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HomeMy WebLinkAboutRBPR-03-2016-23453.TIF .,SY A � THIS IS NOT A PERMIT Case # RBPR-03-2 0 1 6-2345 3 CATAWBA COUNTY HEALTH DEPARTMENT a , 3;) : 0 rfj PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES + ,4r /842 .. :M Residential Building Plan Review - Building New -a-a� • o +',I o IMPROVEMENT- AUTH CONST- NEW WELL a fi . • Contractor *MIKE PALMER HOMES, INC. (MICHAEL PALMER). 6211 DENVER INDUSTRIAL PARK RD, DENVER NC 28037 B:7042576422 C:7045I69227F:7049730002 MIKEPALMER @MIKEPALMERHOMES.COM Owner MAISTRO INVESTMENTS LLC, 137 CROSS CENTER STE 328, DENVER NC 28037 NAME TO APPEAR ON PERMIT *MIKE PALMER HOMES, INC. (MICHAEL PALMER) SITE ADDRESS: 4532 CAYTON DR, MAIDEN NC 28650 PIN # 367804514573 NAME of SUBDIVISION: WYNSWEPT PH 1 Lot# 27 Section/Block PROPERTY SIZE: Square Feet Acres 0.73 DIRECTIONS: Hwy 16 S, L Pembroke Pine St PRIMARY CONTACT: Contractor SEWER TYPE: Septic Tank GALLONS PER DAY: 480 WATER SUPPLY: Private Well DESCRIBE WORK: New 4 bedroom home 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: New 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: #OF OCCUPANTS: 2 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 40 x 50 #OF NEW BEDROOMS:: 4 BASEMENT? No BASEMENT FIXTURES? PLUMBING REQUIRED?Yes Desired system types (Improvement Permit or Authorization to Construct): ACCEPTED: - ALTERNATIVE: CONVENTIONAL: YES OTHER: INNOVATIVE: ANY: Other described: APPLICATION FOR WELL CONSTRUCTION PROPOSED WELL TYPE: Individual Well REPLACE WELL?: NO E9-ehapplication 03/22/2016 15.13 Page t of 5 gA CATAWBA COUNTY case# RBPR-03-2016-23453 -tar Public Health Department Subdivision W YNSWEPT PH 1 1; ? d Environmental Health Division PIN# 367804514573 - PO Box 389. 100-A Southwest Blvd.Newton,NC 28658 /8.42 w NAME ON PERMIT: *MIKE PALMER HOMES, INC. (MICHAEL PALMER), 6211 DENVER INDUSTRIAL PARK RD, DENVER 28037 *MIKE PALMER HOMES, IN( Site Address: 4532 CAYTON DR,MAIDEN NC 28650 - Property Size: Square Feet Acres 0.73 Directions: Hwy 16 S, L Pembroke Pine St 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 nd I beling of all property lines and corners and making the site acca-: ibl- so that - omple ssi�i evaluation can be performed. Date: 13f 2? )Co Signature of Applicant or Agent F �tY/ J r 777 An Environmental Health Specialist will contact you in 5 working da s of application date. If you need further information or assistance please call 828-466-7291 AREA1 FEENAME .• ,.:.v DATE ..,.. FEE AMOUNT Authorization to Construct Fee (New/Expansion) 03/22/2016 $300.00 Fee Improvement Permit Fee 03/22/2016 $150.00 Well Permit & Inspection Fee 03/22/2016 $300.00 TOTAL FEES 5750.00.' 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-eliapplication 03/22/2016 15:13 Page 2 of 5 CA'TAWBA THIS IS NOT A PERMIT L Jim a coutirr 0 iJ CATAWBA COUNTY HEALTH DEPARTMENT rv:+t NorMC.,Winn Application for Environmental Services Page 1 Improvement Permit Authorization to Co truct I✓I Septic Repair ❑ Septic Malfunction ❑ Septic Expansion ❑ New Well Permits Replacement Well ❑ Well Abandonment❑ Well Repair ❑ Existing System Inspection (Pre-Approval Required) fl Application is for New Construction ❑ Existing/F-acility ❑ Property Address iT( �6- '� t)l II ue_ _ - Subdivision t-d 9 r Su�."e_P rn C2 1 .e✓1 1 ��G o�J 6,so Lot# a Acres 'Di,GKJD 55 Section/Block/Phase Driving Directions to Property 1,At uvV t 5 L Pr°m bc'o Ke p,nc 5 -t- NAME TO APPEAR ON PERMIT? -1 Owner ❑ Applicant H Contractor Applicant Contact Information Name 3n,,.,xc Address Phone Cell Phone Owner Contact Information Name ,,,e___ yY' wrs Sou6s1hient LLC Address t3 -7 aross CP cc)4-ei-' Ste_ 32X 1✓1ue4,--AJC ak'o37 Phone • Cell Phone Contractor Contact Information I I Name c.k�\�VaAv er �rne_ Address Ip Xk �.Jenucr Inc v-k T cL Ye i7 $ac NC- ..2-5Y6 3.7 Phone Cell Phone ''10t=(.- SIeo- 2_2/ WHO WILL BE THE PRIMARY CONTACT? Owner ❑ Applicant IJ ontractor Description of Existing St ctures on Site gyp,..C # of Bedrooms *t Structure Dimensions (p0•tt (a 0 # of Occupants 2-.- Basement n Yes No Basement Fixtures a Yes 0-No The Applicant shall notify the local health department upon submittal of this application if any of the following apply to the property, inn question. If the answer to any question is "yes", applicant must attach supporting documentation. 0 0 Yes ��'N4�O Does the site contain any jurisdictional wetlands? 0 Yes lik o Does the site contain any existing wastewater systems? 0 Yes avNo Is any wastewater going to be generated on the site other than domestic sewage? NykYes Is the site subject to approval by any other public agency? 0 Yes o Are there any easements or right of ways on this property'? Describe Existing water supply in use Individual Well ❑ Community Well ❑ Semi-Public Well n County/City/Township Water Line Is a public water supply available? ** ❑ Yes .14,No If applying for an Improvement Permit or Authorization to Construct, Please Indicate Desired System Type(s): (systems can be ranked in order of yo_dt iference) ❑ Accepted ❑ Alternative d Conventional ❑ Innovative ❑ Other ❑ Any C rrA`j 7B q J�L�'. THIS IS NOT A PERMIT COUNTY , CATAWBA COUNTY HEALTH DEPARTMENT „„„,o, „, „ Application for Environmental Services Page 2 Proposed Facility Type n P rim ary Resi dence New Residence ❑ Addition to Residence # of Ncw Bedrooms *t Project Description ("605 e Structure Dimensions 4?,? SrJO #of Occupants 9 Basement n Yes [No Basement Fixtures ® Yes nl-No n Accessory Structure(s) Describe #of New Bedrooms *t if applicable Structure Dimensions # of Occupants Accessory Dwelling ❑ Yes El No Plumbing n Yes ❑ 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.) n Business Specific Type of Business Retail Floor Space #of Employees per Shift #of Shifts ❑ Other Facility Type Specify If Church #of Scats Kitchen n Yes n No If Daycare Specify Occupancy Application for Well Con truction/Abandonment/Repair Proposed Well Type Individual Well n Semi-Public Well fl Community Well Abandonment Type n Drilled n Bored ❑ Dug El 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 ns can be performed. Signature of Owner or Agent / Date I (o Printed Name of Owner or Agent v n / frC-5 Catawba County Environmental Health -lrr n.{-_3o � .;J�yL� �'YI/ULI Rif s` Nowt_ rit-t-leiu+s, �y� IALTrd s nickaytvm hoUJF- n ism gal-C-30_3�j, t 188.10 _� R 1p 36 as.o4 743 C, f tv I 6 EIS Co ° S J .T 40` he. I 2/is.7s 5D 4/1 78.74 \\\IN 0.41.7. bR 188 Parcel: 367804514573, 4532 CAYTON DR 1in=50ft MAIDEN, 28650 This map/repert 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 oy any person or entity. Copyright 2014 Catawba County NC 03/21/2016 Parcel Report Page 1 of 1 Parcel Report - Catawba County NC Parcel Information: Owner Information: Parcel ID: 367804514573 Owner: MAISTRO INVESTMENTS LLC Parcel Address: 4532 CAYTON DR Owner2: null City: MAIDEN, 28650 Address: 137 CROSS CENTER STE 328 LRK(REID): 201377 Address2: null Deed Book/Page: 3309/0674 City: DENVER Subdivision: WYNSWEPT PH 1 State/Zip: NC 28037-5009 Lots/Block: 27/ Last Sale: School Information: Plat BooWPage: 68/196 School District: COUNTY Legal: LOT 27 PLAT 68-196 Elementary School: BALLS CREEK Middle School: MILL CREEK Calculated Acreage: .730 High School: BANDYS Tax Map: null Township: CALDWELL School Map State Road #: null TaxNalue Information: Tax Rates(pdf) Zoning Information: City Tax District: All in County Zoning District: COUNTY County Fire District: BANDYS Zoningl: R-40 Building(s) Value: $0 Zoning2: Land Value: $18,300 Zoning3: Assessed Total Value: $18,300 Zoning Overlay: WP-O Year Built/Remodeled: null/null Small Area: SHERRILLS FORD Current Tax Bill Split Zoning Districts: null/null Zoning Agency Phone Numbers Miscellaneous: Firm Panel Date: null Building Permits for this parcel. Firm Panel ft: null Building Details 2010 Census Block: 2026 WaterShed: WS-IV Protected Area 2010 Census Tract: 011501 Voter Precinct: P1 Agricultural District: PROXIMITY 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 hold liable for any and at 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. ©2016, Catawb County Government, North Carolina. All rights reserved. i /` ,� LIB c Al Idati http://gis.catawbacountync.gov/nornap/parcel_report.php?key=367804514573&typ=P 3/22/2016 •. . . .,8 I • • • �� • IMPROVEMENT PERMIT "ForOfficeaUseonv r k� !CD P FlieNumber%vit., a'-4 5 1 4 • 33 ), Catawba County Public Health Department :a'w ,t •'" ' • • 3 f Environmental Health Division "C o unty�ID N umber 1-520.08 otoel 'y tip„ 4t Evaluated For ,* NEW „( �t ' . � P.O Box 389, 100-A Southwest Blvd -4r,:-,,,;A„.•,: �,-, • _■rr �, w+4 y, J • Newton NC 28658 PERMIT VALID UNTIL. • 02/06/2014 Phone:(828)-465-8270 Fax: (828)465-8276 ❑ Open Fill Sheet *NOTE TO INSPECTIONS DIVISION: Building Permits cannot be issued with this Improvement Permit. Ice C•, �roperty Owner _le0ji-I DeVCI0P+'.k»-f 0c; '-� / Applicant: DANNY EDWARDS S •. _ y' w Address: X885 N HIGHWAY 16 Address: 388 N HWY 16 City: DENVER City: - DENVER ' State/Zip: NC • 28037-600 State/Zip: NC . 28037 V one#: - \siii_ Phone#: . W Property Location & Site Information - 0 (Address/Road#: Subdivision: WYNSWEPT Phase: Lot: 27 4532 PEMBROKE PINE ST Directions . Structure: SINGLE FAMILY HWY 16 SON LEFT JUST BEFORE RANT DRUM RD • #of Bedrooms: 5 #of People:, \ ' later$Ilpply: NEW WELL / \\///,,, System Specifications. // • (-Initial System Site Classification: provisionally suitable Minimum Trench Depth: Inches Design Flow: 6 0 0 Maximum Trench Depth: a 4 Inches Soil Application Rate: 0 3 5 ' Septic Tank: 1 5 0 0 Gallons • 1-Piece: QYes ONo 'System Classification/Description: TYPE III B.SYSTEM W/SINGLE EFFLUENT PUMP Pump Required: (WYes O No OMay Be Required Pump Tank: • 1 5 0 •0 Gallons • `Proposed System: 25%REDUCTION 1-Piece: QYes ' QNe .. RepairSystem Required:U/Yes ONo ONo, but has Available Space • (-Repair System • Site Classification: .provisionally suitable Minimum Trench Depth: Inches , Soil Application Rate: 0• '3 5 Maximum Trench Depth: 3 0. Inches System Classification/Description: Pump Required: /Yes QNo Q May be Required TYPE IV k ANY SYSTEM WITH LPP DISTRIBUTION Pump Tank: 1 5 0 0 Gallons 'Proposed System: 50%REDUCTION NTT- Page 1 of 3 • 1 • • • 24514 10%152008-01061 CDP File Number County ID Number: *Site Modifications 'No grading or construction activity is allowed in areas designated for system and repair without approval of Health Department. • • • • • • • • 'Permit Conditions The issuance of this permit by the Health Department in no way guarantees the issuance of other permits.The permit holder is responsible for checking with appropriate governing bodies in meeting their requirements. Keep all parts of septic minimum:50'from any individual well,creek.or pond'10'from properly lines'15'from home-install lines on conlour•Do not grade,drive,or fill over system or repair • • • • The Improvement Permit shall be valid for5 years from date of Issue with a site plan(means a drawing not necessarily drawn to • Site,Plan scale that shows the existing and proposed property lines with dimensions,the location of the facility and appurtenances,the site for the proposed Wastewater system,and the location of water supplies and surface waters). Plat The Improvement Permit shall be valid without expiration with plat(means a property surveyed prepared by a registered land surveyor,drawn to a scale of one inch equals no more than 60 feet,that Includes:the specific location of the proposed facility • O • and appurtenances,the site for the proposed Wastewater system,and the location of water supplies and surface waters. Plat also means,for subdivision lots approved by the local planning authority and recorded with the county register of deeds,a copy of the recorded subdivisions plat that is accompanied by a site plan that is drawn to scale). The Department and Local Health Department may Impose conditions on the issuance and may revoke the permits for failure of • the system to satisfy the conditions,the rules,or this article.This permit is subject to revocation If the site plan,plat,or Intended use changes(NCGS 130A'335(f)).The person owning or controlling the system shall be responsible for assuring compliance with the laws,rules,and permit conditions regarding system location,Installation,operation,maintenance,monitoring, reporting,and repair(.1930(b)). ApplicanULegal Reps.Signature Requir ? C 'YYess CNoo ApplicantiLegat Reps.Signature: " —�`� `�'�' Date: az / /2 / ; y 'Issued By: 1810-Boyd.Jason Date of Issue: 0 a / 0 6 / a 0 0 9 dAuthorized State Agent: . a" OValid without Expiration? •Hand Drawing Olmport Drawing **Site Plan/Drawing attached.** TotalTime:(HH:MM) Page of � . • • . • 24514 W L52008 o ms i CDP File Number: County File Number: Drawing Type: Improvement Permit Date: 0 a / 0 6 / a 0 0 9 • ornch Scale: 0 0 1 QBiock = 0 6 0 ft Drawing • QN/A - 1 F I l - 1 i 1 VJ I i i 1 i3C' l a -- - ''--- '-'--- ....-- ----• -- - rr III. . .' i 1 t a 1; Y,�I Syc ' rte I •• F 1 . 1 ;LK--i ro e Z-r-fit. C..a • - t` I ?S - I � ! — i li• — - — — • I � — 'r I --:•--_,......,___J. . i I— ` 5'i-2 j i a 6 o • 1- I , _.._...-1 ti----- ' '- F,.1• •'. , I • ... 1 r..- ,.. _ ■ , , -- - Lam . I I _ I . l fi t I p [ vs : ,Q4ot P—L o 1 t — I-- I 1 1 1 . • • I .I . .Page3of3 • . i • 1 I NCDENR Division of Environmental Health On-Site Wastewater Section Date: a / e s ! © 9 9 Soil/Site Evaluation 'File #: a 4 5 1 4. For On-Site Wastewater System PIN #: e e a r a 6 1 'Owner DANNY EDWARDS HECHT DEVELOPMENT CO Proposed-Facility SINGLE FAMILY Proposed Design Flow(.1949) 6 0 0 Location of Site 4532 PEMBROKE PINE ST P 0.81 NEW WELL Pit Property Size Water Supply . Evaluation Method 1940 Horizon SOIL MORPHOLOGY Profile Landscape Depth .1941 Other Profile PS • Slope % (IN) Mineralogy . Matrix Mottle Factors Texture Structure Consistence Color Color • 0 0 1 L 0-24 scl sbk fr ss. sp 1942 Wet. 24-48 sc . fr 55 sp 8 % 1943 Depth . 4 8 1944 Rest. GPS • • Horizon Saprolite .1947 Class Ps r" 81 Profile LIAR 0 • 3 5 0 0 p L 0-24 scl sbk fr ss sp .1942 Wet 24-48 sc sbk fr ss sp .1943 Depth 4 8 . 8 %. .1944 Rest. GPS - • - Horizon Saprolite .1947 Class Ps 7 r4. , . Profile 0 3 5 .LTA R 0 0 3 L 0-24 scl sbk fir ss sp .1942 Wet. 24-48 sc sbk fr ss sp .1943 Depth 4 8 8 %. - 1944 Rest • GPS - Horizon Saprolite 1947 Class Ps ii i ti Profile LTAR 0. • 3 5 . .1942 Wet .1943 Depth .1944 Rest. GPS Horizon Saprolite, .1947 Class J i RA .1942 Wet I .1943 Depth .1944 Rest. • GPS Horizon Saprolite. 1947 Class . ti . • Profile LTAR i_Available Space (.1945) Ps Other Factors(-1946) Site Classification: Ps Initial LTAR: tt . 3 5 Repair LTAR: o . 3 5 Others Present: ' Comments: • • i I Evaluated By: Boyd.Jason I