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HomeMy WebLinkAboutRBPR-09-2016-24644.TIF vS4 A �G THIS IS NOT A PERMIT Case # RBPR-09-2016-24644 d CATAWBA COUNTY HEALTH DEPARTMENT 0 ' YDt'` • �❑m / !� ^C PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES • 4�Cr 842 s,, Residential Building Plan Review - Building New � °� 'r.. •'• • .I irtvici IMPROVEMENT- AUTH CONST- NEW WELL lti;•., '•%• Contact Person MIKE PALMER HOMES (JESSE BROWN III), 7856 MOUNTAIN SHORE DR, SHERRILLS FORD I 28673-9244 C:8283122972 • Contractor *MIKE PALMER HOMES, INC. (MICHAEL PALMER), 6211 DENVER INDUSTRIAL PARK RD, DENVER NC 28037 B:7042576422 C:7045I69227F:7049730002 MIKEPALMER@MIKEPALMERHOMES.COM Owner *MIKE PALMER HOMES, INC. (MICHAEL PALMER), 6211 DENVER INDUSTRIAL PARK RD, DENVER NC 28037 13:7042576422 C:7045169227F:7049730002 MIKEPALMER@MIKEPALMERHOMES.COM NAME TO APPEAR ON PERMIT *MIKE PALMER HOMES, INC. (MICHAEL PALMER) SITE ADDRESS: 4580 CAYTON DR, MAIDEN NC 28650 PIN # 367804519450 NAME of SUBDIVISION: WYNSWEPT PHI Lot# 30 Section/Block PROPERTY SIZE: Square Feet Acres 0.79 DIRECTIONS: Hwy 10 South, to Hwy 16 South, approx 5 miles to Wynswept on left (just past buffalo shoals rd PRIMARY CONTACT: Contractor SEWER TYPE: Septic Tank GALLONS PER DAY: 360 WATER SUPPLY: Private Well DESCRIBE WORK: New single family dwelling, 3 bedroom, attached garage with no bonus, no basements 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 EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: NUMBER OF EXISTING BEDROOMS: - #OF OCCUPANTS: 3 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 41x75 Single family with garage #OF NEW BEDROOMS:: 3 BASEMENT? No 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-chappl ication 09/01/2016 13:53 Page 1 of 4 ,v,A CATAWBA COUNTY Case# RBPR-09,-2016-24644 E .)., 2 Public Health Department Subdivision WYNSWEPT PH 1 ._.^y , 4 Environmental Health Division PIN# 367804519450 PO Box 389, 100-A Southwest Blvd.Newton.NC 28658 842 s. / . NAME ON PERMIT: *MIKE PALMER HOMES, INC. (MICHAEL PALMER), 6211 DENVER INDUSTRIAL PARK RD, DENVER 28037 *MIKE PALMER HOMES, INC. ( MICHAEL PALMER) Site Address: 4580 CAYTON DR, MAIDEN NC 28650 Property Size: Square Feel Acres 0.79 Directions: Hwy 10 South, to Hwy 16 South, approx 5 miles to Wynswept on left (just past buffalo shoals rd 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 la¢eling of all property lines and corners and making the site accessibl a complete site evaluation can be performed. Date: 7////F- Signature of Applicant or Agent —..z2 —77-- An An Environmental Health Specialist will contact you within 5 N r ing days of application date. If you need further information or assistance please call 828-466-7291 AREA1 *****.**.************************************..,.,*****,******************.*.....*...**********************. ,.._ FEENAME 4.. - ..P j 2 DATE FEE.AMOUNT, Authorization to Construct Fee (New/Expansion) 09/01/2016 SI50.00 Fee Improvement Permit Fee 09/01/2016 $150.00 Well Permit & Inspection Fee 09/01/2016 $300.00 -3,-. TOTAL FEES 5600 00 k FEES ARE NON-REFUNDABLE ONCE A SITE VISIT IS MADE OR WORK ON A PLAN REVIEW HAS COMMENCED SYSTEM REDESIGN AND/OR RETRIP WILL INCUR AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) II • £9-ehappllcation 09/01/2016 13:53 Page 2 of 4 CATAW'BA THIS IS NOT A PERMIT COUNTYU1L�Y1! CATAWBA COUNTY HEALTH DEPARTMENT ®�„1 Application for Environmental Services Page 1 Improvement Permit VAuthorization to Cons uct Septic Repair❑ Septic Malfunction ❑ Septic Expansion ❑ New Well Permit K✓ Replacement Well 0 Well Abandonment 0 Well Repair 0 Existing System Inspection (Pre-Approval Required) 0 Application is for New Construction Existing Facility 0 Property Address /KIM CetySri C?- Subdivision In!yr, skit/2i- filar wt/2/ /1 rc�en NC 75((rsO Lot# 36 Acres ,7? Section/Block/Phase Driving Directions to Property 1,,,t ficr,t„f- e,„rt. tt. y l6 r 44 /L , i--�y J4 s °tenni 5 ,.,,res /t herst„r?/ on La (af g 5k.15 .t ) NAME TO APPEAR ON PERMIT? 0 Owner 0 Applicant EXContractor Applicant Contact Informatioon Name Je.AA1 &vinef JzSSe, pw•n Address /j2, !I �nvc✓ hcl✓sa.� / (arlC ,CJ L%i✓cr /1/l 7_941 Phone - is G Z - i{`13$ Cell Phone rt ? Owner Contact InformatioA / Name TO, UG (rt1C✓ /-4 me /J Address l7 it �Lnrar �r/rSi�,a 1 PAre- g1 Dcn✓tr A"- 22o37 Phone '7 jt/., cj fa1 .-' oo Cell Phone Contractor Contact Information Name p4 f44'lL$ Pita � Address (,2 I I +` Nti r Tv.id v c/r,i) Yi(L f,hr at N t. 29037 Phone `-]Ott " `-t' `7 -g2-00 Cell Phone WHO WILL BE THE PRIMARY CONTACT? ❑ Owner Applicant ❑ Contractor Description of Existing Structures on Site /✓Ar # of Bedrooms Structure Dimensions A- #of Occupants A)4 Basement ❑ Yes ❑ No Basement Fixtures CI Yes ® No The Applicant shall notify the local health department upon submittal of this application if any of the following apply to the property question. If the answer to any question is "yes", applicant must attach supporting documentation. O Yes �o Does the site contain any jurisdictional wetlands? ® Yes B--°d//No Does the site contain any existing wastewater systems? O Yes Pd No Is any wastewater going to be generated on the site other than domestic sewage? Yes Vigo Is the site subject to approval by any other public agency? IO Yes No Are there any easements or right of ways on this property? Describe Existing water supply in use U Individual Well U Community Well U Semi-Public Well 0 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 0 Conventional 0 Innovative Other L(Z &eLc w ' 0 Any CATAWBA A THIS IS NOT A PERMIT COUNTY VV 17L"� CATAWBA COUNTY HEALTH DEPARTMENT , Application for Environmental Services Page 2 Proposed Facility Type Primary Residence New Residencp Addig°n to Residence # of New Bedrooms *t 3 Project Description 5,1c bt... /10irtQ- Structure Dimensions 'y-! )t Tr # of Occupants Basement ❑ Yes 6ZI No Basement Fixtures ® Yes at-No U Accessory Structure(s) Describe # of New Bedrooms *t if applicable Structure Dimensions #of Occupants Accessory Dwelling D Yes 9 No Plumbing 9 Yes 9 No Describe Plumbing Needed U Multi-Family Residence# Units #Bedrooms per Unit*t Total# Bedrooms *t Structure Dimensions U 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 9 Other Facility Type Specify If Church# of Seats Kitchen ❑ Yes 9 No If Daycare Specify Occupancy Application for Well Construction/Abandonment/Repair Proposed Well Type Er Individual Well 9 Semi-Public Well 9 Community Well Abandonment Type 9 Drilled 9 Bored ❑ Dug ❑ Unknown Well Repair Requested 9 Yes 9 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 Ii? -� Date �}�//6 L- (� Printed Name of Owner or Agent ,)€,Sc. rY -wrN Catawba County Environmental Health • • • 644.4417 .404 • icy I 165.04 r, 7� rn its • 1 . 9a (14 • 280 `. /65.00 • 9 165.00 CA no.,OR Parcel: 367804519450, 4580 CAYTON DR 1 in=50ft MAIDEN, 28650 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 09/01/2016 Parcel Report Page 1 of 1 Parcel Report - Catawba County NC Parcel Information: Owner Information: Parcel ID: 367804519450 Owner: MIKE PALMER HOMES INC Parcel Address: 4580 CAYTON DR Owner2: City: MAIDEN, 28650 Address: 6211 DENVER INDUSTRIAL PARK RD LRK(REID): 201380 Address2: Deed Book/Page: 3349/0001 City: DENVER Subdivision: WYNSWEPT PH 1 State/Zip: NC 28037-7809 Lots/Block: 30/ School Information: Last Sale: Plat Book/Page: 68/196 School District: COUNTY Legal: LOT 30 PLAT 68-196 Elementary School: BALLS CREEK Middle School: MILL CREEK Calculated Acreage: .790 Tax Map: High School: BANDYS Township: CALDWELL School Map State Road #: TaxlValue Information: Tax Rates(pdf) Zoning Information: City Tax District: All in County Zoning District: COUNTY County Fire District: BANDYS Zoningl: R-40 Building(s) Value: $0 Zoning2: Land Value: $18,600 Zoning3: Assessed Total Value: $18,600 Zoning Overlay: WP-O Year Built/Remodeled: / 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: 2026 WaterShed: WS-IV Protected Area 2010 Census Tract: 011501 Voter Precinct: P1 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 at 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. ( SJI..nJ'� 1 ' a �F+L `3a 411 Cpl I dub.- http://gis.catawbacountync.gov/nomap/parcel_report.php?key=367804519450&typ=P 9/1/2016 e 1 ..> s IMPROVEMENT PERMIT g} ,, ForOfficeUseOnh1 -, 1 , CDP m File Nuber • :a 4 5 ].fir] \0 Catawba County Public Health Department w _ 't County IDNumber yicszooe 01064 �- bpp Environmental Health Division . , - *....r,::., �. � � Evaluated For NEW ` ar. P.O Box 389, 100-A Southwest Blvd \ ,.. -{ . J '� Newton NC 28658 PERMIT VALID UNTIL. Phone:(828)-465-8270 Fax: (828)465-8276 02/02/2014 /� � ❑ Open Fill Sheet Pi).— (Set' 'NOTE TO INSPECTIONS DIVISION: Building Permits cannot be issued with this Improvement Permit. Property Owner,! Applicant: DANNY EDWARDS P. f-�ech+ DeveIprf n+° Address- 885 N HIGHWAY 16 ;`Jr__,_� Address 388 N HWY 16 City: -DENVER City. DENVER State/Zip NC 28037-600 State/Zip NC 28037 hone #. J Phone#: k.)_ Property Location & Site Information \ w Address/Road#. Subdivision WYNSWEPT Phase Lot: 30 1 CI ' 4580 PEMBROKE PINE ST Directions Structure SINGLE FAMILY • HWY 16 SON LEFT JUST BEFORE RANT DRUM RD $of Bedrooms: 5 #of People. 'Water Supply. NEW WELL / System Specifications • Initial System Site Classification. Minimum Trench Depth 2 4 Inches Design Flow- 0 6 0 0 Maximum Trench Depth 3 0 Inches Soil Application Rate Septic Tank: 0 1 5 0 0 0 3 5 Gallons 1-Piece °Yes QNo 'System CSfication/Description Pump Required QYes 0 N °May Be Required iii B. TYPE III B.SYSTEM WISINGLE EFFLUENT PUMP Pump Tank: 0 1 5 0 0 Gallons 1 Proposed System 25%REDUCTION \\ 1-Piece ()Yes 0 N Repair System Required OYes 0 N QNo, but has Available Space • Repair System - 'Site Classification Minimum Trench Depth• Inches Soil Application Rate 0 3 5 Maximum Trench Depth 3 0 Inches 'System Classification/DescriptionPump Required Yes 0 N °May be Required TYPE IV A.ANY SYSTEM WITH LPP DISTRIBUTION Pump Tank: 0 1 5 0 0 Gallons 'Proposed System 50%REDUCTION Page I of 3 L • • • CDP File Number 24517 County ID Number wLszaos-atosa *Site Modifications No grading or construction activity is allowed in areas designated for system and repair without approval of Health Department. • *Permit Conditions The issuance of this permit by the Health Department in no way guarantees the issuance of other permits.The permit holder is responsible for checking with appropriate governing bodies in meeting their requirements Keep all parts of septic and repair minimum:50'from any creek,pond,or individual wet,10'from property lines,15'from home'Lines to be installed on contour'Do not grade,drive,or fill over system or repair area • The Improvement Permit shall be valid for 5 years from date of issue with a site plan(means a drawing not necessarily drawn to Site Plan scale that shows the existing and proposed property lines with dimensions,the location of the facility and appurtenances,the ® site for the.proposed Wastewatersystem,and the location of water supplies and surface waters). Plat The Improvement Permit shall be valid without expiration with plat(means a property surveyed prepared by a registered land 0 surveyor,drawn to a scale of one inch equals no more.than 60 feet,that Includes:the specific location of the proposed facility and appurtenances,the site for the proposed Wastewater system,and the location of water supplies and surface waters. Plat also means,for subdivision lots approved by the local planning authority and recorded with the county register of deeds,a copy of the recorded subdivisions plat that is accompanied bya site plan that is drawn to scale). The Department and Local Health Department may impose conditions on the issuance and may revoke the permits for failure of the system to satisfy the conditions,the rules,orthis article.This permit is subject to revocation if the site plan,plat,or Intended use changes(NCGS 130A335(f)).The person owning or controlling the system shall be responsible for assuring compliance with the laws,rules,and permit conditions regarding system location,Installation,operation,maintenance,monitoring, reporting,and repair(.1938@)). Applicant/Legal Reps Signature Required? OYes ONO Applicant/Legal Reps Signature._ _ d J, Date az I /z / ,2107 'Issued By' 1610-Boyd,Jason Date of Issue 0 d / 0 a / .2 0 0 g Authorized State Agent: V 6.-(4OValid without Expiration? 'Hand Drawing 0 Import Drawing **Site Plan/Drawing attached.** TotalTime:(HH:MM) • • Page 2 of 3 CDP File Number: 24517 County File Number WLS2006-01064 Drawing Type Improvement Permit Date 0 a I 0 a / 2 0 0 9 ®Inch Scale 0 0 1Oglock = 0 6 0 ft Drawing ON/A I I I I 16 S. o %-(' e 1 A.-e_-'--syn.-4 ; !_-,, 1 i. 5131. to ..4 ;, ( e i i u- N' SBe 1I11 - .. 5DI . 1 M . �r.. �6S ` O D PF 6KDkr_ PZNC _ - �- ... _ ;- __ ..... i -i-- ._. 1 I Page 3 of J i I • i NCDENR ' Division of Environmental Health Date. e 0 v On-Site Wastewater Section Soil/Site Evaluation 'File # e 0 e 0 For On-Site Wastewater System PIN It: e 8 0 1 6 4 `Owner DANNY EDWARDS HECHT DEVELOPMENT CO Proposed Facility SINGLE FAMILY Proposed Design Flow( 19491 0 0 6 0 0 Location of Site 4580 PEMBROKE PINE ST Property Size 0.79 Water Supply NEW WELL Evaluation Method Pt 1940 Horizon SOIL MORPHOLOGY Profile# LandsscSape Depth 1941 Other Profile (IN) Mineralogy Matrix Mottle Factors Slope % Texture Structure Consistence Color Color 0 0 1 L 0-40 sci sbk tr ss sp 1942 Wet ' 40-48 sc sbk fr ss sp 1943 Depth 4 8 6 1944Rest. Horizon GPS Saprolite 1947 Class Ps Profile LTAR u 3 5 0 0 ,] L 0-48" scl sbk fr ss sp 1942 Wet. 1943 Depth 4 8 6 % 1944Rest Horizon GPS • Saprolite 1947 Class Ps SI Profile 0 3 5 LTAR 0-48" sc sbk it ss sp 0 0 3 L 1942 Wet 1943 Depth 4 8 6 n/ 1944 Rest Horizon GPS Saprolite 1947 Class Ps Profile LTAR 0 3 5 1942 Wet 1943 Depth o/n 1944 Rest Horizon GPSSaprolrte 1947 Class i Profile LTAR • 1942 Wet. • 1943 Depth 1944 Rest Horizon GPS Saprolite 1947 Class �4 ; Profile LTAR Available Space ( 1945) Ps Other Factors(.1946) Site Classification. Ps Initial LTAR 0 3 5 Repair LTAR 0 3 5 Others Present. Comments Evaluated By: Boyd.Jason NGDENR ' Division of Environmental Health On-Site Wastewater Section Date 0 a / e a / a e o 9 Soil/Site Evaluation File # For On-Site Wastewater System PIN * m 8 0 1 6 4 1940 Horizon SOIL MORPHOLOGY Profile# Landscape Depth .1941 Other Profile POS Slope % (IN) Mineralogy Matrix Mottle Factors Texture Structure Consistence Color Color 1942 Wet 1943 Depth 1944Horizon Res[. GPS Saprolite 1947 Class Profile LTAR 1942 Wet. 1943 Depth 1944 Rest Horizon GPS Sepiolite 1947 Class Profile LTAR 1942 Wet- 1943 Depth 0 1944 Rest Horizon GPS Sepiolite 1947 Class Profile LTAR • 1942 Wet 1943 Depth 0/0 1944orton Horizon GPS Saprolite 1947 Class 1942 Wet 1943 Depth 1944 Rest. Horizon GPS Saprolite 1947 Class LTAR Comments'