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HomeMy WebLinkAboutRBPR-08-2016-24607.TIF vJ$A G THIS IS NOT A PERMIT Case # RBPR-08-2016-24607 riz-v fin CATAWBA COUNTY HEALTH DEPARTMENT E PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES �' ti r. 1842 sM Residential Building Plan Review - Building New n Is s ti RUTH CONST - NEW WELL o ' o} Contractor SAME AS OWNER, , Owner JONATHAN RHONEY, 1988 SIGMAN ST, HICKORY NC 28602 C:8283030482 NAME TO APPEAR ON PERMIT Jonathan Rhoney SITE ADDRESS: 4173 LEFEVERS RD, VALE NC 28168 PIN # 267704716646 NAME of SUBDIVISION: Lot# 1 Section/Block PROPERTY SIZE: Square Feet Acres 3.51 DIRECTIONS: Hwy 10 West , turn left beside Banoak School 1st RD on the right approx 1 mile propertyis on the right PRIMARY CONTACT: Owner - SEWER TYPE: Septic Tank GALLONS PER DAY: 360 WATER SUPPLY: Private Well DESCRIBE WORK: 1 story 3 bedroom single family dwelling with unfinished basement with open attached carport 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? Yes Are there any easements or right-of-ways on this property? No APPLICATION FOR: New Structure STRUCTURE TYPE: PRIMARY RESIDENCE FACILITY TYPE: Single Family Residence 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:: 75x50 #OF NEW BEDROOMS:: 3 BASEMENT? Yes BASEMENT FIXTURES? No PLUMBING REQUIRED?Yes Desired system types (Improvement Permit or Authorization to Construct): ACCEPTED: ALTERNATIVE: CONVENTIONAL: OTHER: INNOVATIVE: ANY: YES Other described: APPLICATION FOR WELL CONSTRUCTION PROPOSED WELL TYPE: Individual Well REPLACE WELL?: NO E9-chapplication 08/26/2016 14:35 Page 1 of 4 oA CATAWBA COUNTY Case a RBPR-08-2016-24607 tt 2 Public Health Department Subdivision Environmental Health Division "rt PIN#W. '7 267704716646 -0yl. PO Box 389. 100-A Southwest Blvd,Newton.NC 28658 18.2 SP NAME ON PERMIT: (JONATHAN RHONEY), 1988 SIGMAN ST, HICKORY NC 28602 ( Jonathan Rhoney) Site Address: 4173 LEFEVERS RD, VALE NC 28168 Property Size: Square Feet Acres 3.51 Directions: Hwy 10 West , turn left beside Banoak School 1st RD on the right approx 1 mile propertyis on the right 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/Authorizedbunty and state officials are granted right of entry to conduct necessary inspections to determine compliance with applicable laws and ruleunde7tand/that I am solely responsible for the proper identification and labeling of 1 property lines and corners and making the site access'. = so that a co fete site evaluation can be performed. Date: 8j- 2,L.— / j Signature of Applicant or Agent / - An Environmental Health Specialist will contact you with- 5 working .ays o .p. [cation date. If you need further information or assistance please call 828-466-7291 AREA2 FEENAMEDATE FEE AMOUNT Authorization to Construct Fee (New/Expansion) 08/26/2016 $150.00 Fee Well Permit& Inspection Fee 08/26/2016 $300.00 ' TOTALTOTAL:FEE r $450.00 ' l 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 08/26/2016 1435 Page 2 of 4 CATAWBA THIS IS NOT A PERMIT ��n 6� �1� a�6U1 COUNTY ,- --..., CATAWBA COUNTY HEALTH DEPARTMENT N,„tia ,o„ - Application for Environmental Services Page I Improvement Permit❑ Authorization to Construe Septic Repair H Septic Malfunction ❑ Septic Expansion ❑ New Well Permit''Replacement Well ❑ Well Abandonment❑ Well Repair n Existing System Inspection (Pre-Approval Required) ❑ Application is for New Construction Existing Facility [ Property Address 41/ 73 Le eVPr6. ,I Subdivision v4/e- NC cR.�/6Z Lot# Acres t/,OO Section/Block/Phase Driving Directions to Property If w y /6 i,✓e5 F , / 4i L talc P 6 p S, 'de- By.,ea /S Schon/ /sr ifd ® K1 I-he- r, s6Iyfi,Toy /, ,`/,, Pro perry , s 0 v NAME TO APPEAR ON PERMIT? 1� Owner ❑ Applicant ❑ Contractor Applicant Contact Information TTF”' Name Address Phone Cell Phone Owner Contact Information Name Coati y,ha,•i /3 he, e v Address y, q LGT> e✓ets /'<d ✓q M- x/67 Phone g oa g-- 303 O H 9' U Cell Phone Contractor Contact Information Name Address Phone Cell Phone WHO WILL BE THE PRIMARY CONTACT? Owner n Applicant [ Contractor Description of Existing Structures on Site \/C,X_cf' ( ai— #of Bedrooms *j' Structure Dimensions #of Occupants Basement ❑ Yes ❑ No Basement Fixtures CI 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 i nestion. If the answer to any question is "yes", applicant must attach supporting documentation. ® Yes 'o Does the site contain any jurisdictional wetlands? CI Yes IS9'N Does the site contain any existing wastewater systems? 0 Yes f o Is any wastewater going to be generated on the site other than domestic sewage? 'Yes II'�1� o Is the site subject to approval by any other public agency? 0 Yes �o Are there any/easements 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) 0 Accepted ❑ Alternative ❑ Conventional 0 Innovative ❑ Other any C A T`Aw A THIS IS NOT A PERMIT COODUN•TTYYC1VV 1J• CATAWBA COUNTY HEALTH DEPARTMENT ` Application for Environmental Services Page 2 Proposed Facility Type ,�, /' ❑ Primary Residence Ly6w Residence ❑ Addition to,Residence # of New Bedrooms *j 3 Project Description MPG/6'C- Structure Dimensions 75 X 50 # of Occupants y Basement Yes ❑ No Basement Fixtures ® Yes 'No ❑ Accessory Structure(s) Describe # of New Bedrooms *t if applicable Structure Dimensions # of Occupants Accessory Dwelling ❑ Yes Li No Plumbing _ Yes ❑ No Describe Plumbing Needed D Multi-Family Residence# Units #Bedrooms per Unit*j' Total #Bedrooms *1. Structure Dimensions I-1 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 I[1 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 ❑ Unknown Well Repair Requested ❑ Yes ❑ 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. Signature of Owner or Agent /.+ T' f - Date. cr G2 e--- /6 Printed Name of Owner or Agent/dot VmngV."44i1 87 4mci Catawba County Environmental Health /7/ .... A COs is. / A. 7060 --\\ os / P A / Q. LS.) 7 O ill \ a 0 0 ?5 0 as / / J ice '�'\ '\ O `-- tip v4.ele's� /V "--- bo \ \ N \ ( 7-": Parcel: 267704716646, 4173 LEFEVERS RD , 1 in=80ft v \\W —0 be in bock of fritvw.. ihslied or-port 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 08/26/2016 Parcel Report Page 1 of 1 Parcel Report - Catawba County NC Parcel Information: Owner Information: Parcel ID: 267704716646 Owner: RHONEY JONATHAN DEAN Parcel Address: 4173 LEFEVERS RD Owner2: City: Address: 1988 SIGMAN ST LRK(REID): 101243 Address2: Deed Book/Page: 3332/0780 City: HICKORY Subdivision: State/Zip: NC 28602-8116 Lots/Block: 1/ Last Sale: School Information: School District; Plat Book/Page: 75/44 Legal: LOT 1 PL 75-44 Elementary School: Middle School: Calculated Acreage: 3.510 Tax Map: High School: Township: BANDYS School Map State Road #: 2046 TaxNalue 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: $22,500 Zoning3: Assessed Total Value: $22,500 Zoning Overlay: Year Built/Remodeled: / Small Area: 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: WaterShed: 2010 Census Tract: Voter Precinct: 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. nc cc v\di I # Ls-0 t \ 60now . amsc 31cOn 3CcQ bbl I. http://gis.cataw acountync.gov/nomap/parcel_report.php?key=267704716646&typ=P 8/26/2016 CATA\VBA COUNTY ■ t" r'' oCase a MPV-08 015-063755 C'^ s Public Health Deportment tJ`. J} /. p' 4s:-r, Subdivision '{ 'l �I Enc'conmcnutl licalth Division 7+ , - i1: PINI 267704721742 \�®",4 PO Box 389. 100-A Southwest Blvd.Newton..NC 28658 10• i ' LOT,/ 4 +- r o NAME ON PERMIT: DANNY SHULL, 4199 LEFEVERS RD, VALE NC 28168 I Site Address: 4173 LEFEVERS RD, VALE NC 28163 h,. __; Property Size: Square Feet: 174,240.00 Acres:4.00 Directions: Hwy 10 West, Turn left beside Banoak School, 1st road on the right apporixmately 1 mile, property is on the right. Improvement Permit Facility: Primary Residence - house Permit Category: New Septic Bedrooms 3 WATER SUPPLY: Private Well Basement'? Yes Basement Plumbing? Yes INITIAL SYSTEM SPECIFICATIONS ... ._... .-..- - Permit Valid: Expires In Five Years: _X_ No Expiration: Projected Daily Flow 360 g.p.d Proposed Wastewater System: 25% REDUCTION Type: 1110 - OTHER NON-CONN TRENCH SYSTEMS Permit Conditions: REPAIR SYSTEM SPECIFICATIONS Repair System Required? Required Proposed Wastewater System: 25% REDUCTION Type: IIIG -OTHER NON-CONN TRENCH SYSTEMS Landscaping or ether site alterations that potentially divert groundwater or surface water toward the septic system, or prevent proper drainage away from the septic system, including the direction of gutter flows or foundation drains, is not approved, and may result in failure to acorove the initial system installation,or the suspension/revocation of existing permits. The issuance of this permit by the Health Deportment does not guarantee the issuance of other permits. It is the responsibility of the apphcan'Jpropeity owner to insure that oil Catawlm County Planning/Zoning and t3uilding Inspections requirements are met. This Improvement Permit is subject to revocation if the site plan,plat or the intended use changes,or if site conditions are altered. The Improvement Permit is not affected by a change in ownership of the property. This permit was issued in compliance with the provisions of the Forth Carolina 'Lars gad Rules for Sewage Treatment and Disposal Systems' (ISA NCAC IRA .1900). Neither Catawba County nor the Environmental Health Specialist warrants that the septic lank system will continue to function satisfactorily for any given period of time. Megan McBride 08/13/2015 AUTHORIZED SlEATE AGENT APPROVAL DATE Permit Expiration Date: 08/12/2020 'Jo grading or construction actirrpy is allowed in areas designated for system and repair without approval of the Health Department. ehpennit OR:1312015 10:04 Page 1 u1'3 IP ENPk-073015-a-)aitp X1173 Le{egers Rd, dale, 4 Lik kine 5 S4wwv\ are profo9ecl. Lo\ mvs4 be recorded fira. -ID--(1A4 1SSURA(e be AC ferr"4• Y\ dr;ve, roYaci,e, Cut of -f Y oV?r jf�-hc pyeCA.- 5 o ,.50 .59 SP rlre"Aral ass, Red b»w , 41-5c !,o Postel ^� 44 3B0.}F0+r 151 >' �el� Are° 1 apo' Lecevers Rd• loo' • DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES Shed of_ DNISIDN OF ENVIRONMENTAL HEALTH PROPERTY ID ti: .08-SLTE WASIEWATERSECIION COUNTY: • SOIL/SITE EVALUATION ((�� for ON-SITE WASTEWATER Stip! OWNER: pawlSh�l1 APPLICATION DATE T Eli FR,b7 x(115 ��d}� ADDRESS: DATE EVALUATED 6-7-15 PROPOSEDFACIIITY: 3 L PROPOSED DESIGN FLOW(.1949): . PROPERTY SIZE: 11.00_0(,N5E 4173 LOCATION OF SITE Lf i en Rd,YOJate, PROPERTY RECORDED: 'WATER SUPPLY: I Private Q Public ® Well Q Slung Q Other , EVALUATTONMEIHOD: D Auger Boring N Pit U Girt . TYPE OF WASTEWATER: N Sewage D Induzma1Pmxu D herd ' _" .c: c::..n.,.u.Ev_ ........._......_ .............. ....._._._......:o:-::-..._...__......_... '-.__.-.., ..._........_...__._._....... ..._,_..._._._-"7f.I:L__..::::: _':F.:[C iL..:i._SE:iL::_. ' :::: u.:::Gii`r.:-E:�ficEE4:'.-ri3i,�__iiiF_..._ if_EJEEFtfSl;_1___ _lo..:_::; %$ii _-:__._ iF_- . . .._.::: :: ._:::r. :ce:::::_:. ,.:.,rs mne:a _.. ;_ . _._:::.::::::c:::.-.:::c::.::_ ra.r. -- --_.........._... -..:. :: a941 ::-= _:........ 1`:: . FTi t Flt fl / kk .��IJ. . +� I�fi': �ve-Eiih_.��i�i_ i vji�i ._, :_�11ii.- l l 9it .. _ 711:-=.::! SCAYE O*I' .iL41 1411 SOIL A 1956 19G -i'. _ SLI70.1Tt DEPTH. > I UR l POty.- Tri.CP3 l'9£TnESSF SOTI: Swh&(t BFiRa P S : • 1'-':F'S407:S'% .- € {A) j ttaI•L'!{& -j. :N.<ESCAX.t1CY L 491c OEP7;$ A$$ kiURLT :,szrAB- 0-to SL.yv ,SS,SPKe L Io-36 Ute, SbK -�v.ss, Sexp - • PS 1 5 5p — . 36 • 0.3 . 0- 7 (:1;; 51*- .... .,.,. i._ -6.sc sip )T-36 CU SAP wsbkk£k- -6',Ss,Tz/ PS 2 3G — 3.3 0-0 CI-,sby— ;lictIf , 'SD-k0 CLiSMP, .i, 4t 4-155.%, _ CS 3 lip 0.3 I _ 4 l I _ I DESCRPTtoa D.TIIAL SYSTEM REPAIR SYSTEM OTHER FACTORS(.1946) Aav7nble Spate(.1945) PS pS SFIE CLASSIFICATION(.194S):( ��y O syx=Typto) `.g 114 EVALUATERES I: UUPA-I rill — • Sit LIAR 0,3 0.3 U COMMENTS: 0 t1 f I � LLcg s RA . (Nri Sc&le)•