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HomeMy WebLinkAboutEHPR-03-2016-23491.TIF c$ THIS IS NOT A PERMIT Case # EHPR-03-2016-23491 rti LSI � CATAWBA COUNTY HEALTH DEPARTMENT 0� Xo 3F`� 0 fr-s�''�' PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES t '7a inet err /842 sM Environmental Health Plan Review - OSWP izo 3• o+h .o , IMPROVEMENT �, . • v 0 , t,,, Applicant PETRICA (PETE) STOIAN, 1437 SWEETBRIAR LN, HICKORY NC 28602 C:8283129482 Owner NARAYAN PERSAUD, 1813 BETRY PL, RALEIGH NC 276023067 NAME TO APPEAR ON PERMIT Petrica (Pete) Stoian SITE ADDRESS: 5877 PINEWINDS DR, HICKORY NC 28602 PIN # 279009173350 NAME of SUBDIVISION: BAKERSVIEW MEADOWS Lot ft 1 Section/Block PROPERTY SIZE: Square Feet 22215.60 Acres 0.51 DIRECTIONS: South on 127 Hwy, Right onto Pinewinds Dr, Property is on the left. PRIMARY CONTACT: Applicant SEWER TYPE: Septic Tank GALLONS PER DAY: 360 WATER SUPPLY: Public Water DESCRIBE WORK: IP for Purchase` 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 Vacant Lot EXISTING STRUCTURES ON SITE(IF ANY) DIM EXISTING STRUCTURE: NUMBER OF EXISTING BEDROOMS: #OF OCCUPANTS: 4 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 65x70 #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: 119-ehapplirnion 03/29/2016 08:17 Page I of ,�A CATAWBA COUNTY Case a EHPR-03-2016-23491 -2" ' Public Health Department Subdivision BAKERSVIEW MEADOWS < -"-`r Environmental Health Division PIN/I 279009173350 `�- PO Box 389, 100-A Southwest Blvd,Ncwton,NC 28658 /842 su NAME ON PERMIT: ( PETRICA(PETE) STOIAN), 1437 SWEETBRIAR LN, HICKORY NC 28602 ( Petrica (Pete) Stoian) Site Address: 5877 PINEWINDS DR, HICKORY NC 28602 Property Size: Square Feet 22,215.60 Acres 0.51 Directions: South on 127 Hwy, Right onto Pinewinds Dr, Property is on the 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 abeling of all property lines and corners and making the site accele_so tha sit evalu an be performed. Dater- 2 — l (� Signature of Applicant or Agent An Environmental Health Specialist will contact you within working days of application date. If you need further information or assistance please call 828-466-7291 AREA2 FEENAME; *s 6 �„"? DATE"IIt3ibigFEEAMOUNT.u1 Improvement Permit Fee � 03/29/2016 5150.00 �. it� �j V +l'-1474,44 AL FEES-44.,h i i ° + 3 4++++!+++++,24+14.14+A "4+ � .,r';. Jrti... 5100 00 r ,. ".L,,e„g i, 4 .....,�,�,� -, . .,tom�,r''s 3.Vi, ffthl 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-chapel ication 03/29/2016 08:17 Page 2 of 4 CATAWBA THIS IS NOT A PERMIT COUNTY CATAWBA CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services Page 1 Improvement Permit Authorization to Construct n Septic Repair n Septic Malfunction ❑ Septic Expansion n New Well Permit n Replacement Well n Well Abandonment ❑ Well Repair n Existing System Inspectiionn Pre-Approval Required) n Application is for New Construction �J Existing Facility ❑ y t t$C P.. \ 1` Property Address .: --- c� 7�' � � Subdivision Gi.-11--Cr S Vi 2�1 M . ouoS' ,new n-I,C 14 COL,c-1 IOC 2€11° Lot# I Acres Section/Block/Phase Driving Directions to Property Sbl.,`tin (7n 11) Rudy )b PiSUEw!! 1 Q\C 6�r•MQkr A �11lti- 1a an - 44,w_ Ie-(-A a+'4 -r' Sc P& LCrs Vie....) 11tec.ctuw NAME TO APPEAR ON PERMIT? I { Owner X4pplicant ❑ Contractor . Applicant Contact Information / Name- CP Q,+r: Lc S-ku:c�i1 ( F�e 1-e) Address )437 St... ce4%,r Zm r La,.0 'c cer.� �l.>`. 2a,0 Phone Cell Phone '\/ CH 87 Owner Contact Information Name Svc_ rP¢r Seti\ rlarc..4C/1 Address ! 2 Di_ Oa It 5 , we_ Z?boz -3ob7 Phone Cell Phone Contractor Contact Information Name License# Address Phone Cell Phone WHO WILL BE THE PRIMARY CONTACT? ❑ Owner Applicant ❑ Contractor Description of Existing Structures on Site #of Bedrooms *1. Structure Dimensions # of Occupants Basement ❑ Yes n No Basement Fixtures ❑ Yes ❑ No 1 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 L�'3. No Does the site contain any jurisdictional wetlands? ❑ Yes fiziNo Does the site contain any existing wastewater systems? ❑ Yes No Is any wastewater going to be generated on the site other than domestic sewage? ❑ Yes ,INo 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 Existi g water supply in use El Individual Well — Community Well ❑ Semi-Publi Well County/City/Township Water Line Is a public water supply available? **t 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) J ❑ Accepted ❑ Alternative K Conventional El Innovative ❑ Other ❑ Any cArrAki mA THIS IS NOT A PERMIT '° COUNTY VV, ^,. CATAWBA COUNTY HEALTH DEPARTMENT No„„ Application for Environmental Services Page 2 Proposed Facility Type Primary Residence r New Residence n Addition to Residence #of New Bedrooms *t Project Description )--k u-...12_ Structure Dimension's (eS X 10 # of Occupants 4 Basement ❑ Yes No Basement Fixtures ❑ Yes No ❑ Accessory Structure(s) Describe #of New Bedrooms *t if applicable Structure Dimensions # of Occupants Accessory Dwelling ❑ Yes ❑ No Plumbing _ Yes n No Describe Plumbing Needed I I Multi-Family Residence#Units #Bedrooms per Unit*t Total # Bedrooms *t 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 n Yes ❑ No If Daycare Specify Occupancy Application for Well Construction/Abandonment/Repair Proposed Well Type n Individual Well IT Semi-Public Well IT Community Well Abandonment Type IT Drilled n Bored Dug n Unknown Well Repair Requested I Yes n 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 Date % _ 2 S ( 6 . Printed Name of Owner or A ut �f /�e/ t° c/o k- V Catawba County Environmental Health i 5 *xa r \ \ 1 1 gyp fl0 _ 1 OR Y V e t. ° ° r \ s — . -- s — s r -- r 0000 — ii rY�I ° 1p0 3� \J • 30 d p0' — �‘1 ,� r '' .: /VA . ..- � L , ■ - - 4 t. �- - — 5 - - - °`�-. \ o — - - ,0 o N1:- ° -- _--S 1 ' -- 4.i r 3- pp r 2 1p0 s9.84 I A t,? i z •39 — 00• `x. -' --1 Parcel: 279;091 3350, 5877 PINEWINDS DR tin=50ft HICKORY. _'8G? ' This map/report i giuc c propared from the Catawba County, NC Geospatial Information Services. Catawba County has made substantial efforts to ensure the ac racy a.ration and labeling information contained on this map or data on this report.Catawba County promotes and recommends the independent rit/ n rf any data yam'tuned on this map/report product by the user.The County of Catawba,its employees,agents,and personnel,discla ai t:'.Ilia be held lia':de for any and all damages,loss or liability,whether direct,indirect or consequential which arises or may wise from this n'c ;/roc traU ict or the use 'hereof by any person or entity. Copyright 2014 Catawba County NC 03/28/2016 Parcel Report Page 1 of 1 Parcel Report - Catawba County NC Parcel Information: Owner Information: • Parcel ID: 279009173350 Owner: PERSAUD NARAYAN D SR Parcel Address: 5877 PINEWINDS DR Owner2: PERSAUD CHANDRAWATTEE City: HICKORY, 28602 Address: 1813 BETRY PL LRK(REID): 602533 Address2: null Deed Book/Page: 2953/1486 City: RALEIGH Subdivision: BAKERSVIEW MEADOWS State/Zip: NC 27602-3067 Lots/Block: 1/ null Last Sale: School Information: Plat Book/Page: 44/2 School District: COUNTY Legal: LOT 1 1 PL 44-2 BAKERSVIEW PL 44-2 Elementary School: MOUNTAIN VIEW Middle School: JACOBS FORK Calculated Acreage: .510 Tax Map: null High School: FRED T FOARD Township: HICKORY School Map State Road #: 2952 Tax/Value Information: Tax Rates(pdf) Zoning Information: City Tax District: All in County Zoning District: COUNTY County Fire District: MOUNTAIN VIEW Zoningl: R-20 Building(s) Value: $0 Zoning2: null Land Value: $19,900 Zoning3: null Assessed Total Value: $19,900 Zoning Overlay: WP-O Year Built/Remodeled: null/null Small Area: MOUNTAIN VIEW Current Tax Bill Split Zoning Districts: null/null Zoning Agency Phone Numbers Miscellaneous: Firm Panel Date: 2007-09-05 Building Permits for this parcel. Firm Panel #: 3710279000J Building Details 2010 Census Block: 1000 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. ©2016, Catawba County Government, North Carolina. Ad rights reserved. http://gis.catawbacountync.gov/nomap/parcel_report.php?key=279009173350&typ=P 3/29/2016 BA C CATAWBA COUNTY ETifii C, 100A SOUTHWEST BLVD NEWTON NORTH CAROLINA 28658 RECEIPT " �� a C PHONE: 828.465.8399 U a! \842 sm www.catawbacountync.go v Tuesday, March 29, 2016 PAYOR: Stoian, Petrica(Pete) PAYMENTS TRANSACTION NUMBER: TRC-645666-29-03-2016 PAYMENT DATE : 03/29/2016 PAYMENT TYPE: Credit Card INVOICE NUMBER FEE NAME FEE AMOUNT 03-16-326547 Improvement Permit Fee 5150.00 TOTAL PAYMENTS : $150.00 EHPR-03-2016-23491 CASE TYPE: Environmental Health Plan Review WORK CLASS: OSWP SITE ADDRESS: 5877 PINEWINDS DR, HICKORY NC 28602 Applicant PETRICA (PETE) STOIAN, 1437 SWEETBRIAR LN, HICKORY NC 28602 C:8283129482 ** NO PEOPLESOFT ACCOUNT ASSIGNED ** Owner NARAYAN PERSAUD, 1813 BETRY PL, RALEIGH NC 276023067 receipt 03/29/2016 08:16 Page I of 1