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HomeMy WebLinkAboutRBPR-04-2016-23557.TIF v^4�'A THIS IS NOT A PERMIT Case # RBPR-04-2016-23557 E... —_ y CATAWBA COUNTY HL'ALTH DEPARTMENT . e:j Ei Ie. ®' PLAN REVIEW APPLICATION FOR_ ENWIWNMENTAL. SERVICES /842 SM Residential Building Plan Review - Building Relocation ti ° AUTH_CONST •0o Owner WILLIAM JONES,4449 S NC 16 HWY, MAIDEN NC 28650 H:82846119I2 HOME:8284611912 NAME TO APPEAR ON PERMIT William Jones SITE ADDRESS: 4449 SNC 16 HWY, MAIDEN NC 28650 PIN # 367803405064 NAME of SUBDIVISION: Loth 2 Section/Block PROPERTY SIZE: Square Feet Acres 322 DIRECTIONS: 16S on right just before Pine Leaf Dr PRIMARY CONTACT: Owner SEWER TYPE: Septic Tank GALLONS PER DAY: 240 WATER SUPPLY: Private Well DESCRIBE WORK: relocate an existing dwelling 26 x 38 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: New Structure STRUCTURE TYPE: PRIMARY RESIDENCE FACILITY TYPE: Single Family Residence OTHER DESCRIPTION: DESCRIPTION OF relocating dwelling EXISTING STRUCTURES ON SITE(IF ANY) DIM EXISTING STRUCTURE: 26 x 34 NUMBER OF EXISTING BEDROOMS: if OF OCCUPANTS: 2 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 26 x 38 #OF NEW BEDROOMS:: 2 BASEMENT? No BASEMENT FIXTURES? No PLUMBING REQUIRED?Yes Desired system types(Improvement Permit or Authorization to Construct): ACCEPTED: ALTERNATIVE: CONVENTIONAL: OTHER: INNOVATIVE: ANY: Other described: 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,ttt )a comp to - aluation can be performed. Date: i D/ — /� Signature of Applicant or Agent �, e--r_.. ,lete An Environmental Health Specialist will contact you within 5 working days of a•plication date. If you need further information or assistance please call 828-466-7291 AREA1 E9-ehapplication 04/01/2016 17:11 Page 1 of4 as CATAWBA, COUNTY Case n RBPR-04-2016-23557 ti® Public Health Department Subdivision � Environmental Health Division PINt/ 367803405064 PO Box 389, 100-A Southwest Blvd,Newton.NC 28658 /842 NAME ON PERMIT: (WILLIAM JONES),4449 S NC 16 HWY, MAIDEN NC 28650 ( William Jones) Site Address: 4449 S NC 16 HWY, MAIDEN NC 28650 a Size: Square 3.22 Property uare P S Feet Acres Directions: 16S on right just before Pine Leaf Dr "FFENAME ` ? + ,DATE _, rEFFEAMOUNT < �..... ...,.....,i ham...... ..............it ...�.,_. ,.. ,..... ,:. Authorization to Construct Fee (New/Expansion) 04/01/2016 $150.00 Fee 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-ehapplication 04/01/2016 17:11 Page 2 of 4 C TAwB e THIS IS NOT A PERMIT COUNTY 1v.- �` 1 CATAWBA COUNTY HEALTH DEPARTMENT $ N F. - ` Application for Environmental Services Page 1 Improvement Permit H Authorization to ConstrucX Septic Repair n Septic Malfunction H Septic Expansion H New Well Permit n Replacement Well H Well Abandonment❑ Well Repair n Existing System Inspection (Pre-Approval Required) H Application is for New Construction n Existing Facility k'Sgroperty Address}'/+? fl 1 Wy' //� Subdivision /40idzN ,ilC . /77tj'/5o Lot# Acres ection/Block/Phase 4 Driving Directions to Property59 W' 071 /C V 6C5 r /fe ?t9 - tie �c z NAME TO APPEAR ON PERMIT? n Owner ❑ Applicant If Contractor Applicant Contact Information Name Address Phone Cell Phone '7' Owner Contact Information Name h),//ift-M Te;Aie Address LF l� 5'ffi/� /h AA cc i A/C. qG S�� Phone (2 sr, )46 -,7-3 Cell Phone c-9t'_ / _/11 2 Contractor Contact Information Name License # Address Phone Cell Phone WHO WILL BE THE PRIMARY CONTACT? H Owner n Applicant ❑ Contractor Description of Existing Structures on Site ft o U-4 S # of Bedrooms *t Structure Dimensions P4 X 3 ct # of Occupants (2-- Basement ❑ Yes No Basement Fixtures ❑ Yes I/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 V No Does the site contain any jurisdictional wetlands? ®'Yes ❑ No Does the site contain any existing wastewater systems? ❑ Yes WNo Is any wastewater going to be generated on the site other than domestic sewage? C'Yes ❑ No Is the site subject to approval by any other public agency? ❑ Yes Cam]No Are there any easements or right of ways on this property? Describe Existing water supply in use E Individual Well n Community Well n Semi-Public Well n County/City/Township Water Line Is a public water supply available? ** ❑ Yes H 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) _10 Accepted ❑ Alternative ❑ Conventional ❑ Innovative ❑ Other Any CATAWBA THIS IS NOT A PERMIT COUNTY - CATAWBA COUNTY HEALTH DEPARTMENT „e � ,, Application for Environmental Services Page 2 Proposed Facility Type ❑ Primary Residence L New Residence n Addition to Residence # of New Bedrooms *t Project Description Structure Dimensions # of Occupants Basement n Yes n No Basement Fixtures ❑ Yes n No H 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 H Multi-Family Residence# Units #Bedrooms per Unit*j' Total # Bedrooms *t Structure Dimensions H 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 ❑ Yes ❑ No If Daycare Specify Occupancy Application for Well Construction/Abandonment/Repair Proposed Well Type ❑ Individual Well n Semi-Public Well ❑ Community Well Abandonment Type ❑ Drilled n Bored ❑ Dug n Unknown Well Repair Requested ❑ Yes n 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 ( .9z Date — Printed Name of Owner or Agent 14J,//A-AA A A/ e 5 \31\ Permit EHPR-6-15-21716 Public Health Departmeent nt CATAValthA COUNTY Name William Jones a G d Fiffi ii2F Environmental Health Division Address 4449 Hwy 16 S Maiden NC k:��!' PO Box 389, 100A Southwest Blvd,Newton NC 28658 PINK 367803405064 I842 su (828)465-8270 Fax (828)465-8276 'MD(828)465-82M Site Plan Improvement Permit ( 7y w +. �o' L Y l b Y - I ank DP rnr�sD k P° 1-i ? " ML , 14 actL. \1hr v N�� sr i�2 I-1 Gd 0 fi. c a I Cy(4-- cA 3 Ai > Y"ti ,"" , Zo ^ rt r ry a 25,0 Xt.) ko nit_ 'S O pt 1 fl S rt 1 D 5 . `( 6r Z$5 , pc , P w 1 ? D-Y' asso .J lore �� L Lit Scale 0 0 -5 • • Catawba County Environmental Health N / / ~ . \/ 4 r E' \ f na CO 4 1, bi ti r sy 7.t / 0'7 o V3 / dev ,,%. or,-„, 'V l nco / it -cP • 111, I r J /T \ i r r I • i 7: 0 o v I 2gy�9 i • I //1/1 h, I f I Parcel: 367803405064, 4449 S NC 16 HWY 1 in=80ft MAIDEN, 28650 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 04/01/2016 Parcel Report Page 1 of 1 Parcel Report - Catawba County NC Parcel Information: Owner Information: Parcel ID: 367803405064 Owner: JONES WILLIAM L Parcel Address: 4449 S NC 16 HWY Owner2: JONES JUDY B City: MAIDEN, 28650 Address: 4449 S NC 16 HWY LRK(REID): 4991 Address2: null Deed Book/Page: 3211/0750 City: MAIDEN Subdivision: State/Zip: NC 28650-9030 Lots/Block: 2/ School Information: Last Sale: Plat BooWPage: 72/191 School District: COUNTY Legal: LOT 2 PLAT 72-191 Elementary School: BALLS CREEK Middle School: MILL CREEK Calculated Acreage: 3.220 Tax Map: 005 K 06001 High School: BANDYS Township: CALDWELL School Map State Road #: 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: $45,000 Zoning2: null Land Value: $24,800 Zoning3: null Assessed Total Value: $69,800 Zoning Overlay: WP-O,RP-O Year Built/Remodeled: 1946/null Small Area: BALLS CREEK Current Tax Bill Split Zoning Districts: null/null Zoning Agency Phone Numbers Miscellaneous: Firm Panel Date: 2007-09-05 Building Permits for this parcel. Firm Panel #: null Building Details 2010 Census Block: 3006 WaterShed: WS-IV Protected Area 2010 Census Tract: 011602 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 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. ©2016, Catawba County Government, North Carolina. All ri is reserved. fi �: 1� I 7__1,301 101 7f3 So I )(lab, http://gis.catawbacountync.gov/nomap/parcel_report.php?key=367803405064&typ=P 4/1/2016 T6 , CATA\V RA COUNTY 0 ; y`•�fy' 0 Case k IMPV-08-2015-063438 ;�r ''\ Public Health Department ic •_� fi � F,-,:r%om '*r Subdivision•< u p, 1 Environmental Health Division 3 } PlN/ 367803405064 4�4 k+1°/ PO Box 389, 100-A Southwest Blvd,Newton.NC 33658 k , tr + r LOIN 2 NAME ON PERMIT: WILLIAM JONES, 4449 S NC 16 HWY, MAIDEN NC 28650 Site Address: 4449 S NC 16 HWY, MAIDEN NC 28650 Property Size: Square Feet: 140,263.20 Acres:3.22 Directions: Hwy 16 S, on right just before Pine Leaf Dr Improvement Permit Facility: Primary Residence Permit Category: New Septic Bedrooms 2 WATER SUPPLY: Private Well Basement? No Basement Plumbing? No INITIAL SYSTEM SPECIFICATIONS Permit Valid: Expires In Five Years: _X_ No Expiration: Projected Daily Flow 240 g.p.d Proposed Wastewater System: 25% REDUCTION Type: IIIG - OTHER NON-CONV'fRENCH SYSTEMS Permit Conditions: IP to determine if home can be moved for Highway 16 Widening Project. Existing home to be mow to new location with new system. Existing tank to be pumped, crushed and back filled with soil. Existing wells to be used. Keep all parts of new system and future repair minimum: 50'from any well, 10'from property lines 20'from home to allow for potential sun room addition., 5' from any building foundation, 10' from property lines. Lines to be installed on contour. Do not grade drive or over system or repair. REPAIR SYSTEM SPECIFICATIONS Repair System Required? Required Proposed Wastewater System: 25%REDUCTION Type: IIIG -OTHER NON-CONY TRENCH SYSTEMS Landscaping or other site alterations that potentially dived 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 existing permits. The issuance of this permit by the Health Department does not guarantee the issuance of other permits. It is the responsibility of the applicantlproperty owner to insure that all Catawba County Planoin✓Zoniag and Building Inspections requiremems are met. This Improvement Penn it is subject to revocation if the site plan,plat or the intended use changes, or if site conditions are altered. 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 'Lo ms and Rules In,Sewage Treatment and Disposal Systems' (I5A NCAC I8A .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. Jason Boyd 08/05/2015 MITI loulrrD STATE AGENT APPROVAL OATH Permit Expiration Date: 08/04/2020 No grading or construction activity is al/owed in areas designated for system and repair without approval of the Health Department. 1 chpemoit 08/05/2015 10:01 Page 1 of 3 • � Aim' Permit EHPR-6-15-21716 3 G CATAWBA COUNTY k'�" Z public Health Department Name William Jones 2 mr��� — Address 4449 Hwy 16 S Maiden NC i F,avironmental Health Division Aga..! Y PO Box 389, 100A Southwest Blvd, Newton NC 23653 PINT 367303405064 1842 su (S28)465-8270 Fax (328)465-S276 'I DD(828)465.3260 Site Plan Improvement Permit ( 7y) Li �Y 1J f. 4-10..(L �� Lo «-1. ; 0c � , I rc-a� k R �5 } fi n° ou£il, Sr/ P.oW r � D U CA,I- \ is4 C....-) 0( \`I 213Q 1"1e Mt. 51-• i.)v.,.. J Ud pfi~ti S<< 4,47 ` t 2� ( 1 �3 a. v�d 1snc5 1—n I-,c. I Cy(} --N 4krc._ 2s70yJ 1� - VI° ML "11 O C 1 ! '+, Pb l f 4?-., rt c75+FN c,Id j 0 C . C 6 ' 2_,c7 . le i /t P` L ' j' }/a1 P/ as . L. { I 1 a / �c L l 19 D Scale ` 5 y.5-1-r--, Department of Environment, Heelfh,and Natural Resources Sheet: Division of Environmental Health Properly ID: On-site Wastewater Section Lot*: SOIUSITE EVALUATION File t for ON-SITE WASTEWATER SYSTEM AppID: EHPR-6-1 5-217 1 6 Owner: William Jones Applicant: Address: 4449 Hwy 16 5 Maiden NG Date Evaluated: 8/4/2015 Proposed Facility: 2 BR hcme Design Flow(.1949) 240 Properly Size'. Location of Site: Property Recorded: Wafer Suppy pvt well [ I Spring ( )Other Evaluation Method: pits by owner I I Cut Type of Wastewater: X Sewage [ ] Industrial Process I I Mixed P 'u�ufll II4 rl "' ji'.l :i:I M i, ,1'�`7 iii Ili z✓a ."'III��C�I�II�IS�IIIr194.i i n7)'ll •I_:a'/. I II �II II`� ' �I II t: d Ik ate: I? I•1 1940 d� II'II r' it S„+I +!' P� ,i' f N 11 F �{� J'i TRW: Lry'Lit v �. I �� 4ti ' $ICI, '4 d111111t141' '+m'>dNl,l„I''i II1 . 91PN1942 �1±' titry I:1111111 Uh6i a tic m �' y�i, 1L ,L niliw4n 1 I I 41I] 1 f . k ]bill t 0.47. :2 'oi �'� ) 13dl It. -'11 :,II II4I I)�I 6''I ili.19.4:I Ilf ° I iofll 4'14., IL.�S..I v�andscape sHorizcnl uii����iiWA�u��..r ,�Yi�IJ�����ti"Y19411 I�p �I �� t.i�. Sall d5 � I _. 1943(1�� I1h 11.,19561�gk.1944'i� .�lfl Pro,lie.gnilb'_. 1 _ rr� '1 u,: a I , 4il-�i ; 4rr `F nl ni i"nI f! mn' ¢u:annir'gil T *e01ny t .. kEM1.'� , 1 Pkoswlion�gl 111 Depth C ,s truc s"'""1' II�101r;1r -.. "-lence'dl r r gA W+et illn ;i: I �311i1S 1"'" 'f Sapro J' gRestc fill r"{.e,Class i-4 1 ._>d ' .,Slope h'1.iI 1 to ')I�a s Ir,Sexture�� IulilllllTA Mmera,ogys..t: ill,�l kd i kolor IL Iis • ,:Depth(IN)- )`urI.Classa r IIhuldori ilit r, .d&111AR,�..0„, 1 LL 2% 0-18” topsoil 18-24" SCL SS SP SEXP FR 24-72" SC S5 SP SEXP FR 72" PS.3 2 same as 1 P5.3 3 same as 1,2 PS.3 4 5 6 7 I Description Initial System Repair System Other Factors(.1946): Available Space(.1945) PS PS Soil Evaluation By: Jason Boyd System Type(s) 1110 IIIG Others Present: William Jones Site LIAR .3 .3 Site Classification(.1948): Ea Site Evaluation By: Others Present: Sheet. COMMENTS: Moving existing home for hwy 16 widening FILE 4: Landscapo Position Group Texture .1955 LTAR Structure R-Ridge I S-Sand 1.2-0.8 SG-Single Grain SS-Shoulder Slope LS-Loamy Sand M-Massive LS-Linear Slope CR-Crumb FS-Fool Slope II SL-Sandy Loam 0.8-0.5 GR-Granular NS-Nose Slope L-Loam SBK-Subangular Blocky HS-Head Slope ABK-Angular Blocky CC•Concave Slope III SI-Silt 0.6-0.3 PL-Platy CV-Convex Slope SICL-Silty Clay PR-Prismatic T-l errace Loam FP-Flood Plain CL-Clay Loam SCL-Sandy Clay Loam IV SC-Sandy Clay 0.4-0.1 SIC-Silty Clay C-Clay Consistence Consistence Minorato49 Moist Wet SEXP-Slightly Expansive • VFR-Very Friable NS-Non-Sticky EXP-Expansive FR-Friable 55-Slightly Sticky FI-Firm S-Sticky VFI-Very Firm VS-Very Sticky EFI-Extremely Firm NP-Non-Plastic SP-Slightly Plastic P-Plastic VP-Very Plastic Sketch of Soil Evaluation Locations k.,)V ? 6 S S pia IL uv‘.) 9 Y' , u ce L B3 66 1