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HomeMy WebLinkAboutRBPR-04-2016-23652.TIF P' \ THIS IS NOT A PERMIT Case # RBPR-04-2016-23652 d� `er;a CATAWBA COUNTY HEALTH DEPARTMENT 0 •rr- f 0 e PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES • /84,a 7 SM Residential Building Plan Review - Building New no r-ro 01• Ca T*5 AUTH_CONST- NEW WELL It ;.,; Contractor MARK COX, 1731 UNION ST, MAIDEN NC 28650 C:7046341747 Land Owner DAVID COX,2791 DAVID COX RD, MAIDEN NC 28650 Owner KEVIN COX,2107 OKLAHOMA CT, LINCOLNTON NC 28092 C:7046340219 NAME TO APPEAR ON PERMIT Kevin Cox SITE ADDRESS: 2737 DAVID COX RD, MAIDEN NC 28650 PIN # 365604738470 NAME of SUBDIVISION: Lot# Section/Block PROPERTY SIZE: Square Feet Acres 29.36 DIRECTIONS: From Buffalo Shoals Rd, Left onto David Cox Rd. Property is 500 feet on the Right. PRIMARY CONTACT: Owner SEWER TYPE: Septic Tank GALLONS PER DAY: 360 WATER SUPPLY: Private Well DESCRIBE WORK: 2 story dwelling w/attached garage (no basement) 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 vacant EXISTING STRUCTURES ON SITE(IF ANY) DIM EXISTING STRUCTURE: NUMBER OF EXISTING BEDROOMS: #OF OCCUPANTS: 2 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 53 x71 #OF NEW BEDROOMS:: 3 BASEMENT? No BASEMENT FIXTURES? No 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-chapplication 04/14/2016 13:05 Page 1 of4 st,A � CATAWBA COUNTY Cased RBPR-04-2016-23652 all 1 Public Health Department Subdivision 6 ;; .��®�•4 Environmental Health Division PINS' 365604738470 12 PO Box 389, 100-A Southwest Blvd,Newton,NC 28658 SM NAME ON PERMIT: ( KEVIN COX), 2107 OKLAHOMA CT, LINCOLNTON NC 28092 ( Kevin Cox) Site Address: 2737 DAVID COX RD, MAIDEN NC 28650 a Size: Square 29.36 Property uare P S Feet Acres Directions: From Buffalo Shoals Rd, Left onto David Cox Rd. Property is 500 feet on the 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 labeling of all property lines and corners and making the site accessible so that a complete sit evaluation can be performed. Date: 47—/4/ IC' 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 AREA1 •xoai irrari : v,i*1; f r I yv 4T i 1 w e Gl nii .: ,FEFNAME;y / a _ DATF h ` r ,FEEAMOUNT !;? Authorization to Construct Fee (New/Expansion) 04/14/2016 $150.00 Fee Well Permit& Inspection Fee 04/14/2016 $300.00 rr 1 rt`f TOTAL°FEES , I i s ; x, - - + ,31-$45000 'tr _. FEES ARE NON-REFUNDABLE ONCE A SITE VISIT IS MADE OR WORK ON A PLAN REVIEW HAS COMMENCED SYSTEM REDESIGN AND/OR RETRIP WILL INCUR AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) E9-ehapplication 04/14/2016 13:05 Page 2 of 4 CAT wB© THIS IS NOT A PERMIT COUNTY ,e,,"n"'-',.,..., CATAWBA COUNTY HEALTH DEPARTMENT NorIF 7;;;;n.> Application for Environmental Services Page 1 Improvement Permit n Authorization to Construct Septic Repair n Septic Malfunction n Septic Expansion n New Well Permit'Replacement Well n Well Abandonment❑ Well Repair ❑ Existing System Inspection (Pre-Approval Required) n Application is for New Construction ❑ Existing Facility TI k Property Address 42 / 3 I /Jc ' 't (cm Fa Subdivision Lot# Acres /7 Section/Block/Pha e Driving Directions to Property /(, 5 — I Oil /J�itc4ijo Shah- Cross d('ep tc$/ mc,oler £? L oil z 4o/d r AV oil ,6 he 1/4 1041/ NAME TO APPEAR ON PERMIT? Owner ❑ Applicant n Contractor Applicant Contact Information Name Address Phone Cell Phone Owner Contact Information Name Krvi/ (' c7 ) Address ,)/C)7 04/61 M00.10 (51. L/rr&'/nIon. 4/C. ,2a'0 '0 Phone //2 Cell Phone 70q 6 5`://_ Off/J Contractor Contact Information Name License# Address Phone Cell Phone WHO WILL BE THE PRIMARY CONTACT? wner _ Applicant n Contractor Description of Existing Structures on Site # of Bedrooms *.j. Structure Dimensions it of Occupants Basement ❑ Yes ❑ No Basement Fixtures Yes ❑ No T 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 allo Does the site contain any jurisdictional wetlands? ❑ Yes 111-No Does the site contain any existing wastewater systems? ❑ Yes allo Is any wastewater going to be generated on the site other than domestic sewage? Et Yes o Is the site subject to approval by any other public agency? Yes 0'No Are there any easements or right of ways on this property? Describe Existing water supply in use ❑ Individual Well Community Well n Semi-Public Well 7 County/City/Township Water Line Is a public water supply available? ** n 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) AI❑ Accepted ❑ Alternative lE y Conventional ❑ Innovative ❑ Other ❑ Any cAT"At m A THIS IS NOT A PERMIT COUNTY E**"""°°!� CATAWBA COUNTY HEALTH DEPARTMENT „„,;„—;;;;;;;;;-...N., AppIication for Environmental Services Page 2 Proposed Facility Type n Primary Residence 21/New Residence n Addition to Residence # of New Bedrooms *t 3 Project Description Structure Dimensions §3 'rc 7/ / # of Occupants Basement Yes IV'No Basement Fixtures ❑ Yes /No n Accessory Structure(s) Describe #of New Bedrooms *t if applicable Structure Dimensions # of Occupants _ Accessory Dwelling f l Yes ❑ No Plumbing n Yes n No Describe Plumbing Needed U 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 Ti Yes No If Daycare Specify Occupancy Application for Well Construction/Abandonment/Repair Proposed Well Type L Individual Well 7 Semi-Public Well ❑ Community Well Abandonment Type ❑ Drilled ❑ Bored ❑ Dug n Unknown Well Repair Requested Ti Yes Ti 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 comers and making the site accessible so that a complete site evaluation can be performed. Signature of Owner or Agent �%.)L� � Date 1/—/V /4 " N Printed Name of Owner or Agent .44t3A CATAWBA COUNTY Perini; EHPR 3-(6-2330t G Name Kevin Cox ' Eta Z Public Health Department Address 2737 David Cox Rd Maiden NC " +' '` Environmental Health Division a PO Box 389, I QUA Southwest Blvd.Newton NC 28653 PIN 365604738470 I, . 2 a� (82S)465-8271) Fns (828)465.5276 'IUD(828)465-8200 Site Plan Improvement Permit TD t„) ,_ ,J, ) C, x � ) IvL ( H \ 7 ' Vow 55 I 4t a ' % C L v\ r P Z5 T ST j2. c 100 d , f , 1 lc. . C Q 1 = -t 55 . 9 0 -� •dzi- I ,SJ L :So,..„,)Q, -`l c ZS , gg pCCl.c 1 yJcpg_rty 12 $ • 3 '4 / �L 5 t.o— 5 v r` l/ _1 r {��1 d t 401t-4 c . : 6 0 1' v [.' S Vv't f'.k.<,) La y S e v�,-! o /' i Scale it • •Catawba County Environmental Health A,ola ) (7' tea ,�'i 4 . x _ m V .____,At.........7„. ..,ie, . issik .y ., . .1 VI .- .. • awe v Ttgi)v. _ . . 1 - ,opr.7\ . 14 ' ! - _ it �„Apo n off.,_ •15 2, -a 4 .. ii. o� q V .) in fir( seo � l , • \ i, r � , . „s. i , \,......____,, ;:. v� 60• Zy i \ Ny o 4. \ / t'xA Parcel: 365604738470, 2791 DAVID COX RD 1in=300ft 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 04/14/201fi Parcel Report Page 1 of 1 Parcel Report - Catawba County NC Parcel Information: Owner Information: Parcel ID: 365604738470 Owner: COX DAVID EDWARD Parcel Address: 2791 DAVID COX RD Owner2: COX JUDY D City: MAIDEN, 28650 Address: 2791 DAVID COX RD LRK(REID): 201220 Address2: null Deed Book/Page: 2227/1271 City: MAIDEN Subdivision: State/Zip: NC 28650-9645 Lots/Block: / School Information: Last Sale: School District: COUNTY Plat Book/Page: Legal: 2813 DAVID COX RD Elementary School: TUTTLE Middle School: MAIDEN Calculated Acreage: 29.360 High School: MAIDEN Tax Map: null School Map Township: CALDWELL 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: $293,900 Zoning2: Land Value: $147,000 Zoning3: Assessed Total Value: $440,900 Zoning Overlay: Year Built/Remodeled: 2000/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 #: 3710365600J Building Details 2010 Census Block: 4013 WaterShed: null 2010 Census Tract: 011600 Voter Precinct: P9 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 tor 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 rights reserved. —11P Ved / PO( \17 C C ,C lutes. http://gis.catawbacountync.gov/nomap/parcel_report.php?key=365604738470&typ=P 4/14/2016 CATA\YBA COUNTY o .�, I• 0 Case 14 IMP V-04-20 1 6-0 7092 0 _C y Publte Health Department i sy;��• �� SL'I);Iivision *u '" c 3 36560473847E Envirun;ncutal licuhh Diaision �r PINIt I'0 Bois 389. 100-A Southwest Blvd, Newton. NC 28658 ; } LOT# 2 jam} ar- ' - NAME ON PERMIT: KEVIN COX, 2107 OKLAHOMA CT, LINCOLNTON NC 28092 Site Address: 2737 DAVID COX RD, MAIDEN NC 28650 Property Size: Square Fees 66,211.20 Acres:1.520 Directions: From Buffalo Shoals Rd, Left onto David Cox Rd. Property is 500 feet on the Right. Improvement Permit Facility: Primary Residence Permit Category: New Septic Bedrooms 3 WATER SUPPLY: Private Well Basement? No Basement Plumbing? INITIAL SYSTEM SPECIFICATIONS Permit Valid: Expires In Five Years: _X_ No Expiration: Projected Daily Flow 360 g.p.d Proposed Wastewater System: 25% REDUCTION Type: IIIG -OTHER NON-CONY TRENCH SYSTEMS PUMP REQUIRED Permit Conditions: Keep all parts of septic system and repair system if needed minimum: 100' from any well, 10' from property lines, 5' from home including deck or porches, 15' from any pool. Lines to be installed on contour. Do not grade drive or fill over system or repair area. If outlet plumbing from home can be held high enough grade and tank kept shallow, a pump system MAY not be required. REPAIR SYSTEM SPECIFIC ATIONS Repair System Required? Required Proposed Wastewater System: 25% REDUCTION Type: IIIG - OTHER NON-CONY TRENCH SYSTEMS PUMP REQUIRED Landscaping or ether site alterations that potentially divert groundwater or surface water toward the septic system, or prevent proper drainage away from the septic system. including the direction of gutter fows or foundation drains, is not approved.and may result in failure to approve the initial system installation, or the suspensicnirevocation 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 applican liproperty owner to insure that all Catawba County Planning'%oning 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 'Lams and Rules for Sewa.ce Treatment and Disposal Systems' (I5A NCAC I 8A .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 04/07/2016 AUTHORIZED STATE AGENT APPROVAL.DATE Permit Expiration Date: 04/07/2021 No grading or construction activity is a/lmeed in areas designated far system and repair twrhoni approval of the Health Depmvnent. chpermit 01/07/2016 08:45 Page ! of 3 .}U' s r' Permit# EHPR 3-16-23301 CATAWBA COUNTY Name Kevin Cox I �ENKA Z Public Health Department Address 2737 David Cox Rd Maiden NC d m, ` HI Environmental Health Division PINS 365604738470 Co PO Box 389, I00A Southwest Blvd,Newton NC 28658 1. , 'j, , (828)465.8270 Fes (828)465-8276 IUD(828)465-821)0 Site Plan Improvement Permit IS T ✓Je �i ) G0Xg- ) prtvV U lr r t l tr--, �� , L ' I3 .ott 1111, 2Li' 1% ; \\ -n IV w 5.5 Lt z, • 3 6 2 N ,,„ ' O 2 1 f L , Pt C Z5 s� a 4 fop, a ; 1 f 1 y iy Q i67. V, It vv. 15 5 .41 -- _ J -� ci .0 .1 r_ C ei c4, d l5 / 1,..\ay.8c. f-o 2-5 Igcc■C 122 . 3 —lf � I \ I— I % -,w fc 6 0 IN�,, rk<e) ( 5 " rci t..-.?ar 1 Scale S Department of Environment,Health,and Natural Resources Sheet: Divisioh of Environmental Health Property ID: On-sire Wastewater Section Lot#: SOILISITE EVALUATION File: for ON-SITE WASTEWATER SYSTEM AppID: EHPR-3-16-23301 Owner: Kevin Cox Applicant: Address: 2737 David Cox Rd Maiden NC Date Evaluated: 3/2372016 Proposed Facility: 3 BR home Design Flow(.1949) 360:egg Property Size: Location of Site: Property Recorded: Water Supply: pvl well I )Spring I ]Other Evaluation Method: pits by Jimmy Dellinger [ ]Cut Type of Wastewater: X Sewage [ I Industrial Process [ )Mixed p ' 1 'j+ .. s ;'v l ft�� � I iGx y'e L -4. e wfficliSE t r itlIPApw '# y�'g' rw "S ar4Jt`g r ' R i r'r r ie LA i r;Yy w {s Sc u' r ortVin4 lfl( ,ti `=.�iaK �i 11P.ROFILEiFCgTORS i- x9a Fs i yr u.9 Ir * `' zg••• v y A ^l;"Y y x ] Bing t3 Flt fD x- a`'rlonz r: m 941"'1 ¢` 5941> k ififI il Soil""iL 's " '4.1943 p 9,,g 956 i';air t 3rPr0file x I e :: k'lt7 Posllioru ;Ibeplh' �Ix' Structure! t" �Gons�stence ?I I J ill` t Neinehsi' z�-So li�I.�a e°S proi'K ' Resf���-t �Cless 4.�" 2 y v r l 4 are% i rib Irti ∎I - r 9 i i+. fl i v fs.I Wi a - d .v"y 4. -Y 'bepx. rift �nv' t:2mfi,I 1 F T R f # d: ,:""Slope/ . . .K(i...D k4,6, ezture t ,'iii,, Mlneralogy.x!- ,l, ,-,..�iievlor x Depth,(100 t* ClassY-J' Hpriz „ : r8..LTARir" 1 LL 6-9% 0-6" topsoil 6-36" SC SS,SP,SEXP,FR 48" PS.3 36-48" SC w/sap 2 LL 6-8% 0-6" topsoil 6-24" SC 48" PS.3 24-48" SC wf sap SS,Sp. SEXP,FR 3 same as 1,2 48" PS.3 Description Initial System Repair System Other Factors(.1945): Available Space(.1945) PS PS Soil Evaluation By: Jason Savo System Type(s) Ill BG III BE Others Present: Kevin Cox and Jimmy Dellinger Site LIAR .3 .3 Site Classification(.1948): PS Site Evaluation By: Others Present: Sheet: COMMENTS: FILE it: Landscape 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-Foot Slope II 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 Ill 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 Vat 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 EA-Extremely Firm NP-Non-Plastic SP-Slightly Plastic P-Plastic VP-Very Plastic Sketch of Soil Evaluation Locations 5 J �/ S (2_ 0 7 l '•• 313 ( 1 l �