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HomeMy WebLinkAboutRBPR-09-2016-24645.TIF THIS IS NOT A PERMIT Case # RBPR-09-2016-24645 dCATAWBA COUNTY HEALTH DEPARTMENT �`w ,%s0 � PLAN REVIEW APPLICATION FOR ENVIRONMENTAL, SERVICES � {:�� ti•r 3i /842 SM Residential Building Plan Review - Building New IMPROVEMENT - AUTH CONST - NEW WELL -l'iF•' ' f: Contact Person MIKE PALMER HOMES (JESSE BROWN Ill), 7856 MOUNTAIN SHORE DR, SHERRILLS FORD 28673-9244 C:8283122972 Contractor *MIKE PALMER HOMES, INC. (MICHAEL PALMER),6211 DENVER INDUSTRIAL PARK RD, DENVER NC 28037 B:7042576422 C:7045 I 69227F:7049730002 MIKEPALMER@MIKEPALMERHOMES.COM Owner MAISTRO INVESTMENTS LLC, 137 CROSS CENTER STE 328, DENVER NC 28037 NAME TO APPEAR ON PERMIT *MIKE PALMER HOMES, INC. (MICHAEL PALMER) SITE ADDRESS: 4504 CAYTON DR, MAIDEN NC 28650 PIN # 367804511509 NAME of SUBDIVISION: WYNSWEPT PH 1 Lot# 25 Section/Block PROPERTY SIZE: Square Feet Acres 1.19 DIRECTIONS: Hwy 10 South,to Hwy 16 South, approx 5 miles to Wynswept on left Oust past buffalo shoals rd) PRIMARY CONTACT: Contractor SEWER TYPE: Septic Tank GALLONS PER DAY: 360 WATER SUPPLY: Private Well DESCRIBE WORK: New two-story, single family dwelling, 3 bedroom, attached garage with finished 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:: 58x50 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-ehapplieation 09/01/2016 14:04 Page I of4 CoA CATAWBA COUNTY Case# RBPR-09-2016-24645 1...;-111%, Public Health Department Subdivision WYNSWEPT PH 1 C , -K/ Environmental Health Division PIN# 367804511509 �b PO Box 389. 100-A Southwest Blvd,Newton.NC 28658 Jg.2 sM NAME ON PERMIT: *MIKE PALMER HOMES, INC. ( MICHAEL PALMER), 6211 DENVER INDUSTRIAL PARK RD, DENVER 28037 *MIKE PALMER HOMES, INC. ( MICHAEL PALMER) Site Address: 4504 CAYTON DR, MAIDEN NC 28650 Property Size: Square Feet Acres 1.19 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 rule ' I understand that I am solely responsible for the proper identification and lagelin of all property lines and corners and making the site accessible so t e plete site evaluation can be performed. Date: q /�/f2 Signature of Applicant or Agent �� •r/ _ An Environmental Health Specialist will contact you within 5 wdrking days of application date. If you need further information or assistance please call 828-466-7291 AREA1 *********************************************************************************************************** ..qrb e ®_.4- ... _. FEENAME k' _ ' . DATE rt FEEAMOUNT .1 Authorization to Construct Fee (New/Expansion) 09/01/2016 $150.00 Fee Improvement Permit Fee 09/01/2016 $150.00 Well Permit& Inspection Fee 09/01/2016 $300.00 TOTAL,FEES b :. 4 5600001 's 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) h9-chapplication 09/01/2016 14:04 Page 2 of 4 CATAWBA THIS IS NOTA PERMIT COUNTY CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services Page I Improvement Permit Authorization to Construct i Septic Repair❑ Septic Malfunction ❑ Septic Expansion ❑ New Well Permit1Replacement Well ❑ Well Abandonment❑ Well Repair ❑ Existing System Inspection (Pre-Approval Required) ❑ Application is for New Construction $ Existing Facility ❑ 40" Property Address ` I fay-ten C-i- Subdivision LJrt5i /cp� fn a, n/C 1bcct) Lot# ,25r Acres /. /9 Section/Block/Phase /PLR.,Z Driving Directions to Property //dM panel (.n-t: —to it._ /-fwr /® Se„{A LIT l(. C 1 a / .'f u try f ♦ [ /..Ai f jabs, if lea NAME TO APPEAR ON PERMIT? ❑ Owner ❑ Applicant 'Contractor Applicant Contact Information Name r —6extnt5 `7 X550 I +GWr' Address (0211 kn-itr S eh,sT�,c.1 &tic 14.E Nt✓tvcf Nt- 29o31 Phone .764- (p(p2 - Lfc`jca Cell Phone gra .3 29 "12- Owner Contact Information rr Name MLt,Ice ?/a.�Mzr homes • Address �,7 `)/f (%JQ { Je;i k 14.1 J & f anvzr A)C_ 0 Pio S7 Phone 70t{_ (Leg caz-o-D Cell Phone Contractor Contact Inffopormation � // Name /#,, /a/n't1 r f/trn9Ls , Address t z„ .averZ,d, Irish 1 /'ark- rein .t..- A/c Z9o37 Phone .7 Uy . cf01 _$2-00 Cell Phone Ca241 '31 L-2512— WHO WILL BE THE PRIMARY CONTACT? ❑ Owner %Applicant ❑ Contractor Description of Existing Structures on Site /V A #of Bedrooms *t A/A- Structure Dimensions At 4- #of Occupants iV A- Basement ❑ Yes ❑ No Basement Fixtures ® Yes ® No The Applicant shall notify the local health department upon submittal of this application if any of the following apply to the propertyinquestion. If the answer to any question is"yes", applicant must attach supporting documentation. a Yes NJ No Does the site contain any jurisdictional wetlands? 0 Yes i�f Does the site contain any existing wastewater systems? ❑Yes Is any wastewater going to be generated on the site other than domestic sewage? XYes tlo Is the site subject to approval by any other public agency? ' 0 Yes �No Are there any easements or right of ways on this property? Describe Existing water supply in use ❑ Individual Well Li Community Well ❑ Semi-Public Well ❑ County/City/Township Water Line Is a public water supply available? ** ❑ Yes 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) ,� ( 1:1 Accepted 0 Alternative 0 Conventional 0 Innovative 0 Other L5I�y h[rr 1 >, 0 Any CATAWBA 7DA THIS IS NOT A PERMIT COUNTY CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services Page 2 Proposed Facility Type 'l Primary Residence ❑ New Residence ❑ Addition to Residence # of New Bedrooms *t 3 Project Description 5, {. &ti.lf ki,nc Structure Dimensions Sc 4-' , # of Occupants 3 Basement ❑ Yes No Basement Fixtures ® Yes 0,No U 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) # Employees per Shift #of Shifts Dining Area(Sq. Ft.) U Business Specific Type of Business Retail Floor Space # of Employees per Shift # of Shifts ❑ Other Facility Type Specify If Church#of Seats Kitchen 0 Yes ❑ No If Daycare Specify Occupancy Application for Well Cons uction/Abandonment/Repair Proposed Well Type Individual Well q Semi-Public Well ❑ Community Well Abandonment Type 0 Drilled ❑ Bored ❑ Dug 0 Unknown Well Repair Requested ❑ Yes 0 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 comers and making the site accessible so that a complete site evaluation can be performed. Signature of Owner or Agent Date u Printed Name of Owner or Agen JESSE —3(06-) f\ Catasowba County Environmental Health i \\,..\\N---- 96®^_ w 9;y�_ 950 201,56 7....\IS S"' '''',.., ' Lit"1 IL,", ,e.,:ipir , .41111111111111111111.- \/ `` "N to 9. (11 )\k IP J 139.13 V 120.20 \\.\8.79 w 12.14 0 • elks (ON DR 11, 1 \Nor.. 2 208.48 930 i Parcel: 367804511509, 4504 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: 367804511509 Owner: MAISTRO INVESTMENTS LLC Parcel Address: 4504 CAYTON DR Owner2: City: MAIDEN, 28650 Address: 137 CROSS CENTER STE 328 LRK(REID): 201375 Address2: Deed Book/Page: 3309/0674 City: DENVER Subdivision: WYNSWEPT PH 1 State/Zip: NC 28037-5009 Lots/Block: 25/ Last Sale: School Information: School District: COUNTY Plat Book/Page: 68/196 Legal: LOT 25 PLAT 68-196 Elementary School: BALLS CREEK Middle School: MILL CREEK Calculated Acreage: 1.190 High School: BANDYS Tax Map: Township: CALDWELL School Map State Road #: TaxNalue 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: $21,300 Zoning3: Assessed Total Value: $21,300 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 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. All rights reserved. c_cOV 37ciern 33 Yk I °(c http://gis.catawbacountync.gov/nomap/parcel_report.php?key=367804511509&typ=P 9/1/2016 16 �r�" � IMPROVEMENT PERMIT N , is dor Office Use Ony y,:ire 9 \ CDP FIIelumber� a 4 5` 1 a 9 \ Catawba County Public Health Department +�'* F r WL - � WL�200801059 + t. Environmental Health Division "County ID Number .,#o«,�, valuated For NEWS- J P.0 Bax 389, 100-A Southwest Blvd rs Newton NC 28658 PERMIT VALID UNTIL . 02/11/2014 Phone: (828)-465-8270 Fax: (828}465-8276 ❑ Open Fill Sheet w‘ *NOTE TO INSPECTIONS DIVISION: Building Permits cannot be issued with this Improvement Permit. �� . itcropertyowner: y T Bhp Applicant: DANNY EDWARDS �c c h} �P✓ �Omer�l • t Address: 885 N HIGHWAY 16 Address: 388 N HWY 16 City: DENVER ' , City: DENVER • ( 1 State/Zip: NC 28037-600 State/Zip: NC 28037 W hone#: ' Phone*: —2. S . Property Location 8 Site Information Address/Road#: Subdivision: WYNSWEPT Phase: Lot: 25 / 4504 PEMBROKE PINE ST Directions • Struc ure: SINGLE FAMILY HWY 16 SON LEFT JUST BEFORE RANT DRUM RD #of Bedrooms: .`J #of People: `"I� • . • \ 'LNater Supply: NEW WELL _ • \\/ System Specifications \ initial System Site-Classification: PS LPP Minimum Trench Depth: . Inches . Design Flow: 4 8 0 Maximum Trench Depth: 1 a Inches Soil Application Rate: 0 3 5 Septic Tank: - 1 5 0 0 . Gallons 1-Piece: • - . QYes. QNo `System Classification/Description: . TYPE IV A.ANY SYSTEM WITH LPP DISTRIBUTION Pump Required: • cvYes 0 No 0May Be Required Pump Tank: 1 5 0 0 Gallons \ 'Proposed System: OTHER • \ 1-Piece: • QQNo Repair System Required:93Yes 0N ONo, but has Available Space / Repair System 'Site Classification: PS Drip Minimum Trench Depth: Inches • Soil Application Rate: 0 3 5 . Maximum Trench Depth: 6 Inches Pump Required: jYes ONo 0 May be Required . 'System Classification/Description: . TYPE IV A.ANY SYSTEM WITH LPP DISTRIBUTION Pump Tank: 1 5 0 0 Gallons - •Proposed System; OTHER / � ' • Pagel of3 • • • • • • 24512 WLS200B-01059 CDP File Number County ID Number: . *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 minimum:50'from any creek,pond,or individual well•IS from home'10'from property lines'Lines to he installed on contour' Do not grade,drive,or fill over system or repair area'System must be designed by engineer due to soil conditions • 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 Ian scale that shows the existing and proposed property lines with dimensions,the location of the facility and appurtenances,the • site for the proposed Wastewater system,and the location of water bupplies and surface waters). • Plat The Improvement Penn it shall be valid without expiration with plat(means a property surveyed prepared by a registered land • surveyor,drawn to a scale of one inch equals no more than 60 feet,that Includes:the specific location of the proposed facility Q ' and appurtenances,the site for the proposed Wastewater system,and the location of water supplies and surface waters. Plat • also means,for subdiJision 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 ate plan that is drawn to scale). ' • ' The Department and Local Health Department may impose donditions on the issuance and may revoke the permits for failure of - the system to satisfy the conditions,the rules,or this article.This permit Is subject to revocation If the site plan,plat,or Intended use changes(NCGS 130A336(Q).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(b)). Applicant/Legal Reps.Signature Required? Yes ONo • • • Applicant/Legal Reps.Signature:/44"1"7,11C1— .--/•,---- •Date: oz / / z / 200 9 • • 'Issued By: 1810-Boyd,Jason Date of Issue: 0 �a / 1 1 / a 0 0 9 • • Authorized State Agent: 671 OValid without Expiration? • ( Hand Drawing Olmport Drawing • **Site Plan/Drawing attached.** Total' me:(HH.M s) • Page 2 of 3 • • • • 24512 W LS2008-a 1059 CDP File Number: County File Number: Drawing Type: Improvement Permit Date: 0 2 / 1 1 / 2 0 0 9 • 0 Inch Scale: 1 OBlock = 6 0 ft. • Drawing ONIA ' I I . 2e ( . S( . l . I• , • Nzl—t- .lsy: w:�rP I • k o I�r_� fir P 1 .c i rt,n.! S400 rte '.- - i • ..i m I j — i PANG • I 1 1 • 1 i i , i i i , i i • 1 • ' 1 i • 1 -_ I -" • -- -_- -.....__..1 , I , """"" Page 3 of 3 • • • •• • NCDENR ' ' • Division,ofEnvironmental Health On-Site Wastewater Section Date: e a / 1 / a © e 9 Soil/Site Evaluation. `File #: • 2 4 5 1 2 • For OnaSite Wastewater S• ystem PIN #: o 8 6 1 o s 9 • 'Owner DANNY EDWARDS HECHT DEVELOPMENT CO Proposed Facility SINGLE FAMILY Proposed Design•Flow(.1949) 6 0 0 Location of Site 4504 PEMBROKE PINE ST NEW WELL • Pit Property Size 0.8 Water Supply Evaluation Method 1940 Horizon SOIL MORPHOLOGY . Profile# Landscape Depth .1941 Other Profile Slope % (IN) Texture Structure Consistence Color Color Factors 1 0-32 scl sbk fr ss sp 1942 Wet • 10 % .1943 Depth 3 a 1944 Rest. GPS - Horizon Saprolite. .1947 Class PS LPP Profile 0 LTAR 3 5 • 2 0-24 scl sbk fr ss sp .1942 Wet. • .1943 Depth • 2 4 10 ' 1944 Rest. Horizon GPS Saprolite: • .1947 Class PS LPP i . Profile 03 5 LTAR ' 0-21 sicl sbk fr ss sp 1942 Wet. 3 . 10 .1943 Depth a 1 1• 944 Rest. Horizon GPS • Saprolite. - .1947 Class PS Drip Pa Profile LTAR © • 3 5 • ' 1942 Wet_ • 1943 Depth • .1944 Rest Horizon ' GPS Saprolite: 1947 Class Profile LTAR; • 1942 Wet .1943 Depth .1944 Rest. Horizon —.— GPS Saprolite .1947 Class CA • Profile LTAR • Available Space (H 945) Other Factors(.1946) • Site Classification: Ps Initial LTAR: o . 3 5 Repair LTAR: o . 3 5 Others Present: - Comments: Megan McBride present at evalulation, limited soil depth to chrome 2 conditions,system and repair must be kept up hill to right side of lot Evaluated By: Boyd.Jason • NCDENR • • • Division of Environmental Health On-Site Wastewater Section Date: e 2 / i it / 2 0 0 9 Soil/Site Evaluation File#: a 4 5 1 2 • For On-Site Wastewater System • PIN #: o e otos 9 1940 Horizon SOIL MORPHOLOGY Prof le# LanPdsscSape Depth .1941 Other Profile Slope TO (IN) Mineralogy • • Matrix Mottle Factors Texture Structure Consistence Color Color . .1942 Wet. 1943 Depth °/n 1944 Rest Horizon GPS • Saprolite. 1947 Class Profile LTAR • • . . .1942 Wet. 1943 Depth • . I1944Rest. Horizon • GPS Saprolite' l .1947 Class ref` Profile LTAR _ • . ' 1942 Wet. .1943 Depth 1944 Rest. Horizon GPS . Saprolite: • A947 Class . Profile LTAR • 1942 Wet .. .1943 Depth %• . .�- • 1Horizonst. • •GPS Saprolite. p1941II7 Class LTARe ' .1942 Wet. ' • .1943 Depth • .1944 Rest Horizon . GPS Saprolite: .1947 Class ti=s'- - LTAR Comments: