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HomeMy WebLinkAboutRBPR-07-2016-24369.TIF THIS IS NOTA PERMIT Case # RBPR-07-2016-24369 .<de CATAWBA COUNTY HEALTH DEPARTMENT 0_v, ' „0 PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES T *:1714.+ {''it 1842 SM Residential Building Plan Review - Swimming Pool +S EXS_SYSTEM rOaA ' . } Owner KENNETH THURMAN, 1056 FOX CHASE DR,NEWTON NC 28658 H:8282942217 C:8287815231 HOME:8282942217 NAME TO APPEAR ON PERMIT KENNETH THURMAN SITE ADDRESS: 1056 FOX CHASE DR,NEWTON NC 28658 PIN # 372013036986 NAME of SUBDIVISION: FOX CHASE Lot# 4 Section/Block PROPERTY SIZE: Square Feet 17,859.60Acres 0.41 DIRECTIONS: Startown to Sandy Ford Rd turn right on Fox Chase, 3rd house on right PRIMARY CONTACT: Owner SEWER TYPE: Septic Tank GALLONS PER DAY: 360 WATER SUPPLY: Public Water DESCRIBE WORK: Inground Swimming Pool 24x38 (including decking) 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? Yes 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: Existing Structure STRUCTURE TYPE: ACCESSORY STRUCTURE FACILITY TYPE: House OTHER DESCRIPTION: DESCRIPTION OF Single Family Dwelling EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: 63x75 NUMBER OF EXISTING BEDROOMS: 3 #OF OCCUPANTS: 2 PROPOSED CONSTRUCTION Desired system types (Improvement Permit or Authorization to Construct): ACCEPTED: ALTERNATIVE: CONVENTIONAL: OTHER: INNOVATIVE: ANY: YES Other described: 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 identificatio an4 labeling of all property lines and corners and making the site accessibl- so that a complete - evaluation can be performed. Date: /- 6 — 2 p /6 Signature of Applicant or Agent _ „ZAP::_ An Environmental Health Specialist will contact you within 5 working days application date. If you need further information or assistance please call 828-466-7291 AREA2 SETBACKS: 5' set back from house unless deck is connecting the two E9-chapplication 07/26/2016 09:59 Page 1 of4 /t3A • CATAWBACOUNTY Case# RBPR-07-2016-24369 i Public Health Department Subdivision FOX CHASE Gts� , d r Y Environmental Health Division PIN# 372013036986 •:. PO Box 389, 100-A Southwest Blvd.Newton,NC 28658 /842 :. NAME ON PERMIT: ( KENNETH THURMAN), 1056 FOX CHASE DR,NEWTON NC 28658 ( KENNETH THURMAN) Site Address: 1056 FOX CHASE DR,NEWTON NC 28658 Property Size: Square Feet 17,859.60 Acres 0.41 Directions: Startown to Sandy Ford Rd turn right on Fox Chase, 3rd house on right ; FFENAME; DATE „FEE AMOUNT , Existing Tank Check Fee 07/26/2016 $80.00 — .'E ` TOTAL FEES - $80,061. w 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 07/26/2016 09:59 Page 2 of4 CATATHIS IS NOT A PERMIT ' I.�� coiln,rr CATAWBA COUNTY HEALTH DEPARTMENT �. Application for Environmental Services Page 1 Improvement Permit ❑ Authorization to Construct❑ Septic Repair❑ Septic Malfunction ❑ Septic Expansion ❑ New Well Permit❑ Replacement Well Well Abandonment n Well Repair n Existing System Inspection (Pre-Approval Required) n Application is for /New Construction Existing Facility E. Property Address /0 5 (D [a X C/7�j C' D r it Subdivision ALFY'/A :? , ,t�. e` 6S9 Lot# Acres Section/Block/Phase Driving Directions to Property $a s d y / (' /Aa5CGus a on Let- NAME TO APPEAR ON PERMIT? n Owner /Applicant ❑ Contractor Applicant Contact Information / Name �G h n e )�1 ci Y/I Ll/M/{A/ Z C�Io re /0510 Fog l�4 e �.^ . v P e=✓7`^ n I L Phone £s2 s._ .29 y 2 i 2 Cell Phone (F29 - 78/- / Owner Contact Information Name Address Phone Cell Phone Contractor Contact Information Name Address Phone Cell Phone WHO WILL BE THE PRIMARY CONTACT? Owner F 11 Applicant n Contractor Description of Existing Structures on Site 4 f 044 /VA 45 2 PP Sy, /7, #of Bedrooms *j' 3 Structure Dimensions _X (J # of Occupants Basement ❑ Yes "No Basement Fixtures ® Yes U 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. O Yes 19No Does the site contain any jurisdictional wetlands? 0 Yes ,?to4 Does the site contain any existing wastewater systems? O Yes ® No Is any wastewater going to be generated on the site other than domestic sewage? le Ycs 0 No Is the site subject to approval by any other public agency? C Yes l;;>♦'No Are there any easements or right of ways on this property? Describe Existing water supply in use ❑ Individual Well n Community Well ❑ Semi-Public ell IV-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 0 Alternative 0 Conventional ❑ Innovative 0 Other \KAny THIS IS NOT A PERMIT "'' AFt u CATAWBA COUNTY HEALTH DEPARTMENT counr--- . ��o„,7� Application for Environmental Services Page 2 Proposed Facility Type ❑ Primary Residence ❑ New Residence I I Addition to Residence # of New Bedrooms *t Project Description Structure Dimensions #of Occupants Basement ❑ Yes ❑ No Basement Fixtures ® Yes C2 No I I Accessory Structure(s) Describe „1/4 i , W l .L+i; # of New Bedrooms *t if applicable Structure Dimensions .21A. 3 - # of Occupants Accessory Dwelling ❑ Yes n No Plumbing n Yes [ No Describe Plumbing Needed I Multi-Family Residence# Units #Bedrooms per Unit*t Total# Bedrooms *j Structure Dimensions ❑ Food Service Specify Type # Seats Floor Space-Entire Food Service Facility (Sq Ft) # Employees per Shift #of Shifts Dining Area(Sq. Ft.) I Business Specific Type of Business Retail Floor Space # of Employees per Shift # of Shifts ❑ Other Facility Type Specify If Church# of Seats Kitchen E. Yes No If Daycare Specify Occupancy Application for Well Construction/Abandonment/Repair Proposed Well Type ❑ Individual Well E. Semi-Public Well n Community Well Abandonment Type n Drilled ❑ Bored n Dug ❑ Unknown Well Repair Requested ❑ Yes n 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 depai latent 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 7 -2 6 - 2 di Printed Name of Owner or Agent Catawba County Environmental Health 1 ----- 902, di 26 •1 airmalie \\1 `'o 11 `b lii il'{,''��I¢tt�q�}I�l,l in "1 N1=.4 1 NF1 •• lily... illi 11 riotf.,) 1i11II N ny , Ihlf Nk1 I I. n j II;'xi• I I �C, t 3 1 III ��I r1 .fiP7fu I ISS. Iii 4th ni�1' ? 1,ktr ,v tie 1, I^Ili IL,) it tl G1 r It iil 01lfit �fl7 po5-r----d-R o 40///app-.. . '4 N CC pO 14 ,p II . pi Lit O I!IW 11 'ql� , 401 Q ii n U fir j'' liIjplg s#I .O * `�111f If�;S `y: 4 _� us p 0 ii\jc,./- 1tc71? O r -6_ 4 %%.".".."..."''''''''.."6.."'"" "." '"'at"le Wi h 01.28 rn co i . �„mur Parcel: 372013036986, 1056 FOX CHASE DR 1 in=50ft NEWTON, 28658 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 07/26/2016 Catawba County Environmental Health .„, . .., _.....v..0.-•-- 1 ‘. --Wk. pro' ot , 41 4, ir. r' - it , _ . . 1i .14 4. _, 4 _ e :r .....,. 1/!, _ ... s— N. Iq hi! ii: i f„, - -�• '111: - i •414)L___ '-- -.1.,.:•- 1. 1 -1-A17 ' 1 j a* • -•' ,• W o -01441 x 41, - ---- , AiLit o _ `-• ' 1111110Pi -‘ : " 't-'Z f.. '- . /PI P* 4 El r" it jpicr •_ _ • L ., Imo.E r- i • # , l �• t' ii t '`' .l- • - I 7 Oil ii r I. . Parcel: 372013036986, 1056 FOX CHASE DR 1 in=50ft NEWTON, 28658 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 07/26/2016 Parcel Report Page 1 of 1 Parcel Report - Catawba County NC Parcel Information: Owner Information: Parcel ID: 372013036986 Owner: THURMAN KENNETH EVANS Parcel Address: 1056 FOX CHASE DR Owner2: THURMAN GAIL M City: NEWTON, 28658 Address: 1056 FOX CHASE DR LRK(REID): 902511 Address2: Deed Book/Page: 2522/0843 City: NEWTON Subdivision: FOX CHASE State/Zip: NC 28658-8599 Lots/Block: 4/ School Information: Last Sale: $205,000 on 2003-10-10 Plat Book/Page: 50/164 School District: COUNTY Legal: LOT 4 4 PL50-164 FOX CHASE PL 50- Elementary School: STARTOWN Middle School: MAIDEN 164 Calculated Acreage: .410 High School: MAIDEN Tax Map: School Map Township: NEWTON State Road #: Tax/Value Information: Tax Rates(pdf) Zoning Information: City Tax District: All in County Zoning District: COUNTY County Fire District: HICKORY RURAL Zoningl: R-20 Building(s) Value: $241,100 Zoning2: Land Value: $30,100 Zoning3: Assessed Total Value: $271,200 Zoning Overlay: Year Built/Remodeled: 2002/ Small Area: STARTOWN Current Tax Bill Split Zoning Districts: / Zoning Agency Phone Numbers Miscellaneous: Firm Panel Date: 2007-09-05 Building Permits for this parcel. Firm Panel #: 3710372000J Building Details 2010 Census Block: 1049 WaterShed: 2010 Census Tract: 011701 Voter Precinct: P34 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. j rPO� LD I c erde �(1� 1�j -�S\ 2° 2(-1 )(3b 3 3 ,® ppi lcda5. http://gis.catawbacountync.gov/nomap/parcel_report.php?key=372013036986&typ=P 7/26/2016 , , �� CATAWBA COUNTYHEAtLTH DEPARTMENT goad Telephone: (828)465-8270/TDD: (828)465-8200 WLS N OZr7 IP l� AC (JAL nt. Opr. Punt. Y Sys. Type 3`nk Well Print. Replacement Well Well Rpr. Prmt. Orvne;Agent ' SS Phone Address Subdivision 4Sdo .lock/P e _ LLott/Le Directions: l� ir60 iie- ©n/ {_(rty C_ - \/ Property Address / �. Facility: House ,\/ Mobile Home Business Multi-family . Other: Pin Number - y _0, - _ ♦ sr, .tar Other . Zoning Approval # # Bedrooms 3 #Seats # Employees .t Application Rate S GPD Flowg(O-jJ.' ��!}� Hot Tub or Spa ye ' al Fixtures Basement ye•� . 100% Repair Area yes/no Basement Plumbing Water Supply, rivate Well Public Semi-Public #7477##****#**###*# . * #***###*####**#**#****##4###*****##44*#####*4####**###*##4t##**7774#4#4**r,**k##**# #4Rp*7777*7777# Type of System: Trench Bed Pump Pump/Panel Panel LPP Other 7\ /0 (7 L- �" Septic Tank Size //)70 Pump Tank Size Nitrification Field: Total Square Feet ')7v Depth of Stone .✓fi. if SBed Size ,r^ /'french Width !7 Total Lcngrth of All Trenches d Number of Trenches Trench Lengt /J -/c2 .l; Feet on Center 9 Maximum Trench/ Depth7�iI Length Ca Distance of Nearest Well il/i *DO NOT INSTALL SEPTIC WHEN WET* *WELL RECORD REQUIRED AT COMPLL N* ****#*#***7**#*****#**#****#*********#*******#4444****** *.4*********7****4#** 7#§#4 774##***4L**** 4** *****************44 Tapo % Slope - y�n i Vµ` �'(/I,Y-V'�/' lr �OOP- Texture �b`>'/4 IIVd, �� 1� `ck -- Structure / /,I An ,* f Clay Min. („'u de / .. • Soil Wetness �'� �J / I ' �' S a • , ..•• ..• Soil Depth : t / / V Availab Hoz. at " ) I� I � �� �� Available space yes/no ��_,�-� r-; t Overall Class S PS U I i 2 1j . .Comment: . _ yy�� t f 4 � � S l�t� , LJ I5 ' C` �a 0., Ut` �' 7 � S t� • `V IVN� Pil ,V ,' . al fa — _ YAR f i Filter Required il', (' t�, �I pp� - ' z Riser required when 01;11I 11 tank is more than 6 - /1U, inches deep. .. I ,,� **NO GUARANTEE OR WARRANTY IS IMPLIED OR GIVEN AS TO THE PERFORMANCE OR LENGTH OF TIME THIS SYSTEM WILL FUNCTION" *******4444***4***7******#4***4***777474**********##*4**4*4*4*.**4#*7*77***.4*******4***4*4*4****4*4**#4*4*#****4#**4***44* *Improvement Permit has no expiration date and is transferable, but may be revoked if site plans or intended use changes for the proposed facility. An Authorization to Construct is valid for(5) five years from date issued and is not transferable. Well Permit valid for 5 years ' IP provided site conditions do not change. Well location, installation, and protection must meet slate and local regulations, and must be V, inspected and approved by a representative of the Catawba County Health Department before any portion of the installation is put into use:- The sedThe siting of the well by the Health Department staff is to provide protection from kno :n possible sources of contamination. No volume ofd water is guaranteed at any site by the Health Department. , s Permit Date �j ell ' El • fri Owner/Agent 75/27-.-- • Septic Tank If y • L i ox-se..,- - Date l P O3 EHS t Well Installed By Well Grout Approval Date Well Head Approval Date Dale Sample Collected Date of Results Results EHS White-Office Yellow-Owner/Agent - Pink-Building Inspection Authorization to Construct