Loading...
HomeMy WebLinkAboutEHPR-08-2016-24501 (2).TIF / � THIS IS NOT A PERMIT Case # EHPR-08-2016-24501 CATAWBA COUNTY HEALTH DEPARTMENT Cl r v 3PrEl nirV '&11170V',410:/:1;" ' d ter_ PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES 1842 sM Environmental Health Plan Review - OSWP ,'o o + o , IMPROVEMENT -_. • o Applicant VENTURE PROPERTIES VII, LLC (SHEA DAVIS), PO BOX 843, WILKESBORO NC 28697 B:3366678000 SHEA@VPDEVELOPMENT.COM Contact Person BREC (JENNIFER EDWARDS), 126 EXECUTIVE DR SUITE 220, WILKESBORO NC 28697 C:3368444088 Land Owner SHERRY HOUSTON KENWORTHY, 5290 36TH ST DR NE, HICKORY NC 28601 NAME TO APPEAR ON PERMIT Venture Properties VII, LLC (Shea Davis) SITE ADDRESS: 4796 RIVER BEND RD, CLAREMONT NC 28610 PIN # 375419502943 NAME of SUBDIVISION: Lot# Section/Block PROPERTY SIZE: Square Feet 87,991.20 Acres 2.02 DIRECTIONS: Hwy 16 North &travel about 3.6 miles, Site is on your Right at the intersection of River Bend Rd. PRIMARY CONTACT: Contact Person SEWER TYPE: Septic Tank GALLONS PER DAY: 200 WATER SUPPLY: Public Water DESCRIBE WORK: New Dollar General Store. IP Only at this time* Will be combining 3 lots together. 200 GPD - State Flow Reduction letter attached. Retail Floor Space -7,302 Storage - 1,798 Building Dimensions -70'8" x 130"4" 3 employees -2 shifts *Required to connect to Public Water. 3 well Abandonments will be needed at time of AC. Old Septic on property to be abandoned. 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: New Structure STRUCTURE TYPE: ** NO STRUCTURE SELECTED** FACILITY TYPE: Business OTHER DESCRIPTION: DESCRIPTION OF Storage Bldgs (to be removed) EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: NUMBER OF EXISTING BEDROOMS: #OF OCCUPANTS: PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 70'8"x 130'4" EMPLOYEES PER SHIFT: 3 NUMBER OF SHIFTS: 2 TOTAL EMPLOYEES: 0 SEATING CAPACITY: TOTAL FLOOR SPACE (SQ FT): 9,100 RETAIL FLOOR SPACE (SQ FT): 7,302 DINING AREA FLOOR SPACE (SQ FT): Desired system types (Improvement Permit or Authorization to Construct): ACCEPTED: ALTERNATIVE: CONVENTIONAL: OTHER: INNOVATIVE: ANY: YES Ii9-chapplicalinn 08/16/2016 09:49 Page 1 of4 4',A CATAWBA COUNTY Case EHPR-08-2016-24501 v .Q' flc:42 Public Health Department Subdivision 2 t 14) Environmental Health Division P11\01 375419502943 ' 1� PO Box 389. 100-A Southwest Blvd,Newton.NC 28658 4142 w NAME ON PERMIT: VENTURE PROPERTIES VII, LLC (SHEA DAVIS), PO BOX 843, WILKESBORO NC 28697 Venture Properties VII, LLC ( Shea Davis) Site Address: 4796 RIVER BEND RD, CLAREMONT NC 28610 Property Size: Square Feet 87,991.20 Acres 2.02 Directions: Hwy 16 North & travel about 3.6 miles, Site is on your Right at the intersection of River Bend Rd. 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 identificatt ns and labeling of all property lines and corners and making the site a sible so that a complete site evaluation can be performed. Date: X/�(p'(� Signature of Applicant or Agent 1 rl._I ���1 I An Environmental Health Specialist will contact you within 5 working days of`applicationaptdate. If you need further information or assistance please call 828-466-7291 AREA2 FIIIImp .M 1l JIFrrl . r, - u" hilii 1[,^fir^ni rli i�'li. olpili 1'411('�E i Ritir ',i7 a1hFEENAM E=tll,41N ,,. • .� .. Itl�u�l�,b�l'Id,i1,1 "ai.:initi�;i DATE_LI?jl+l FFE'AMOUNT:;a. Improvement Permit Fee 08/12/2016 $150.00 in+ill -.TOTAE)FEES ,I , I;'�� 'liNill 1'' 1'V'a�u {flllrij)i Iw$15o00 � �� ���l�l�l� il�rrdl I + a�aslth il.to a r'ataltillhttI littt 9'iµ uws. W,.di1111111811 •4 I is d „AASil11.:,_..,42:4110k -A'li 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) 119-clmpplioation 08/16/2016 09:49 Page 2 of4 CATAWBA THIS IS NOT A PERMIT CATAWBA COUNTY HEALTH DEPARTMENT coury l Application for Environmental Services Page 1 Improvement Permit❑� Authorization to Construct[ Septic Repair❑ Septic Malfunction❑ Septic Expansion ❑ New Well Permit Replacement Well ❑ Well Abandonment Well Repair ❑ Existing System Inspection(Pre-Approval Required) ❑ Application is for New Construction rig Existing Facility ❑ Property Address River Bend Road 0;94 N $C.ilr Reay Subdivision N/A Claremont NC LI"Mr R,it'bend Lot# Acres 2.02 k, x LISl t Mitt be, • F' Je,'edctio£n/BSWa.elock/ irn Phase Driving Directions to Property Get on HWY 16 N,travel 3.6 miles and site is on your right at intersection with Riverbend Road NAME TO APPEAR ON PERMIT? ❑ Owner Applicant ❑ Contractor Applicant Contact Information Name Venture Properties VII, LLC Address PO Box 843 Wilkesboro NC 28697 Phone 336-667-8000 Cell Phone Owner Contact Information Name Sherry Houston Kenworthy Address 5290 36th Street Dr NE Hickory NC 28601 Phone Cell Phone Contractor Contact Information RECEIVED Name Address AUG 10 2016 Phone Cell Phone CATAWV 6A COiilt 1' WHO WILL BE THE PRIMARY CONTACT? ❑ Owner ❑ Applicant ❑ Contractor ENVIRONMENTAL HEALTH Description of Existing Structures on Site #of Bedrooms *j Structure Dimensions #of Occupants Basement ❑ Yes ❑ No Basement Fixtures Q Yes ® 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. 0 Yes E No Does the site contain any jurisdictional wetlands? E Yes 0 No Does the site contain any existing wastewater systems? 0 Yes 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? O Yes 0 No Are there any easements or right of ways on this property? Describe Existing water supply in use ❑ Individual Well ❑ Community Well ❑ Semi-Public Well Q 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 0 Alternative E Conventional 0 Innovative 0 Other 0 Any cATAWBA THIS IS NOT A PERMIT cou�rCATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services Page 2 Proposed Facility Type ❑ Primary Residence ❑ New Residence ❑ Addition to Residence #of New Bedrooms *t Project Description Structure Dimensions #of Occupants Basement ❑ Yes ❑ No Basement Fixtures ® Yes a No ❑ 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 ❑ Food Service Specify Type # Seats Floor Space-Entire Food Service Facility (Sq Ft) �[dean" #Employees per Shift #of Shifts Dining Area (Sq. Ft.) Pr"o"" glivl7to ❑e Business Specific Type of Business Commercial Retail ritr " tC 13o'Q" Retail Floor Space-9190 #of Employees per Shift 3 #of Shifts 2 SiVir6 ;e, CMS 7i 30. ❑ Other Facility Type Specify If Church#of Seats Kitchen ❑ Yes ❑ No If Daycare Specify Occupancy Application for Well Construction/Abandonment/Repair Proposed Well Type 0 Individual Well ❑ Semi-Public Well ❑ Community Well Abandonment Type ❑ Drilled ❑ Bored ❑ Dug ❑o Unknown Well Repair Requested ❑ Yes ❑■ No Describe Calculated Design Flow, Commercial T 200 GPD 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 transferable. 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 evaluationat/lIcan be performed. performed. )) Signature of Owner or Agent /lJ\�U ,�11)U 1 KuYU�Ja i6 Date 1 -1 - (p I 1 1 Ip Printed Name of Owner or Agent Sb\ �Yb,Y10U&tVl V\R nt�oc�al E :. R North Carolina Department of Environment and Natural Resources Division of Environmental Health Beverly Eaves Perdue Terry L. Pierce Dee Freeman Governor Director Secretary Memorandum To: NC Environmental Health Specialists From: Ted Lyon, On-Site Water Protection Section Chief Subject: Design Flow Reduction for Dollar General Stores Date: July 30, 2010 Based on separate sets of data provided for more than ten stores in the past for flow reductions for Dollar General Stores, a proposed design daily flow of 200 gpd may be used. This design flow can only be used with the following conditions: 1. Tanks must be sized on the un-reduced design flow(120 gpd/1,000 square feet of retail space area). 2. Use of low-flow fixtures such as spring-loaded or automatically activated faucets with flow rates of one gallon per minute or less, low-flow urinals which use 0.5 gallons per flush or less, and low-flow toilets which use 1.6 gallons per flush or less. Cut sheets of the fixtures must be provided. 3. A floor plan of the building must be provided. The retail sales floor area must be less than 8,000 square feet. 4. If a pump system is used, a Section approved flow equalization control panel must be used. The flow equalization control panel limits the amount of effluent discharged to the drainfield when the lag float is triggered and only one timed dose is delivered. Non-flow equalization control panels are programmed to discharge all effluent in the pump tank to the drainfield when the lag float is triggered. 5. The control panel should be set up to limit the daily dose to the drainfield to be no more than the maximum design daily flow of 200 gpd. 6. The tenants are prohibited from disposing into the wastewater system any chemical cleaners or any other compound which may be harmful to the bacteria in the wastewater system, including but not limited to quaternary ammonia compounds. 7. The tenants are prohibited from disposing of any food waste(solid or liquid) into the system. 8. The improvement permit, authorization to construct, and operation permit issued must be specify a Dollar General store. Any change to a facility designated as a Dollar General store would require a re-evaluation of the design flow and the system design, and revised permits would have to be issued. On-site Water Protection Section—Ted Lyon,Chief Pd 1642 Mail Service Center,Raleigh,North Carolina 27699-1642 CD/I�I i Phone:919-733.28951 FAX:919-715-3227 ww. 2271 Internet wdeh.entstate.nc.us/osvm new/newt/1iindex.htm Jiatta,1<b'' An Equal OppaWMy\Minnabve Action Employer Parcel Report Page 1 of 1 ?V)ex14 9K9A 3%sve- P/Ceptitiv Parcel Report - Catawba County NC Parcel Information: Owner Information: Parcel ID: 375419501904 Owner: KENWORTHY SHERRY HOUSTON Parcel Address: 4874 N NC 16 HWY Owner2: City: CLAREMONT, 28610 Address: 5290 36TH STREET DR NE LRK(REID): 55203 Address2: Deed Book/Page: 2006E/0069 City: HICKORY Subdivision: COUNTRY SIDE ESTATES State/Zip: NC 28601-7009 Lots/Block: 1 & 2/A Last Sale: School Information: Plat Book/Page: 15/107 School District: COUNTY Legal: LOT 1 & 2 2A PL 15-107 CO SIDE PL 15- Elementary School: LYLE CREEK Middle School: RIVER BEND 107 Calculated Acreage: 1.030 High School: BUNKER HILL Tax Map: 1620 04010 School Map Township: CLINES State Road #: 16 TaxNalue Information: Tax Rates(pdf) Zoning Information: City Tax District: All in County Zoning District: COUNTY County Fire District: OXFORD Zoningl: RC Building(s) Value: $3,600 Zoning2: Land Value: $44,900 Zoning3: Assessed Total Value: $48,500 Zoning Overlay: WP-O Year Built/Remodeled: / Small Area: ST STEPHENS/OXFORD Current Tax Bill Split Zoning Districts: / Zoning Agency Phone Numbers Miscellaneous: Firm Panel Date: 2007-09-05 Building Permits for this parcel. Firm Panel #: 3710375400J Building Details 2010 Census Block: 2009 WaterShed: WS-IV Protected Area 2010 Census Tract: 010101 Voter Precinct: P27 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. Ne), iScinc-r-Pity 2Ntrt F-rM1- http://gis.catawbacountync.gov/nomap/parcel_report.php?key=375419501904&typ=P 8/12/2016 Parcel Report Page 1 of 1 ( cw Parcel Report - Catawba County NC Parcel Information: Owner Information: —k (Parcel ID: 375419502943 Owner: KENWORTHY SHERRY HOUSTON Parcel Address: 4796 HIVER BEND RD Owner2: City: CLAREMONT, 28610 Address: 5290 36TH STREET DR NE LRK(REID): 55202 Address2: Deed Book/Page: 2006E/0069 City: HICKORY Subdivision: COUNTRY SIDE ESTATES State/Zip: NC 28601-7009 Lots/Block: 3/A School Information: Last Sale: $3,000 on 1982-01-01 School District: COUNTY Plat Book/Page: 15/107 Legal: LOT 3 3A PL 15-107 CO SIDE PL 15-107 Elementary School: LYLE CREEK Middle School: RIVER BEND Calculated Acreage: .500 Tax Map: 1620 04009 High School: BUNKER HILL Township: CLINES School Map State Road #: 1704 TaxNalue Information: Tax Rates(pdf) Zoning Information: City Tax District: All in County Zoning District: COUNTY County Fire District: OXFORD Zoningl: RC Building(s) Value: $1,000 Zoning2: Land Value: $9,600 Zoning3: Assessed Total Value: $10,600 Zoning Overlay: WP-O Year Built/Remodeled: / Small Area: ST STEPHENS/OXFORD Current Tax Bill Split Zoning Districts: / Zoning Agency Phone Numbers Miscellaneous: Firm Panel Date: 2007-09-05 Building Permits for this parcel. Firm Panel #: 3710375400J Building Details 2010 Census Block: 2009 WaterShed: WS-IV Protected Area 2010 Census Tract: 010101 Voter Precinct: P27 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=375419502943&typ=P 8/12/2016 Parcel Report Page 1 of 1 Parcel Report - Catawba County NC Parcel Information: Owner Information: Parcel ID: 375419503942 Owner: KENWORTHY SHERRY HOUSTON Parcel Address: 4816 RIVER BEND RD Owner2: City: CLAREMONT, 28610 Address: 5290 36TH STREET DR NE LRK(REID): 55201 Address2: Deed Book/Page: 2006E/0069 City: HICKORY Subdivision: COUNTRY SIDE ESTATES State/Zip: NC 28601-7009 Lots/Block: 4/A School Information: Last Sale: School District: COUNTY Plat Book/Page: 15/107 Elementary School: LYLE CREEK Legal: LOT 4 4A PL 15-107 CO SIDE PL 15-107 Middle School: RIVER BEND Calculated Acreage: .490 High School: BUNKER HILL Tax Map: 1620 04008 Township: CLINES School Map State Road #: 1704 Tax/Value Information: Tax Rates(pdf) Zoning Information: City Tax District: All in County Zoning District: COUNTY County Fire District: OXFORD Zoningl: RC Building(s) Value: $0 Zoning2: Land Value: $9,500 Zoning3: Assessed Total Value: $9,500 Zoning Overlay: WP-O Year Built/Remodeled: / Small Area: ST STEPHENS/OXFORD Current Tax Bill Split Zoning Districts: / Zoning Agency Phone Numbers Miscellaneous: Firm Panel Date: 2007-09-05 Building Permits for this parcel. Firm Panel #: 3710375400J Building Details 2010 Census Block: 2009 WaterShed: WS-IV Protected Area 2010 Census Tract: 010101 Voter Precinct: P27 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=375419503942&typ=P 8/12/2016 4'A C CATAWBA COUNTY O LT 01111� LoN NORTH CAR BLVD RECEIPT a NEWTON, NORTH CAROLINA 28658 d r�"�°�s� a PHONE: 828.465.8399 \U MOS `'C Tuesday, August 16, 2016 \8 42 1 `� se+ www.catawbacountync.gov PAYOR: Venture Properties VII, LLC Venture Properties VII, LLC(Davis, Shea) PAYMENTS TRANSACTION NUMBER: TRC-784523-16-08-2016 PAYMENT DATE : 08/16/2016 PAYMENT TYPE: Check 3478 INVOICE NUMBER FEE NAME FEE AMOUNT 08-16-331641 Improvement Permit Fee $150.00 TOTAL PAYMENTS : 5150.00 EHPR-08-2016-24501 CASE TYPE: Environmental Health Plan Review WORK CLASS: OSWP SITE ADDRESS: 4796 RIVER BEND RD, CLAREMONT NC 28610 Applicant VENTURE PROPERTIES VII, LLC, PO BOX 843, WILKESBORO NC 28697 B:3366678000 SHEA@VPDEVELOPMENT.COM ** NO PEOPLESOFT ACCOUNT ASSIGNED ** Contact Person BREC, 126 EXECUTIVE DR SUITE 220, WILKESBORO NC 28697 C:3368444088 Land Owner SHERRY HOUSTON KEN WORTHY, 5290 36TH ST DR NE, HICKORY NC 28601 receipt 08/16/2016 09:47 Page I of I