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HomeMy WebLinkAboutRBPR-03-2016-23393.TIF THIS IS NOT A PERMIT Case # RBPR-03-2016-23393 ` a CATAWBA COUNTY HEALTH DEPARTMENT D 1,to•3j` PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES •„f � � /842 sM Residential Building Plan Review - Building Addition . . o + �o EXS_SYSTEM o ` o a ij Contractor TYLER WOODWARD, 6297 PINE RIDGE CT, HICKORY NC 28601 C:8282344756 WOODWARDCONSTRUCTIONNC a GMAIL.COM Owner JOSEPH PAUSSA, 2614 36TH AV NE, HICKORY NC 28601 C:828-396-2608 NAME TO APPEAR ON PERMIT T ler Woodward SITE ADDRESS: 2614 36TH AV NE, HICKORY NC 28601 PIN # 372410461086 NAME of SUBDIVISION: HICKORY WOODS Lot# 29 Section/131ock H PROPERTY SIZE: Square Feet Acres 0.35 DIRECTIONS: Snow Creek Rd/25th St NE/right on 24th St PI NE/left 26th ST Dr NE/go to end/house directly ahead PRIMARY CONTACT: Contractor SEWER TYPE: Septic Tank GALLONS PER DAY: 360 WATER SUPPLY: Public Water DESCRIBE WORK: Revised dimensions 4/1/16 - Only expanding existing concrete pad by 2ft instead of the original 4 ft. Total dimensions of sunroom will be 12x29. adding sunroom on existing patio area and expanding area 4 x 29 /total sunroom sized 14 x 29 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 single family dwelling EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: 53 x 53 NUMBER OF EXISTING BEDROOMS: 3 #OF OCCUPANTS: 2 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 12 x 29 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: I - icafion 04/01/2016 14:54 Page 1 of4 / \ \ CATAWBA COUNTY Case# RBPR-03-2016-23393 Public Health Department Subdivision HICKORY WOODS 2 /9'y 4 Environmental Health Division PINt# 372410461086 -4 PO Box 389. 100-A Southwest Blvd. Newton. NC 28658 I842 su NAME ON PERMIT: (TYLER WOODWARD), 6297 PINE RIDGE CT, HICKORY NC 28601 ( Tyler Woodward) Site Address: 2614 36114 AV NE, HICKORY NC 28601 Property Size: Square Feet Acres 0.35 Directions: Snow Creek Rd/25th St NE/right on 24th St PINE/left 26th ST Dr NE/go to end/house directly ahead 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 ite e aluation can be performed. Date: L7� as Signature of Applicant or Agent 'it-T.4, livazy � An Environmental Health Specialist will contact you within orking days of application date. If you need further information or assistance please call 828-466-7291 AREA2 i##ttr++#•tt#####t•**** ****W tt+#tt####*4+*h#+t4 i#+###++#######t###k#**k MYt**Y#i#i++##+*+t###+ft#+#####MM###• FEENAME x luN; ( ' I i Iitit. , � {I "`b DATEyiiv: l,FEE"AMOUNT;u Existing Tank Check Fee 03/14/2016 $80.00 E 1i a a TOTAL FEES L..t " L...h,ak,kg, 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) t39-ehappliruion 04/01/2016 14:54 Page 2 of 4 vS?'A • THIS IS NOT A PERMIT Case # RBPR-03-2016-23393 fi � CATAWBA COUNTY HEALTH DEPARTMENT 0 FPI, xo ti� r ''� PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES ti-z . ' �'r4{ 842 $M Residential Building Plan Review - Building Addition 3• .o+'to EXS_SYSTEM :- , o ' 0.5 . , : . Contractor TYLER WOODWARD, 6297 PINE RIDGE CT, HICKORY NC 28601 C:8282344756 WOODWARDCONSTRUCTIONNC @GMAIL.COM Owner JOSEPH PAUSSA, 2614 36TH AV NE, HICKORY NC 28601 C:828-396-2608 NAME TO APPEAR ON PERMIT Tyler Woodward SITE ADDRESS: 2614 36TH AV NE, HICKORY NC 28601 PIN # 372410461086 NAM I E of SUBDIVISION: HICKORY WOODS of# 29 Section/Block H PROPERTY SIZE: Square Feet Acres 0.35 _ DIRECTIONS: Snow Creek Rd/25th St NE/right on 24th St PI NE/left 26th ST Dr NE/go to end/house directly ahead PRIMARY CONTACT: Contractor SEWER TYPE: Septic Tank GALLONS PER DAY: 360 WATER SUPPLY: Public Water DESCRIBE WORK: adding sunroom on existing patio area and expanding area 4 x 29 /total sunroom sized 14 x 29 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 single family dwelling EXISTING STRUCTURES ON SITE(IF ANY) DIM EXISTING STRUCTURE: 53 x 53 NUMBER OF EXISTING BEDROOMS: 3 #OF OCCUPANTS: 2 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 14 x 29 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: E9-ehapplication 03/14/2016 17:32 Page I of 4 • $w CATAWBA COUNTY Case# RBPR-03-2016-23393 fi®i Public Health Department Subdivision HICKORY WOODS d ---* Environmental Health Division �` 100-A Southwest Blvd,Newton.NC 28658 P1794 372410461086 PO Box 389, its 2 sx NAME ON PERMIT: (TYLER WOODWARD), 6297 PINE RIDGE CT, HICKORY NC 28601 ( Tyler Woodward) Site Address: 2614 36TH AV NE, HICKORY NC 28601 Property Size: Square Feet Acres 0.35 Directions: Snow Creek Rd/25th St NE/right on 24th St PI NE/left 26th ST Dr NE/go to end /house directly ahead 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. 1 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 d labeling of all property lines and corners and making the site accessible so that a complete to evaluation can be performed. Date: 3 / 74. 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 DATE. FEE AMOUNT Existing Tank Check Fee 03/14/2016 $80.00 TOTAL FEES $80:00 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-chapplication 03/14/2016 17:32 Page 2 of 4 1/ CATAWBA THIS IS NOT A PERMIT CouNTY i ..• - CATAWBA COUNTY HEALTH DEPARTMENT � � Application for Environmental Services Page 1 Improvement Permit❑ Authorization to Construct 1, I Septic Repair❑ Septic Malfunction ❑ Septic Expansion ❑ New Well Permit ❑ Replacement Well ❑ Well Abandonment❑ Well Repair n Existing System Inspection (Pre-Approval Required* Application is for New Construction ❑ Existing Facility iyi Property Address o ' /LS 3&%TN /-71/t,/ p�✓ Subdivision Abc,A) Y l•1)ooLS I1 i c/c-ot y N. C/. o'2g4o/ Lot # /29 / Acres Section/Block/Phase Driving Directions to Property Snow G.CE f� 2D Jo as" rh sr No TAP n tar 0 i a y t/a Sr PL r/L Tt✓C, Z__6 it- on/ ocz6T// sr 4Et /t/6 - 7o to E'O - Ala'Ls l vi72-EZ-fLy 4,/E/9.t . NAME TO APPEAR ON PERMIT? ❑ Owner ❑ Applicant iN Contractor Applicant Contact Information Name jyt,« LA)ojbw,2D Address ‘,:t 9-7 f,,:/L. tile- C44 ///ice /✓c'- 21601 Phone Cell Phone yak a31 I/13-6 Owner Contact Information Name Sarep// /II P,garsg Address a",' 36 lb Avc rvt N/c'ku9 A(e-;- 6,71'0/ Phone Al Cell Phone Jjs- ,2(3 12. 9 Contractor Contact Information /� � Name -yta. WE'o. va,W d/b/A Wcu>7WC/[.Q (r77_02q License # 3X o/ Address 7;z 97 /-,i✓E�in5/ C" Ai 4 n.y ll/L 2160/ Phone / Cell Phone /4 a 39 I/73-i WHO WILL BE THE PRIMARY CONTACT? ❑ Owner ❑ Applicant ® Contractor Description of Existing Structures on Site kou-5 6 #of Bedrooms *t 3 Structure Dimensions 3 ' k 5-3 ' # of Occupants o2 Basement ❑ Yes KI No Basement Fixtures ❑ Yes E 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. $E1 No Does the site contain any jurisdictional wetlands? a Yes ❑ No Does the site contain any existing wastewater systems? ❑ Yes a No Is any wastewater going to be generated on the site other than domestic sewage? Yes 1 No Is the site subject to approval by any other public agency? ❑ Yes El 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 ® County/City/Township Water Line Is a public water supply available? **)4 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) ❑ Accepted ❑ Alternative ❑ Conventional ❑ Innovative ❑ Other )4 Any cATA�1 ]BA THIS IS NOT A PERMIT • COUNTTYY,t�VV � CATAWBA COUNTY HEALTH DEPARTMENT • Application for Environmental Services Page 2 wonh Groi Proposed Facility Type El Primary Residence ❑ New Residence g Addition to 6 Residence # of New Bedrooms *t Project Description Add/ucn fa exisfiny 2010 „he) en aSwire Structure Dimensions %y' X a9 # of Occupants Basement ❑ Yes ® No Basement Fixtures ❑ Yes 1C'No n Accessory Structure(s) Describe #of New Bedrooms *t if applicable Structure Dimensions # of Occupants Accessory Dwelling ❑ Yes n No Plumbing ❑ Yes n No Describe Plumbing Needed ❑ Multi-Family Residence# Units #Bedrooms per Unit*t Total # Bedrooms *t 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 n 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, 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. Signature of Owner or Agent GZrr d � Date 3 —// — /4 Printed Name of Owner or A ent J 0 SEPH /�• rthArs4 - Catawba County Environmental Health • 02611 , 619 to • a 00"rr''''—‘.% ihN.:;L- a1 i r ` 105 100 14\It 36TH AV NE FrerN+ 23 101 100 o r1l 0 w 4N) I e 2614 .. • e 2622 A4 t n , N N CO In KO .. 6 u) .2528 r * 5 ' 4:44,V11201:,t4 Ina,piitltrt At 2,,, le( ti. ,, 50 .,, r °-'' yam= 101 ` rear 36 . Parcel: 372410461086, 2614 36TH AV NE 1in=50ft HICKORY, 28601 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 03/14/2016 Parcel Report Page 1 of 1 Parcel Report - Catawba County NC Parcel Information: Owner Information: Parcel ID: 372410461086 Owner: PAUSSA JOSEPH MICHAEL Parcel Address: 2614 36TH AV NE Owner2: PAUSSA HEDY OLGA City: HICKORY, 28601 Address: 2614 36TH AV NE LRK(REID): 49781 Address2: Deed Book/Page: 3137/1590 City: HICKORY Subdivision: HICKORY WOODS State/Zip: NC 28601-8296 Lots/Block: 29/H Last Sale: $175,000 on 2012-07-26 School Information: School District: COUNTY Plat Book/Page: 23/10 Elementary School: SNOW CREEK Legal: LOT 29 HKY WOOD PL 23-10 Middle School: ARNDT Calculated Acreage: .350 Tax Map: 1401 03029 High School: ST STEPHENS Township: CLINES School Map State Road #: Tax/Value Information: Tax Rates(pdf) Zoning Information: City Tax District: All in County Zoning District: COUNTY County Fire District: ST STEPHENS Zoningl: R-20 Building(s) Value: $170,500 Zoning2: Land Value: $16,100 Zoning3: Assessed Total Value: $186,600 Zoning Overlay: Year Built/Remodeled: 2004/ Small Area: ST STEPHENS/OXFORD Current Tax Bill Split Zoning Districts: / Zoning Agency Phone Numbers Miscellaneous: Firm Panel Date: 2007-09-05 Building Permits for this parcel. Firm Panel #: 3710372400J Building Details 2010 Census Block: 2012 WaterShed: 2010 Census Tract: 010301 Voter Precinct: P29 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. a/HHEB S\fiC(Y) 490 1-�, 3cov 5c41 /dab. Acthn x7 a (ex r y http://gis.catawbacountync.gov/nornap/parcel_report.php.key=372410461086&typ=P 3/14/2016 1 . CATAWBA COUNTY HEALTH DEPARTMENT pOSr Telephone: (828)465-t) TDD: (828)465-8200 wi.s #03 —Clia6 Impror:efient Permit )c AC K Repair Perntitc Opt:f tiork Permit. ,System Typea(i Well Permit. Replacement Well Owner/Agent .-11 Y'1 e. I RA Phone Address Subdivision NZ CO 1' Ire i<i Section/Bloc Phas- Lot#�_ Lot S• Dire ns: Ia sj• .. 1 — Cwt (40'/ �L ve- - e_ /In . 25' ,s+ ,N _) 24 .c--e JllI�� �� IE31� w=� !t 11a'mv- fr 4- Fh �� Property Address Z . /4- 36 I r'• Facility: House Mobile Home Business Multi-family - Other: Pin Number 3 7Z 4- log-6 I i s-/7 Other . Zoning Approval# #Bedrooms .5 #Seats #Employees . Application Rate f 3 5 PD Flow 360 Hot Tub or Spa yes/no Special Fixtures Basement yes/no . 100% Repair Area yesn pc to Basement Plumbing yes/no Water Supply: Private Well Public x SZmi-Public Type of System: Trench Bed Pump Pump/Panel Panel LPP then Z.J o Septic Tank Size /CUD Pump Tank Size Nitrification Field: Total Square Feet 7 7 U Depth of Stone A/4 Bed Size Trench Width 3`�I a Total Length of All Trenches 2-56 r. r ber of Trenches i Trench Length 7(/75/7S/3 Z-11 Feet on Center Maximum Trench Dept ' 4 Distance of Nearest Well f I *DO NOT INSTAL1.SEPTIC WHEN WET* * %LLl. .-I) REQUIRED AT COMPLETION* *****************************************************************************A***f*****#***************** ***************** Topo Z % Slope it'-j I,t l L:112%rti ,.. , `r - !' tJ/.c- ` it( 4'%t4f-3--, U'4 o n Texture G/ ,7 U Structure "ft � Clay Min. ( ! ( i Soil Wetness .t ) a t Ogrr I \ Vt)1� Soil Depth 3 �� 4 u4-11-064c- Restric. lioz. at3 I Gr•1- 6 ^ y�+• + p 'J. Available space a no 41 Drti. j I i y 'l�' Overall Class S U '� ''N PI Nt4 1` Comments: VIE // \,1, / 45 �t n k`I p 1 Yh. 04 l re-Kt/I. ' (� , kt) j( _..I. ' r '‘.' \"V' . :‘.)'( 1;2- le \\Ojt)(11 AI') 1/4 . pc,,i, GA- 2 6 ......-. , , l' 41.- \____.__i---:____, -- h t7 1 e - CSC No Idea:: 3 `� ce ' t t I �� VD t Filter ReyuHcd Ca ., q ,� Riser required ~then k r— �� V tank is more than 6 inches deep. **NO GUARANTEE OR WARRANTY IS IMPLIED OR GIVEN AS TO THE PERFORMANCE OR LENGTH OF TIME THIS SYSTEM WILL FUNCTION** ************************************************************************************************************************ *Improvement Permit has no expiration date and is transferable, but may he 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 ,-fore any por on of the installation is put into use. The siting of the well by the Health Department staff is to provide pr .ection fr,m kiip. sihle sr -es of contamination. No volume of water is guaranteed at any site by the Health Department. ...... Permit Date /P— /...1.- 3 E '. X9 , .6...a_jj, Owner/Agent ',/ Septic Tank Installs y ' /1, (,.. I/:, , Date '(C -fI•CL EHS 7?'-,,,/ �o Well Installed By V Well Gr.ar royal Date Well Head Approval Date Date Sample Collected Date of Results Results EHS V.hue-Office Yellow-Owner/Agent Pink - Buifding Ihspection Authorization to C'onsrrucr