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HomeMy WebLinkAboutEHPR-07-2016-24382 (2).TIF gA i� TRIS IS NOTA PERMIT Case # EIIPR-07-2016-24382 L CATAWBA COUNTY HEALTH DEPARTMENT 0; so e PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES �� 1842 sM Environmental Health Plan Review - OSWP o o o ABANDONMENT .-.19 �Q * ■ S ti . Contra`ttor MCCALL BROTHERS, INC., 6740 BROOKSFIIRE BLVD, CHARLOTTE NC 28216 H:7043991506 C:7043090071 HOME:7043991506 Owner THE VILLAGE AT SHERRILLS FORD LLC, 617 N MAIN ST, BELMONT NC 28012 8:7044002626 Paid By MCCALL BROTHERS, INC (ANDREA KNOX), 6740 BROOKSHIRE BLVD, CHARLOTTE NC 282 C:7043991506 NAME TO APPEAR ON PERMIT McCall Brothers, Inc. SITE ADDRESS: 3893 SLANTING BRIDGE RD, SHERRILLS FORD NC 28673 PIN # 460716844357 NAME of SUBDIVISION: Lot# 2 Section/Block PROPERTY SIZE: Square Feet 61,855.20 Acres 1.42 DIRECTIONS: Intersection of Hwy 150& Sherrills Ford Rd, Next to Sherrills Ford Fire Dept. PRIMARY CONTACT: Contractor SEWER TYPE: Public Sewer GALLONS PER DAY: WATER SUPPLY: Private Well DESCRIBE WORK: 3 Well Abandonments on the same property: 2 - Drilled 1 - Bored -20", 50' Deep 2 existing structures on the property will be removed for further development. 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? No Are there any easements or right-of-ways on this property? No APPLICATION FOR: Existing Structure STRUCTURE TYPE: ** NO STRUCTURE SELECTED ** FACILITY TYPE: House OTHER DESCRIPTION: DESCRIPTION OF 2 Buildings (to be Removed for further land development) EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: NUMBER OF EXISTING BEDROOMS: #OF OCCUPANTS: PROPOSED CONSTRUCTION Desired system types (Improvement Permit or Authorization to Construct): ACCEPTED: ALTERNATIVE: CONVENTIONAL: OTHER: INNOVATIVE: ANY: Other described: APPLICATION FOR WELL ABANDONMENT ABANDONMENT TYPE: Drilled E9-ehnppl ication 07/28/2016 08.52 Page 1 of 8 �n CATAWBA COUNTY Case# EHPR-07-2016-24382 7.: G Public Health Department Subdivision 4 -^•�v. 4, Environmental Health Division PIN# 460716844357 PO Box 389. 100-A Southwest Blvd.Newton,NC 28658 /8/1, s. NAME ON PERMIT: MCCALL BROTHERS, INC. ( ), 6740 BROOKSHIRE BLVD, CHARLOTTE NC 28216 McCall Brothers, Inc. ( ) Site Address: 3893 SLANTING BRIDGE RD, SHERRILLS FORD NC 28673 Property Size: Square Feet 61,855.20 Acres 1.42 Directions: Intersection of Hwy 150& Sherrills Ford Rd, Next to Sherrills Ford Fire Dept. 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 1 ;iiii ti+i I"1 irkl c �I 111�n + i,; �� fI Ph1 (Iu+lI 11 _a sl ul�l1111) .P�P l d'A�I ,v, +if.,,DATE ,i �uFErTc ENA'ME, •� ;ILV6hu��+ +�� l� I�r.1u:��.1.uII+IIII�hIJJO'us. ��d11ILFEE AMOUNNI Well Abandonment Fee 07/27/2016 $100.00 Well Abandonment Fee 07/27/2016 $100.00 Well Abandonment Fee 07/27/2016 $100.00 TOTALIFEES °iG'�"i Ii�II°E`9 tII;I +.lil1llj$300l00F1 411 tit laIDE l.1% �l' att;StY , • . a ' + ' fualathfiflllfltiiLu gtJllBx111I bill+,pk I:IIIII�Ihw 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 07/282016 08:52 Page 2 of 8 THIS IS NOTA PERMIT Case # EHPR-07-2016-24382 -rainriezi CATAWBA COUNTY HEALTH DEPARTMENT „Fr �0 18��” PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES f� L . At 42 sm Environmental Health Plan Review - OSWP So +f ABANDONMENT . , Applicant MCCALL BROTHERS, INC., 6740 BROOKSHIRE BLVD, CHARLOTTE NC 28216 H:7043991506 C:7043090071 HOME:7043991506 Owner THE VILLAGE AT SHERRILLS FORD LLC, 617 N MAIN ST, BELMONT NC 28012 8:7044002626 Paid By MCCALL BROTHERS, INC (ANDREA KNOX), 6740 BROOKSHIRE BLVD, CHARLOTTE NC 282 C:7043991506 NAME TO APPEAR ON PERMIT SITE ADDRESS: 3893 SLANTING BRIDGE RD, SHERRILLS FORD NC 28673 PIN # 460716844357 NAME of SUBDIVISION: Lot# 2 Section/Block PROPERTY SIZE: Square Feet 61,855.20 Acres 1.42 DIRECTIONS: Intersection of Hwy 150 & Sherrills Ford Rd, Next to Sherrills Ford Fire Dept. PRIMARY CONTACT: Contractor SEWER TYPE: Public Sewer GALLONS PER DAY: WATER SUPPLY: Private Well DESCRIBE WORK: 3 Well Abandonments on the same property: 2 - Drilled 1 - Bored -20", 50' Deep 2 existing structures on the property will be removed for further development. 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? No Are there any easements or right-of-ways on this property? No APPLICATION FOR: Existing Structure STRUCTURE TYPE: ** NO STRUCTURE SELECTED ** FACILITY TYPE: House OTHER DESCRIPTION: DESCRIPTION OF 2 Buildings (to be Removed for further land development) EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: NUMBER OF EXISTING BEDROOMS: #OF OCCUPANTS: PROPOSED CONSTRUCTION Desired system types(Improvement Permit or Authorization to Construct): ACCEPTED: ALTERNATIVE: CONVENTIONAL: OTHER: INNOVATIVE: ANY: Other described: APPLICATION FOR WELL ABANDONMENT ABANDONMENT TYPE: Drilled P9-chapplicatirm 07/27/2016 15:51 Page I of 8 �\3ACATAWBA COUNTY ase a EHPR-07-2016-24382 3- ��..rr,i� Public Health Department Subdivision < ".AllQ j �'o t „�, Environmental Health Division PIN# 460716844357 Inky PO Box 389. 100-A Southwest Blvd,Newton.NC 28658 842/+V NAME ON PERMIT: Site Address: 3893 SLANTING BRIDGE RD, SHERRILLS FORD NC 28673 Property Size: Square Feet 61,855.20 Acres 1.42 Directions: Intersection of Hwy 150& Sherrills Ford Rd, Next to Sherrills Ford Fire Dept. 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 identifica�'• and I beling of all property lines and corners and making the site acfe/§�iblernso�thhat aaccoQmp�lete site evaluation can be performed. Date: ' r J,�( Signature of Applicant or Agent iS �1 1. irynI ( 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 7EP,111i i $P igru iililllia I!. (l1I{�,IHll9 ii— ; fj'1 i fli!tir. p"r'lll deo-,",: r ,t ignii:QC FEF NAM [la Ilii'I' l ,Lj ` ailiti)!'hir y�E„1l;i ';_DATFy� FFEIAMOUNT_ Well Abandonment Fee 07/27/2016 $100.00 Well Abandonment Fee 07/27/2016 $100.00 Well Abandonment Fee 07/27/2016 $100.00 nt I- TOTA{i'FEESIIII1111 jiblIIiVitilllliPit : lliillill'g h30OO'a' a ! i { R .$ �a: 4.•, -"1 1211I1111111111thrilli111Wd 111k 112 Ti1n ,•usl'inup�111f811NpIi0lelle dWWW r" '14111111V— ' '• ra duYlah111.,_., f 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 07/27/2016 15:51 Page 2 918 C_ ATAWBA THIS IS NOT A PERMIT • cotmrt- CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services Page 1 Improvement Permit❑ Authorization to Construct❑ Septic Repair n Septic Malfunctior ❑ Septic Expansion n New Well Permit❑ Replacement Well ❑ Well Abandonment 33 Well Repair ❑ Existing System Inspection (Pre-Approval Required) ❑ Application is for New Construction ❑ Existing Facility ❑ Property Address3893 Slanting Bridge Rd Subdivision Bridge Water Sherrills Ford, NC 28673 Lot# Acres Section/Block/Phase Driving Directions to Property Intersection Hwy 150&Sherrills Ford Rd.Next to sherritis Ford Fire department NAME TO APPEAR ON PERMIT? ❑ Owner ❑ Applicant ® Contractor Applicant Contact Information NameMcCall Brothers Inc Address6740 Brookshire Blvd, Charlotte. NC 28216 Phone704-399-1506 —1 CellPhone704-309-0071 Owner Contact Information NameD,R Horton AddressP,O Box 668608, Charlotte NC 28216 Phone I Cell Phone Contractor Contact Information Name Address Phone Cell Phone WHO WILL BE THE PRIMARY CONTACT? ❑ Owner ❑ Applicant ❑ Contractor Description of Existing Structures on Site cleared land #of Bedrooms *-1- Structure Dimensions_ #of Occupants Basement n Yes ❑ No Basement Fixtures a Yes 0 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. D Yes 0 No Does the site contain any jurisdictional wetlands? n Yes ID No Does the site contain any existing wastewater systems? 0 Ycs 0 No Is any wastewater going to be generated on the site other than domestic sewage? O Yes 0 No Is the site subject to approval by any other public agency? 0 Yes 87 No Are there any casements 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) O Accepted ❑ Alternative 0 Conventional ❑ Innovative ❑ Other 0 Any CATAWBA 7BA THIS IS NOT A PERMIT COUNTY r.„.. ,,, CATAWBA COUNTY HEALTH DEPARTMENT Application.for Environmental Services Page 2 Proposed Facility Type ❑ Primary Residence ❑ New Residence n Addition to Residence #of New Bedrooms *t Project Description Bridge water Subdivison Structure Dimensions #of Occupants Basement ❑ Yes r] No Basement Fixtures el Yes a No ❑ Accessory Structure(s) Describe #of New Bedrooms st if applicable Structure Dimensions -- #of Occupants Accessory Dwelling ❑ Yes ❑No Plumbing ❑ Yes n No Describe Plumbing Needed ❑ Multi-Family Residence#Units #Bedrooms per Unit*t Total#Bedrooms *7 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 E Other Facility Type Specify If Church#of Seats Kitchen ❑ Yes ❑ No If Daycare Specify Occupancy Application for Well Construction/Abandonment/Repair Proposed Well Type ❑ Individual Well 0 Semi-Public Well ❑ Community Well Abandonment Type ADrilled ISI Bored 0 Dug El Unknown Well Repair Requested 0 Yes ❑ No Describe#3 20" Bored well.50' Deep Calculated Design Flow, Commercial 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. 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 maybe 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 he performed. �r <51 LG �7 Signature of Owner or Agee/ ./ �/ [/CC-� < 7�/�/1� Date / — 7' � } Printed Name of Owner or Agent Parcel Report Page 1 of 1 Parcel Report - Catawba County NC Parcel Information: Owner Information: Parcel ID: 460716844357 Owner: THE VILLAGE AT SHERRILLS FORD Parcel Address: 3893 SLANTING BRIDGE RD LLC City: SHERRILLS FORD, 28673 Owner2: LRK(REID): 803909 Address: 617 N MAIN ST Deed Book/Page: Address2: Subdivision: City: BELMONT Lots/Block: 2/ State/Zip: NC 28012-3137 Last Sale: Plat Book/Page: 75/12 School Information: Legal: LOT 2 PLAT 75-12 School District: COUNTY Calculated Acreage: 1.420 Elementary School: SHERRILLS FORD Middle School: MILL CREEK Tax Map: Township: MOUNTAIN CREEK High School: BANDYS State Road #: 1844 School Map Tax/Value Information: Tax Rates(pdf) Zoning Information: City Tax District: All in County Zoning District: COUNTY County Fire District: SHERRILLS FORD Zoningl: PD-CD Building(s) Value: $134,800 Zoning2: Land Value: $61,900 Zoning3: Assessed Total Value: $196,700 Zoning Overlay: WP-O Year Built/Remodeled: 1980/ Small Area: SHERRILLS FORD Current Tax Bill Split Zoning Districts: / Zoning Agency Phone Numbers Miscellaneous: Firm Panel Date: Building Permits for this parcel. Firm Panel #: Building Details 2010 Census Block: 1019 WaterShed: WS-IV Critical Area 2010 Census Tract: 011504 Voter Precinct: P31 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=460716844357&typ=P 7/27/2016 Catawba County Environmental Health x-8.35 B40 ji g50� • op eh' CYa C.7. Ct" 577 N./• • Parcel: 460716844357, 3893 SLANTING lin=60ft BRIDGE RD SHERRILLS FORD, 28673 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 07/27/2016 �4 A Cp CATAWBA COUNTY 100A SOUTHWEST BLVD . V R NEWTON,NORTH CAROLINA 28658 RECEIPT K i',, les! PHONE: 828.465-8399 Wednesday, July 27, 2016 g1,S��1�..842 sn, www.catawbacountync.gov PAYOR: McCall Brothers, Inc McCall Brothers, Inc (Knox, Andrea) PAYMENTS TRANSACTION NUMBER: TRC-754124-27-07-2016 PAYMENT DATE: 07127/2016 PAYMENT TYPE: Credit Card Payment by phone from Andrea INVOICE NUMBER FEE NAME FEE AMOUNT 07-16-330949 Well Abandonment Fee $100.00 0416-330949,,:4, KBL„ a e n1/435andonm"e'ntIERIt ,.. IlEli1Ei11 '`zlh!NIln$100:00 07-16-330949 Well Abandonment Fee 5100.00 TOTAL PAYMENTS : $300.00 EHPR-07-2016-24382 CASE TYPE: Environmental Health Plan Review WORK CLASS: OSWP SITE ADDRESS: 3893 SLANTING BRIDGE RD, SHERRILLS FORD NC 28673 Applicant MCCALL BROTHERS, INC., 6740 BROOKSHIRE BLVD, CHARLOTTE NC 28216 H:7043991506C:7043090071 Owner THE VILLAGE AT SHERRILLS FORD LLC, 617 N MAIN ST, BELMONT NC 28012 B:7044002626 Paid By MCCALL BROTHERS, INC, 6740 BROOKSHIRE BLVD, CHARLOTTE NC 28216 C:7043991506 ** NO PEOPLESOFT ACCOUNT ASSIGNED ** receipt 07/27/2016 15:51 Page 1 of 1