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HomeMy WebLinkAboutRBPR-07-2015-22040.TIFApplicant THIS IS NOT A PERMIT Case # RBPR-07-201-22040 CATAWBA COUNTY HEALTH DEPARTMENT PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES Residential Building Plan Review - Deek/Porch AUTH CONST - SEPTIC MALFUNCTION BRYAN S WANN. 1903 TODD ST, NEWTON NC 28658 C:2283655617 Land Owner LARRY SIMMONS. 1903 TODD ST, NEWTON NC 28658 NAME TO APPEAR ON PERMIT Bryan Swann SITE ADDRESS: 1903 TODD ST. NEWTON NC 28658 PIN # 362916943199 NAME of SUBDIVISION: SPRING ECHO Lot # 27-31 Section/13lock _ PROPERTY SIZE: Square Feet Acres 0.51 DIRECTIONS: 1903 Todd SU Newton PRIMARY CONTACT: Applicant SEWER TYPE: Septic Tank GALLONS PER DAY: WATER SUPPLY : Private Well DESCRIBE WORK: "septic tank only Malfunction - & check setbacks for new decks/ "adding 42 x 6 front deck & 16 x 16 rear 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: STRUCTURE TYPE: FACILITY TYPE: Single Family Residence DESCRIPTION OF single family EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: NUMBER OF EXISTING BEDROOMS: Existing Structure PRIMARY RESIDENCE OTHER DESCRIPTION: # OF OCCUPANTS: PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 42 x 6 front deck/ 16 x 16 rear deck Desired system types (Improvement Permit or Authorization to Construct). ACCEPTED ALTERNATIVE. OTHER Other described: INNOVATIVE CONVENTIONAL ANY YES 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 lobelin of all property lines and corners and making the site accesssi I o that a complete site a nation can be performed Date: -7A1_-r115 Signature of Applicant or Agent -�/;i-+' _7. �..,�'� 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 E9 - ehapplicauon 07/29/2015 14:08 Page I of 7 CATAWBA COUNTY �� 2)Public Health Department Environmental Health Division PO Boz 389, 100-A Southwest Blad, Newton. NC 28658 !g 2 w NAME ON PERMIT: ( BRYAN SWANN), 1903 TODD ST, NEWTON NC 28658 ( Bryan Swann) Site Address: 1903 TODD ST, NEWTON NC 28658 Property Size: Square Fcet Acres 051 Directions: 1903 Todd St/ Newton Case # "PR -07-2015-22040 Subdivision SPRING ECHO PING 362916943199 FEENAME DATE FEE AMOUNT Authorization to Construct (Repair) Fee 07/29/2015 5150.00 TOTAL FEES $150.00 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 - ahapphcauon 07/29/2015 14 08 Page 2 of 7 i �l i id THIS IS NOT A PERMIT uvurs s_ CATA`VBA COUNTY HEALTH DEPARTMENT Application for Environmental Services Page 1 Improvement Permit ❑ Authorization to Construct ❑ Septic Repair ❑ Septic Malfunction Septic Expansion ❑ New Well Permit ❑ Replacement W01 ❑ WellAbandonmenl ❑ Well Repair ❑ Existing System Inspection (Pre -Approval Required) ❑ j Application is for New Construction ❑ Existing Facility E]I Property Address iq,3 j () LOV '5-f- Subdivision !i./Fa17-V-X rte( .:2 k6S8' Lot N Acres Driving Directions to Property NANIF TO APPEAR ON PERMIT? N Owner Applicant Contact Information Name f �/� r`/}N Section/Block/Phase >rC�Dl��e. >1zn..t.GI �tc,d� � O�II�c�- t.�cetr✓�tfb�ctel� L-1 Applicant ❑ Contractor Address ./ (y /) 3 �' 'I U /)© ,S i ! O..t/, y G Phone .1a.1 ) 36S t % ( Cell Phone �� a�� 36/T til/ 7 Owner Contact Information Name SA" Address j Phone ( Cell Phone Contractor Contact Lnformation Name Address Phone Cell Phone WHO WILL BETRE PRINIARY" CONTACT? N Owner ® Applicant ❑ Contractor Des.... .. _ ..., ...---.... _.,... . ............. .., .. _ - -- -- — cription of Existing Structures on Site # of Bedrooms * j 3 Structure Dimensions _ # of Occupants Li _ 13asement X Yes ❑ No Basement Fixtures Ye. KJ 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 ANO Does the site contain env jurisdictional wetlands? A Yes 0 No 0 Yes P(No kYes 0 No 0 Yes KNo Existing water Does the site contain any existing wastewater systems? Is any wastewater going to be generated on the site other than domestic sewage? Is the site subject to approval by any other public agency? Are there any easements or right of ways on this property? Describe use ^ Individual \Voll Well 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 0 Conventional 0 Innovative 0 Other Any �1IN T q� � �`F TIIIS IS NOT A PERMIT C L21JUyT�i.. VV & CATA`YBA COUNTY HEALTH DEPARTMENT Application for Enviromnental Services Page 2 Proposed Facility Type �y ❑ Primary Residence ❑ New Residence Addition to Residence # of New Bedrooms *j C/ i Project Description FA0s/F i1':, X 6 HL%< %/„x'%L Dw�-Kt Structure Dimensions # of Occupants Basement ❑ Yes ❑ No Basement Fixtures rj Yes ® No ❑ Accessory Structure(s) Describe # of New Bedrooms *r 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 # of Employees per Shift # of Shifts ❑ Other Facility Type Specify If Church # of Seats Kitchen ❑ Yes ❑ No Retail Floor Space If Daycare Specify Occupancy Application for Well Construction/Abandonment/Repair Proposed Well Type ❑ Individual Well ❑ Semi -Public Well Abandonment Type ❑ Drilled ❑ Bored Well Repair Requested ❑ Yes ❑ No Describe ❑ Community Well ❑ Dug ❑ Unknown Calculated Design Flow, Commercial f Additional information may be required to determine design Bow 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. T 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 revolted 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 trate, complete and correct. Authorized county and state officials are granted right of entry to conduct necessary inspections to determine compliance with applicable laws and rites. I understand that I am solely responsible for the 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 �/ Z • �u�'� Date %/ `3/1,$ Printed Name of Owner or Agent Catawba County Environmental Health ; "' }}� 3199 r' j ti x szsa ' i O All i rs7..9,; Parcel: 362916943199, 1903 TODD ST NEWTON, 28658 1 in=40ft 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 arses or may arise from this map/report product or the use thereof by any person or entity. Copyright 2014 Catawba County INC 07/29/2015 Parcel Report Parcel Report- Catawba County NC Parcel Information: Parcel ID: 362916943199 Parcel Address: 1903 TODD ST City: NEWTON, 28658 LRK(REID): 40430 Deed Book/Page: 1888/0679 Subdivision: SPRING ECHO Lots/Block: 27-31/ Last Sale: $65,500 on 1994-06-01 Plat Book/Page: 13/33 Legal: LOT 27-31 27-31 F PI -1 3-33 SPR ECHO PL 13-33 Calculated Acreage: .510 Tax Map: 081 N 06002A Township: NEWTON State Road #: Tax/Value Information: Tax Rates(pdf) City Tax District: NEWTON County Fire District: All in City Building(s) Value: $105,200 Land Value: $10,200 Assessed Total Value: $115,400 Year BuilURemodeled: 1991/ Current Tax Bill Miscellaneous: Building Permits for this parcel. Building Details W aterShed: Voter Precinct: P34 Parcel Report Data Descriptions List all Owners Deed History Report Owner Information: Owner: SIMMONS LARRY JAMES Owner2: SIMMONS JOCK T Address: 1903 TODD ST Address2: City: NEWTON State/Zip: NC 28658-9317 School Information: School District: COUNTY Elementary School: STARTOWN Middle School: MAIDEN High School: MAIDEN School Map Zoning Information: Zoning District: NEWTON Zoningl: R-20 Zoning2: Zoning3: Zoning Overlay: Small Area: Split Zoning Districts: / Zoning Agency Phone Numbers Firm Panel Date: 2007-09-05 Firm Panel #: 3710362900J 2010 Census Block: 2022 2010 Census Tract: 011702 Agricultural District: Assessment Report Page 1 of 1 This map/report product was prepared from the Catawba County, NC Geospabal 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 venhcabon of any data contained on this map/repos 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 parson or entity © 2015, Catawba County Government, North Carolina. All rights reserved. �C S�Pfic fw �jlt\kAVt fv Y C,LI c[k http://gis.catawbacountync.goN,/nomap/parcel_report.php?key=362916943199&typ=P 7/29/2015 ., 1.,dv Cot CATAWBA COUNP' HEALTH DEPARTMENT N2 0 0,17 7 7 (704) 465-8270 Lot Evaluation I/ Impr1/ovement Permit Repair Permit / Completion Permit �t' Ovner/Agent y( t�. Phone PJfa — G/9-5 Address I Y � U nl6Ih Au i. N[ A-At,�a- Subdivisi 6'NEe— au - �/c%ry .�Sic.tion/Block Lot#_ Lot Sizzee dU P0d l Directions: /0' w/,'a� �Lvfp(rnc��h l q �/� F�7 AN9 Y' K t lA/VI/VlW^N /'/tib i Y� ///W'1 <-✓j� A 6W14/40 A V✓�IL- ;tr;I - Facility: House C,//Mobile Home_ Business_ Other: Zoning Approval yes/no Multi-family_ Other 1002 Repair Area ves/no Bedrooms Seats Employees GPD Flow Application Rate Hot Tub 0 yes/Special Fixtures REPAIR NOTICE: MUST BE WITHIN Basement es no Bas e' no 30 DAYS OR DAYS FROM DATE OF nt Plunbing ye Hater Sup y' Private_ //Public PERMIT. Type of System: TrenchV Bed System— Other (Specify) Tank Size: Septic Tank 1LO v 7 Pump Tank 7 ii Nitrification Field: Total Square Feet y Depth of Stone /1) Bed Size Trench Width 3 Total Length of All Trenches (2 �6 Number of Trenches i t W 7f Individual Trench Length 0 K6 / �0 /_/_ Feet on Center Maximum Trench Depth i Distance of Nearest Well .'ri0 Lot Evaluation: Approved yea/no (Void After 24 months) Topo 2 Slope 1 Sketch of lot Evaluation Site - System Design - Final Texture I Structure (31ck.t�je11 Clay Nin. Soil Wetness Ofi - --;- - Soil Depth Restric. Hoz. at Ur I Available space ves/nol Overall Class S PS U I Comments: I 6 3x I / Permit Date f��/_l" I/��O (Improvement Permit void after 60 months) Owner/Agent Sanitarian /�.���tA4 Installed ByseB�u 0494 1441" Date L Sanitarian 4V1.a (Note any changes/information in red or bv,sketch on back)