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Home My WebLink AboutEHPR-08-2016-24468 (2).TIF g'A CO THIS IS NOT A PERMIT Case# EHPR-08-2016-24468 •d � m H CATAWBA COUNTY HEALTH DEPARTMENT ®��x o PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES �� 184 SM Environmental Health Plan Review - OSWP 'o,'- o d kap, ABANDONMENT °� M i. o , o.� Applicant TROY CONSTRUCTION (ONEE PRESSLEY), 1951 NC 73, IRON STATION NC 28080 B:7042404135 C:8284609541 Owner LARRY SHARPE, 1072 ZION CHURCH RD, HICKORY NC 28602-9100 NAME TO APPEAR ON PERMIT Troy Construction (Onee Pressley) SITE ADDRESS: 2175 ASHBURY LN, HICKORY NC 28602 PIN # 370113144926 NAME of SUBDIVISION: Lot# Section/Block PROPERTY SIZE: Square Feet 29,620.80 Acres 0.68 DIRECTIONS: Hwy 127 S, left on Zion Church Rd, left Ashbury Lane, end of road on left PRIMARY CONTACT: Applicant SEWER TYPE: Septic Tank GALLONS PER DAY: WATER SUPPLY: Private Well DESCRIBE WORK: Well abandonment, home to be destroyed 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? APPLICATION FOR: Existing Structure STRUCTURE TYPE: PRIMARY RESIDENCE FACILITY TYPE: House OTHER DESCRIPTION: DESCRIPTION OF home on site to be destroyed 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: 139-ehapplicauort 08/08/2016 16:26 Page 1 of 8 gA CATAWBA COUNTY Case# EHPR-08-2016-24468 G Public Health Department Subdivision 4, Environmental Health Division PIN# 370113144926 PO Box 389, 100-A Southwest Blvd,Newton,NC 28658 1$42 sM NAME ON PERMIT: TROY CONSTRUCTION (ONEE PRESSLEY), 1951 NC 73, IRON STATION NC 28080 Troy Construction ( Onee Pressley) Site Address: 2175 ASHBURY LN, HICKORY NC 28602 Property Size: Square Feet 29,620.80 Acres 0.68 Directions: Hwy 127 S, left on Zion Church Rd, left Ashbury Lane, end of road 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 anSl I beling of all property lines and corners and making the site accessi so that a complete site evaluation can be performed. Date: '6L II t(p 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 AREA2 ************************************************************************************************************ FEENAME , ,y r E 3I DATE FEE AMOI<JNT Well Abandonment Fee 08/08/2016 $100.00 TOTALFEES y. $100.00 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 08/08/2016 16:26 Page 2 of 8 ATA 'rills IS NOT A PERMIT 115 CATAVVBA COUNTY HEALTH DEPARTMENT Application for Environmental Services Page 1 q65-8 g Improvement Permit [-I Authorization to Construct Septic Repair E Septic Malfunction Septic Expansion n New Well Permit Replacement Well Li Well AbanddiarientZ Well Repair [11 Existing System Inspection (Pre-Approval Required) Application is for New Construction L Existing Facility Property Address a o s Lec-r-5E . Subdivision Pc\CV-0 112-44 Lot# Acres Section/Block/Phase Driving Directions to Property NAME TO APPEAR ON PERMIT? Ej Owner I:j Applicant it:1 Contractor Applicant Contact Information Name "Tg,..01 CO 51-RAJ C11 t>A'-r--T""--ier: re ss ley Address 195\ NC, 1 11c3t.-1 2- (-) o Phone 104 2.140- 4135 1 ccii Phone 82,3R--t.b40---95L1 I Owner Contact Information Name As-t2.9,-G- I A-0124 \f\1 ' Address t U 0(,,,1 t..1 ikj 2q Phone 1. Cell Phone Contractor Contact Information Name Address 161st Ns-c.„ of,,) pc_ 22-c), -0 Phone Cell Phone WHO WILL BE THE PRIMARY CONTACT? E Owner Eg Applicant Contractor Descripticm of Existing Structures on Site__.1At\\ A:Lkaka,, + kAVAtte., Ap______bs,_aethromezt. it of Bedrooms *t Structure Diniensiohs ti of Occupants Basement Yes CI No Basement Fixtures Q Yes 'Ai 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? Yes RP: No. Does the site contaill any existing wastewater systems? 0 Yes 111..No Is any wastewater going to be generated on the site other than domestic sewage? 30: Yes ON° Is the site subject to approval by any other public agency? 0 Yes n No Are there any easements or right of ways on this property? Describe Existing water supply inue Individual Well fl Community Well El Serni-Public Well El County/City/Township Water Line Is a public water supply available? *" Yes El No If applying for an Improvement Permit or Authorization to.Construct,Please Indicate Desired System Type(s): (systems can be ranked in order of preference) O Accepted 0 Alternative 0 Conventional 0 Innovative 0 Other 0 Any cATA 8 A THISJS NOT A PEWIT covygry CATAW13A COUNTY HEALTH DEPARTMENT Application for Environmental Services Page 2 Proposed Facility Type [1] Primary Residence El New Residence D Addition to Residence # otiNew Bedrooms *t Project.Description Structure Dimensions #of Occupants Basement 0 Yes 0 No Basement Fixtures 01 Yes No Ell Accessory Structure(s) Describe #`of New Bedrooms *t if applicable structure Dimensions #of Occupants Accessory Dwelling ID Yes 0 No Plumbing E Yes No Describe Plumbing Needed Multi-Family Residence#Units #BedrOoms per Unit*-1- Total.#Bedrooms *t Structure Dinterisions 0 Food Set-vice Specify Type II 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 it of Employees per Shift #of Shifts E. Other Facility Type Specify If Church# of Seats Kitchen El Yes El No If Daycare Specify Occupancy Application for Well Construction/Abatidonntent/I2epair Proposed Well Type D individual Well Scnii-Public Well 0 Conimuriity Well Abandoitritent Type DI Drilled 1: Bored 0 Dug 121 Unknown Well Repair Requested r Yes 1,i1 No Describe Calculated Design Flow, Commercial f Additional information may be required to determine design flow from certain facilities. This value will he determined dui ina consultation with on-site staff. *Any room that will be intended for sleeping at the tithe 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 future. If structure is plumbed bin 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-expii-ing under certain specified conditions.An Authorization to Construct issued by this department is valid for(S)five years,frorathe 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 inforniatinnprovided herein isltrue,complete and correct. Authorized count) and state officials are granted right of entry to conduct necessary inspections to determine compliance with applicable laws andriiles. I understand that I am solely responsible for the proper identification and labeling of all property lines and corners mid making the site accessible so that a complete site evaluation can be performed. Signature of Owner or Agent Date Printed Name of Owner or Agent ■ .- . _ Catawba County:EMiironmental Health \ (77;77 173.42 \ \ 89.02 173.34 \ \ t..) xa 0 , , , , . , , , ; ‘,.. r---,---i . r- • i CI o o . 0 Well .... - : 0 : N . • . , „.... .\ ! . ? ; i \ r , \.---, CZ flemwaWmataalwrmossio. i (178) . \ ..- _...— .-... ...... _ .......„.. ....... . ,.... ....... ..„..,.....__.... ______.....,........- \ \ 60 z \ ....t ›- IX in = 0 1 \ Parcel: 370113144926, 2175 ASHBURY LN 1in.--50ft HICKORY, 28602 ., , This map/report product was prepared,fromthe.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 mapireport_product by the user.The County of Catawba,its employees,agentS,and personnel,disclaim,and stiall not beheld liable for any and all damages,loss or liability,whether direct,indirect'or consequential which irises or may arise from this map/report product or the use thereof by any person or entitY. Com tight 2014 Catawba County NC ..._. .. .. i Parcel Report - Catawba County NC Parcel Information: Owner Information: Parcel ID: 370113144926 Owner: SHARPE LARRY WILLIAM Parcel Address: 2175 ASHBURY LN Owner2: SHARPE WAYNE LOUIS City: HICKORY, 28602 Address: 1072 ZION CHURCH RD LRK(REID): 48039 Address2: Deed Book/Page: 2091/1764 City: HICKORY Subdivision: State/Zip: NC 28602-9100 Lots/Block: / School Information: Last Sale: $51,500 on 1998-06-01 Plat Book/Page: School District: COUNTY Legal: HKY LINCOLNTON HWY Elementary School: MOUNTAIN VIEW Middle School: JACOBS FORK Calculated Acreage: .680 Tax Map: 132H 01011A High School: FRED T FOARD Township: HICKORY School Map State Road #: 1175 TaxNalue Information: Tax Rates(pdf) Zoning Information: City Tax District: All in County Zoning District: HICKORY County Fire District: MOUNTAIN VIEW Zoning1: CC-1 Building(s)Value: $8,800 Zoning2: Land Value: $26,700 Zoning3: • Assessed Total Value: $35,500 Zoning Overlay: Year Built/Remodeled: 1965/ Small Area: Current Tax Bill Split Zoning Districts: / Zoning Agency Phone Numbers Miscellaneous: Firm Panel Date: 2007-09-05 Building Permits for this parcel. Firm Panel#: 3710370100J Building Details 2010 Census Block: 2018 WaterShed: 2010 Census Tract: 011102 Voter Precinct: P23 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 Geospatlal 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. 102016,Catawba County Government,North Carolina.All rights reserved. (OA C CATAWBA COUNTY O� 100A SOUTHWEST BLVD Alla 4, NEWTON,NORTH CAROLINA 28658 RECEIPT 4� PHONE: 828.465.8399 U �;tia Monday, August 8, 2016 1E L842 sM www.catawbacountync.gov PAYOR: Troy Construction Troy Construction(Pressley, Onee) PAYMENTS TRANSACTION NUMBER: TRC-772734-08-08-2016 PAYMENT DATE: 08/08/2016 PAYMENT TYPE: Credit Card 169815799 INVOICE NUMBER FEE NAME FEE AMOUNT 08-16-331364 Well Abandonment Fee $100.00 TOTAL PAYMENTS : $100.00 EHPR-08-2016-24468 CASE TYPE: Environmental Health Plan Review WORK CLASS: OSWP SITE ADDRESS: 2175 ASHBURY LN, HICKORY NC 28602 Applicant TROY CONSTRUCTION, 1951 NC 73, IRON STATION NC 28080 B:7042404135C:8284609541 **NO PEOPLESOFTACCOUNTASSIGNED ** Owner LARRY SHARPE, 1072 ZION CHURCH RD, HICKORY NC 28602-9100 receipt 08/08/2016 16:15 Page 1 oft