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HomeMy WebLinkAboutEHPR-08-2016-24579 (2).TIF ��A VG THIS IS NOTA PERMIT Case # EHPR-08-2016-24579 1` '21 CATAWBA COUNTY HEALTH DEPARTMENT 6r. °••,. .W J...) ` 4 }t�"�' PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES '�• � fieri /842 s�� Environmental Health Plan Review - OSWP •° • •�° + . .0 IMPROVEMENT •i • r a• r Applicant BRIAN&JULIE MATTHEW, 6878 GRACIE LN, VALE NC 28168 C:8283088514 Contractor *NORMAN CONSTRUCTION LLC (TRAVIS NORMAN), 9376 JACOB FORK RIVER RD, CONNEI SPRINGS NC 28612 C:8283085667 Land Owner MICAHEL& MARSHA BUECHE, 3512 WELLMAN RD,VALE NC 28168 NAME TO APPEAR ON PERMIT Brian & Julie Matthew SITE ADDRESS: 3449 WELLMAN RD, VALE NC 28168 PIN # 266702982829 NAME of SUBDIVISION: Lot# Section/Block PROPERTY SIZE: Square Feet 887,752.80 Acres 20.38 DIRECTIONS: Hwy 10 West, Right onto Cooksville Rd, First Right onto Wellman Rd, house is 1/4th mile on the Left. PRIMARY CONTACT: Contractor SEWER TYPE: Septic Tank GALLONS PER DAY: 360 WATER SUPPLY: Private Well DESCRIBE WORK: IP for Purchase' 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? No Are there any easements or right-of-ways on this property? No APPLICATION FOR: New Structure STRUCTURE TYPE: — PRIMARY RESIDENCE FACILITY TYPE: House OTHER DESCRIPTION: DESCRIPTION OF Vacant Lot EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: NUMBER OF EXISTING BEDROOMS: #OF OCCUPANTS: 4 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: House w/attached garage 60x60 #OF NEW BEDROOMS:: 3 BASEMENT? Yes BASEMENT FIXTURES? Yes PLUMBING REQUIRED? Desired system types (Improvement Permit or Authorization to Construct): ACCEPTED: ALTERNATIVE: CONVENTIONAL: OTHER: INNOVATIVE: ANY: YES Other described: E9-eliappl'ic nine 08/24/2016 11:06 Page I of 4 CATAWBA COUNTY Case# EHPR-08-2016-24579 I Public Health Department Subdivision f 4 ®1 K! Environmental Health Division PIN# 266702982829 . PO Box 389, 100-A Southwest Blvd,Newton.NC 28658 /8.2 w NAME ON PERMIT: (BRIAN& JULIE MATTHEW), 6878 GRACIE LN, VALE NC 28168 ( Brian & Julie Matthew) Site Address: 3449 WELLMAN RD, VALE NC 28168 Property Size: Square Feet 887,752.80 Acres 20.38 Directions: Hwy 10 West, Right onto Cooksville Rd, First Right onto Wellman Rd, house is 1/4th mile on the 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 and labeling of all property lines and corners and making the site accessi le so that complete site evaluation can be performed. Date: q —(c 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 -Trim f a riiil pi- li fir!!!•- 4 a A X111 ' ti:�ji t'•,' si n ^ ;1±11 y�IFEENAMEt &� -IF 1i4 •!.,,..' DATE :i,i i FEElAMOUNT Improvement Permit Fee 08/24/2016 $150.00 1111111S150'OO,Ir� . •�xvl`�v t�.yBw �IliautiliJl4.h�1 J`".!`�' Rh1GIilIl1lIWiU1i 1,npyu r t H(u t�O1tl�llnYWJ�r 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-ehappl icauon 08/24/2016 11:06 Page 2 of4 CATAWBA THIS IS NOT A PERMIT coux�r� , •^�•>.. CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services Page 1 Improvement Perm Authorization to Construct E Septic Repair li Septic Malfunction Septic Expansion ❑ New Well Permit n Replacement Well ❑ Well Abandonment❑ Well Repair E Existing System Inspection (Pre-Approval Required) D • Application isfoor 'ew Construction" Existing Facility _ Property AddressQ( �)�`-1"J�y (j1 Ypc I I Subdivision Lot# Acres Section/Block/Phase Driving Directions to Property FI of 7' w t&-ejd- ----tLc✓vt I /Ni"di 1I- 6'J✓1 rh�C l(e � . - e e t-,rs.-1- 1 `J Ad- Lr �cl ti e 774-ta NAME TO APPEAR ON PERMIT? ❑ Owner pplicant LJ Contractor Applicant Contact Information ���/� /ad*� Name r ., 3LA i ��l{i ( e 4.3 Address ) (2v Ln �/ Phone ?.‘,2_� 3 S S I Cell Phone Owner Contact ve Information // /' Name /C//10 o- cc- mp/./S'//t.a 6/.e_P—C' "i Address Phone Cell Phone Contractor Contact Informationat� Name ' r ✓ c....,,,,,‘.> r^/,/✓vtc� Address `+37( ortmo4 Fc-,(---(- Vtt c /CA c ^vie,( c ✓/�k- pi- 4 1 2 WL Phone Cell Phone I sic WHO WILL BE TIIE PRIMARY CONTAC ? ❑ Owner ❑ Applicant S Contractor Description of Existing Structures on Site 1 #of Bedrooms *'j' Structur Ihmensrons -CO' x 6 0 #of Occupants Basement -a-Yes No Basement Fixtures e'1'es i o 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 CI< Does the site contain any jurisdictional wetlands? rl Yes �®'No Does the site contain any existing wastewater systems? E ID Yes No Is any wastewater going to be generated on the site other than domestic sewage? ® Yes En< Is the site subject to approval by any other public agency? El Yes afSlo Are there any easements or right of ways on this property? Describe Existing water supply in use F-72-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) �❑ Accepted ❑ Alternative ❑ Conventional ❑ Innovative El Other Any CATAWBA THIS IS NOT A PERMIT cou 'ry an.,� CATAWBA COUNTY HEALTH DEPARTMENT ,, a Application for Environmental Services Page 2 Proposed Facility Type ❑ Primary Residence ❑ New Residence ❑ Addition to esidence .# of N� w Bedrooms *j Project Description S ( C (� vvc 14.1 i ` L GC"'q ..C2- Structure QStructure Dimens'ons (moo >( S o # of Occupants �f Basement es ❑ No Basement Fixtures ® Yes a No L 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 *1- 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 ❑ Other Facility Type Specify If Church# of Seats Kitchen ❑ Yes n No If Daycare Specify Occupancy • Application for Well Construction/Abandonment/Repair Proposed Well Type -- Individual Well ❑ Semi-Public Well ❑ Community Well Abandonment Type ❑ Drilled ❑ Bored ❑ Dug 5 Unknown Well Repair Requested ❑ Yes -T 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 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. �ignature of Owner or Agent _ ... ,t DateSt' —7( Pr VI rinted Name of Owner or Agent Catawba County Environmental Health • (298 • • • • • • • ch 0 �� 0 e • o vi A ID ..-43. \' . . '' ear 5) 78) • / Parcel: 266702982829, WELLMAN RD VALE, 1 in=100ft 28168 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 08/24/2016 Catawba County Environmental Health ilic ill 3g 11J 1� ` .r11gD .1.-C-9-d i..4 'Of 4 11.105. 105 ~`. � Cl y -flilibtki., AIN li ..,. . ')/(,#). 4%1IL . 1110 ,,,. . t. ititigt, v, 23 .... . ott...(, ,,,,,,,„... �s (3 „At yti v • m^ 1117 i lk%. yr k . --,__/ ,37 Parcel: 266702982829, WELLMAN RD VALE, lin=300ft 28168 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 08/24/2016 Parcel Report Page 1 of 1 Parcel Report - Catawba County NC Parcel Information: Owner Information: Parcel ID: 266702982829 Owner: BUECHE MICHAEL G Parcel Address: WELLMAN RD Owner2: BUECHE MARSHA K City: VALE, 28168 Address: 3512 WELLMAN RD LRK(REID): 10991 Address2: Deed Book/Page: 3275/0036 City: VALE Subdivision: State/Zip: NC 28168-7575 Lots/Block: / Last Sale: $88,500 on 2015-01-28 School Information: School District: COUNTY Plat Book/Page: Elementary School: BANOAK Legal: Middle School: JACOBS FORK Calculated Acreage: 20.380 High School: FRED T FOARD Tax Map: 011 B 02016 Township: BANDYS State Road #: 1107 Tax/Value Information: Tax Rates(pdf) Zoning Information: City Tax District: All in County Zoning District: COUNTY County Fire District: COOKSVILLE Zoningl: R-40 Building(s) Value: $0 Zoning2: Land Value: $83,800 Zoning3: Assessed Total Value: $83,800 Zoning Overlay: WP-O Year Built/Remodeled: / Small Area: PLATEAU Current Tax Bill Split Zoning Districts: / Zoning Agency Phone Numbers Miscellaneous: Firm Panel Date: 2007-09-05 Building Permits for this parcel. Firm Panel #: 3710266600J Building Details 2010 Census Block: 1006 WaterShed: WS-III Protected Area 2010 Census Tract: 011802 Voter Precinct: P2 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. II ©2016, Catawba County Government, North Carolina. AM rights reserved. \9k) Addn '. 3,-/Liq Vvelfn'i Yid. hap://gis.catawbacountync.gov/nomap/parcel_report.php?key=266702982829&typ=P 8/24/2016 �y'A Co CATAWBA COUNTY ,fie rt IOOA SOUTHWEST BLVD NEWTON,NORTH CAROLINA 28658 RECEIPT mm;p ats PHONE: 828.465.8399 U 'G vaso. �C Wednesday, August 24, 2016 1$4'1 sM www.catawbacountync.gov PAYOR: *Norman Construction LLC *Norman Construction LLC(Norman, Travis) PAYMENTS TRANSACTION NUMBER: TRC-798076-24-08-2016 PAYMENT DATE : 08/24/2016 PAYMENT TYPE: Check 2480 INVOICE NUMBER FEE NAME FEE AMOUNT 08-16-331960 Improvement Permit Fee $150.00 TOTAL PAYMENTS : S150.00 EHPR-08-2016-24579 CASE TYPE: Environmental Health Plan Review WORK CLASS: OSWP SITE ADDRESS: 3449 WELLMAN RD, VALE NC 28168 Applicant BRIAN& JULIE MATTHEW, 6878 GRACIE LN, VALE NC 28168 C:8283088514 Land Owner MICAHEL& MARSHA BUECHE, 3512 WELLMAN RD, VALE NC 28168 Contractor *NORMAN CONSTRUCTION LLC, 9376 JACOB FORK RIVER RD, CONNELLYS SPRINGS 1` C:8283085667 ** NO PEOPLESOFT ACCOUNT ASSIGNED ** receipt 08/242016 11:06 Page 1 of 1