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HomeMy WebLinkAboutEHPR-04-2016-23658 (2).TIF OG THIS IS NOT A PERMIT Case # EHPR-04-2016-23658 , n CATAWBA COUNTY HEALTH DEPARTMENT 0 "oy 0 v MAO, PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES ti- 4s. - 1842 sM Environmental Health Plan Review - OSWP a - • + �o IMPROVEMENT 0 '4`'~ , , o 1. • Applicant STEFAN & LISA KOENIG, 7018 RIDGEWAY RD, STANLEY NC 28164 C18123604221 Contact Person BERKSHIRE HATHAWAY (CARRIE SMITH), 7930 W KENTON CIR, HUNTERSVILLE NC 28078 C:7047799575 Owner MARC& DENISE HAYES, 7490 WINDY PINE CIR, DENVER NC 28037 NAME TO APPEAR ON PERMIT Stefan & Lisa Koenig SITE ADDRESS: 6652 GOOSE POINT DR, DENVER NC 28037 PIN # 369604742935 NAME of SUBDIVISION: PEBBLE BAY PH 4 Lot# 154 Section/Block PROPERTY SIZE: Square Feet 45,302.40 Acres 1.04 DIRECTIONS: From Denver: Hwy 16 North, Right on Campground Rd, Left on Catawba Burris Rd, Left onto Goose Point Dr, Lot is at the end of the road on Right. PRIMARY CONTACT: Contact Person SEWER TYPE: Septic Tank GALLONS PER DAY: 480 WATER SUPPLY: Community Well DESCRIBE WORK: IP for Purchase* 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? No Are there any easements or right-of-ways on this property? No APPLICATION FOR: New Structure STRUCTURE TYPE: PRIMARY RESIDENCE FACILITY TYPE: House OTHER DESCRIPTION: DESCRIPTION OF Vacant Lot EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: NUMBER OF EXISTING BEDROOMS: 4 #OF OCCUPANTS: 3 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: House 60x70 #OF NEW BEDROOMS:: 4 BASEMENT? Yes BASEMENT FIXTURES? No PLUMBING REQUIRED? Desired system types(Improvement Permit or Authorization to Construct): ACCEPTED: ALTERNATIVE: CONVENTIONAL: OTHER: INNOVATIVE: ANY: YES Other described: P9-ehapplicatinn 04/15/2016 10:51 Page 1 of 5 V3 ,,,, CATAWBA COUNTY Case# EHPR-04-2016-23658 C' y Public Health Department Subdivision PEBBLE BAY PH 4 4 .4Q H. Environmental Health Division a I11�` ^c I IN# 369604742935 1-411- PO Box 389. 100-A Southwest Blvd. Newton,NC 28658 /8.2 w NAME ON PERMIT: ( STEFAN& LISA KOENIG), 7018 RIDGEWAY RD, STANLEY NC 28164 ( Stefan & Lisa Koenig) Site Address: 6652 GOOSE POINT DR, DENVER NC 28037 Property Size: Square Feet 45,302.40 Acres _ 1.04 Directions: From Denver: Hwy 16 North, Right on Campground Rd, Left on Catawba Burris Rd, Left onto Goose Point Dr, Lot is at the end of the road on 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/'Slabeling of all property lines and corners and making the site accessibl o that complete site evaluation can be performed. Date: —/ �`/4 Signature of Applicant or Agent accessibl jj4----- 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 ipiM!iEi j �'ilm if � u� il"ilI n�igr � AE I J MinOlUNlr 'Jilt,' i � i i iilr i j , lit_Improvement Permit Fee 04/15/2016 $150.00 ..tIIIr,pilllilji�I �'�1ToTAE FEES "'' a IEl 'i''' IIVIIIilhIi NIIIt h HIIillik S150.0[01 II;I,�1b� hI IIJI a...��hlltNYII�G .. i 't,.eIJw.EddLELthipPh(iitlBd111111WIW111 NG11116' '1ilin10111111i'Iahh,ill111:- 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) H9-chappl i cation 04/15/2016 10.51 Page 2 of 5 4 A C CATAWBA COUNTY OG 100A SOUTHWEST BLVD a ; NEWTON, NORTH CAROLINA 28658 RECEIPT d 0" " iii` PHONE: 828.465.8399 L d�°v,' `'C Friday, April 15, 2016 i842 SM www.catawbacountync.gov PAYOR: Koenig, Stefan & Lisa PAYMENTS TRANSACTION NUMBER: TRC-655644-15-04-2016 PAYMENT DATE : 04/15/2016 PAYMENT TYPE: Credit Card Payment by phone with Lisa INVOICE NUMBER FEE NAME FEE AMOUNT 04-16-327260 Improvement Permit Fee $150.00 TOTAL PAYMENTS : S150.00 RHPR-04-2016-23658 CASE TYPE: Environmental Health Plan Review WORK CLASS: OSWP SITE ADDRESS: 6652 GOOSE POINT DR, DENVER NC 28037 Applicant STEFAN& LISA KOENIG, 7018 RIDGEWAY RD, STANLEY NC 28164 C:8123604221 ** NO PEOPLESOFT ACCOUNT ASSIGNED ** Contact Person BERKSHIRE HATHAWAY, 7930 W KENTON CIR, HUNTERSVILLE NC 28078 C:7047799575 Owner MARC& DENISE HAYES, 7490 WINDY PINE CIR, DENVER NC 28037 receipt 04/15/2016 10:50 Page 1 of 1 C TA«]R e THIS IS NOT A PERMIT cous�w 1u[ CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services Page I Improvement Perm4 Authorization to Construct❑ Septic Repair❑ Septic Malfunction❑ Septic Expansion ❑ New Well Permit❑ Replacement Well ❑ Well Abandonment❑ Well Repair ❑ Existing System Inspection (Pre-Approval Required) ❑ Application is for New Construction ❑ Existing Facility` ❑ Property Address 52 e e j Ltt ))f . Subdivision P60U e Ray eiWe l /de a$�33-7 Lot# / 51 Acres(_ 6-0 et Section/Block/Phase ?HI Driving Directions to Property — a &' V' . ' 1 u. a. 1 ' ThrrtS Rte. z-f On t, s-e poi nr. NAME TO APPEAR ON PERMIT? ❑ Owner 0 Applicant ❑ Contractor Applicant Contact Information Name 54-ePoo d L Sa. ko-en( Address -7a1� \� el/33i) RA. 4'k kB I �-' 293 Phone Cad sw> I Cell Phone ca{N e Owner Contact Information Name V C 3 CC %- -e Cr Y \)e 115 e * R\ e S Address 7 y °W v4y ?\AC Cac-c'e p �v r so( a So 3 7 Phone /� Cell Phone toot Tnfnrmatinn 1 4-S('m Name �� }�{ '� SI'17f1yv Address 30 Ken- an ( Hot�k ' c& l E, '. 25307 Phone C`eell Phone c0(.1 -77e - 5 ../ S WHO WILL BE THE PRIMARY CONTACT? ¢ Owner Applicant ❑ Contractor fl y-4 0 o (,, Description of Existing Structures on Site \Jc.t n-4- LO+ #of Bedrooms *j' Structure Dimensions #of Occupants Basement ❑ Yes ❑ No Basement Fixtures Yes ® 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. a Yes 0 No Does the site contain any jurisdictional wetlands? ® Yes ®No Does the site contain any existing wastewater systems? C Yes EI No Is any wastewater going to be generated on the site other than domestic sewage? ® Yes ®No Is the site subject to approval by any other public agency? C Yes to 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? ** ❑ 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 j4Conventional ❑ Innovative ❑ Other ❑ Any • CArr'AWBA THIS IS NOT A PERMIT COUNTY / CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services Page 2 Proposed Facility Type ❑ Primary Residence New Residence ❑ Addition to Residence #of New Bedrooms *j' Project Description —Inc Structure Dimensions (hf t 3' # of Occupants 3 Basement tg Yes ❑ No Basement Fixtures ® Yes ','ti No ❑ Accessory Structure(s) Describe #of New Bedrooms *j' if applicable Structure Dimensions # of Occupants Accessory Dwelling ❑ Yes n No Plumbing ❑ Yes ❑ No Describe Plumbing Needed ❑ Multi-Family Residence# Units #Bedrooms per Unit*j 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 ❑ Yes n No If Daycare Specify Occupancy Application for Well Construction/Abandonment/Repair I pI Proposed Well Type ❑ Individual Well ❑ Semi-Public Well WCommunity 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 / "� Date �l'��J Printed Name of Owner or Agent 3 ( 11 Il nit-Y v. CATAWBA Geospatial Real Estate Search cursrr __a_ Information Services '`. r ■ NH A ill, S l ©cJ Nil AV X °4,,. G CC t .,,, \� SLQe. 5(e G0° N�� w- -E tin=100ft s Parcel: 369604742935, 6652 GOOSE POINT DR DENVER, 28037 Owners: HAYES MARC EMMET, HAYES DENISE Owner Address: 7490 WINDY PINE CIR Values - Building(s): $14,900, Land: $176,800, Total: $191,700 This maplreport product was prepared from the Catawba County.NC Geospatiai 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 0411412016 Catawba County Environmental Health ,,1, ,•l I'll filV. f I � t g F 1• I, II I t �' d'Gj �I �It' h II 4, 1 i i ) °2 i d .,I, ,�1, �,tl t.� . II I P i�IrIt I r � I,a;l1�, h I C I tir "III.,(� I, ,,. p l6 411 i V i• r � I I k•il ���al�l �� 'I1 tyt awe MillS111116::,9� a 1' -- � ^.Li 4.32 \ -- — ^0 — h P — — 1631 b,_. IP AS— .— — S° / 64.02 Parcel: 369604742935, 6652 GOOSE POINT DR 1in=6011 DENVER, 28037 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 04/15/2016 Parcel Report Page 1 of 1 Parcel Report - Catawba County NC Parcel Information: Owner Information: Parcel ID: 369604742935 Owner: HAYES MARC EMMET Parcel Address: 6652 GOOSE POINT DR Owner2: HAYES DENISE City: DENVER, 28037 Address: 7490 WINDY PINE CIR LRK(REID): 802864 Address2: null Deed Book/Page: 2931/0602 City: DENVER Subdivision: PEBBLE BAY PH 4 State/Zip: NC 28037-9363 Lots/Block: 154/ null Last Sale: $218,000 on 2008-08-25 School Information: School District: COUNTY Plat Book/Page: 63/1 Legal: LOT 154 154 PL63-1 PEBBLE BAY PL Elementary School: SHERRILLS FORD Middle School: MILL CREEK 63-1 Calculated Acreage: 1.040 High School: BANDYS Tax Map: null School Map Township: MOUNTAIN CREEK State Road #: null TaxNalue Information: Tax Rates(pdf) Zoning Information: City Tax District: All in County Zoning District: COUNTY County Fire District: SHERRILLS FORD Zoningl: R-30 Building(s) Value: $14,900 Zoning2: null Land Value: $176,800 Zoning3: null Assessed Total Value: $191,700 Zoning Overlay: CRC-O,WP-O,FPM-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: 2007-09-05 Building Permits for this parcel. Firm Panel #: 3710369600J Building Details 2010 Census Block: 4012 WaterShed: WS-IV Critical Area 2010 Census Tract: 011504 Voter Precinct: P41 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. ©2016, Catawba County Government, North Carolina. All rights reserved. http://gis.catawbacountync.gov/nomap/parcel_report.php?key=369604742935&typ=P 4/15/2016 CATAWBA COUNTY HEALTH DEPARTMENT p cocci Telephone: (828)465-8270 TDD: (828)465-8200 WLS 11 Sgf/e97 Improvement Permit V.-AC Repair P t . Opera{ionPermit. System Type Well P M. Replacement Well Owner/Agent / x/47 LLC Phon 7� -�ia� Address WY & 4e,., ,/ g/4�/ ma 2ri'/'f Subdivision 77Ko6lv.�t Section/Block/Phase PA Lot# Lot Size /,04 ,Ae^ Directions: ant .L o.-- swat , , a -is . 'A`-�; 7ff, 70 Ja/ al - ',tor _ /Art Cr/74 Property Address Facility: House ✓Mobile Home Business Multi-family Other: Pin Number?/i36FCenye fee R--/ii-7 Other • . Zoning Approval# N Bedrooms N Seats N Employees . Application Rate 3 GPD Flow 4/8ej Hot Tub or Spa eg, o Special Fixtures . Basemen yes/ o . 100% Repair Are yes no Basement Plumbing es o Water Supply: Private Well Public ,/Semi-Public ****************** ***************************************************************************************************** Type of System: Trench Bed Pump V Pump/Panel Panel LPP Other ,eci../r,. ;,,.--1 -70 logo fre Septic Tank Size iow Pump Tank Size s° Nitrification Field: Total Square Feet Depth of Stone 47 '. 34/6 Bed Size Trench Width Total Length of All Trenches Sa Number of Trenches • Trench Length / / I_/ /_Feet on Center Maximum Trench Depth 1,3. Distance of Nearest Well >/gyp *DO NOT INSTALL SEPTIC WHEN WET* *WELL RECORD REQUIRED AT COMPLETION* *************************************************************************************************************************** T... % Slope Te re O S • re Clay O. N. Soil oi] Wet ne - " Soil De!, " Restr'•. Hoz. at " Av:t able space yes o / p Overall Class S PS U "/ ,/, r � / 'Comments: - i'Oil fr ,s, • . sc6t�- .. / ='60 P c o-mAa) El /" / 4/✓ I Filter Required Riser required when 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" **************************************************************************************************************************•**** al 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 before any portion of the installation is put into use. The siting of the well by the Health Department staff is to provide protection from known possible sources of contamination. No volume of water is guaranteed at any site by the Health Department. ' Permit Date a �i EHS - _ • Owner/Agent 9jo,rte/$ /_ P)!j Septic Tank Installed By Date EHS Well Installed By Well Grout Approval Date Well Head Approval Date f Date Sample Collected . Date of Results Results EHS White-Office Yellow-Owner/Agent Pink-Building Inspection Authorization to Construct . i i DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES if Sheet of f DIVISION OF ENVIRONMENTAL HEALTH ,., PROPERTY ID N• ON-SITE WASTEWATER SECTION % COUNTY SOIL/SITE EVALUATION O / for ON-SITE WASTEWATER SYSTEM OWNER. ' 1 ICY ' ,g d, APPLICATION DATE ADDRESS: "tort' /59- DATE EVALUATED•/D- —b f- PROPOSED FACILITY 11'k K PROPOSED DESIGN FLOW( 1949): 4'W 1,09' PROPERTY SIZE. LOCATION OF SITE. // PROPERTY RECORDED WATER SUPPLY 0 Private 0 Public 0 Well 0 Spring 0 Other EVALUATION METHOD: 0 Auger Boring 0 Pit 0 Cut TYPE OF WASTEWATER: 0. Sewage 0 Industrial Process 0 Mixed \ :FP :._: ... .. _.. ai.... o SOIL MORPHOLOGY..: 011 E R.... F (1941) PROFILE FACTORS f Li 1940 .. E LAND. ROR1 1942 SCREE ZON 1941 :194 SOIL' 1943: 1956 194A- - 'p POSITION:: DEPTH STRUCTURE/ ., CONSISTENCE/ WETNESS/ SOIL SANtO RESTR PROFILE! "' SLOPE (IN!)... TEXTURE.:' MINERALOGY COLOR "'DEPTH CLASS ..HOAR CLASS ... : : .. .. &LIAR:;! SAS O,—.a, Sc 1JkS k sr s XP 71-" Li 9 V. 51,5 ()- 0 c(.L wk S ''` P " q .; w 2 : `.lid. +til , -5 . F n !, VVV t3 •).-9 cat_ se ( Cr- C‘7s/9 36 3 diP %t IS t . ,. _ -. S o-36 Set- -Zit' �6 "- n, ! 4 '4r" . as- h DESCRIPTION INITIAL SYSTEM REPAIR SYSTEM OTHER FACTORS( 1944): SITE CLASSIFICATION( 1948): 11 t fL5 Available Space(1945) S System Type(s) // e, n /EVALUATED BY . OS/l dKS�/ , t`e'`( /o 621 EVALUATED PRESENT - Site LTAR . 3. .V r - . ' � COMMENTS. 7r; 2 Mote P7-- ---.?/ LEGEND use the following standard abbreviations SOIL CONVENTIONAL LIT MINERALOGY/ LANDSCAPE POSITION GROUP TEXTURE .1955 LTAR' .1957 LTAR* CONSISTENCE STRUCTURE CC(Concave Slope) I S(Sand) 1.2-0.8 0.6-0.4 NEXP(Non-expansive) G(Single Grain) CV(Convex Slope) LS(Loamy Sand) SEX?(Slightly Expansive) M(Massive) D(Drainage Way) EXP(Expansive) CR(Crumb) DS(Debris Slump) II SL(Sandy Loam) 0.8-0.6 0.4-0.3 GR(Granular) FP(Flood Plain) L([tram) 5IIK(Subaagular Blocky) FS(Foot Slope) ASK(Angular Blocky) H(Head Slope) DI SCL(Sandy Clay Loam) 0.6-03 0.3-0.15 PL(Platy) L(Linear Slope) SiL(Silt Loam) PR(Prismatic) N(Nose Slope) CL(Clay Loam) R(Ridge) SiCL(Silty Clay Loam) MOIST WET S(Shoulder Slope) Si(Silt) T(Terrace) VFR(Very Friable) NS (Nan-sticky) IV ly SC(Sandy Clay) 0.4-0.1 0.2-0.05 FR(Friable) 55(Slightly SiC(Silty Clay) FI(Finn) S(Sticky) C(Clay) VFf(Very Finny.Vay Sticky) VS(Wry Sticky) 0(Organic) None EFI(Extremely Firm) NP(Non-plait) SP(Slightly Plastic) *Adjust LTAR due to depth,consistence,structure,soil wetness,landscape,position,wastewater flaw and quality P(Plastic) NOTES VP(Very Plastic) HORIZON DEPTH N inches below natural soil surface 1 DEPTH OF FILL In inches from land surface RESTRICTIVE HORIZON Thickness and depth from land surface SAPROLlTE S(suitable)or U(unsuitable) SOIL WETNESS inches from land surface to free water or inches from land surface to soil colors with chrome 2 or less-record Munsell color chip designation CLASSIFICATION S(Suitable),PS(Provisionally Suitable),orU(Unsuitable) Evaluation of saprolile shall be by pits. Long-term Acceptance Rate(LTAR):gal/day/flr Show profile locations and other site features(dimensions,reference or benchmark,and North). • • • • • • • • • DENR(######) Review.(##11##) •