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HomeMy WebLinkAboutRBPR-06-2016-24121.TIF va$A - . › THIS IS NOT A PERMIT Case # RBPR-06-2016-24121 n 'La d _-y e CATAWBA COUNTY HEALTH DEPARTMENT EN ro"'VI; 0 ':5s' `< PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES 1 \842 M Residential Building Plan Review - Building New 'L • rto New . •• - AUTH CONST- NEW WELL :0• o'-. o" — — - •sc.. • Contact Person DANNY BARNES. . C:7045169222 Contractor *MIKE PALMER HOMES, INC. (MICHAEL PALMER), 6211 DENVER INDUSTRIAL PARK RD, DENVER NC 28037 B:7042576422 C:7045169227F:7049730002 MIKEPALMER@MIKEPALMERHOMES .COM Owner *MIKE PALMER HOMES, INC. (MICHAEL PALMER), 6211 DENVER INDUSTRIAL PARK RD, DENVER NC 28037 B:7042576422 C:7045169227F:7049730002 MIKEPALMER @MIKEPALMERHOMES.COM NAME TO APPEAR ON PERMIT *MIKE PALMER HOMES, INC. (MICHAEL PALMER) SITE ADDRESS: 4548 CAYTON DR, MAIDEN NC 28650 PIN # 367804516438 NAME of SUBDIVISION: WYNSWEPT PHI Lot 28 Section/Block PROPERTY SIZE: Square Feet Acres 0.77 DIRECTIONS: Hwy 16 turn on Layton Dr (just before Rant Drum) Property on Left PRIMARY CONTACT: Contact Person SEWER TYPE: Septic Tank GALLONS PER DAY: 360 WATER SUPPLY: Private Well DESCRIBE WORK: New Single Family Dwelling, 54x64, no 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 approva[by any other public agency? Yes Are there any easements or right-of-ways on this property? No APPLICATION FOR: New Structure w .__ 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:: 54x64 House #OF NEW BEDROOMS:: 3 - _ BASEMENT? No BASEMENT FIXTURES? No PLUMBING REQUIRED?Yes Desired system types (Improvement Permit or Authorization to Construct): ACCEPTED: ALTERNATIVE: CONVENTIONAL: OTHER: INNOVATIVE: ANY: YES Other described: APPLICATION FOR WELL CONSTRUCTION PROPOSED WELL TYPE: Individual Well REPLACE WELL?: NO E9-chapplication 06/17/2016 09:52 Page 1 of 4 CATAWBA COUNTY Case# RBPR-06-2016-24121 Public Health Department Subdivision WYNSWEPT PH 1 • l < "1 Environmental Health Division PIN# 367804516438 :M PO Box 389, 100-A Southwest Blvd,Newton,NC 28658 1842 NAME ON PERMIT: *MIKE PALMER HOMES, INC. (MICHAEL PALMER), 6211 DENVER INDUSTRIAL PARK RD. DENVER 28037 *MIKE PALMER HOMES, INC. ( MICHAEL PALMER) Site Address: 4548 CAYTON DR. MAIDEN NC 28650 • Property Size: Square Feet Acres 0.77 Directions: Hwy 16 turn on Cayton Dr(just before Rant Drum) Property on Left 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 Sn t t a complete site evaluation can be performed. Date: 6-17-IL Signature of Applicant or Agent An Environmental Health Specialist will contact you within 5 wor ing days of application date. If you need further information or assistance please call 828-466-7291 AREA1 FEENAME DATE ' FEE AMOUNT Authorization to Construct Fee (New/Expansion) 06/17/2016 $150.00 Fee Improvement Permit Fee 06/17/2016 $150.00 Well Permit & Inspection Fee 06/17/2016 $300.00 TOTAL FEES $600:00 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-chapplication 06/17/2016 09:52 Page 2 of 4 T'' THIS IS NOT A PERMIT C�1 ``f!�`� CATAWBA COUNTY HEALTH DEPARTMENT court ;,. _. Page 1 ,,„n.e�„,. Application for Environmental Services a Improvement Permit Authorization to oust ct� Septic Repair❑ Septic Malfunction❑ Septic Expans of n ❑ New Well Permit epl cement Well ❑ Well Abandonment❑ Well Repair n Existing System Inspection (Pre-Approval Required) Li . Application is for New Construction Existing Facility ❑ Property Address i✓r g ` 1 �h in(1� Subdivision W n SUA? y Lot# an / Acres e / Section/Block/Phase a ' '/ 1t''''�7 - ' - i - On t .1 Driving Directions to Property ■ W � (! - 4 NAME TO APPEAR ON PERMIT? XOwner ❑ Applicant AContractor ��� Applicant Contact Information a , ter• 0� Name fil Il p 1 ✓ e at erg H Pea 1+y AddresV t Act)y / 8 t,1Sih as loch l,Et.- 10C c4 fu3 7 Phone rf 0 3-17,S' I Ce one tl p/�- a-/�Jo2 Owner Contact Information / Name rn 1 KC Pa I mer ((v) 1 ke P I carer NL✓neS V Addre5gallet4t1_s'17'1Q 1 l2viC- .1)1'. Den ue v k)C 02 6 3 7 Phone 11-00-k 6 a (--k ck 3t Cell Phone '-(� 5-1 6 —^r 210 `� Contractor Contact Information �GILS trt I-01) IV\ ti rr- p_e) Name `,2 cc, w J 2 0.. �Q 5 �� J Address D.,tc / :� Q.-v,v Qs,- h--,e9,�5 Nr`Yti..\ y czr\/ �-� . c�(z.n./nor `its 0-51) Phone 1"-4-0 y — (; D-D__ — 4 4 3cza Cell Phone p‘-( —1;16 r-c{OD-' 3- WHO WILL BE THE PRIMARY CONTACT? ❑ Owner n Applicant _ ontractor Description of Existing Structures on Site \A / UX! O # of Bedrooms *j' a Structure Dimensions if of Occupants Basement ❑ Yes ® No Basement Fixtures 0 Yes CI No The Applicant shall notify the local health department upon submittal of this application if any of the following apply to the property ' question. If the answer to any question is "yes", applicant must attach supporting documentation. 0 Yes Does the site contain any jurisdictional wetlands? 0 Yes Does the site contain any existing wastewater systems? 0 Yes Ni- 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? 0 Yes No Are there any easements or right of ways on this property? Describe Existing water supply in use — Individual Well n Community Well U Semi-Public Well ❑ County/City/Township Water Line Is a public water supply available? ** ❑ Yes xi 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 conventional El Innovative ❑ Other ' ✓ec4�f'fitio ❑ Any C AT jA�}[ BA THIS IS NOT A PERMIT cuunr�° �9 1 L� CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services Page 2 Proposed Facility Type Et Primary Residence New Residence ❑ Addition to Residence # of New Bedrooms *t 3 _ Project Description "40-c..1.-,c- Structure Dimensions3 ' l0'1 Dec.()# of Occupants a Basement n Yes _ -No Basement Fixtures ri Yes [ 'NE n Accessory Structure(s) Describe # of New Bedrooms *t if applicable Structure Dimensions # of Occupants Accessory Dwelling n Yes I I No Plumbing n Yes n 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 n Other Facility Type Specify If Church# of Seats Kitchen ❑ Yes ❑ No If Daycare Specify Occupancy Application for Well Const on/Abandonment/Repair Proposed Well Type iwidual Well ❑ Semi-Public Well C Community Well Abandonment Type r Drilled n Bored ❑ Dug n Unknown Well Repair Requested I I Yes E o 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 y r Date 61/6/g1 Yc Printed Name of Owner or Agent ( � 1 e )Q 1 mer ' IU{�E3 ll( G] _ m2o a O so lTgnl' H '"s °-'-A- -im n P- om°- m oa m O zP ri m `` E8 _ - o e -a w — 0 V m va O ( / / N / /O /1 12'17'3$" / n 0_ 199.08' ( r / o °W y v m rm N O O / I/ C \ B>4�. r O / / O yr O n / '''-711°P O3 Eo . ±m W i 41 r d - / t r ` / 1 in N / L_ m m. / / 21000' --_____ / / / / / W ( c(5' 0 / C m Catawba County Environmental Health 185.04 /27.61 c ti 145.87 19.46 32.88 c4 Poly oft 912.00 330.97 3,'24 Parcel: 367804516438, 4548 CAYTON DR $1 We') 1 in=50ft MAIDEN, 28650 j9 •3300 3 3boSix' Neu) 1le ft -130 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. Coovriaht 2014 Catawba County NC Parcel Report Page 1 of 1 Parcel Report - Catawba County NC Parcel Information: Owner Information: Parcel ID: 367804516438 Owner: MIKE PALMER HOMES INC Parcel Address: 4548 CAYTON DR Owner2: null City: MAIDEN, 28650 Address: 6211 DENVER INDUSTRIAL PARK RD LRK(REID): 201378 Address2: null Deed Book/Page: 3335/0410 City: DENVER Subdivision: WYNSWEPT PH 1 State/Zip: NC 28037-7809 Lots/Block: 28/ Last Sale: School information: Plat Book/Page: 68/196 School District: COUNTY Legal: LOT 28 PLAT 68-196 Elementary School: BALLS CREEK Middle School: MILL CREEK Calculated Acreage: .770 Tax Map: null High School: BANDYS Township: CALDWELL School Map State Road #: null Tax/Value Information: Tax Rates(pdf) Zoning Information: City Tax District: All in County Zoning District: COUNTY County Fire District: BANDYS Zoning1: R-40 Building(s) Value: $0 Zoning2: Land Value: $18,500 Zoning3: Assessed Total Value: $18,500 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 #: 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 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=3 678045 1 643 8&typ=P 6/17/2016 • ,� • IMPROVEMENT PERMIT , IaForoffc �ueeOnv' p tit p COP File Numbery x 4 5 1 5 Catawba County Public Health Department --�_ ' "£ County ID Number Wts2008 01D62 '* : y®°fir„ Ra Environmental Health Division ; �,_ •, , .aF P:0 Box 389, 100-A Southwest Blvd Evaluated For yy NEWy ,#,u ' J - - Newton NC 28658 PERMIT VALID UNTIL 02/04/2014 Phone: (828)-465-8270 Fax: (828)465-8276 ❑ Open Fill Sheet Se, 'NOTE TO INSPECTIONS DIVISION: Building Permits cannot be issued with this Improvement Permit. (F:roperty Owner: uecht *p I�PN htp F h " , Applicant: DANNY EDWARDS • C Address: 885 N HIGHWAY 16 Address: 388 N HWY 16 City: DENVER City: DENVER A 1 State/Zip: NC . 28037-600 State/Zip: NC 28037 W hone#: Phone#: O . Property Location & Site Information dress/Road#: Subdivision: WYNSWEPT Phase: Lot: 28 4548 PEMBROKE PINE ST • • Directions • Structure: SINGLE FAMILY HWY 16 S ON LEFT JUST BEFORE RANT DRUM #of Bedrooms: 5 RD #of People: Water Supply: NEW WELL System Specifications (-Initial System \ Site Classification: provisionally suitable Minimum Trench Depth: a 4 Inches Design Flow: 0 '6 0 0 Maximum Trench Depth: 3 0 Inches Soil Application Rate: Septic Tank: 1 5. 0 9 0 3. 5 . Gallons 1-Piece: . QYes QNo `System Classification/Description: TYPE MI B.SYSTEM W/SINGLE EFFLUENT PUMP Pump Required: QYes 0 No OMay Be Required Pump Tank: -1 5 0 0 Gallons `Proposed System: 25%REDUCTION / \\ 1-Piece: QYes No Repair System Required:QJYes ONo ONo, but has Available Space Repair System 'Site Classification: provisionally suitable Minimum Trench Depth: 3 0 Inches Soil Application Rate: 3 5 Maximum Trench Depth: . 3 0 Inches 'System Classification/Description: Pump Required: 2j Yes ONo Q Maybe Required TYPE IV A.ANY SYSTEM WITH LPP DISTRIBUTION Pump Tank: 1 5 0 0 Gallons 'Proposed System: 50 o REDUCTION / Page 1 of3 // • • • 24515 WLS2008-01062 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 pans of septic and repair minimum:S0:from any individual well.creek,or pond'15'from home'10'from properly lines'Install lines en , contour-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,an 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 bya registered land O surveyor,drawn to a scale of one inch equals no more than 60 feet,that includes:the specific location of the proposed facility 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 satisfythe conditions,the rules,or this article.This permit Is subject to revocation if the site plan,plat,or Intended use changes(NCGS 130A-S35(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(.1938(b)). Applicant/Legal Reps.Signature Required? $Yes ONO • • Applicant/Legal Reps.Signature:l,i Date: 02 / /2 / • *Issued By:, 1810-Boyd.Jason ((�� • Date•-of Issue: 0 x / 0 4 / 2 0 0 9 Authorized State Agent: �j /J C OValid without Expiration? 45Hand Drawing Olmport Drawing ," **Site Plan/Drawing attached.** Total Time:(HH:MM) • • Page 2 of 3 • • • • • • 24515 w�szoas oioez CDP File Number: County File Number: Drawing Type: Improvement Permit Date: 0 a / 0 4 / . a 0 0 9 ijlnch . Scale: 1 QBlock = 6 0 k Drawing QN/n i �16s .-.6 ' V ! 255, 2,..J1v“k,. ., I 'Pc . 5Y , r : . , N`_ - I-0 _.i I it P ° I. _ { ° I ej i c t fsu t� A - .f, 1,:.; w, 6 0 0 k ( 1- N/ t: . i - Page 3 of 3 _______ --- • NCDENR ' Division of Environmental Health On-Site Wastewater Section Date: e a / 0 4 / 2 0 0 9 Soil/Site Evaluation *File#: 2 4 5 1 5 For On-Site Wastewater System PIN #: o s e tea z `Owner DANNY EDWARDS HECHT DEVELOPMENT CO Proposed Facility SINGLE FAMILY Proposed Design Flow(.1949) 0 0 6 0 o Location of Site 4548 PEMBROKE PINE ST Property Size 0.79 Water Supply NEW WELL Evaluation Method Pit .1940 Horizon SOIL MORPHOLOGY Profile# Landscape Depth .1941 Other Profile POS Slope % (IN) Mineralogy Matrix Mottle Factors Texture Structure Consistence Color Color . 0 0 t L 0-24 scl sbk fr ss sp ,1942 Wet 24-48 sc sbk fr ss sp 8 %. .1943 Depth 4 8 .1944 Rest, GPS Horizon Saprolite. 1947 Class Ps giji Profile LTAR e • 3 5 © 0 ] L 0-24 scl sbk fr ss sp 1942 Wet 24-48 sc sbk fr ss sp • .1943 Depth 4 8 . 8 °/n • .1944 Rest GPS Horizon Saprolite . 1947 Class Ps Profile 0 i 3 5 LTAR— © © 3 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 Profile LTAR 8 • 3 5 .1942 Wet. 1943 Depth ok .1944 Rest. GPS Horizon Saprolite: .1947 Class LTARR .1942 Wet .1943 Depth • 1944 Rest GPS Horizon Saprolite .1947 Class Profile LTAR Available Space (.1945) Ps Other Factors(.1946) Site Classification: Ps Initial LTAR: e . 3 5 Repair LTAR: 0 . 3 5 Others Present: Comments: Evaluated By: Boyd.Jason NCDENR ' Division of Environmental Health On-Site Wastewater Section Date: 0 a / e 4 / 7 0 0 9 Soil/Site Evaluation File #: a 4 s 1 5 • For On-Site Wastewater System PIN #: o a o tee z • • 1940 Horizon • SOIL MORPHOLOGY Profile# Landscape Depth 1941 Other Profile PS Slope% (IN) Mineralogy Matrix Mottle Factors Texture Structure Consistence Color Color .1942 Wet. .1943 Depth 1944 Rest. GPS - - - - Horizon _ Saprolite. .1947 Class Profile LTAR _ • .1942 Wet • 1943 Depth 1944 Rest GPS Horizon Saprolite: .1947 Class • Profile • 1942 Wet. • 1943 Depth .1944 Rest. • GPS Horizon Saprolite. .1947 Class Profile LTAR • • .1942 Wet. • .1943 Depth .1944.Re st. GPS Horizon Saprolite: • .1947 Class Lf%e 1942 Wet. • • .1943 Depth 1944 Rest GPS Horizon Saprolite: • .1947 Class 171%r Comments: • i •