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Home My WebLink AboutRBPR-07-2015-21933.TIFContractor Owner THIS IS NOT A PERMIT Case It RBPR-07-2015-21933 CATAWBA COUNTY HEALTH DEPARTMENT PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES Residential Building Plan Review - Building New IMPROVEMENT - AUTHI CONST *ISENHOUR CONSTRUCTION, MARK F (MARK ISENHOUR), 3530 DUCK POND DR, CONOVE 28613- B:(828)312-6571 C:8283126571178284592800 MARK9156@CHARTER.NET WILLIAM ELLIS, I I I CLINTON ST, SOUTH HAVEN MI 49090 NAME TO APPEAR ON PERMIT William Ellis SITE ADDRESS: 2411 EAGLE DR NE, CONOVER NC 28613 PIN # 375206481901 NAME of SUBDIVISION: ROCK BARN CLUB OF GOLF Lot # 7 Section/Block D PROPERTY SIZE: Square Peet Acres 0.87 DIRECTIONS: into Rock Barn Golf Club / left on Eagle Dr/ on left at corner of Club House & Eagle Or PRIMARY CONTACT: Contractor SEWERTYPE: Septic Tank GALLONS PER DAY: 480 WATER SUPPLY : Public Water DESCRIBE WORK: 1 story dwelling w/attached & basement (partially finished) 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: STRUCTURE TYPE: FACILITY TYPE: Single Family Residence DESCRIPTION OF vacant lot EXISTING STRUCTURES ON SITE (IF AN DIM EXISTING STRUCTURE: NUMBER OF EXISTING BEDROOMS: New Structure PRIMARY RESIDENCE OTHER DESCRIPTION: # OF OCCUPANTS: 2 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 75 x 64 # OF NEW BEDROOMS:: 4 BASEMENT? Yes BASEMENT FIXTURES? Yes Desired system types (Improvement Permit or Authorization to Construct). ACCEPTED ALTERNATIVE: OTHER. INNOVATIVE: Other described: PLUMBING REQUIRED? Yes CONVENTIONAL: YES ANY E9 - chapplicauon D7/13/2015 13 23 Page t of 4 CATAWBA COUNTY Case # RBPR-07-2015-21933 �T GL Public Health Department Subdivision ROCK BARN CLUB OF GOLF Environmental Health Division PIN# 375206481901 / PO Bos 389, 100-A Southwest Blvd- Newton. NC 28659 iati,M NAME ON PERMIT: ( WILLIAM ELLIS), III CLINTON ST, SOUTH HAVEN MI 49090 ( William Ellis) Site Address: 2411 EAGLE DR NE, CONOVER NC 28613 Property Size: Square Feet Acres 0.87 Directions: into Rock Barn Golf Club / left on Eagle Dr/ on left at corner of Club House & Eagle Dr 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/rule,'.I un island t am s Iy responsible for the proper identification �nd labehg of all property Tines and corners and making the site accessibla p7eitcZailron can be performed. Date: % _ / 2 / Signature of Applicant or Aoent An Environmntal Health Specialist will contact you withiV5 wdrkin�day oate. If you need further information or assistance please call 828-466- AREA2 FEENAME DATE FEE AMOUNT Authorization to Construct Fee (New/Expansion) 07h3/2015 $300.00 Fee Improvement Permit Fee 0711312015 $150.00 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) EQ - ehapplicannn 07/13/2015 13 23 Page 2 of 4 CAT L THIS IS NOT A PERMIT FLIT! NTL CATAWBA COUNTY HEALTH DEPARTMENT -,, Application for Enviromnental Services Page 1 Improvement Permit ❑ Authorization to Construct/ Septic Repair ❑ Septic Malfunction ❑ Septic Expansion ❑ New Well Permit ❑ Replacement Well ❑ Well Abandonment ❑ Well Repair ❑ Existing System Inspection(PApproval Required) ❑ ❑ PropertyAddress QL/Application is for New Construction Existing Facility ((1J2 3�Z Subdivision -POCL Rfw� L� mon_ ✓ n C a -Z (, j 3-_ Lot# 1% Acres 77 ection/Block/Phase Driving Directions to Property -.TA -�D Di le- /J/ThMt tic�0�� L�u� Lr dvi L � T)(\nA A L P C' 44' Co a n -,e,2 0-(Q CA, A (�1 r�u.s � �.-jd �,�a.. / NAME TO AtPEAR ON PERD'HT? d Owner ❑ Applicant RContractor Applicant Contact Information Name Address Phone 3i�_(ps -7 I Cell -hone Owner Contact Information Name Address r t).w n Phone Cell Phone Contractor3�ontact Information _ Name -M4 f J�pt (i/1 r<2Gi {� CM_GT Address ()�iv Phone ] Cell Phone ��d �(� 7/ WHO WILL BE THE PRIMARY CONTACT? ❑ Owner ❑ Applicant [Z Contractor 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 ip question. If the answer to any question is "yes", applicant must attach supporting documentation. ® Yes I Does the site contain any jurisdictional wetlands? ® Yes T Does the site contain any existing wastewater systems? r) Yes Is any wastewater going to be generated on the site other than domestic sewage? ®Y Is the site subject to approval by any other public agency? es to Are there any easements or right of ways on this property? Describe Existm water supply in use ❑ Individual 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): J (systems can be ranked in order of your reference) El Accepted 0 Alternative Conventional ❑ Innovative ❑ Other„ ❑ Any Cca�PERMIT CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services Page 2 Proposed Facility Type Primary Residencet New Rnesidence Addition to Residence # of New Bedrooms * j Project Description 7tlL ti,C Structure Dime ns ] �i >r (� # of O upants Basement Yes ❑ No Baser at 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 r ❑ 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 t 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 RILL 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 time 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 time proper identification and labeling of all property lines and comers and malting the site accessible so that a complete site evaluation can be performed. Signature of Owner or Agent /4 Date Printed Name of Owner or Agent 14 /-P, lG r � S �6I { 0 q oc>-- CATAwsA Geospatial Permit Center `` Information Services :. 23 / �r 103 �EAGtE��R.NE 165 . I N w + E S Parcel: 375206481901, 2411 EAGLE DR NE CONOVER, 28613 Owners: ELLIS WILLIAM E, ELLIS JANE L Owner Address: 111CLINTON ST Values - Building(s): $0, Land: $117,300, Total: $117,300 1 in=60ft This map/report 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 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 arise from this map/report product or the use thereof by any person or entity Copyright 2014 Catawba County NC 07/13/2015 V,82 CATAWBA COUNTY Public Health Department Environmental Health Division PO Box 389, 100-A Southwest Blvd, Newton, NC 28658 ... Case IMPV-04-2014-049216 Subdivision ROCK BARN CLUB OF GO PIN# 375206481901 LOT4 7 FHp�ou- - Qol4- Isg`-43 NAME ON PERMIT: WILLIAM E ELLIS Site Address: 2411 EAGLE DR NE, CONOVER NC 28613 Property Size: Square Feet 37,89720 Acres 0.87 Directions: INTO ROCK BARN GOLF CLUB, LEFT ON EAGLE, ON LEFT AT CORNER OF CLUB HOUSE AND EAGLE Improvement Permit Facility: Primary Residence - house Permit Category: New Septic Bedrooms 4 WATER SUPPLY: Public Water Basement? Yes Basement Plumbing? Yes INITIAL SYSTEM SPECIFICATIONS Permit Valid: Expires In Five Years _X— No Expiration: Projected Daily Flow 480 g,p,d Proposed Wastewater System: 25% REDUCTION Type: HIG - OTHER NON-CONV TRENCH SYSTEMS Permit Conditions: REPAIR SYSTEM SPECIFICATION_ S _ Repair System Required? Required Proposed Wastewater System: 50% REDUCTION Type: IVA - ANY SYSTEM WITH LPP DISTRIBUTION PUMP 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 suspension/revocation of existinq permits. The issuance of this permit by the Health Department does not guaramee 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 ore uttered. 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 Taivs and Rules for Servaee Treatment and Disposal Svsten.s' (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. Mi McBride 04/29/2014 AUTHORIZED STATC AGENT APPROVAL DATE Permit Expiration Date 04/24/2019 No grading or construction activity is allowed in areas designatedfoi systems and repair without approval oftne Health Deportment. FG - chprnnn 04/29/2014 12 13 Page I ora i P EH P�- Oy- 2A!'�-18843 TAI'S �3PV h ri i 5 tAOo in4e4ej -T)y Sa�- iw ;dull PuvpseS Du P,A d'nue, nfag, evk, oY - ill Ncy �fi� ctreGs, �pvSc 'V110 (ORCC4 }D PVWk C t io�er, 1ci.�s Ep�, N. NE =50 illiv- +Yl..y,P?'hKJ,.FB;.,,, ; 11-1404 — 11114 "` :2 <Z -a i 1 �o o� 5• TIS \S i �� Proposed .8u, � Bedrox^ �3. o F{WSe. So�40 -o d r' 43' X75' Ep�, N. NE =50 illiv- +Yl..y,P?'hKJ,.FB;.,,, ; 11-1404 — 11114 "` :2 DEPARTMENFOFENVDiONMENY AND MATVRALRESOURCES - Shuet��oJT„ DNIS10NOFENMONMENGLHEALTH PROPERTY 0N.51TE WASIEWATERSECITON COUNTTY:Y: SDIIlSITE EVALUiiTTON C=3 1 AFF: wtfillam E. &lPsoN-srrEwAPPUCAnoxDUA SYSTEM EriRR DN?oj 3 ADDBECr , DATEEVALVATEDt 22-( PROPOSEDFACRxM,499NwCt PROPOSED DMGM FLOW (. 1949): S0 PROPEBTYSIZE:0.97ncres LOCATIONOFSITE; 24(( tR!la Or NE (000tt'r PROPERTYRECORDED: WATER SUPPLY: 0 r ivata `N Puhuc 0 Well 0 S- 9 0 Othm EVALUATION34FTHOD: 0 Aug=Bmiq 0 Pit U Ctd V\fr6A(a4 06e* L&mO5 TYPE OF WASTEWATER 0 Sc p 0 Indtutrisl Pmxss 0 Waxed V b I D -4g Cl. Shk 1 , 670 I I f 2 ( I Wa-Eev & 3V . i ID -q% CL, S' LIC I 3 I wore✓ P„ I j 4 I i f � , 1 JJJ j I-Gm, SPxp I DESCMmi? f "A' � KMAMSYMVJI OTHMFACTORS(.1946)• A%vNhlc Spa (.1945) P5 P5 i SITE CLASSINCATTON(1948,): G } h rtwt�7 Z EVALUATED SY• /, rw 7rykdn k jSite LTAR I G • '� OTHER(S) PRESENT: .v COMMENTS: . 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