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HomeMy WebLinkAboutRBPR-04-2016-23604.TIF •yy,A •G t THIS IS NOT A PERMIT Case # RBPR-04-2016-23604 y •"_* �- y CATAWBA COUNTY HEALTH DEPARTMENT 11:1 J• K �� PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES �k" �' y __ 5M1� Residential Building Plan Review - Building New ro �o:: • • • • AUTH CONST - NEW WELL -d Via. ;y o Contractor *TUCKER BUILDERS, ERIC D (ERIC TUCKER),4154 E MAIDEN RD, MAIDEN NC 28650 B:7044004881 C:704-400-4881 EDTBUILDERS @GMAIL.COM Land Owner STANLEY ALLEN, 102 3RD ST SW. CATAWBA NC 28609 Owner JOSEPH LASALA, 116 KILBORNE RD, MOORESVILLE NC NAME TO APPEAR ON PERMIT Joseph Lasala SITE ADDRESS: 5467 THREE SISTERS LN, CATAWBA NC 28609 PIN # 368902581117 NAME of SUBDIVISION: Lot# 2 Section/Block PROPERTY SIZE: Square Feet Acres 1 DIRECTIONS: travel Non Sherrills Ford RD, Turn Son Buffalo Shoals RD, 1/4 mile turn left onto Battle Run Community, right onto Muskey DR at the end on the end PRIMARY CONTACT: Contractor SEWER TYPE: Septic Tank GALLONS PER DAY: 480 WATER SUPPLY: Private Well DESCRIBE WORK: single family dwelling 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: 6 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 42 x 85 #OF NEW BEDROOMS:: 4 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 O4107/2016 13:07 Page 1 of 5 B CATAWBA COUNTY Case# RBPR-04-2016-23604 fi�x Public Health Department Subdivision d '-°�e. Environmental Health Division P1N# p,,' 5 - 368902581117 ?' PO Box 389, 100-A Southwest Blvd,Newton,NC 28658 \/842 w NAME ON PERMIT: (JOSEPH LASALA), 116 KILBORNE RD,MOORESVILLE NC ( Joseph Lasala) Site Address: 5467 THREE SISTERS LN, CATAWBANC 28609 Property Size: Square Feet Acres 1 Directions: travel N on Sherrills Ford RD, Turn S on Buffalo Shoals RD, 1/4 mile turn left onto Battle Run Community, right onto Muskey DR at the end on the end 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 add labeling of all property lines and corners and making the site access' o,that c e to evaluation can be performed. Date: D?—o/t/6 Signature ofApplieant 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 AREA1 'FEENAtME. ' '' DATE .FEE-AMOUNT I Authorization to Construct Fee (New/Expansion) 04/07/2016 $300.00 Fee Well Permit& Inspection Fee 04/07/2016 5300.00 , ..,TOTAL FEES ,' 5600.00 i '1 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-ehappl ication 04/07/2016 13:07 Page 2 of 5 CATAWBA THIS IS NOT A PERMIT COUNTY CATAWBA COUNTY HEALTH DEPARTMENT • �" "Application for Environmental Services " - - Page l- Improvement Permit ❑ Authorization to Cons uct Septic Repair ❑ Septic Malfunction n Septic Expansion [ New Well Permit R /'�Replacement Well ❑ Well Abandonment ❑ • Well Repair ❑ Existing System Inspection (Pre-Approval Required) ❑ Application is for New Construction ❑ Existing Facility ❑ Property Address c15 7 /io r e S'5/ b G Subdivision Lot# 9 Acres / AC-et SectionBloc hase • Driving DDiir{e/ctions to Property /rave'// / a Yl7 57?�c-r /i/�5 rirr-'J y� !/1I'/��v1 Sxd--IS owl L c-L 4- � 56* 2/ //cy/�[( - &n Kit' ; k T& /!L - '-'7" C�onA,J-L, - e e,.a� _f NAME TO APPEAR ON PERMIT? �I Owner ❑ Applicant ❑ Contractor Applicant Contact Information Name � s cpL1 Lasaja Address ( ([p K t l 6Or P& 724 (}/('bore-SU;tte. N e, Phone Cell Phone Owner Contact Information Name • Address Phone Cell Phone Contractor Contact Information Name Erik,- C7 . -lit 7cey License # 1-45:5-1?v2 Address 'f ,,x ,? ii ) iv - ,{)(, 02 c---4.3 7 Phone Cell Phone 4/—roc; — �fr�'� WHO WILL BE IHE PRIMARY CONTACT? ❑ Owner n Applicant Contractor Description of Existing Structures on Site t/e},lir-- # of Bedrooms *t Structure Dimensions # of Occupants Basement ❑ Yes n No Basement Fixtures n Yes n No The Applicant shall notify the local health depai tuient upon submittal of this application if any of the following apply to the property tyestion. If the answer to any question is "yes", applicant must attach supporting documentation. ❑ Yes ON -- Does the site contain any jurisdictional wetlands? ❑ Yes I No Does the site contain any existing wastewater systems? ❑ Yes 5-1\19—� Is any wastewater going to be generated on the site other than domestic sewage? ❑ Yes L�9"N/o Is the site subject to approval by any other public agency? -- ❑ Yes i.�'No Are there any easements or right of ways on this property? Describe Existing water supply in use ❑ Individual Well n Community Well n Semi-Public Well ❑ County/City/Township Water Line Is a public water supply available? ** ❑ Yes U"FIo If applying for an Improvement Permit Authorization to Construct,Please Indicate Desired System Type(s): (systems can be ranked in order of you reference) ❑ Accepted ❑ Alternative Conventional ❑ Innovative ❑ Other ❑ Any LLB° scAs 0(14 CATAYY 1JA THIS IS NOT A PERMIT CO , --ma CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services Page 2- "" Proposed Facility Type ❑ Primary Residence New Residence ❑ Addition to Residence # of New Bedrooms *t Project Description ,9 5'h no-) Structure Dimensions 4i°2 X S # of Occupants Y Basement ❑ Yes pNo Basement Fixtures ❑ Yes RI--No n Accessory Structure(s) Describe # of New Bedrooms *1- if applicable Structure Dimensions # of Occupants Accessory Dwelling ❑ Yes ❑ No Plumbing ❑ Yes ❑ No Describe Plumbing Needed n Multi-Family Residence#Units #Bedrooms per Unit*t Total#Bedrooms *t 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.) n 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 Constr ion/Abandonment/Repair Proposed Well Type Individual Well n Semi-Public Well Community Well Abandonment Type n Drilled n Bored n Dug Unknown Well Repair Requested ❑ Yes I 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 label' g 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 4a ��%�� Date / U QC6 Printed Name of Owner or Agent ), Catawba County, North Carolina This map product was prepared from the Catawba County,NC,Geospatial Information System. N Catawba County has made substantial efforts to ensure the accuracy of location and labeling information A --------- containedon this map Catawba County-promotes and-recommends the-independent verification-of any----- data contained on this map product by the user.The County of Catawba,its employees,agents and i! �! 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 product or the use thereof by any person or entity. ii Selected Parcel Number: 3689-02-58-1117 1 inch=60 feet Prepared for: `l 01 a— i -� ,0 3 0 1. oc, 00 MMO t 5467 01 • i _ 5491 > •••"‘ I CP 01 11 •moo 1 - 549,9 THIS IS NOT A LEGAL DOCUMENT -Date Saved: 1/12/2016 Time: 12:18:-• ' ` Parcel Report Page 1 of I Parcel Report- Catawba County NC Parcel Information: Owner Information: • Parcel ID: 368902581117 Owner: This parcel is currently being processed Parcel Address: Owner2: null City: Address: null LRK(REID): 302334 Address2: null Deed Book/Page: City: null Subdivision: State/Zip: null null Lots/Block: 2/ • School Information: • Last Sale: Plat Book/Page: 75/161 School District: null Legal: null Elementary School: null Middle School: null Calculated Acreage: 1.000 Tax Map:!-null High School: null Township:null State Road #: TaxNalue Information: Tax Rates(pdf) Zoning Information: City Tax District: All in County Zoning District: null County Fire District: All in City Zoning!: null Building(s) Value: $0 Zoning2: null Land Value: $0 Zoning3: null Assessed Total Value: $0 Zoning Overlay: null Year Built/Remodeled: null/null Small Area: null Current Tax Bill Split Zoning Districts: null/null Zoning Agency Phone Numbers Miscellaneous: Firm Panel Date: null Building Permits for this parcel. Firm Panel #: null Building Details 2010 Census Block: null WaterShed: null 2010 Census Tract: null Voter Precinct null Agricultural District null Parcel Report Data Descriptions List all Owners Deed History Report Assessment Report This madrepon product was prepared from the Catawba County,NC.Geospatlai 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 ilable for any and all damages,loss or liability,whether direct,indirect or consequential which arises or may arse from this mapheport product or the use thereof by any person or entity. ©2016, Catawba County Government, North Carolina. All rights reserved. C 36 4$05>d i IV" -- fe I ( `-3 http://gis.catawbacountync.gov/notnap/parcel_report.php?key=36890258 1 1 1 7&typ=P 4/7/2016 � 1 '� N CATAWBA COUNTY 0 a , 0 Case IMPV-02-2016-069206 .7,47111:".4 PublicHcalth Department qE ,c1 � Subdivision < • Environmental Health Division +• r3 IN MI 368901477961 PO Box 389, 100-A Southwest Blvd, Newton, NC 28658 i LOTb 2 /8.2 sm - 8 NAME ON PERMIT: JOSEPH LASALA, 116 KILBORNE, Site Address: 5457 THREE SISTERS LN, CATAWBA NC 28609 Property Size: Square Feet:43,560.00 Acres:1.00 Directions: Travel North on Sherrils Ford Rd, Turn South on Buffalo Shoals Rd, 1/4 mile, Turn Left into Battle Run Community, Right onto Muskey Dr, At the end of the road. Improvement Permit Facility: Primary Residence - House Permit Category: New Septic Bedrooms 4 WATER SUPPLY: Private Well Basement? No Basement Plumbing? INITIAL SYSTEM SPECIFICATIONS Permit Valid: Expires In Five Years: _X_ No Expiration: Projected Daily Flow 480 g.p.d Proposed Wastewater System: 25% REDUCTION Type: IIIG - OTHER NON-CONY TRENCH SYSTEMS Permit Conditions: 'Do not grade, fill, or drive over any designated septic area. REPAIR SYSTEM SPECIFICATIONS Repair System Required? Required Proposed Wastewater System: 25% REDUCTION Type: IIIB - SYSTEM W/SINGLE EFFLUENT PUMP PUMP *MAY BE* REQUIRED 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 applicant/property owner to insure that all Catawba County Planning/Zoning and Building Inspections requirements are met. This Improvement Permit 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 'Laws and Rules for Sewage Treatment and Disposal Systems' (15A NCAC ISA .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. Robbie Phelps 02/15/2016 AUTHORIZED STATE AGENT APPROVAL DATE Permit Expiration Date: 02/12/2021 No grading or construction activity is allowed in areas designated for system and repair wilhord approval of the health Department. chpennii 02/17/2016 10:23 Page 1 of 3 Ci. -.... ‘ • Z (CI 0-) c.f) co ...... ....o Z . - 0 1 (I- N :. I • - 3 - 0 -- )-- Cj 4-cs --J 1-1-i :7) Lij i 1 II tv, C---- 4 k t 11 rt. L.k.: LsJ i ; ..„-----4 a. rNt :Cilv .,:..'' 5 0756.; C._ r•n..s tinv 7.,42°E, 4.1.551;632's 411 1 06.9 _.-..-e- .---\ "E 151 .°8' - • ' -,..57 _. . ' ‘ 93.51 0 • .2. - I . , sc . ‘. • it S. N. 200 as) ° . 1.0 ---$) .-.. /.e kr:7 --1---- 12C - s — ...) s_ z .rs No Lai 24-_ rr) ec ci • te, ka cr, ko . C•4 Ul 1--.. . Uk C7 fic i--*, ..L. ‘A-0 1/43 j % Lk, Fc ss° .... .. dig 164,60' .c. -- i':. ---fq or521 qi. ....so.. ..... -,--- ... . ...•1:•`•• / In t Ckb\PI s 0............br 5 2 7° _ se ...•••••••"" ."1. 326.75 -1 .... .s. 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'`,..• Department of Environment, Health,and Natural Resources Sheet: Division of Environmental Health Property ID: On-site WastewaterSection Lot#: 2 • SOIL/SITE EVALUATION File#: for ON-SITE WASTEWATER SYSTEM AppID: 22522 Owner: Joseph LaSala Applicant: Address: 5467 Three Sisters Ln Date Evaluated: Proposed Facility: 4br Design Flow(.1949) 480 Property Size: Location of Site: Property Recorded: Water Supply: [ ]Public [ 1 Individual [x]Well [ ]Spring [ 1 Other Evaluation Method: [ ]Auger Boring [x]Pit [ ]Cut Type of Wastewater: [x ]Sewage [ ] Industrial Process [ ]Mixed P "�Se. r fin, z }�Y '='` 4 `5."X HW C tl , <a PSR t,r-} n -+fl.r," R , ` "' t% ASn Yr`01 ""`"C 4 }z3 sJtz.-.x x u4.'t ' #Ha ar 1r to 1 A'— e +. s .. s t ,es z 1 'a,T .L,i( !- P: Eg " Va r r�tlK4?, (i ,:3 ra , r` a, s r t, SOIL MORPHOLOCSYfia , a F b=t fi 3 ,>a } � , iO s'. ,4 n i +v y 1941.x.. Ar 1 ---�f`r'" �. e ro�f.ORSfe m�'? ' 4:1:i14:4-44(. lT 1 a 1+S t^ � i f E �, :rth u , i,t fl(? ��. O , .� s t � 4 y�, �, M�1e 'M�" PROFILExFAC �,�� � �� z ,) „ rtl '1 19 0 .s1 r 4 s< r rf ; • r`tt', ''a .;e "°, "a' 't+81942 rw.1 t 2' ��''ti wpr ,1 dr.4- , Landscape Honzo iir 1941 4 .1..' 19411,r ,v, ,,, , rlSoil z! r 6.t,af943�1e k 195 1.994 �,;Profile , �r^q I , s E r Posl oN I i Depth-' `' Str ct"ure/ 1 �,°Cons slence ' ,x . Wetnests/, Soil 1 I' Sapro '= Restr 3 s. Glass ,'.>:`.:` r+ r; c, ,u +1 ,.f" eY41.4 t r aI tiN1 n , =`sh es t ar,, '�- t 9 E5a{`~4+�st .. at' , r ,rt„� Slope"/, - 1(IN±) Texture=,y- „ , �j Mme alogy'� �, { ' Colors;laga, DeptrilUt Class ,,7Hpnze2 P.a- 81�ETAR 1 0-40 c,sbk fr,ss,sp 40-60 cl+sap,sbk fr,ss,sp 48 0.325 2 0-24 cl,sbk fr,ss,sp 24-38 cl+sap,sbk fr,ss,sp 38-48 sap fr 38 s 0.325 3 0-12 scl,wsbk fr,ss,sp 12-35 cl,sbk fr,ss,sp 35-50 cl+sap,sbk fr,ss,sp 50 0.35 4 0-36 c,sbk fr,ss,sp 36-48 c+floating rock fr,ss,sp 48 0.3 Description Initial System Repair System Other Factors(.1946): Available Space(.1945) s s Soil Evaluation By: Robbie Phelps System Type(s) 25% 25% Others Present: Site LTAR 0.325 0.325 Site Classification(.1948): PS Site Evaluation By: Others Present: Sheet: COMMENTS: FILE#: Landscape Position Group Texture .1955 LIAR 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-Foot Slope it SL-Sandy Loam 0.8-0.6 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-Terrace 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 Mineralogy Moist Wet SEXP-Slightly Expansive VFR-Very Friable NS-Non-Sticky EXP-Expansive FR-Friable SS-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 i ', i£• . 1 :A O Z v ylO'l� '' r P / 1 1 2 o Q ~ n 1 in 1 "` 0 b 4 1 . 1 V. 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