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HomeMy WebLinkAboutRBPR-09-2016-24663.TIF va4 A • THIS IS NOT A PERMIT Case # RBPR-09-2016-24663 d. + CATAWBA COUNTY HEALTH DEPARTMENT , � PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES 1 01 + te:u 18. 2 sM Residential Building Plan Review - Building New < tggT tt IMPROVEMENT - AUTH CONST - NEW WELL ' T . = . '` o _ ; Applicant GINGER SMITH, 291 GRAPEVINE TRAIL, STATE RAOD NC 28676 C:3364693101 Owner HAROLD INGRAM. 1134 WANDERING LN, HICKORY NC 28601 NAME TO APPEAR ON PERMIT Ginger Smith SITE ADDRESS: 6208 VANDRESSER PT, HICKORY NC 28601 PIN # 373512857470 NAME of SUBDIVISION: VAN DRESSER AND HOYLE PROP UNR Lot# 7A Section/Block PROPERTY SIZE: Square Feet Acres 0.4 DIRECTIONS: HWY 16 TO SPRINGS RD TURN RIGHT ON WANDERING LANE RIGHT ON SULPHUR SPRINGS RIGHT ON LYNCHBURG LEFT ON VANDRESSER APPROXIMATELY 1/10 MILES ON RIGHT ACROSS COVE FROM CAMPGROUND BEACH , PRIMARY CONTACT: Applicant SEWER TYPE: Septic Tank GALLONS PER DAY: 240 WATER SUPPLY: Private Well DESCRIBE WORK: BUILDING SINGLE FAMILY DWELLING 2 BEDROOMS 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: PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 26X40 #OF NEW BEDROOMS:: 2 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: REPLACE WELL?: NO E9-ehapplicaion 09/02/2016 14:59 Page 1 o15 08- CATAWBA COUNTYcaSC RBPR-09-2016-24663 tit's Public Health Department VAN DRESSER AND HOYLE Subdivision ¢,lai44Environmental Health Division 373512857470 � PO Box 389, 100-A Southwest Blvd,Newton.NC 28658 PIN# Ig NAME ON PERMIT: (GINGER SMITH),291 GRAPEVINE TRAIL. STATE RAOD NC 28676 ( Ginger Smith) Site Address: 6208 VANDRESSER PT, HICKORY NC 28601 Property Size: Square Feet Acres 0.4 Directions: HWY 16 TO SPRINGS RD TURN RIGHT ON WANDERING LANE RIGHT ON SULPHUR SPRINGS RIGHT ON LYNCHBURG LEFT ON VANDRESSER APPROXIMATELY 1/10 MILES ON RIGHT ACROSS COVE FROM CAMPGROUND BEACH 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 accelsiqe so that a co plate site ev Ituation can be performed. Date: i-Z—/C, Signature of Applicant or Agent An Environmental Health Specialist will contact you within 5 workifig days of application date. If you need further information or assistance please call 828-466-7291 • AREA2 SETBACKS: 50' LAKE BUFFER FEENAME DATE `; ') FEE AMOUNT Authorization to Construct Fee (New/Expansion) 09/02/2016 $150.00 Fee Well Permit& Inspection Fee 09/02/2016 $300.00 TOTAL FEES 5450 00 'i 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-chapplication 09/02/2016 14:59 Page 2 of 5 CATAWBA THIS IS NOT A PERMIT coeur CATAWBA COUNTY HEALTH DEPARTMENT tion��„,oii� Application for Environmental Services Page 1 Improvement Permit❑ Authorization to onstruct Septic Repair E Septic Malfunction ❑ Septic Expansion ❑ New Well Permit Replacement Well ❑ Well Abandonment❑ Well Repair ❑ Existing System nspection (Pre-Approval Required) ❑ Application\ is for New Construction Existing Facility ❑ Property Address (p` �, DS yan]resser 1D+ - Subdivision {�iCk 0f 1) me ' Lot# Acres o 40 Section/Bloch/Phase 4 Driving Directions to Property NW 1 '-f-o Se(i IQ , "+1,t.rt C( -Iv-1- bh Vlavic{erI�'rs Lane, �; r- z SwI?hur Se Ccvc\s, Rpt+ on Lv�nckbus GI LBF+ onandresser. A prox ylo �n�le., f on r� ,-+ - Ac 1 b-)5 Co\fe -Yr-15m earn-Pybw rct. scratch_ NAME TO APPEAR ON PERMIT?Owner ❑ Applicant ❑ Contractor Applicant Contact Information Name Address Phone Cell Phone Owner Contact Information Name 0ngqer, (Liik _ 1 * Addressa011' G,reA/i ry 1 hct i I Sf i*t t” )OaCi, IQ c op'(,f7(0 Phone 33 . (,q_al0 Cell Phone 3, ,_q 3/u' Contractor Contact Information Name Address Phone Cell Phone WHO WILL BE THE PRIMARY CONTACT? Owner ❑ Applicant ❑ Contractor Description of Existing Structures on Site \\L /y�I1` VlI Lc jic # of Bedrooms *T Structure lJimensions l t # of Occupants Basement ❑ Yes ❑ No Basement Fixtures a 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. C Yes C1 o Does the site contain any jurisdictional wetlands? C Yes ®'No Does the site contain any existing wastewater systems? ID Yes E'No Is any wastewater going to be generated on the site other than domestic sewage? Yes Is the site subject to approval by any other public agency? 0 Yes I Are there any easements or right of ways on this property? Describe Existing water supply in use [ idividual Well I I Community Well ❑ Semi-Public Well ❑ County/City/Township Water Line Is a public water supply available? ** ❑ Yes [I 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 0 Alternative 0 Conventional 0 Innovative 0 Other )4 Any cATA�j �A THIS IS NOT A PERMIT `��TTY VV 17 CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services Page 2 Proposed Facility Type ❑ Primary Residence ig New Residence ❑ Addition to Residence #of New Bedrooms *t Project Description Net,0 Nome Structure Dimensions 0IoYJ ai # of Occupants Basement ❑ Yes g No Basement Fixtures ® Yes >1 No ❑ Accessory Structure(s) Describe #of New Bedrooms *j' if applicable Structure Dimensions # of Occupants Accessory Dwelling ❑ Yes ❑ No Plumbing [ Yes ❑ No Describe Plumbing Needed ❑ Multi-Family Residence# Units #Bedrooms per Unit*j Total # Bedrooms *j 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 ❑ 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 n 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 sk-A Date q- —16 Printed Name of Owner or Agent 0q.P Y SYVI t(4-11I Catawba County Environmental Health • 'r�th.�y�I`v r'I i t t (,p+, xk I t"rl j .� r1'wpp"xrow,,. ""„1 t5, 41lI�Ili�,,. I,g 41lil�i'v'3� '(i�'"u ty q��Nt, ilWin dip�,„IAE ,th ,p.,';. „ l) -;' u un �! L uAt i 1,4i, �n h.P F �ir+q�gr nA�'.,yPill! �It I S E 11 r t if `'r7� , li + } i % 1,411+41‘ ti illi'a'Illll ( I firl F 1 bi `t';� tk , T11 t h ,11 1 lif+ c I ��� 01,f Y a .4m lu r ti41= :,,+2.a �... f 1�, i.R i +�, ra p f tx P 1 • , I ( 1) 11yI x la Vit; ' 1�1 t f'� v �y.” I�. 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It 1� I('1 sy I. j�l ' ..02 + 'r 1ll y 1 r. py • . . � l � < a r r � hruNfi4955 Ailla li 11 skill i'.3 s li 'i ,tk..'•i Si s,, ,,,cis,• im (340) 410l t 7 1' 'N Gi ;64m Cif, III 60 147.28 !3201 .0 :fi 147.28 -Niiik9 1i ,1 I r \s b ''l P 8 II • 0 N 'N 1.4 Parcel: 373512857470, 6208 VANDRESSER PT lin=60ft HICKORY, 28601 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. 09/02/2016 Copyright 2014 Catawba County NC Parcel Report Page 1 of 1 Parcel Report - Catawba County NC Parcel Information: Owner Information: Parcel ID: 373512857470 Owner: INGRAM HAROLD Q LFI Parcel Address: 6208 VANDRESSER PT Owner2: INGRAM DIXIE H LFI City: HICKORY, 28601 Address: 1134 WANDERING LN LRK(REID): 40315 Address2: Deed Book/Page: 3064/0522 City: HICKORY Subdivision: VAN DRESSER AND HOYLE State/Zip: NC 28601-8794 PROP UNR Lots/Block: 7A/ School Information: School District: COUNTY Last Sale: Plat Book/Page: Elementary School: SNOW CREEK Middle School: ARNDT Legal: LOT 7A 7A VAN DRESSER + HOY Calculated Acreage: .400 High School: ST STEPHENS Tax Map: 0807 01008 School Map Township: CLINES State Road #: 1693 TaxNalue Information: Tax Rates(pdf) Zoning Information: City Tax District: All in County Zoning District: COUNTY County Fire District: ST STEPHENS Zoningl: R-40 Building(s) Value: $700 Zoning2: Land Value: $92,400 Zoning3: Assessed Total Value: $93,100 Zoning Overlay: CRC-O,FPM-O Year Built/Remodeled: / Small Area: ST STEPHENS/OXFORD Current Tax Bill Split Zoning Districts: / Zoning Agency Phone Numbers Miscellaneous: Firm Panel Date: 2007-12-18 Building Permits for this parcel. Firm Panel #: 3710373500K Building Details 2010 Census Block: 1026 WaterShed: 2010 Census Tract: 010201 Voter Precinct: P33 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 Carotin II rights reserved. ! , It' ( Lit 2 )2' 2c-/O &Jw� http://gis.catawbacountync.gov/nornap/parcelreport.php?key3 73512857470&typ=P 9/2/2016 gtsr n\ CATAWBA COUNTY mr#Ir .};Ei Case IMPV-08-2016-076178 4iPublic Health Department Subdivision VAN DRESSER AND HOYL �.1. 4' , .Environmemal Health Division t -S �r 4 PINf( 373512657470 'N:4./ PO lox 389, I DO-A Southwest 131sd, Newton, NC 78658 - �`C •--�-_ 0 r LOTH 7A !yamy4t ; 1. r'. 840 10 . r . NAME ON PERMIT: GINGER SMITH, 291 GRAPEVINE TRAIL, STATE RAOD NC 28676 Site Address: 6208 VANDRESSER PT, HICKORY NC 28601 Property Size: Square Feet: 17,424.00 Acres:0.4 Directions: Hwy 16, Right onto St Peters Ch Rd & go to the end, Right onto Wandering Ln, Right onto Sulphur Springs Rd, Right onto Lynchburg, Left onto Van Dresser approx. 2/10ths of mile on Right. (across the beach from the campground) , Improvement Permit Facility, Primary Residence Permit Category: New Septic Bedrooms 2 WATER SUPPLY: Private Well Basement? No Basement Plumbing? No INITIAL SYSTEM SPECIFICATIONS Permit Valid: Expires In Five Years: _X No Expiration: Projected Daily Flow 240 g.p,d Proposed Wastewater System: 50% REDUCTION Type: IIIB -SYSTEM W/SINGLE LH:'LUENT PUMP PUMP REQUIRED Permit Conditions: REPAIR SYSTEM SPECIFICATIONS Repair System Required? Required Proposed Wastewater System: 50% REDUCTION Type: IVA-ANY SYSTEM WITH LPP DISTRIBUTION PUMP REQUIRED landscaping or other 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 approve the initial system installation. or the suspension/revocation of existino permits. The issuance of this permit by the Health Department dues riot guarantee the issuance of other permits. It is the responsibility of the applicant/property owner to insure that all Catawba County Planting//.oxine and Building 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 North Carolina 'Laws and Rn/er far Snva2e Treatment and Disno vnl Systems' (15A NCAC ISA .1900). Neither Catawba County nor the Environmental ti ealth Specialist wu r rants that the septic tank system will continue to function satisfactorily for any given period of time. Steven Price 08/26/2016 AUTHORIZED sTATE AGENT APPROVAI.DATE 06/26/2021 Permit Expiration Date: No grading or construction activity is allowed in areas designated for s,ystenr and repair without approval of the Health Department, chp:moil 03/262016 11:32 • EHPR 07-2016-24366 6208 Vandresser Pt, Hickory • Do not cut, drive, fill,or grade over septic or repair areas. • This is an improvement permit only and is not intended for septic installation purposes. • Septic area should be protected from surface water from neighboring lot to prevent soil erosion. 101 0,3110444"` 59 A-52 tom' ul 10 L/p • .5-0'4 {td �p r � Ems— —�—' y 3' 3No' �' pi" DEPARTMENT OF HEALTH AND HUMAN SERVICES :Off re- 07- 2016— zy 3 66 Sheet I of I __ DNISION 01,PUBLIC FIEALTI•I,ENVIRONMENTAL.I IIEALTH SECTION PROPERTY ID n: ON-SITE WATER PROTECTION BRANCH COUNTY: Catawba SOIL/SITE EVALUATION for ON-SITE WASTEWATER SYSTEM / (Complete all fields in full) OWNER: ff'rs(c( /cj.-.. -% _ APPLICATION DATE ADDRESS: DATE EVALUATED: Wu/4. PROPOSED FACILITY: PROPOSED DESIGN FLOW(.1949): PROPERTY SIZE: •Y LOCATION OF SITE: 6 soy ✓ted.-cssc' ff PROPERTY RECORDED: WATER SUPPLY: 0 Private G Public g Well 0 Spring U Other EVALUATION METHOD: lI Au er Boring $j Pit 0 Cut TYPE OF WASTEWATER: 1'Q Sewage U Industrial Process ❑Mixed P R SOIL MORPHOLOGY OTHER 0 r (.1941) PROFILE FACTORS t .1940 L • LANDSCAPE HORIZON' _ . POSITION) DEPTH 1942 PROFILE p SLOPE% (IN.) .1941 .1941 SOIL .1943 .1956 .1944 CLASS STRUCTURE/ CONSISTENCE/ WETNESS/ SOIL SAPRO RESTR &LTAR TEXTURE MINERALOGY COLOR DEPTH CLASS 110RIL o—y iss6rc- so- A Se- Ps LSY -yg ssx. c i ic l Na- 'f8 da p-lo G+� SL P1 -CC 1,-s p- z.y 54k. C T--,c se ,✓A- I4S u,✓ AM- p� 2 hG z9- 9.5- "S6t « 4, 0.3 4S- Y8 Pc/,,, 0- 1 GL Sc fe. Ser. its 2- 37• s>61_ c FF s� "[A- Li ig Am- a es 3In,� 37-'U "s6t cc r-4JC b� Linke, • 0 -7 C-I sc- Ft. se' Ps 1-5 '7 -35- Sbk c (-R- ft( MA- '4) MA- w4 4 106 35--HE "Selo et.. r--ft- Ser 0.3 I Is./ s OPSCRIPtJON INI'IiAL SYSTEM REPAIR SYSTEM m OTHER FACTORS(.1946): Available Space(.1945) PC A C SITE CLASSIFICATION(.1948):(^- System fS 4 Ill 115 J 0n},, EVALUATED BY: S'+-`-- `^— System'fype(s) 4�.><.� SoL �b tee � �cf OTIIER(S)PRESEN"I': Site L'I'AR D.) O s 3 COMMENTS: Lore. a7-tor b- 2y3G4 Catawba County Environmental Health p,. Lam, Il atS,/ r i C r } r TM Li. M it-It� TW t#A S"ir 4:* F+rOte .K.• y� r} Y • §mitt i" Ar ro b .fr J * J'p't' yFSr Vat- A ca Let of t 56.3•` Jnn ` ' b� } h� �.kI 5 4' 1 tgilsw 'gam g'ct,^t ,- F➢ r eicy,,„ii h ',:", -pith r cel»'�y "�-s4 k' r'd'4 L�, \�t ys : '1-'s ' �� �.Y p. } elf ikht.8 �s�^x��:r1 w^.:S�ai ',k L•t T>, ti �+ • Y+2 - • • .-44741Y 4 t 4� `K Nu 'afore ey.t '''S.L; th l 4140>t lee • ....414444%.174",' r Jg "�L" li -may%' 42.: 1 Olt J tt ,'t - ...t.69f �� . g` . .,, Sa�` 3 ti ' ‘241 tM .f 955ill 4 i a Py( Q ;` 't CO • 64 ci tt ciDs, 14:::0214-/ aintlisigagis m ti . 1415:1 - 111 \--..11.31‘-flt):::::::: q 80 147,28 (320) 147.Ehit I I' * . 'Irk: r ii(1.1 41 1O J N 1.4 Parcel: 373512857470, 6208 VANDRESSER PT 1 in=60ft HICKORY, 28601 This map/repon product was prepared from the Catawba County NC Geospatial Information Services. Catawba County has made substantial aeons to ensure the accuracy of location and labeling information contained on this map or data on d Is report.Catawba County promotes arid recommends the independent verification of any data=tarried on this map/report product by the user.The County of Catawba,its employees,agents,and