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HomeMy WebLinkAboutEHPR-03-2016-23302.TIF n SBA G THIS IS NOT A PERMIT Case# EHPR-03-2016-23302 •C ..1 �' CATAWBA COUNTY HEALTH DEPARTMENT 0 -Y• . 0 K 1 PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES 842 :M Environmental Health Plan Review - OSWP o + }o:o ' � f r r • r r • IMPROVEMENT O tl T Applicant DARRIN REID, 2729 GETTYSBURG PL, CLAREMONT NC 28610 H:8284599699 C:828-312-5119 HOME:8284599699 Owner LOUISE HUFFMAN, 6760 GREEDY HWY, HICKORY NC 28602 NAME TO APPEAR ON PERMIT Louise Huffman SITE ADDRESS: 1585 GRAND OAKS LN, HICKORY NC 28602 PIN # 268901469961 NAME of SUBDIVISION: Lot# 1 Section/Block PROPERTY SIZE: Square Feet 130,680.00 Acres 3.00 DIRECTIONS: Hwy 127 South, Greedy Hwy, Right onto Grand Oaks Lane, 2 vacant lots on Left PRIMARY CONTACT: Applicant SEWER TYPE: Septic Tank GALLONS PER DAY: 360 WATER SUPPLY: Private Well DESCRIBE WORK: IP for Subdividing* 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? No Are there any easements or right-of-ways on this property? No APPLICATION FOR: New Structure STRUCTURE TYPE: PRIMARY RESIDENCE FACILITY TYPE: House OTHER DESCRIPTION: DESCRIPTION OF EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: NUMBER OF EXISTING BEDROOMS: #OF OCCUPANTS: 1 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: House 30x40 #OF NEW BEDROOMS:: 3 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: F9-ehapplicalion 03/02/2016 11:28 Page I of 4 V,A \ CATAWBACOUNTY Case# EHPR-03-2016-23302 M1' ciY 1\ Public Health Department Subdivision am_ Environmental Health Division PIN( 268901469961 .4_ / PO Box 389, 100-A Southwest Blvd,Newton,NC 28658 Ig¢ su NAME ON PERMIT: ( LOUISE HUFFMAN), 6760 GREEDY H WY, HICKORY NC 28602 ( Louise Huffman) Site Address: 1585 GRAND OAKS LN, HICKORY NC 28602 Property Size: Square Feet 130,680.00 Acres 3.00 Directions: Hwy 127 South, Greedy Hwy, Right onto Grand Oaks Lane, 2 vacant lots on Left 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 o that a completeAsoifr aluation can be performed. Date: 3/7_/j y Signature of Applicant or Agent A _ An Environmental Health Specialist will contact you -nlewor ;it• days if application date. If you need further inforniation or assistance please ca 1828-466-7291 AREA2 a I q iTl Z d '�' ^ rv-« 4'T .. '°,H^a 5ner "? °N', 5µFEENAME ^u tr a� 4s i rx e �s a fi� i f`4S DATE- �'iir r s, 9'E �r� gg .-� � 3t� a�r�..ti.-k �aw��.; �.,,.P„ 3.� �.�ua,tIgFEEAMOUNTg Improvement Permit Fee 03/02/2016 $150.00 paEl a' C TOTAL FEES t n'§` ' ,” `t ;pt .i s '-1 ti- L` 5150 00i d c dk, Pnr e a E v k$,i0tf�,�,, "�.-tYA 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-ehappl lotion 03/02/2016 11:28 Page 2 of 4 CAT W BA THIS IS NOT A PERMIT COUNTY "'yy"`='�, CATAWBA COUNTY HEALTH DEPARTMENT ° '' h. Application for Environmental Services Page 1 Improvement Permit Authorization to Construct n Septic Repair❑ Septic Malfunction n Septic Expansion n New Well Permit❑ Replacement Well n Well Abandonment 7 Well Repair n Existing System Inspection (Pre-Approval Required) ❑ IIApplication is for New Construction X Existing Facility ❑ Property Address 6728-y� 4.s Loin L Subdivision I0//3.6 A/z-'p jyne,„7 Lot# / Acres "7,00 Section/Block/Phase Driving Directions to Property \\ /V( PA) 2689- 0/- 546 - 996/ NAME TO APPEAR ON PERMIT? n Owner ❑ Applicant ❑ Contractor Applicant Contact Information Name n4„,-,-, � ��. Address z724 Ce11 ,-4- M/4 c t C/a mn7cwi— 1V G 2 6,4' Phone 827` ys9_96 7 Cell Phone J/2 _S/� 7 Owner Contact Information Name 011/Se )A,a--", Address e7Go �e1y // XM, - /itch iJG Zgc a a— Phone l Cell Phone Contractor Contact Information Name License# Address Phone Cell Phone WHO WILL BE THE PRIMARY CONTACT? n Owner I I Applicant ❑ Contractor Description of Existing Structures on Site # of Bedrooms *I. Structure Dimensions # of Occupants .„. ) Basement ❑ Yes n No Basement Fixtures ❑ Yes n 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. ❑ Yes Does the site contain any jurisdictional wetlands? ❑ Yes —gl"c9O Does the site contain any existing wastewater systems? El L� Yes 'N Is any wastewater going to be generated on the site other than domestic sewage? ❑ Yes L��f NNo�o Is the site subject to approval by any other public agency? ❑ Yes L2'No Are there any easements or right of ways on this property? Describe Existing water supply in use 177tndividual Well n Community Well n Semi-Public Well ❑ County/City/Township Water Line Is a public water supply available? ** n 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 -eference) 7 ❑'7 ❑ Accepted Alternative onventional ❑ Innovative ❑ Other ❑ Any CATAW_ BA THIS IS NOT A PERMIT COUNTY _ CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services Page 2 NortM1 Cam�lna Proposed Facility Type ❑ Primary Residence New Residence ❑ Addition to Residence # of New Bedrooms *f 3 Project Description Ler / Lac, /��FF,. ,. Structure Dimensions Jot yo # of Occupant Basement ❑ Yes Ri■lo Basement Fixtures ❑ Yes No ❑ Accessory Structure(s) Describe # of New Bedrooms *t if applicable Structure Dimensions # of Occupants Accessory Dwelling ❑ Yes n No Plumbing ❑Yes ❑ No Describe Plumbing Needed n Multi-Family Residence# Units #Bedrooms per Unit*t Total # Bedrooms *f Structure Dimensions n 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 ❑ Individual Well ❑ Semi-Public Well n Community Well Abandonment Type n 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. Pennits 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 are n Date /z� Printed Name of Owner or Agent rri a �te� Parcel Report Page 1 of Parcel Report - Catawba County NC Parcel Information: Owner Information: Parcel ID: 268901469961 Owner: HUFFMAN LOUISE M Parcel Address: 6760 GREEDY HWY Owner2: City: HICKORY, 28602 Address: 6760 GREEDY HWY LRK(REID): 1370 Address2: Deed Book/Page: 1212/0607 City: HICKORY Subdivision: State/Zip: NC 28602-9226 Lots/Block: / Last Sale: School Information: School District: COUNTY Plat Book/Page: Elementary School: BANOAK Legal: Middle School: JACOBS FORK Calculated Acreage: 9.750 Tax Map: 002 B 01031 High School: FRED T FOARD Township: BANDYS School Map State Road #: 1120 TaxNalue Information: Tax Rates(pdf) Zoning Information: City Tax District: All in County Zoning District: COUNTY County Fire District: PROPST Zoningl: R-40 Building(s) Value: $30,000 Zoning2: Land Value: $57,500 Zoning3: Assessed Total Value: $87,500 Zoning Overlay: WP-O Year Built/Remodeled: 1963/ Small Area: MOUNTAIN VIEW Current Tax Bill Split Zoning Districts: / Zoning Agency Phone Numbers Miscellaneous: Firm Panel Date: 2007-09-05 Building Permits for this parcel. Firm Panel #: 3710268900J Building Details 2010 Census Block: 1020 WaterShed: WS-III Protected Area 2010 Census Tract: 011801 Voter Precinct: P24 Agricultural District: 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. ©2015, Catawba County Government, North Carolina. All rights reserved. S` 3, 00 ACTT ,, Ib b biota Coo Lil http://gis.catawbacountync.gov/nomap/parcel_report.php?key=268901469961&typ=P 3/2/2016 Catawba County Environmental Health \ in ev bat Si ik\I Ilk N.2 4 w .0. ''p ... O, . lipt .., 4 v. p... _ • w .N.,„ c (.._ + z rJo 7 Go Ni • <y' • (' • „.....„--,-- n 0 t. , 8 ::'. ,e'r ,4. ill . 2\_...-------1-7. 0 1- 1 T ,� 75,r, III ikesome;68 Q. 1 , %so, ^81, 0— -- 176.60 • GREEDy Hvvy Parcel: 268901469961, 6760 GREEDY HWY 1in=150ft HICKORY, 28602 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 03/02/2016 CATAWBA COUNTY 131 § � 100A SOUTHWEST BLVD NEWTON, NORTH CAROLINA 28658 RECEIPT I`iG PHONE: 828.465.8399 U Wednesday, March 2, 2016 1842 srn www.catawbacountync.gov PAYOR: REID, DARRIN PAYMENTS TRANSACTION NUMBER: TRC-630358-02-03-2016 PAYMENT DATE : 03/02/2016 PAYMENT TYPE: Check 8196 INVOICE NUMBER FEE NAME FEE AMOUNT 03-16-325763 Improvement Permit Fee $150.00 TOTAL PAYMENTS : S150.00 EHPR-03-2016-23302 CASE TYPE: Environmental Health Plan Review WORK CLASS: OSWP SITE ADDRESS: 1585 GRAND OAKS LN, HICKORY NC 28602 Applicant DARRIN REID,2729 GETTYSBURG PL, CLAREMONT NC 28610 H:8284599699C:828-312-5119 ** NO PEOPLESOFT ACCOUNT ASSIGNED ** Owner LOUISE HUFFMAN, 6760 GREEDY HWY, HICKORY NC 28602 receipt 03/02/2016 11:27 Page I of I