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HomeMy WebLinkAboutEHPR-02-2016-23290 (2).TIF ° 14AR-29-2016(TUE) 08: 14 DEMON SURVEYORS (FAX)704 483 2170 P. 661/002 r,Q THIS IS NOT PERMIT Case# EHPR-02-2016-23290 •••6,` tom • ¢ ■ ;; p® ,a CATAW13A COUNTY HEALTH DEPARTMENT 0 Pl'..{p .j: ••0 j r PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES '� '` !_r L • '" Environmental Health Plan Review - OSWP •o _ - o+.i. a Zilt1 �•IMPROVEMENT El. T ?3/h —n Ie S n. �- Contractor WESLEY HOWARD BUILDERS INC. (WESLEY HOWARD),4832 BURRIS RD, DENVER NC 280: C:7044004593 Owner MARK&SANDRA VOLAK, 7010 MCLOTHIAN LN, HUNTERSVELLE NC 28078 NAME TO APPEAR ON PERMIT Wesley Howard Builders Inc. (WESLEY HOWARD) SITEADDRESS: 4680 GOLD FINCH DR, DENVER NC 28037 PIN # 460601167843 NAME of SUBDIVISION: PEBBLE BAY PH 3 REVISION Lot N 126 Section/Block PROPERTY SIZE: Square Fan_,. 62,290.80 Acres_ 1.43 DIRECTIONS: Hwy 16 South, Left onto Campground Rd, Left onto Burris Rd, Righy on 8ankhead Rd, Left onto Gold Finch&lot is 4th on Right. PRIMARY CONTACT: Contractor SEWER TYPE: Septic Tank GALLONS PER DAY: 360 WATER SUPPLY: Community Well DESCRIBE WORK: Revised 3/17/16 - No Basement IP for Purchase" 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", than 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? No Are there any easements or right-of-ways on this property? No APPLICATION FOR: New Structure STRUCTURE TYPE: PRIMARY RESIDENCE FACILITY TYPE: House OTHER DESCRIPTION: DESCRIPTION OF EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: NUMBER OF EXISTING BEDROOMS: #OF OCCUPANTS; 2 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 60x80 w/attached Garage #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: MAR-29-2016(TUE) 08: 14 DEDMON SURVEYORS (FAX)701 483 2170 P. 002/002 •~41+ 2 Public Health Department y_ Subdivision PEBBLE BAY PH 3 REVISION < fi®,,, '"1 Environmental 4lealtlt Division PIN# 460601167843 r � PO fox 389. 100-A Southw'csl Blvd,Newton, NC 28658 NAME ON PERMIT: WESLEY HOWARD BUILDERS INC. ( WESLEY HOWARD),4832 BURRIS RD, DENVER NC 28037 Wesley Howard Builders Inc. ( WESLEY HOWARD) Site Address: 4680 GOLD FINCH DR, DENVER NC 28037 Property Size: Square Feet 62,290.80 Acres 1.43 Directions: Hwy 16 South, Left onto Campground Rd. Left onto Burris Rd, Righy on Bankhead Rd. Lett onto Gold Finch 8 lot is 4th on 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 lithe 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 ands /.. IaJbeliinng f all property lines and corners and making the site accessibl so hat ace plele evaluation can be performed, Date: _ _ 4 Signature of Applicant or Agent 7 An Environmental Health Specialist will contact you within 5 wor mg days of application date. I ryou need further information or assistance please call 828-466-7291 AREA1 q?P6L",.Gbt1yR w f:pr i 5l'?Wv ` �ir r., =ti9 �,r :idt r ''�Ut,uttl dpi1:t 9s" J! fl rou .., FEENAME1 pgRAV'illi— y■.4t., 1 ,I:;a. y t t'C� .,:ipDATELFSi FFF4AMO'IJN:1Th4p Improvement Permit Fee 02/26/2016 $150.00 71171g g FTO O. ::1'1 r$,;P+:ri.U `_�°i,;nV � r«.'hp� r r 1 0UH r'' ,O E 4ry t-.44. st ^ - C1dA�r.i!r err zxns seiale:t- r.,rrrvi wfora.. .aw,,,,,, 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) • BA �� THIS IS NOT A PERMIT Case # EHPR-02-2016-23290 6 CATAWBA COUNTY HEALTH DEPARTMENT 0o' 0 PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES } �� + 1113101: J842 SM Environmental Health Plan Review - OSWP •oI • o +h,o IMPROVEMENT 1 � Contractor WESLEY HOWARD BUILDERS INC. (WESLEY HOWARD), 4832 BURRIS RD, DENVER NC 280: C:7044004593 Owner MARK & SANDRA VOLAK, 7010 MCLOTHIAN LN, HUNTERSVILLE NC 28078 NAME TO APPEAR ON PERMIT Wesley Howard Builders Inc. (WESLEY HOWARD) SITE ADDRESS: 4680 GOLD FINCH DR, DENVER NC 28037 PIN # 460601167843 NAME of SUBDIVISION: PEBBLE BAY PH 3 REVISION Lot# 126 Section/Block PROPERTY SIZE: Square Feet 62,290.80 Acres 1.43 DIRECTIONS: Hwy 16 South, Left onto Campground Rd, Left onto Burris Rd, Righy on Bankhead Rd, Left onto Gold Finch & lot is 4th on Right. PRIMARY CONTACT: Contractor SEWER TYPE: Septic Tank GALLONS PER DAY: 360 WATER SUPPLY: Community Well DESCRIBE WORK: IP for Purchase* 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? No Are there any easements or right-of-ways on this property? No APPLICATION FOR: New Structure STRUCTURE TYPE: PRIMARY RESIDENCE FACILITY TYPE: House OTHER DESCRIPTION: DESCRIPTION OF EXISTING STRUCTURES ON SITE(IF ANY) DIM EXISTING STRUCTURE: NUMBER OF EXISTING BEDROOMS: #OF OCCUPANTS: 2 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 60x80 w/attached Garage #OF NEW BEDROOMS:: 3 BASEMENT? Yes BASEMENT FIXTURES? Yes PLUMBING REQUIRED? Desired system types (Improvement Permit or Authorization to Construct): ACCEPTED: ALTERNATIVE: CONVENTIONAL: OTHER: INNOVATIVE: ANY: YES Other described: E9-eliapplicaion 02/26/2016 16:23 Page 1 of 5 /g• CATAWBA COUNTY Case tt EI-IPR-02-2016-23290 (e- per,n Public Health Department Subdivision 'f-� L PEBBLE BAY PH 3 REVISION <% `''�£ 4 Environmental Health Division PIN# 460601167843 '- PO Box 389, 100-A Southwest Blvd, Newton,NC 28658 I:42 sv NAME ON PERMIT: WESLEY HOWARD BUILDERS INC. ( WESLEY HOWARD),4832 BURRIS RD, DENVER NC 28037 Wesley Howard Builders Inc. ( WESLEY HOWARD) Site Address: 4680 GOLD FINCH DR, DENVER NC 28037 Property Size: Square Feel 62,290.80 Acres 1.43 Directions: Hwy 16 South, Left onto Campground Rd, Left onto Burris Rd, Righy on Bankhead Rd, Left onto Gold Finch & lot is 4th on 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 belin of all property lines and corners and making the site access' le so that a co ete sit valuation can be performed. Date: 272G 7/4' Signature of Applicant or Agent /1r/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 p kd a T pn t f rais a 7 4 vaRi a r .aR 'F =i e t FEENAME i 1 « ,?1: H h .ig-t.tVargrailliDATEINSIIITEEAMOUNTE Improvement Permit Fee 02/26/2016 $150.00 r batty l � :TOTAtL EES v; Al f J7t'E �i2 ^ r-. ia latili mi si5 0 00 t ° t 3 , t,fv .._.n i, Li c -ai tini ®t 'Cw °T_. 'ii itiiiiiiiti .Gat' . dmiii,i' tp sf. 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-chapplicauon 02/26/2016 16:23 Page 2 of 5 CATAWBA THIS IS NOT A PERMIT coun7r CATAWBA COUNTY HEALTH DEPARTMENT � """� NorIF— � Application for Environmental Services Page 1 Carali Improvement Permit Authorization to Construct❑ Septic Repair ❑ Septic Malfunction ❑ Septic Expansion ❑ New Well Permit❑ Replacement Well n Well Abandonment❑ Well Repair ❑ Existing System Inspection (Pre-Approval Required) ❑ Application is for New Construction Existing Facility 111 Property Address Llo00 64 1NQ.4 Drive Subdivision ?ebk(G go, be,o4« tie 7k03-7 Lot# X A2 Acres Section/Block/Phase_ 3 Driving Directions to Property p � 11 I b SoJk '7 Ca^^Pro r&j 0 iv Sews 12A (� C) a) bo,N 1.teLJ (-ectA I(�. pAi Go Id ]-irJc4 Lo 1 0'3 RI NAME TO APPEAR ON PERMIT? ❑ Owner ❑ Applicant Kontractor Applicant Contact Information Name \NCArk BSc! V❑\CV\L Address Phone Cell Phone --Owtter-eurmattinformation- ., Name ,iii Grover q 5,s,vi Nn}u4 Nei i Address ' VC (4 YQaal /�e' eCA ( ev ✓ `" Phone Cell Phone lot-f-- '371 - oz so Contractor Contact Information VName .je[&I Apwnrd License# try-3S' Address X2 Aupyt5 (le Pc„ ecSL NIL- X037 Phone Cell Phone 7c4- LEoo - i499 3 WHO WILL BE THE PRIMARY CONTACT? ❑ Owner ❑ Applicant Zeontractor Description of Existing Structures on Site # of Bedrooms *t Structure Dimensions #of Occupants Basement ❑ Yes ❑ No Basement Fixtures TI 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 :-g_I No Does the site contain any jurisdictional wetlands? ❑ Yes Elo Does the site contain any existing wastewater systems? ❑ Yes j-!o Is any wastewater going to be generated on the site other than domestic sewage? ❑ Yes .LINO Is the site subject to approval by any other public agency? ❑ Yes LI No Are there any easements or right of ways on this property? Describe Existing water supply in use ❑ Individual Well ❑ Community Well ❑ Semi-Public Well Cy*`� \\ ❑ County/City/Township Water Line Is a public water supply available? ** 2-Yes ❑ No V 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) J ❑ Accepted ❑ Alternative 0 ei Conventional ❑ Innovative ❑ Other El Any CATAWBA THIS IS NOT A PERMIT . COUNTY „wee"' CATAWBA COUNTY HEALTH DEPARTMENT • „0„„ ,;;;;;-..., Application for Environmental Services Page 2 Proposed Facility Type ❑ Primary Residence New Residence ❑ Addition to Residence #of New Bedrooms *t 3 Project Description New ko-K Structure Dimensions CO X 10 # of Occupants Z Basement El Yes n No Basement Fixtures { -Yes ❑ No ❑ Accessory Structure(s) Describe # of New Bedrooms *t if applicable Structure Dimensions # of Occupants Accessory Dwelling n Yes n No Plumbing n Yes ❑ No Describe Plumbing Needed n Multi-Family Residence# Units #Bedrooms per Unit*t Total # Bedrooms *1. Structure Dimensions n 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 n Yes ❑ No If Daycare Specify Occupancy Application for Well Construction/Abandonment/Repair Proposed Well Type n Individual Well n Semi-Public Well n Community Well Abandonment Type ❑ Drilled ❑ Bored ❑ Dug n Unknown 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. 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 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. �J Signature of Owner or Agent �/(/, ; (( Date 2-44/b Printed Name of Owner or Agent �E5 j-{pwctroi Catawba County Environmental Health 351. o/ f �l ra i 0 ® " m .141 oT rn I ; \- f cvs •44.74 g / R I ______zvyy,„\\N\ 1 4: I I e ' 235 00 Alf tiki,c'' p Y" .. 159.75 394,75 1 / n 44 To 0 f Lo . 0 - l . `, s o ,.._. 471.82 1 160.01 T. — _ — — — O O 7' 1 40.00 '' .44./ 0 1 g a :r' I > e“49 it co Hlt • 431.75 I 1 0 r o I I . r------7 Parcel: 460601167843, 4680 GOLD FINCH DR 1 in=80ft DENVER, 28037 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 02/26/2016 Parcel Report Page 1 of 1 Parcel Report - Catawba County NC Parcel Information: Owner Information: Parcel ID: 460601167843 Owner: VOLAK MARK J Parcel Address: 4680 GOLD FINCH DR Owner2: VOLAK SANDRA J City: DENVER, 28037 Address: 7010 MCLOTHIAN LN LRK(REID): 802819 Address2: Deed Book/Page: 3204/1601 City: HUNTERSVILLE Subdivision: PEBBLE BAY PH 3 REVISION State/Zip: NC 28078-8416 Lots/Block: 126/ Last Sale: $42,500 on 2013-08-14 School Information: Plat Book/Page: 62/103 School District: COUNTY Legal: LOT 126 PLAT 62-103 Elementary School: SHERRILLS FORD Middle School: MILL CREEK Calculated Acreage: 1.430 Tax Map: High School: BANDYS Township: MOUNTAIN CREEK School Map State Road #: Tax/Value Information: Tax Rates(pdf) Zoning Information: City Tax District: All in County Zoning District: COUNTY County Fire District: SHERRILLS FORD Zoning1: R-30 Building(s) Value: $0 Zoning2: Land Value: $42,100 Zoning3: Assessed Total Value: $42,100 Zoning Overlay: WP-O Year Built/Remodeled: / Small Area: SHERRILLS FORD Current Tax Bill Split Zoning Districts: / Zoning Agency Phone Numbers Miscellaneous: Firm Panel Date: 2007-09-05 Building Permits for this parcel. Firm Panel it: 3710460600J Building Details 2010 Census Block: 4013 WaterShed: WS-IV Critical Area 2010 Census Tract: 011504 Voter Precinct: P41 Agricultural District: Parcel Report Data Descriptions List all Owners Deed History Report 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/report product or the use thereof by any person or entity. ©2015, Catawba County Government, North Carolina. All rights reserved. http://gis.catawbacountync.gov/nomap/parcel_report.php?key=460601167843&typ=P 2/26/2016 Ar o CATAWBA COUNTY t' .. ib IOOA SOUTHWEST BLVD NEWTON, NORTH CAROLINA 28658 RECEIPT mi2J PHONE: 828.465.8399 ? �i►° Friday, February 26, 2016 /842 sM www.catawbacountync.gov PAYOR: Wesley Howard Builders Inc. Wesley Howard Builders Inc. (HOWARD, WESLEY) PAYMENTS TRANSACTION NUMBER: TRC-627847-26-02-2016 PAYMENT DATE : 02/26/2016 PAYMENT TYPE: Check 2596 INVOICE NUMBER FEE NAME FEE AMOUNT 02-16-325667 Improvement Permit Fee 5150.00 TOTAL PAYMENTS : $150.00 EHPR-02-2016-23290 CASE TYPE: Environmental Health Plan Review WORK CLASS: OSWP SITE ADDRESS: 4680 GOLD FINCH DR, DENVER NC 28037 Owner MARK& SANDRA VOLAK, 7010 MCLOTHIAN LN, HUNTERSVILLE NC 28078 Contractor WESLEY HOWARD BUILDERS INC.,4832 BURRIS RD, DENVER NC 28037 C:7044004593 **NO PEOPLESOFTACCOUNTASSIGNED ** receipt 02(26(2016 16:22 Page I of 1