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HomeMy WebLinkAboutEHPR-03-2016-23492.TIF 444s3A •� THIS IS NOT A PERMIT Case # EHPR-03-2016-23492 :T EM CATAWBA COUNTY HEALTH DEPARTMENT D P,I.LW -? j9 PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES �i{ 1842 sM Environmental Health Plan Review - OSWP .� IMPROVEMENT • ,,; '' 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: 5885 PINEWINDS DR, HICKORY NC 28602 PIN # 279009172267 NAME of SUBDIVISION: BAKERSVIEW MEADOWS Lot# 2 Section/Block PROPERTY SIZE: Square Feet 22,215.60 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: 1 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: P.9-chapplwa ion 03/29/2016 08:18 Page 1 or4 ,gA CATAWBA COUNTY Case a EHPR-03-2016-23492 Qil)G Pub lic Health Department Subdivision BAKERSVIEW MEADOWS 6 Environmental Health Division PIN#^ 279009172267 r-lu- PO Box 389, 100-A Southwest Blvd,Newton.NC 28658 1842 :u NAME ON PERMIT: ( PETRICA(PETE) STOIAN), 1437 SWEETBRIAR LN, HICKORY NC 28602 ( PETRICA(Pete) STOIAN) Site Address: 5885 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 a lely responsible for the proper identification an4 labeling of all property lines and corners and making the site accessible that a comple i e ev t et?can be performed. Date: -- ok - l C Signature of Applicant or Agent An Environmental Health Specialist will contact you within torking days f application date. If you need further information or assistance please call 828-466-7291 AREA2 FEENA ttsl �y ' iyk 1 ltx1 Atjtflekk �,D TE hrvl1 3'FEE'A OUNT' ) k't�t t ius]...,...c..0 t':M1�.y . .L $}a ih m. -_ 2.41 Improvement Permit Fee 03/29/2016 $150.00 1 t:, ':j°t` TOTAL FEES r v 'x ix"' ° ;i'r4 " x.174 ';;,Et $150 0044 FI . k t e�t _ , L..a.,5,t . °..> ...1..:... ik-,-k;.d Ana:.= _ .,_..k._.,_ ... .. .. . ' ,ai.erat5 .... ._!+ .-_.-., 5<. . S _' FEES ARE NON-REFUNDABLE ONCE A SITE VISIT IS MADE OR WORK ON A PLAN REVIEW HAS COMMENCED SYSTEM REDESIGN AND/OR RETRIP WILL INCUR AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) 1:9-ehapplicatlen 03/29/2016 08:18 Page 2 o14 C TA BA THIS IS NOT A PERMIT counT�r a�"°°`�, CATAWBA COUNTY HEALTH DEPARTMENT NoaF Oarefn+ Application for Environmental Services Page I Improvement Permit, Authorization to Construct ❑ Septic Repair n Septic Malfunction ❑ Septic Expansion H New Well Permit Replacement Well ❑ Well Abandonment H Well Repair H Existing System Inspection (Pre-Approval Required) n Application is for New Construction A Existing Facility ❑ � Property Address S 15% 9 &�,}\e Ivl$' 5 Subdivision .�4C"4 }-{ICA-4.9r-i k1C -22(0 0-2._ Lot# 2 Acres Section/Block/Phase Driving Directions to Property Jo u V On 12.7 (4,-- 1 m4144 r. r-,ks LI- o n Pne•.Ji r\ac 1)r . 1o4 ; S be-Wr ,e 4I-k2 -Ciri4 hok5'e on -4' e 1 . tf NAME TO APPEAR ON PERMIT? H Owner Applicant ❑ Contractor Applicant Contact Information Name PP }f •r es c'1-c+ ;c„7.‘ (RI_ r) Address )L13'-? S tit C-1-hr; e.. (_ L .6� I,t lkc.ko Ai kg__ 2.1u v 2 Phone Cell Phone 37 J - 2-Ciy Efe Owner Contact Information 4t-c-) Name "Scat_ P4Ise- ,t A (Ckc rld cotutc Address lg 13 I�ie.4-/'y PL Pea.)4-,•c) L. Ng— Z,Z(oot 30 b 7 Phone Cell Phone Contractor Contact Information Name License# Address Phone Cell Phone WHO WILL BE THE PRIMARY CONTACT? H Owner PApplicant ❑ Contractor Description of Existing Structures on Site it of Bedrooms *1. Structure Dimensions # of Occupants Basement ❑ Yes n No Basement Fixtures n 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 C "No Does the site contain any jurisdictional wetlands? ❑ Yes Oir No Does the site contain any existing wastewater systems? ❑ Yes 17 No Is any wastewater going to be generated on the site other than domestic sewage? ❑ Yes No Is the site subject to approval by any other public agency? ❑ Yes 9 No Are there any easements or right of ways on this property? Describe Existing water supply in use ❑ Individual Well ❑ Community Well ❑ Semi-Public Well County/City/Township Water Line Is a public water supply available? ** ,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) ❑ Accepted ❑ Alternative lyConventional ❑ Innovative ❑ Other ❑ Any cArrAv m THIS IS NOT A PERMIT COUNTY t,,Vv-^`1 .,,: CATAWBA COUNTY HEALTH DEPARTMENT „„,„,e7,;;;;;--...„ Application for Environmental Services Page 2 Proposed Facility Type n Primary Residence g New Residence ❑ Addition to Residence #of New Bedrooms *t Project Description YIOUS-Q Structure Dimensions (ocx ) O # of Occupants I Basement n Yes No Basement Fixtures ❑ Yes ®'No H Accessory Structure(s) Describe #of New Bedrooms *t if applicable Structure Dimensions # of Occupants Accessory Dwelling n Yes ❑ No Plumbing n Yes ❑ No Describe Plumbing Needed H 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.) n Business Specific Type of Business Retail Floor Space #of Employees per Shift # of Shifts H 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 ❑ Individual Well I Semi-Public Well ❑ Community Well Abandonment Type n Drilled n Bored ❑ Dug 7 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 RETR[P 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 depa Intent 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 Ag= Date 3—2Z Printed Name of Owner or Age la t i C"% Catawba County Environmental Health k' \\ i \\ \ <_ 1 , r3 1/4\ \\ \\.\\ ■ t 45 p1NE�wo oR 1 r, 100 p0 .- 's 30 100 �� y --- + -n -4O^JJ . •00.0a- 10C- ) '. (a \\'/ 9 . /� ta 11 of t l 2 � �C � y G / _- y �s-s v ...sots,' .t 60 00 5 r,? � .'S 4 1 P i t t i a E L't' 2 "t % \ OQ -0{3 -I -i-A-./ 100 — ' .- Parcel: 2730091 . 2267, 5885 PINEWINDS DR 1in=50ft HICKORY. 286: J. This map/repot.itioduf' is prepared from the Catawba County,NC Geospatial Information Services. Catawba County has made substantial efforts to ensure the r _•.sracy ,cation and labeling information contained on this map or data on this report.Catawba County promotes and recommends the independe srific, t of any dam contained on this map/report product by the user.The County of Catawba,its employees,agents,and personnel,di.. .::m,any all not be field liable for any and all damages,loss or liability,whether direct, indirect or consequential which arises or may arise from this: •,ap/repf :roduct or the use thereof 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: 279009172267 Owner: PERSAUD NARAYAN D SR Parcel Address: 5885 PINEWINDS DR Owner2: PERSAUD CHANDRAWATTEE City: HICKORY, 28602 Address: 5897 PINEWINDS DR LRK(REID): 602534 Address2: null Deed Book/Page: 2953/1486 City: HICKORY Subdivision: BAKERSVIEW MEADOWS State/Zip: NC 28602-8965 Lots/Block: 2/ null School Information: Last Sale: Plat Book/Page: 44/2 School District: COUNTY Elementary School: MOUNTAIN VIEW Legal: LOT 2 2 PL 44-2 BAKERSVIEW PL 44-2 Middle School: JACOBS FORK Calculated Acreage: .510 High School: FRED T FOARD Tax Map: null Township: HICKORY School Map State Road #: 2952 TaxNalue 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. AM rights reserved. http://gis.catawbacountync.gov/nomap/parcel_report.php?key=279009172267&typ=P 3/29/2016 �Ti CATAWBA COUNTY s,+ e`t Case# WLS2007-00399 1,/ It,r.∎ Pip His Hadar Department ,,rrte�\4 i fhwirmmwnad Health DICbiOtt Subdiv�is/ion BAKERSVIEW MEADOWS � �i'/�2 PO Box 389, 100-A Southwest Blvd,Newton.NC 23658 Sect/I3IJPh/Lot# 2 � ;� (823)465-8270 FAX(828)465-8'276 TDD(828)465-8200 42-� P1N# 279009171274 Applicant/Owner NARAYAN PERSAUD Site Address: .558 J 'INEW INDS DR HICKORY NC Property Size: SF .51 ACRES Directions: HWY 127/ LT INTO PINEWINDS DR AFTER SCHOOL Improvement Permit Permit Valid For: Five years ,_ .... No Expiration Facility(Residential): House House X Mobile Home Multi-Family Bedrooms 4 New? Addition? Projected Daily Flow ybp g.p.d Water Supply Private Well? Public?;/ Semi-Public? Basement: N Basement Plumbing N HotTub/Spa: N Special Fixtures(explain): Proposed Wastewater System: 3f5o '�`-"4"�f'°� Type: 5 Proposed Repair: 2-550 rtca.i.-}:0rx Permit Conditions: . ke-''''P c.11 p..r2a 0 sc-PF€., ts.:n• ', toa 'Fr. -� b _ � I O ' r - r0 --r ' ¢,D 5' c(, -,, ‘N 4,-...„ -444 t•• ••4" fo �2- Igt4F.tla3 C4..+cyr r m,.xi - • I >L art.in- .�f P:11 0 ...r' SYStc-r. * frsnc,L. !beer, e..cy inc_ r�.v,.t) Owner or Legal Representa 've Sipinature: Date: Authorized State Agent: t.)cy( Date: ;13e/61 The issuance of this permit by th eatth Department does not guarantee the issuance of other permits. It is the responsibility or the applicant/property owner to insure that all Catawba County Planning/Zoning and Building Inspections requirements are met. This Improvement Permit is subject to revocation if the site platy 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 'Lbws and Rules 1w- Sewage Treatment and Disposal Systems' (ISA NCAC 78A .1900). Neither Catawba County nor the Environmental Health Specialist warn!its than the septic tank system will continue to function satisfactorily for any given period of time. Authorization to Construct Wastewater System (Required for Building Permit). See site plan and additional attachments( ) Proposed Wastewater System: Type: Wastewater Flow g.p.d New Repair Expansion Soil LTAR: g.p.d./ft2 Type of Facility: Basement: N Basement Plumbing: N HotTub/Spa: N Special Fixtures(explain): Wastewater System Requirements Tank Size: Septic Tank gal Pump Tank gal Grease Trap gal Drainfield: Total Area: sq ft Total Length: it Maximum Trench Depth in Trench Width ft Minimum Soil Cover Minimum Trench Seperation It Distribution: Distribution Box SerithpDistribution _ Pressure Manifold LPP Other Additional Specifications: Authorized State Agent: Date: Permit Expiration Date: I have read and accept the specifications and di conditions of this permit as indicated. Owner or Legal Representative Signature: Date: Fo`rrm`'B// CATAWBA COUNTY i•ptcr-9•;>' Case# WLS2007-00399 i;,/ Q\c!.;\� Public HeHein Dopier man Subdivision �: sC s) Environmental Health Division BAKERSVIEW MEADOWS qsq/ PO Box 389, 100-A Southwest Blvd.Newton.NC 28658 Sect113L/PhJLot it 2 (838)465-8270 FAX(828)465-8276 TDD(823)465-8200 PINK 279009171274 Applicant/Owner NARAYAN PERSAUD Site Address: PINEWINDS DR HICKORY NC Property S 55'85 SF 51 ACRES Directions: HWY 127/ LT INTO PINEWINDS DR AFTER SCHOOL © Improvement Permit El Authorization To Construct 1VeII Permit SITE PLAN I up' F ft."L.lx arc,-, :c.c ,/ 2 r, 1d;+,;., 1 p 1-a ,2s o is 60 x5o •• 4138 pr.- o� w 0 Qo n F k cp '; ; V CA n • 7 V 0 ` ' O 1 3 Y 'j i • et .too' Scale System components represent approximate contours only. The contractor must flag the system prior to beginning the installation to ensure that proper grade is maintained. Do not install system under wet conditions. This permit is subject of revocation if the site plan or site conditions are altered. Au h 'zed State Agent Date Form C r\TilemarkFonmNW-Cave e n DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES Sheet of DIVISION OF ENVIRONMENTAL HEALTH PROPERTY 1D N: ON-SITE WASTEWATER SECTION COUNTY: SOIL/SITE EVALUATION I-11-S Doc)) - ol�,,j, n //�� for ON-SITE WASTEWATER SYSTEM 1 �D OWNER: I` e-,"`/c.n. 9,r3c„a APPLICATION DATE 3 I ADDRESS: DATE EVALUATED: 703 e`I PROPOSED FACILITY: 4e a FI, PROPOSED DESIGN FLOW(.1949): irret Oda PROPERTY SIZE: b,S 1 LOCATION OF SITE: Lie.Le-°S v•LL J MI.)a L. ) T4 L PROPERTY RECORDED: WATER SUPPLY: 0 Private "Public 0 Well 0 Spring 0 Other EVALUATION METHOD: �,A Auger Boring U Pit O Cut TYPE OF WASTEWATER: L� Sewage 0 Industrial Process 0 Mixed p .ii :: ::: :: SOIL MORPHOLOGY F ::: (.1941) - PROFILE FACTORS .. 1 L 194G E.:: LAND HOIU ....i ,.. , .1943 SCAPE ZON 1941 ... ... 1941 SOIL .1943 '1956 .1944 PROFILE u POSITION/ DEPTH. STRUCTURE/ CONSISTENCEL WETNESS/ SOIL SAPRO RESTR _.... C LS SLOPE% .. IN)!:!:! TEXTURE::!: : °°=pi1NERALOGY- -COLOR DEPTH CLASS HORZ AS :&.LTARI, : a L� 0- la -g, Lr/ Gr tL.' ?R.. .:C-I sI.,IC -;..c ,510. % ););r Fr S'M... 'Z(. ,r 3‘ ¢ t 3 I + Y . � IU 1 I ( 690 I7(., ;aar , P,S 2 3 4 DESCRIPTION INITIAL SYSTEM REPAIR SYSTEM OTHER FACTORS(.1946): Available Space(.1945) r-S PS SITE CLASSIFICATION(.1948): PJ System Type(s) EVALUATED BY: TV.•Y �3 M. q OTHER(S)PRESENT: Site LTAR 3 .3 COMMENTS: �,A ti gA \O� CATAWBA COUNTY \G IOOA SOUTHWEST BLVD NEWTON, NORTH CAROLINA 28658 RECEIPT s PHONE: 828.465.8399 U °<►a ' Tuesday, March 29, 2016 1842 SM vvww.catawbacountync.gov PAYOR: STOIAN, PETRICA(Pete) PAYMENTS TRANSACTION NUMBER: TRC-645667-29-03-2016 PAYMENT DATE : 03129/2016 PAYMENT TYPE: Credit Card INVOICE NUMBER FEE NAME FEE AMOUNT 03-16-326550 Improvement Permit Fee $150.00 TOTAL PAYMENTS : $150.00 EHPR-03-2016-23492 CASE TYPE: Environmental Health Plan Review WORK CLASS: OSWP SITE ADDRESS: 5885 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 08.17 Page 1 of t