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Home My WebLink AboutEHPR-02-2016-23293.TIF $%�� THIS IS NOT A PERMIT Case # EHPR-02-2016-23293•Q F ti CATAWBA COUNTY HEALTH DEPARTMENT C - ,ot 0 v\a" !�C PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES { r 1842 :M Environmental Health Plan Review - Septic Malfunction . Dn. o 7.AUTH CONST- SEPTIC MALFUNCTION Owner KEVIN STARNES, 1816 30TH ST NE, HICKORY NC 28601 C:8283817116 NAME TO APPEAR ON PERMIT Kevin Starnes SITE ADDRESS: 1816 30TH ST NE, HICKORY NC 28601 PIN # 372311551818 NAME of SUBDIVISION: Lot# Section/Block PROPERTY SIZE: Square Feet 12,632.40 Acres 0.29 DIRECTIONS: Springs Rd into Crestmont Development, 1st on Right on 30th St, 1st house on Left with tan siding & brick PRIMARY CONTACT: Owner SEWER TYPE: Septic Tank GALLONS PER DAY: 240 WATER SUPPLY: Public Water DESCRIBE WORK: Need Replacement Lines-Also owns lot beside of him 1820 30th St Ln. 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? Yes 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: Existing Structure STRUCTURE TYPE: PRIMARY RESIDENCE FACILITY TYPE: House OTHER DESCRIPTION: DESCRIPTION OF House, Bldg. EXISTING STRUCTURES ON SITE(IF ANY) DIM EXISTING STRUCTURE: House 65x4 , Bldg. 10x12 NUMBER OF EXISTING BEDROOMS: 2 #OF OCCUPANTS: 2 PROPOSED CONSTRUCTION BASEMENT? No BASEMENT FIXTURES? No PLUMBING REQUIRED? Desired system types (Improvement Permit or Authorization to Construct): ACCEPTED: ALTERNATIVE: CONVENTIONAL: OTHER: INNOVATIVE: ANY: YES Other described: 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. Date: 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 E9-chapplication 02/29/2016 14:00 Page 1 of 7 Syq • CATAWBA COUNTY Case# EHPR-02-2016-23293 .C' i".t ®v2, Public Health Department Subdivision 2 _ ,w 4111 Environmental Health Division PIN# 372311551818 " ®t PO Box 389, 100-A Southwest Blvd,Newton,NC 28658 18,2,3u NAME ON PERMIT: (KEVIN STARNES), 1816 30TH ST NE, HICKORY NC 28601 ( Kevin Starnes) Site Address: 1816 30TH ST NE, HICKORY NC 28601 Property Size: Square Feet 12,632.40 Acres 0.29 Directions: Springs Rd into Crestmont Development, 1st on Right on 30th St, 1st house on Left with tan siding & brick M ii r7, c ii , y Lz t lu€h t r 4 , tl" li /i i s i1V,T na1 kr liFEENAME4: . }o- sa g, t a 2-;;� V- cam-,a--v�v i..a x DATEms,r6 '�B�m FFE AMOUNT Authorization to Construct (Repair) Fee 02/29/2016 $300.00 railiFacloyetAtE ES iIct 'u p "6Nk" # '3 } 1� !t4! 7 l iv 7 5300 003 i¢uG:'u.1 krk t.r...a. ss ba.°kkw4a7:6.iilb!;...k.,. 0 r r,:...z.«.:b :k,: :.u.,. in-k":,--.S.n.tit++m.at`v"4a.+4ttt i tttit 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 02/29/2016 14:00 Page 2 of 7 SBA •� THIS IS NOT A PERMIT Case # EHPR-02-2016-23293 2 Q N d CATAWBA COUNTY HEALTH DEPARTMENT D o ; a El °r PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES his 7842 sM Environmental Health Plan Review - Septic Malfunction o, o ' o . AUTH—CONST- SEPTIC MALFUNCTION • d ox D . f _4.. : Owner KEVIN STARNES, 1816 30TH ST NE, HICKORY NC 28601 C:8283817116 NAME TO APPEAR ON PERMIT Kevin Starnes SITE ADDRESS: 1816 30TH ST NE, HICKORY NC 28601 PIN # 372311551818 NAME of SUBDIVISION: Lot H Section/Block PROPERTY SIZE: Square Feet 12,632.40 Acres 0.29 DIRECTIONS: Springs Rd into Crestmont Development, 1st on Right on 30th St, 1st house on Left with tan siding& brick PRIMARY CONTACT: Owner SEWER TYPE: Septic Tank GALLONS PER DAY: 240 WATER SUPPLY: Public Water DESCRIBE WORK: Need Replacement Lines 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? Yes 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: Existing Structure STRUCTURE TYPE: PRIMARY RESIDENCE FACILITY TYPE: House OTHER DESCRIPTION: DESCRIPTION OF House, Bldg. EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: House 65x40, Bldg. 12x24 NUMBER OF EXISTING BEDROOMS: 2 #OF OCCUPANTS: 2 PROPOSED CONSTRUCTION BASEMENT? No BASEMENT FIXTURES? No PLUMBING REQUIRED? Desired system types (Improvement Permit or Authorization to Construct): ACCEPTED: ALTERNATIVE: CONVENTIONAL: OTHER: INNOVATIVE: ANY: YES Other described: 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 t hat a complete site evaluation can be performed. Date: ??- I 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 E9-ehapplication 02/29/2016 10:16 Page 1 of7 CATAWBA COUNTY Case# EHPR-02-2016-23293 ,T t. ,if Public Health Department Subdivision 6v "' ,Environmental Health Division PINtt triti) 372311551818 -+1- PO Box 389, 100-A Southwest Blvd,Newton,NC 28658 18.2 NAME ON PERMIT: (KEVIN STARNES), 1816 30TH ST NE, HICKORY NC 28601 ( Kevin Starnes) Site Address: 1816 30TH ST NE, HICKORY NC 28601 Property Size: Square Feet 12,632.40 Acres 0.29 Directions: Springs Rd into Crestmont Development, 1st on Right on 30th St, 1st house on Left with tan siding & brick 2tr�i F{�E�"i!"stlb�r'"F;, �'e" I!a 3"d"`,"' ` i,+>a t t t.�i 4ri.r''s gi y r "t "iran ° m 4FEENAMF, vz n} t 1 i 1 t DATE ®r._ . FEE AMOUNT Authorization to Construct (Repair) Fee 02/29/2016 $300.00 i a iirr'-haa t'Z TOTAL FEES t #4 t't,i t a' -a5',e,la rftMI +,+, aK gb h er'g"'r'r i S300 00, 6rrb�e i � a... � atsi >��%R a"'� � srr `F` .3,„' 11.6163 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) E0-ehapplicaiion 02/29/2016 10.16 Page 2 017 CATAWBA THIS IS NOT A PERMIT CATAWBA COUNTY HEALTH DEPARTMENT + Application for Environmental Services Page 1 Improvement Permit n Authorization to Construct n Septic Repair❑ Septic Malfunction Septic Expansion ❑ New Well Permit H Replacement Well H Well Abandonment H Well Repair ❑ Existing System Inspection (Pre-Approval Required) H y Application is for New Construction H Existing Facility r Property Address ! ?(s, 3 p - M£ Subdivision kOiRt ,3L 48&01 Lot# Acres Section/Block/Phase /� 4- Driving Directions to Property%nr,nSS (2c1 i'n4' Crs'S-hmer; -Dev- 15-rer\ !PLY--7+ an .3n't\ �i � H-f ce Orx ie-9- - An C;chns c bQ cic NAME TO APPEAR ON PERMIT? Owner n Applicant n Contractor Applicant Contact Information Name Address Phone Cell Phone Owner Contact Information Name geo,n. .C.:1-01/4Cnes Address 1 4s$1 c 36i-" tt 1 )) j? gy Jd c aR10v Phone tlon e Cell Phone Qpp 3 !, '7l l 4 Contractor Contact Information Name License# Address Phone Cell Phone WHO WILL BE THE PRIMARY CONTACT? Owner ❑ Applicant ❑ Contractor 4 Description of Existing Structures on Site . ,flure - bu l di , # of Bedrooms *j 2 Structure Dimensions $lb , # of Occupants Z Basement ❑ Yes 'R No Basement Fixtures H Yes E No Vacs \7 f7(4 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. ❑ Yes ,No Does the site contain any jurisdictional wetlands? ,-Yes ❑ No Does the site contain any existing wastewater systems? ❑ Yes ea-1\o Is any wastewater going to be generated on the site other than domestic sewage? ❑ Yes ,0"No Is the site subject to approval by any other public agency? ❑ Yes .No Are there any easements or right of ways on this property? Describe Existing water supply in use n Individual Well n Community Well n Semi-Public Well pr County/City/Township Water Line Is a public water supply available? ** Fr Yes n 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 ❑ Other ,2"Any CATAWBA THIS IS NOT A PERMIT • . COUNTY CATAWBA COUNTY HEALTH DEPARTMENT „o„h Application for Environmental Services Page 2 Proposed Facility Type ❑ Primary Residence New Residence ❑ Addition to Residence #of New Bedrooms *t Project Description Structure Dimensions # of Occupants Basement ❑ Yes n No Basement Fixtures ❑ Yes n No ❑ Accessory Structure(s) Describe # of New Bedrooms *t if applicable Structure Dimensions #of Occupants Accessory Dwelling ❑ Yes ❑ No Plumbing n 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.) ❑ Business Specific Type of Business Retail Floor Space # of Employees per Shift # of Shifts ❑ Other Facility Type Specify If Church# of Seats Kitchen n Yes n No If Daycare Specify Occupancy Application for Well Construction/Abandonment/Repair Proposed Well Type ❑ Individual Well n Semi-Public Well n Community Well Abandonment Type n Drilled n Bored n 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. j 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. s( Signature of Owner or Agent )cam _ 5 '4 . Date a,dA -a Ol(p Printed Name of Owner or Agent )4 o; n S 'me 5 Catawba County Environmental Health \:7:3; ---s-%`'N . 0 .424 8 N i C4 t*".. 150 o p 01821 �AW:' Jw\ *1820- 150 0 bC'(rC, � --"tr—l__. ....i... _ _ d 150 —. $ . Wiloo *1 X50.28 — — — _ 150 1 *1815 30 «'ti � Sine pC� 8. f s,r, are -p1 - ' `� IvbC di}e 1.0.24 150 8 o 1806 co — — _ o 0o 01805 Parcel: 372311551818, 1816 30TH ST NE 1 in=50ft 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. Copyright 2014 Catawba County NC 02/29/2016 Parcel Report Page 1 of 1 Parcel Report - Catawba County NC Parcel Information: Owner Information: Parcel ID: 372311551818 Owner: STARNES KEVIN R Parcel Address: 1816 30TH ST NE Owner2: STARNES SHEILA R City: HICKORY, 28601 Address: 1816 30TH ST NE LRK(REID): 54382 Address2: Deed Book/Page: 2216/1321 City: HICKORY Subdivision: State/Zip: NC 28601-3224 Lots/Block: / Last Sale: $93,000 on 2000-07-21 School Information: Plat Book/Page: School District: COUNTY Legal: 1816 30TH ST NE Elementary School: WEBB A MURRAY Middle School: ARNDT Calculated Acreage: .290 Tax Map: 159H 09007A High School: ST STEPHENS School Map Township: HICKORY State Road #: 1541 TaxNalue Information: Tax Rates(pdf) Zoning Information: City Tax District: All in County Zoning District: HICKORY County Fire District: ST STEPHENS Zoningl: R-1 Building(s) Value: $72,100 Zoning2: Land Value: $9,800 Zoning3: Assessed Total Value: $81,900 Zoning Overlay: Year Built/Remodeled: 1957/ Small Area: Current Tax Bill Split Zoning Districts: / Zoning Agency Phone Numbers Miscellaneous: Firm Panel Date: 2007-09-05 Building Permits for this parcel. Firm Panel #: 3710372300J Building Details 2010 Census Block: 2030 WaterShed: 2010 Census Tract: 010303 Voter Precinct: P28 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. Q 2015, Catawba County Government, North Carolina. All rights reserve . I � nn30rpnn �j(,Qn h ,� � e fin 6-*), c_s\ . http://gis.catawbacountync.gov/nomap/parcel_report.php?key=372311551818&typ=P 2/29/2016 SBA CATAWBA COUNTY - 100A SOUTHWEST CAROLINA VD RECEIPT NEWTON,NORTH CAROLINA 28658 sV�e PHONE: 828.465.8399 v 1 . ,�!Jp� 1C Monday, February 29, 2016 /842 sM www.catawbacountync.gov PAYOR: Starnes, Kevin PAYMENTS TRANSACTION NUMBER: TRC-629122-29-02-2016 PAYMENT DATE : 02/29/2016 PAYMENT TYPE: Cash INVOICE NUMBER FEE NAME FEE AMOUNT 02-16-325680 Authorization to Construct (Repair) $300.00 Fee TOTAL PAYMENTS : 5300.00 EHPR-02-2016-23293 CASE TYPE: Environmental Health Plan Review WORK CLASS: Septic Malfunction SITE ADDRESS: 1816 30TH ST NE, HICKORY NC 28601 Owner KEVIN STARNES, 1816 30TH ST NE, HICKORY NC 28601 C:8283817116 **NO PEOPLESOFT ACCOUNT ASSIGNED ** receipt 02/29/2016 10:16 Page I of 1