HomeMy WebLinkAboutRBPR-06-2016-24123.TIF .PA • THIS IS NOT A PERMIT Case # RBPR-06-2016-24123
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Q - CATAWBA COUNTY HEALTH DEPARTMENT El LSI ,* �
441
PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES �' �f. ti• 3i�
X842 s„ Residential Building Plan Review - Building New
AUTH_CONST- NEW WELL E ' ' ''}
Applicant MARC DEAN,2621 EIGHT IRON DR, DENVER NC 28037
C:7049629529
Contractor *MIKE PAI.,MER HOMES, INC. (MICHAEL PALMER), 6211 DENVER INDUSTRIAL PARK RD,
DENVER NC 28037
B:7042576422 C:7045I69227F:7049730002 MIKEPALMER @MIKEPALMERHOMES.COM
Owner CHAD LITTLE INVESTMENTS LLC, 5400 LITTLE PKWY, SHERRILLS FORD NC 28673-9114
NAME TO APPEAR ON PERMIT
Marc Dean
SITE ADDRESS: 4256 RUGGED HILL RD, MAIDEN NC 28650 PIN # 368703436934
NAME of SUBDIVISION: Lot k 3 Section/Block
PROPERTY SIZE: Square Feet Acres 10.27
DIRECTIONS: HWY 16 N TO RIGHT ON RUGGED HILL DR, GO TO TOP OF MOUNTAIN,WHERE THERE IS A GATE (YOU CAN
PUSH GATE OPEN) PROPERTY ON RIGHT AFTER GATE
PRIMARY CONTACT: Applicant SEWER TYPE: Septic Tank
GALLONS PER DAY: 480 WATER SUPPLY: Private Well
DESCRIBE WORK: BUILDING NEW SINGLE FAMILY RESIDENCE 60'X50'
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: 0 #OF OCCUPANTS: 2
PROPOSED CONSTRUCTION
NEW STRUCTURE DIM:: 50X60
#OF NEW BEDROOMS:: 4
BASEMENT? No BASEMENT FIXTURES? No PLUMBING REQUIRED?
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-chapplicaiion 06/17/2016 14:48 Page 1 of4
$A CATAWBA COUNTY case if RBPR-06-20 1 6-24 1 23
4T f 2 Public Health Department
Subdivision
G • 5 "1 Environmental Health Division
' 11/T -; PIN/ 368703436934
'111/T1-1
'— PO Box 389, 100-A Southwest Blvd,Newton.NC 28658
/842 :w
NAME ON PERMIT: (MARC DEAN),2621 EIGHT IRON DR, DENVER NC 28037
( Marc Dean)
Site Address: 4256 RUGGED HILL RD, MAIDEN NC 28650
Property Size: Square Feet Acres 10.27
Directions: HWY 16 N TO RIGHT ON RUGGED HILL DR, GO TO TOP OF MOUNTAIN, WHERE THERE IS A GATE (YOU CAN
PUSH GATE OPEN) PROPERTY ON RIGHT AFTER GATE
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.
Date: 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
FCEl\AME DATE FEE AMOUNT
Authorization to Construct Fee (New/Expansion) 06/17/2016 S300.00
Fee
Well Permit& Inspection Fee 06/17/2016 S300.00
[ � i . TOTAL'FEI S a 5600 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-chappl icarion 06/17/2016 14:48 Page 2 of 4
:r° 3
CATAWBA THIS IS NOT A PERMIT
inert CATAWBA COUNTY HEALTH DEPARTMENT
�.m:c.... Application fot Environmental Services Page 1
•
Improvement Permit S Authorization to Construe Septic Repair❑ Septic Malfunction[1
Septic Expansion fl New Well Per mitReplacementWell ❑ Well Abandonment❑
Well Repair ❑ Existing System Inspection (Pre-Approval Required) ❑
t Application is for New Construction Existing Facility ❑
•
Property Address �J�S 2tti fir e'd f-i I l eel, Subdivision L; 1-4 I G Iv1
-fit 64r-r- i I/c 4rel N G L,j (o 7 3 Lot# 3 Acres / b , 2'7
Section/Block/Phase L u-f - FL (0 4 - 190
Driving Directions to Property ti w y l to tJ 4-n f -} o n R-u.a S p ri (-1 l I Dr; �p . 'o p
he o (- V✓td u.2 l a i n , It) C•r-P -RIR re k u J{ (vat, Cu p LC (4 0 per')
korye 41 On ri 9itt , c C-4-er Sore ,
NAME TO,APPEAR ON PERMIT? ❑ Owner Applicant ❑ Contractor
Applicant Contact Information
Nine MO r DC 4 ri �{� (thN
Address (off ) ? i 4,+ Iron Dr;de �ov..lPr N C 2. 2)031
Phone g
Cell phone � c 4, a - 5 �
Owncr"Contact Information
Name Ckket Li-14-I� I Nve_S-A%er4S LL-C_
Address 514 O la L1 Hi, 1IK AJ , s1 e:r r, Il s "f�a rrj tN L 2- 6, 13
Phone Cell Phone. ?0 _ c o c) t '!
Contractor Contact Information
Name (V I Jae PA.).vnetr
Address & ! I _D e vt V P,r- -17 ch-C -r c I l G.r k f cQ , !?-ea v e r N C 0_ 5' 037 .
Phone -7oct — 5 l .22 1 Cell Phone
- R ` t — SIB - Gaa.-I
WHO WILL-BE TIE PRIMARY CONTACT? ❑ Owner Applicant ❑ Contractor
Description of Existing,Structutes on Site N u N e `
#of Bedrooms *j Structure Dimensions #of Occupants
Basement ❑ Yes ❑ No Basement Fixtures CI Yes .a 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 if No Does the site contain any jurisdictional wetlands?
0 Yes No Does the site contain any existing wastewater systems?
ID Yes ®No Is any wastewater going to be generated on the site other than domestic sewage'?
El Yes a No Is the site subject to approval by any other public agency? n --�
Yes 0 No Are there any easements or right of ways on this property? Describe 0 n i O1 FbVPM2.J (7-e Av t
Existing water supply in use Wridividual Well Li Community Well ❑ Semi-Public Well
❑ County/City/Township Water Line Is a public water supply available? ** ❑ Yes ❑ No
if applying for in Improvement Permit or Authorization to Construct, Please Indicate Desired System Type(s):
(systems can be ranked in order of your preference)
❑ Accepted 0 Alternative El Conventional ❑ Innovative ❑ Other xis(
AnY
CeTA( i7T1 A THIS IS NOT A PERMIT
COUNTY .� CATAWBA COUNTY HEALTH DEPARTMENT
.a„,,;,, ;; Application for Environmental Services Page 2
Proposed Facility Type
❑ Primary Residence 0 New Residence ❑ Addition to Residence #of New Bedrooms *t 4
Project Description NErJ %(-6 A ..:{-rt„L-hi o A
Structure Dimensions 6d0 X 50 #of Occupant z.
Basement [ Yes N No Basement Fixtures ri Yes No-( ‘ I • 4 _.
❑ Accessory Structure(s) Describe
of New Bedrooms *t if applicable Structure Dimensions
#of Occupants Accessory Dwelling ❑ Yes ❑No
Plumbing ❑ Yes ❑No Describe Plumbing Needed
❑ Multi-Family Residence#Units #Bedrooms,per Unit*t
Total#Bedrooms *t Structure Dimensions
(J Food Service Specify Type
#Seats Floor Space-Entire Food Service Facility (Sq Ft)
#Employees per Shift #of Shifts Dining Area(Sq. Ft)
H Business Specific Type of Business Retail Floor Space
#of Employees per Shift #of Shifts
❑ Other Facility Type Specify '
if Church#of Scats Kitchen ❑ Yes ❑No If Daycare SpeeifyOccupancy
Application for Well Const uctionJAbandonmenURepair
Proposed Well Type Individual Well ❑ Semi-Public Well ❑ Community Well.
Abandonment Type ❑ Drilled ❑ Bored ❑ Dug 1ZI. Unknown
Well Repair RequestedXYes ❑ 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-sitestaff.
*Any room that will be intended for sleeping at the time of construction or for'future consideration should be noted as arbedroom and
counted on all applications.The number of bedrooms will he confirmed by rooms identified on house plans as a bedroom at the tune
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 arc 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 fromdhe 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 Pules 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 " Date ° . / y l - a9
.
Printed Name of Owner or Agent p / G. 261./j
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GRAPHIC SCALE - FEET
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SCALE: I. m 60'
Lea m` CHUCK POOVEY,PLS P8: 76 Pc: 22
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m;°.� ROBERT DEDMON,PI S 13899 SHAW
3704 NC H}GHWAY016 NORTH u aN � TOWNSHIP & M
Ina CH=at PT Me P.O_BOX 494-DETER,NC 28037 CATAWBA COUNTY, NC
PHONE 7041483/4908
FAX.704483(2T7o
LOT 113. aw
M $1R/. BY: JRR DRAWN: RD JOB/ 1RLAl7 PLAT 1
Catawba County Environmental Health
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Parcel: 368703436934, 4256 RUGGED HILL RD 1in=150ft
SHERRILLS FORD, 28673
This map/report product was prepared from the Catawba County,NC Geospalial 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
06/17/2016
GATAWBA COUNTY 0 a 0 Case a
. IMPV-06-2016-073021
.77T4
t I L Public Health Department S::▪ + •'LP Subdivision
': Ilfiii!l1444a9; ' Environmental health Division r l'INII
�' a 368703436934
rKb° PO Box 389, 100-A Southwest Blvd,Newton,NC 28658 r-_ , r LOIN 3
! 2 sY ▪ :A t{ Y- {
'
13 Ire.
NAME ON PERMIT: MARC DEAN, 2621 EIGHT IRON DR, DENVER NC 28037
Site Address: 4256 RUGGED HILL RD, MAIDEN NC 28650
Property Size: Square Feet:447,361.20 Acres:10.27
Directions: Hwy 16 S, left Rugged Hill Rd, property on right after gate, gate is not locked
Improvement Permit
Facility: Primary Residence
Permit Category; New Septic 13cdruoms 4
WATER SUPPLY: Private Well
Basement? Yes Basement Plumbing? Yes
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: II1G - OTHER NON-CONY TRENCH SYSTEMS
Permit Conditions: Keep all parts of septic system and repair system minimum: 100' from any well, 10' from property
lines, 15' from home. Lines to be installed on contour. Do not grade drive or fill over system or repair
area.
REPAIR SYSTEM SPECIFICATIONS
Repair System Required? Required
Proposed Wastewater System: DRIP IRRIGATION
Type: IVA-ANY SYSTEM WITH LPP DISTRIBUTION
PUMP REQUIRED ***** OPERATOR REQUIRED
Landscaping or other 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 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 ofthe
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 'Larva and gales for Sewage Treatment and Disposal Systems' (I5A 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.
Jason Boyd 06/02/2016
AUTHORIZED STATE AGENT APPROVAL DATE
Permit Expiration Dale:
06/02/2021
Aro grading or construction activity is allowed in areas designated for system and repair without approval of the Health Department.
ehpcnnil 06/02/2016 10:56 Page I or3
1
„qA A-
' CATAWBACOUNTY EHPR4-16-23730,
Ha2 Permit Public Health Department Name Marc Dean
Q ""°�i►e Y Environmental Health Division Address 4256 Rugged Hill Rd Maiden NC
'W °° PO Box 389, 100A Southwest Blvd, Newton NC 28653 PINK 368703436934
/8, 'j, y, (828)465-8270 Fax (828)465-8270 TDD(828)465-8200 t
•
Site Plan Improvement Permit
/� 4-791)
Is DI
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16 •jSe ' ? r
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1LS � 300.0 P+-2 `
` .' n 164 p CO pt.r+
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un 5 (as(l.v /
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Depart'd nt of Environment,Health,and Natural Resources Sheet:
f,
Division or Environmental Health Property ID:
On-site Wastewater Section Lot#:
SOIL/SITE EVALUATION File#:
• for ON-SITE WASTEWATER SYSTEM AppID: EHPR-4-16-23730
Owner: Marc Dean Applicant:
Address: 4256 Ruggect Hill Rd Maiden NC 28650 Date Evaluated: 5/25/2016
Proposed Facility: 4 BR Home Design Flow(.1949) 480 Property Size:
Location of Site: Properly Recorded:
Water Supply: pvt well [ ]Spring [ 1 Other
Evaluation Method: pits by Allan Henkle wlLarry Henkle ( JCL,'
Type of Wastewater: X Sewage [ ]Industrial Process [ ]Mixed
-p- L« c_IrT It;l, y 1. t 111 1111 tt t �'yk lt{ ,`1WiNJ !:� h` tl�r' I e IF ([vieer.'h�.�. C 3 td c : II J Ij li I,i�11y ppl or, 1I tl'fpilil Ili`, �NX1 ,�1 1 , k:;r - h �. -k,,,fir; � �-1. I � �Nt��ln I � - �r"1 , I � �I I� � I R�`:_;14 1111 atl , aY chilI,IIIII ,II,IIIflil1uellal l0 ,;.1{„i 'i' {�h3.`,,�;4�I,I4, I I�'Ill:l(,lK,, s rut ?t;�„I1„r., , �.;`x81 j N I `N; fr.f , - , f . �d t7 '&`,I t ,� � I l SAIL MORPHOLOGY t1 } f 'lf III '� 1111101'7 Nt�l b,FalIttlr�,.a,dizEw�' wu,l' . ' : ,I1 #Ii 6 aE 1 111 Il i i Ili 1 h i t I t'I r t 1 , tf t f t•F . t:.. . .� : 8 '� � gK p��I r �4 ti '>1
d1Y �F'� 340}�• .t11 p pussy,.. ,x' 11 I �I ryA11111�1Vy21 sl Ili'„1942' ,„1 II, ,',t IIIIIN Pt h �b� 1r„)`,' ,,III ' 1 >y�`�'uli .�
r�wf 'I t� IrA 18thj1a . t _,t,l, li�' � � � �..�� �I'I� (��IIUNx�11 � t�w6 IP I I'�'Iflu I�I w�'” �ltl <� ��Ir� ,�111i, � 1�1
L -4 Landscape' 6d6dHonzonl.311,1111i•-,191411:49; j,q 1319417 ,/1 i I }1Solll.-TI III m .1+.1943( 1 t195 : 1944 1.r ProfileI+"x^
,E. ,�„�J„, tpu�1),pPosdlonl gII1Depth�� litrucu / it Weiess/ I1111TI1;7 I Solli q �rtSapro - IryjI,I�Reslr iI 0 ;,Cassihd°tl
ih6- 'I� F1;r ,oltN"''+ t4"wl.ry IJ YiW"tfrdli s "R2(Y ,. IOIW,l ,V1yn,.y Y!'t ' f ,� .r �t . I hlL,DE�hs ke ',t' Ilc tl I "r&,LTA R .oI
,k,1.6 �1'n�l aa.11f,44.Slope°A 'C 9�.(IN.)S:V. �I'i�1Te>curetl�lk� ,1' n,•WI�MIn_ra'o9Y :`..at7t>, ` IRI �ColoS�• °f, p -�u�'Class;},1,' I� ,kh.r¢I� h.9 I v
1 LL 15-20% 0-6” topsoil
6-14" SCL SS, SEXP, SP,FR 14" US
14"+ ROCK
2 same as 1 14" US
3 LL 15-20% 0-6" topsoil
6-36" SCL
36-60" SC SS SEXP SP FR 60" PS.35
—
4 same as 3
5 same as 3,4
6.7,8 LL 10-15% 0-6" topsoil
6-28" SCL 5S SEXP SP FR 28" PS.35
28"+ ROCK
9,10 LL 10-15% 0-6" topsoil
6-32" SCL SS SEXP SP FR 32" PS .35
Description Initial System Repair System Other Factors(.1946):
Available Space(.1945) PS PS Soil Evaluation By: Jason Boyd
System Type(s) 1110 25% IVA DRIP Others Present: Mike Palmer Allan henkle with Larry Henkle Grading
Site LTAR .35 _ .35/.175 Site Classification(.1948): PS
Site Evaluation 8y:
Others Present:
Sheet: -_
COMMENTS: , FILE#:
Landscape Position Group Texture ,19-$5 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 II SL-Sandy Loam 0.8-0.5 GR-Granular
NS-Nose Slope L-Learn SBK-Subangular Blocky
HS-Head Slope ASK-Angular Blocky
CC-Concave Slope III SI-Silt 0.6-0.3 PL-Platy
CV-Convex Slope SICL-Silly 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 Min eralony
Moist Wet SEXP-Slightly Expansive
VFR-Very Friable NS-Non-Sticky EXP-Expansive
FR-Friable SS-Slightly Sticky
PI-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
,./.1 a 1� • 1 ( )
\ -10'
\ot,t). 35 O
346- 115 gla
r .S•r 1l3
CATAWBA COUNTY NC - Parcel Report
Information Regarding Selected Parcel(s)
Parcel ID: 3687-03-43-6934
Name: CHAD LITTLE INVESTMENTS LLC
Name2:
Address! 5400 LITTLE PKWY
Address2:
City: SHERRILLS FORD
State: NC
Zip: 28673-9114
Account:
Calc Acreage: 10.27
Tax Map:
LRK: 803055
Deed Book: 2989
Deed Page: 0732
Subdivision Name:
Subdivision Block:
Lots: 3
Plat Book: 74
Plat Page: 127
Building Number: 4256
Street Name: RUGGED HILL RD
Site Zip: 28673
Township: MOUNTAIN CREEK
Fire Dist: BANDYS
City/Tax:
State Road:
Total Bldgs Value:
Land Value: $200,300
Total Value: $200,300
Year Built:
Year Remodeled:
Last Sale Date:
Last Sale Amount:
Neighborhood: 128
Watershed: WS-IV Protected Area
Watershed Split: NO
Voter Precinct: P31
E911 District: COUNTY
Zoning: R-40
Zoning2:
Zoning3:
Zoning Split: N
Zoning Overlay: MP-O,WP-O
Zoning District: COUNTY
Split Zoning Dist: N
Split Zoning Dist(1):
Split Zoning Dist(2):
School District: COUNTY
Elementary School: BALLS CREEK
Middle School: MILL CREEK
High School: BANDYS
School Split: NO
P&Z Case Number:
Census Tract 2010: 011501
Census Block 2010: 2035
Small Area Plan: SHERRILLS FORD
Agricultural District:
Printed: Friday, June 17, 2016 11:12 AM
( wo,fri $3oo
' • ojj Wett ' 311°
,1H6-\L_ s)pd