 AVAILABLESPACE (a) Sites shall have sufficient available space to permit the installation and proper functioning of ground absorption sewage treatment and disposal systems, based upon the square footage of nitrification field required for the long-teimacceptancerate determined in accordance with these Rules. (b) Sites shall have sufficient available space for a repair area separate fi•om the area determined in Paragraph (a) ofthis Rule. The repair area shall be based upon the area of the nitrification field requ rcd to accommodate the installationofarepbcernent system as specified in Rule .1955, .1956, or .1957 of this Section. Prior to issuance of the initial Improvement Permit forasite, the local health department shall designate on the permit the original system layout, the repair area, and the type of replacement system. (c) The repair area requirement of Paragraph (b) of this Rule shall not apply to a lot or tract of land: (1) which is specifically described in a document on file with the local health department on July 1, 1982, or which is specifically described in a recorded deed or a recorded plat on January 1, 1983; and (2) which is of insufficient size to satisfy the repair area requirement of Paragraph (b) of this Rule,as deterred by the local health department; and (3) on which a ground absorption sewage treatment and disposal system with a design daily flow of: (A) no more than 480 gallons is to be installed; or (B) more than 480 gallons is to be installed if application for an improvement permit which meets the requirements of Rule .1937(c) of this Subchapter is received by the local health department onor before April 1, 1983. (d) Although a lot or tract of land is exempted under Paragraph (c) from the repair area requirement of Paragraph (b), the maximum feasible area, as determined by the local health department, shall be allocated for a repair area. History Note: Authority G.S. 130.4-335(e) and 0; Eff. July 1, 1982; Amended Eff. February 1, 1992; July 1, 1983; January 1, 1983. Contractor Owner THIS IS NOT A PERMIT Case # RBPR-07-2015-21866 CATAWBA COUNTY HEALTH DEPARTMENT PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES Residential Building Plan Review - Building Alteration IMPROVEMENT - AUTH CONST - EXPANSION *BARLOWE BROTHERS, LLC. (CURTIS BARLOWE). 3811 HEATHERBROOK TR, VALE NC 281 B:(704)462-2731 C.828 -312-3819F-704-462-2731 BARLOWECLBELLSOUTH.NET JOHN TURNIPSEED, 1165 BEAGLE LN, NEWTON NC 28658 C:4043950105 NAME TO APPEAR ON PERMIT John Turnipseed SITE ADDRESS: 1165 BEAGLE LN, NEWTON NC 28658 PIN # 371012959048 NAME of SUBDIVISION: FOX CHASE Lot 52 Section/Block PROPERTY SIZE: Square Peet Acres 04 DIRECTIONS: Startown Rd/left on Sandy Ford/right into Fox Chase/right on Beagle Ln/2nd on left PRIMARY CONTACT: Contractor SEWERTYPE: Septic Tank GALLONS PER DAY: 480 WATER SUPPLY: Public Water DESCRIBE WORK: Finishing basement to include one bedroom, full bath and family room Adding roof over existing deck to become screen deck 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: Existing Structure STRUCTURE TYPE: PRIMARY RESIDENCE FACILITY TYPE: Single Family Residence OTHER DESCRIPTION: DESCRIPTION OF EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: NUMBER OF EXISTING BEDROOMS: 3 # OF OCCUPANTS: 3 PROPOSED CONSTRUCTION # OF NEW BEDROOMS:: 1 BASEMENT? Yes BASEMENT FIXTURES? Yes PLUMBING REQUIRED? Desired system types (Improvement Permit or Authorization to Construct) ACCEPTED: ALTERNATIVE CONVENTIONAL' OTHER INNOVATIVE ANY: Other described. E9-chapphcanon 07/02/2015 11 23 Page I oft CATAWSA COUNTY Case # RBPR-07-201 5-21866 r Public Health Department Suhdrvtston FOX CHASE Environmental Health Division PIN# 371012959048 .- PO Box 389. 100-A Southwest Blvd. � Iewton. NC 28658 1� Z 1M NAME ON PERMIT: ( JOHN TURNIPSEED), I t65 BEAGLE LN, NEWTON NC 28658 ( John Turnipseed) Site Address: 1165 BEAGLE LN, NEWTON NC 28658 Property Size: Square Feet Acres 0.4 Directions: Startown Rd/left on Sandy Ford/right into Fox Chase/right on Beagle Ln/2nd 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: '9-- Signature of Applicant or Agent- 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 AREA2 FEENAME Authorization to Construct Fee (New/Expansion) Fee Improvement Permit Fee TOTAL FEES DATE FEE AMOUNT 07/02/2015 $300.00 07/02/2015 $150.00 $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!02(2015 11 23 Page 2 of 4 17, TAWB1�+�, THIS IS NOT A PERMIT '- CATAWBA COUNTY HEALTH DEPARTMENT Application for Envirotmiental Services Page 1 Improvement Permit Authorization to Construct Ik Septic Repair ❑ Septic Malfunction ❑ Septic Expansion V New WeB Permit ❑ Replacement Well [IWell Abandonment ❑ Well Repair ❑ Existing System Inspection (Pre -Approval Required) ❑ Application is for New Construction ❑ Existing Facility ❑ Property Address )+ lsS 9w S�Z )—" `t Subdivision Tc�'— Lot # Acres �" Section Block/Phase Driving Directions to Property � [u+pw r� �° } �Ll ��JI( �_�Clr i ASN Fl� i'hGCC- Vrt CV&_AC Lc\, An lef► NAME TO APPEAR ON PERMIT? XON mer ❑ Applicantt_ontractor Applicant Contact Information Name Address 'Ss} 1 \ lys �L i� til Phone $aS-3v7-- iS Owner Contact Information Name Address 1 1 L S Phone Contractor Contact Information Name k-) elm Z (J—�� tl�r z , 1 Lt✓ Address 3S ( 1 I Phone 9)fA-3\2,— -381 V R�Lc; n/ L zu i Cc. Cell Phone 26US- —oLOa.:Gi. Cell Phone 4�` -- 34 S - of 05 V'u' >J (, -2-? 1 (o,3 I Cell Phone :gd8-30g - X0 A a WHO WILL BE THE PRIMARY CONTACT? ❑ Owner ❑ Applicant [D ontractor Description of Existing Structures on Site # of Bedrooms *t 3 Structure Dimensions &I X (Do # of Occupants 3 Basement ❑✓ Yes ❑ No Basement Fixtures G"Yes ® No The Applicant shall notify the local health department upon submittal of this application if any of the following apply to the property in question. If the answer to any question is "yes", applicant must attach supporting documentation. n Yes 0i510 Does the site contain any jurisdictional wetlands? M'Yes 110�o Does the site contain any existing wastewater systems? ® Yes EtN'o Is any wastewater going to be generated on the site other than domestic sewage? R2 Yes E,$"No Is the site subject to approval by any other public agency? ® Yes 914o Are there any easements or right of ways on this property? Describe Existing water supply in use ❑ Individual Well ❑ Community Well ❑ Semi -Public Well [✓7 County/City/Township Water Lute 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 ❑ Altemative ❑ Conventional ❑ Innovative 0 Other 0 Any ATA B ,1f. THIS IS NOT A PEP N41T crruaT} C� CATAWBA COUNTY HEALTH DEPARTMENT y Kil ^ o Application for Enviromnenlal Services Page 2 Proposed Facility Type Primary Residence ❑ New Residence ❑ Addition to Residence # of New Bedrooms *j' _ Project Description S's `e°"^z S'<C `ts, Structure Dimensions # of Occupants' Basement ❑ Yes ❑ No Basement Fixtures ® Yes ® No ❑ Accessory Structure(s) Describe # 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 # o1' 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 Calculated Design Flow, Corrurtercial 7 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. j 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 Owner or Agent �>*^� ` Date !^ IS Printed Name of Owner or Agent Catawba County Environmental Health O Parcel: 371012959048, 1165 BEAGLE LN NEWTON, 28658 10X•CHASE•D-: J O 1 in=50ft 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 anses or may anse from this map/report product or the use thereof by any person or entity. Copynght 2014 Catawba County INC 07/02/2015 Parcel Report Parcel Report- Catawba County NC Parcel Information: Parcel ID: 371012959048 Parcel Address. 1165 BEAGLE LN City. NEWTON, 28658 LRK(REID):902570 Deed Book/Page: 2672/0859 Subdivision: FOX CHASE Lots/Block: 52/ Last Sale: $330,000 on 2005-06-24 Plat Book/Page: 50/164 Legal. LOT 52 52 PL50-164 FOX CHASE PL 50-164 Calculated Acreage: 400 Tax Map. Township: NEWTON State Road #: Tax/Value Information: Tax Rates(pdf) City Tax District: All in County County Fire District. HICKORY RURAL Building(s) Value: $252,300 Land Value. $29,700 Assessed Total Value $282,000 Year Built/Remodeled. 2004/ Current Tax BIII Miscellaneous: Building Permits for this parcel. Building Details Watershed: Voter Precinct P34 Parcel Report Data Descriptions List all Owners Deed History Report Owner Information: Owner: TURNIPSEED JOHN M Owner2: TURNIPSEED LAURIE B Address 1165 BEAGLE LN Address2: City: NEWTON State/Zip: INC 28658 School Information: School District. COUNTY Elementary School: STARTOWN Middle School MAIDEN High School MAIDEN School Map Zoning Information: Zoning District: COUNTY Zoningl: R-20 Zoning2: Zoning3: Zoning Overlay: Small Area: STARTOWN Split Zoning Districts: / Zoning Agency Phone Numbers Firm Panel Date: 2007-09-05 Firm Panel # 2010 Census Block: 1049 2010 Census Tract: 011701 Agricultural District: Assessment Report Page I of I This map/report product was prepared from the Catawba County, NC Geospaeal Information services Catawba County has made substantial efforts to ensure the accuracy of location and labeling information contained on this map or data on this report Catawba County promotes and recommends the independent venhcation of any data contained on this map/report product by the user The County of Catawba, its employees, agents, and personnel, disclaim, and shall not be held liable for any and all damages. loss or liability, whether direct, indirect or consequential which anses or may arise from this map/report product or the use thereof by any person or entity © 2015, Catawba County Government, North Carolina. All rights reserved. X qQ y z quo ; pid http://gis.catawbacotintync.gov/nomap/pareel_report.php?key=371012959048&typ=P 7/2/2015 CATAWBA COUNTY HEALTH DEPARTMENT Telephone. (828) 465-5270 T (328) 465-5'_'00 �VLS 1i d DO 4 Improvement Permit ✓AC `- Repair Permit._ Operation Pernrit 7System Type-� "'ell Permit Replacement Well Owner/Agent �r k � . Z,s - ,, 4, o .j r Co nJ T. Phone Is 1 - 6 5 1 I Address ''.530 bcir e. PQna . 2a r o,,,..r Is1L a$b1.3 Subdivision Goy C.bv,d1. �\ Section/Block/Phase LotK Sd .� Lot Siz, t ei Directions: Hw„ I'o W e+ S}ter}uwn (1-d , Lt S4^aY Fora iZd,�+ r4�f7J N �oX C-tn- SIO 4-, 1 Ba,..�lo-.I.rv. 2nJ Io4- u.. W- Property Address 1146 aQe Io UL N_!v y)}an NC_ Uj Facility: House Mobile Home_ Busutess_Mu1u-family_ Other: Pin Number 3 -7 11 Other Zoning Approval # X Bedrooms 3 k Seats M Employees . Application Rate x ,35 CPD Flow .3 Hot Tub or Spa yes/no S2ecial Pictures Basement yes/�g� .100";, Repair Arca es}50 - Basement Plumbing yes u Nater Supply: Private Well_ Public V Semi -Public_ ##Witt#t##4tit####k4#######t##*akt#t##4##fi###fiR#i4fi##4#rf Rrt;tkki#a##k##ii#kit##R#t#aW###iWkiai##rtrW#r###aaiRtrt4#/7###WkWt , 'type of System: Trench BedPump_ Pump/Pant Panel_ LPPOther Septic Tank Size 1000 r p Pump Tank Size Nitrification Field: Total Square Feet 6l) Depth of Stone Bed Size Trench R'idOt 3 Total Length of All 'Trenches a 6 0 Number of Trenches 5 Trench Length 5a 15D /sa ,5a 15cl / Feet on Center _ Maximum Trench Depth a 4 Distance of Nearest Well (O D 1 *DO NOT INSTALL SEPTIC WHEN WET* *WELL RECORD REQUIRED AT COMPLETION* Toport, N %Slopep.,..1� Texture /,(-l. b 57 / S dc.,, ....y - O I fyq r+S o SeP}„ Structure 561< Ur Clay Min. I : I C Zoo 3 YS i�,\ Mi n . Soil Wetness 4 J t Soil Depth 36 h t„Ia- Restric. Hoz. at I .4 J jj �• t Available spac425noI �,`_••• c , 1 I 1 J, r 5 re. ,•••� k o n -x Q_ � Overall Class Sd-53 U I '� \ + IJ—! r..t Comments: &—i. k. a. P �J i Gs �,�� �s possibly 4-Q � � r°.p`ir• vtl jl ��� S�j�`� Filter Required xV fir- �- S Riser required when,` tank inches ee .than 6 g�^51� `G ^ � SYS inches deep. **NO GUARANTEE OR WARRANTY IS IMPLIED OR GIVEN AS TO THE PERFORMANCE OR LENGTH OF TIME THIS SYSTEM WILL FUNCTION** #Wfrt##4tii##t##a4t##af+4t###sas##4tt##i##ts#i#it#k#4#s####tstt##sta#aatt####4t####*t+4i#strtstkt##saWats#tats##sstk#:* *Improvement Permit has no expiration date and is transferable, but may be revoked if site plans or intended use changes for the proposed facility. An Authorization to Construct is valid for (5) five years from date issued and is not transferable. Well Permit valid for 5 years provided site conditions do not change. Well location, installation, and protection must meet state and local regulations, and must be inspected and approved by a representative of the Catawba County Health Department before any portion of the installation is put into use. The siting of the well by the Health Department staff is to provide protection from known possible sources of contamination. No volume of water is guaranteed t any $ite by t re ealth Department. PermPermitDalci �s II� - j XOwnerlA eyt ft% J EHS y EHS g/�� '� Septic Tankonstalled By t'�cX WI. tI>..r Date U f �`" Well Installed By Well Grout Approval Date Wcll HeH Approval D Date Sample Collected - Date of Resu' is Results EHS While - Office Yellow - Owner/Agent Pink - Building Inspeumn Authorn2n0n to Construct 3GREEVE© AORGH .aw 6nl?t`6CCa41•�8 Cifi*CSiE�xN'i ' 5ATI. 9 '.I dKFASi� I � I I II j FASTER I R00`i 1_ F4h1'LYROOM --- - KI.:HEN ' IIw - -- r � � b.I.G. PCR�H I — GARAGEtl rrC EXISTNG MAIN �LOOR PLAN WROO t _E� 6mN ---_-- Wr noxa i�-------- - - - - - i LZ I I � `" • Edi � 1 I � III II ' I I I I I I I I � � I I II ( 9tu0. EICtt L�T� sl•LEa i0163�. L_ - � I BASEMENT PLAN LL'l.EFM'.T F1k+'lGAL4FJ661 ; aflK16Lm - I' 6'WG tcei.7a--_. b6tau.Fla--_ _ I I I I I I a�.wva¢aa� 'j1 aflK16Lm - I' 6'WG tcei.7a--_. b6tau.Fla--_ _ a�.wva¢aa� 'j1 WA4 ZION c�ra�ng