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HomeMy WebLinkAboutEHPR-04-2016-23660.TIF Y A THIS IS NOT A PERMIT Case # EI-IPR-04-20 1 6-2 3 660 FT A —truly. G CATAWBA COUNTY HEALTH DEPARTMENT 0 " xn : .0 IPIOC; d d PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES 2842 SM Environmental Health Plan Review - OSWP • o d 471 ABANDONMENT 0' � 0 Applicant QUANTUM SOLUTIONS OF NA, LLC (JODI SMITH), 1901 CONOVER BLVD E A, CONOVER NC 28613 H:8286157500 C:7049293778 HOME:8286157500 Owner QUANTUM SOLUTIONS OF NA, LLC (MICHAEL MCNEELY), 1901 CONOVER BLVD EA, CON( NC 28613 H:8286157500 C:7049293778 HOME:8286157500 NAME TO APPEAR ON PERMIT Quantum Solutions of NA, LLC (Michael McNeely) SITE ADDRESS: 2611 OLD CONOVER STARTOWN RD, NEWTON NC 28658 PIN # 373115740202 NAME of SUBDIVISION: Lot# Section/Block PROPERTY SIZE: Square Feet 41,817.60 Acres 0.96 DIRECTIONS: Off Hwy 70 Turn at Hardees, Go straight thru 4 way stop, Pass 2 apartment complexes on the right, House will be the 3rd house on the Right. PRIMARY CONTACT: Owner SEWER TYPE: Public Sewer GALLONS PER DAY: 360 WATER SUPPLY: Public Water DESCRIBE WORK: *****2 -Well Abandonments (unknown well types) - 1 may already be abandoned it has a cap. Not sure if it was properly done. want to be sure. Home is now connected to Public Water/Sewer Home is being remodeled to sell. 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: 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 40x72, Bldg 20x20 NUMBER OF EXISTING BEDROOMS: 3 #OF OCCUPANTS: 1 PROPOSED CONSTRUCTION BASEMENT? No BASEMENT FIXTURES? No PLUMBING REQUIRED? Desired system types (Improvement Permit or Authorization to Construct): ACCEPTED: ALTERNATIVE: CONVENTIONAL: OTHER: INNOVATIVE: ANY: Other described: APPLICATION FOR WELL ABANDONMENT ABANDONMENT TYPE: 09-chapplicatIan 04/15/2016 11.12 Page 1 of 10 sew _ CATAWBA COUNTY Case# EHPR-04-2016-23660 Public Health Department Subdivision 4 #13,, 1 'a Environmental Health Division PIN# 373115740202 ‘C61 PO Box 389, 100-A Southwest Blvd,Newton,NC 28658 /R.2 ,. NAME ON PERMIT: QUANTUM SOLUTIONS OF NA, LLC (MICHAEL MCNEELY), 1901 CONOVER BLVD E A, CONOVER N( Quantum Solutions of NA, LLC ( Michael McNeely) Site Address: 2611 OLD CONOVER STARTOWN RD, NEWTON NC 28658 Property Size: Square Feet 41,817.60 Acres 0.96 Directions: Off Hwy 70 Turn at Hardees, Go straight thru 4 way stop, Pass 2 apartment complexes on the right, House will be the 3rd house on the Right. 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 correct. Au horize• •unty and state officials are granted right of entry to conduct necessary inspections to determine compliance with applicable'laws at rules. I u ders :nd that I am solely responsible for the proper identificago7 and labeling of all property lines and corners and making the.site-aeeessi se-the - •+yet- "te-evaluwnr c be performed. Date: - - t_p Signature of Applicant orAgenL--- An Environmental Health Specialist will contact you within 5 workino ays of app 1 :• _: If you need further information or assistance please call 828-466-7291 AREA2 PlIitI)lili'n'4lll!Il i1It.,,. (�11 pppp'�Ip', -- "<�I itlI�I�'F—cyi�E�1�1 19IIT4�'i�""W•tFEENAMEi,. ,161i'l�2, , 1 'h - DATE '.a1ilhi1..FEEJAMOUNTriJ Well Abandonment Fee 04/15/2016 $100.00 Well Abandonment Fee 04/15/2016 $100.00 fir iti'tIl ��I�)I �� 5200°0011I���•N )i I�ITOTAG�FEFSYk h' _ono'»�ld� flit( :o�i1111I��il 'M' o�r�' �l� ��r sf I��i' �. IIGE_.. "'l i the w tini116Jhu itzl.tili; 4,Ei ,49nW nriumuatuluitio L!' s1 NidNL�11»IW,.�;e,u14 JJ lkN'ail;l�l• 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—ehapplication 04/15/2016 11:12 Page 2 of 10 CATAWBA THIS IS NOT A PERMIT COUNTY : CATAWBA COUNTY HEALTH DEPARTMENT rH ..,..„;;;-,:c.' Application for Environmental Services Page 1 Improvement Permit❑ Authorization to Construct ❑ Septic Repair ❑ Septic Malfunction ❑ Septic Expansion ❑ New Well Permit❑ Replacement Well ❑ Well Abandonment ❑ Well Repair ❑ Existing System Inspection (Pre-Approval Required) ❑ Application is for New Construction ❑ Existing Facility ❑ Property Address2611 Old Conover-Startown Road Subdivision Newton, NC 28658 Lot# Acres Section/Block/Phase Driving Directions to Property Off Hwy 70 turn at Hardees, Go straight thru 4 way stop, pass 2 apt complexes on right. 3rd house on right. NAME TO APPEAR ON PERMIT? ❑ Owner ❑ Applicant ❑ Contractor Applicant Contact Information NameQuantum Solutions of NA, LLC Address1901-A Conover Blvd, Conover, NC 28613 Phone828-615-7500 Cell Phone704-929-3778 Owner Contact Information NameMichael McNeely-Quantum Solutions of NA, LLC Address1901-A Conover Blvd, Conover, NC 28613 Phone828-615-7500 Cell Phone704-929-3778 Contractor Contact Information Name Address Phone Cell Phone WHO WILL BE THE PRIMARY CONTACT? ❑ Owner ❑ Applicant ❑ Contractor Description of Existing Structures on Site House and Storage shed/barn #of Bedrooms *t 3 Structure Dimensions #of Occupants 0 Basement ❑ Yes ■ No Basement Fixtures ❑ Yes a 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. D Yes 0 No Does the site contain any jurisdictional wetlands? o Yes ® No Does the site contain any existing wastewater systems? ❑ Yes Q No Is any wastewater going to be generated on the site other than domestic sewage? u Yes 0 No Is the site subject to approval by any other public agency? IQ Yes :o No Arc there any easements or right of ways on this property? Describe Existing water supply in use ❑ Individual Well ❑ Community Well 111 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 ❑ Conventional ❑ Innovative ❑ Other ❑ Any HSa ac/vva- n CATAWBA THIS IS NOT A PERMIT COUNTY .-;, - CATAWBA COUNTY HEALTH DEPARTMENT .A ass cart,- ---....; Application for Environmental Services Page 2 Proposed Facility Type ❑ Primary Residence ❑ New Residence ❑ Addition to Residence #of New Bedrooms *t Project Description Rehabilitating house Structure Dimensions #of Occupants Basement ❑ Yes ❑ No Basement Fixtures ® Yes O; No ❑ Accessory Structure(s) Describe # of New Bedrooms *t if applicable Structure Dimensions #of Occupants Accessory Dwelling ❑ Yes ❑ No Plumbing ❑ 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 ❑ Yes ❑ No If Daycare Specify Occupancy Application for Well Construction/Abandonment/Repair Proposed Well Type ❑ Individual Well ❑ Semi-Public Well ❑ Community Well Abandonment Type ❑ 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. 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° at Date 4-45-/6 Printed Name of Owner or Agent ioha4 .2. mrfiee1 t{ Catawba County Environmental Health \ 4 1 r tr (55C lik 0 / 43.49 <I N, o C> 3049 O itp OtS O 1.1% • s CIN.. N o (2gS) / et pit',® 110 • Ytt yff,` 4 Igg, 'r i, i.•i��F,�.j�•I k 4° S , y•St 4.¢ 4� GOB 4 •@VC �, O� haNA4,'OC 09‘... �0 Parcel: 373115740202, 2611 OLD CONOVER 1in=60ft STARTOWN RD NEWTON, 28658 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 04/15/2016 „Zll L-,BL D. .owa rou noorec 1 ! A L. h t ti r H60( a_ A J T 5 S i c, /I —3 c — i J wm d c .aaec s J RI f-, f;------ g m Va- C6 7,t'''\ 0l }l IIaM L IIaM Parcel Report Page 1 of 1 Parcel Report - Catawba County NC Parcel Information: Owner Information: Parcel ID: 373115740202 Owner: QUANTUM SOLUTIONS OF NORTH Parcel Address: 2611 OLD CONOVER AMERICA LLC STARTOWN RD Owner2: null City: NEWTON, 28658 Address: PO BOX 141 LRK(REID): 31478 Address2: null Deed Book/Page: 3334/0760 City: CONOVER Subdivision: null State/Zip: NC 28613-0141 Lots/Block: null/ null Last Sale: $54,500 on 2005-03-31 School Information: Plat Sale: $54, School District: NEWTON CONOVER Elementary School: NORTH NEWTON Legal: null Middle School: NEWTON CONOVER Calculated Acreage: .960 High School: NEWTON CONOVER Tax Map: 050N 01019 Township: NEWTON School Map State Road #: 1149 TaxNalue Information: Tax Rates(pdf) Zoning Information: City Tax District: NEWTON Zoning District: NEWTON County Fire District: All in City Zoningl: R-20A Building(s) Value: $59,200 Zoning2: null Land Value: $14,100 Zoning3: null Assessed Total Value: $73,300 Zoning Overlay: null Year Built/Remodeled: 1936/null Small Area: null 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 #: 3710373100J Building Details 2010 Census Block: 1033 WaterShed: null 2010 Census Tract: 011701 Voter Precinct: P25 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. All rights reserved. http://gis.catawbacountync.gov/nomap/parcel_report.php?key=3 73 1 1 5 740202&typ=P 4/15/2016 -s3A CATAWBA COUNTY OG 100A SOUTHWEST BLVD �� I"elks y NEWTON, NORTH CAROLINA 28658 RECEIPT U1p�sa►bs PHONE: 828.465.8399 " � • Friday, April 15, 2016 1842 snt www.catawbacountync.gov PAYOR: Quantum Solutions of NA, LLC Quantum Solutions of NA, LLC(Smith, Jodi) PAYMENTS TRANSACTION NUMBER: TRC-65 5661-1 5-04-20 1 6 PAYMENT DATE : 04/15/2016 PAYMENT TYPE: Check 30006 INVOICE NUMBER FEE NAME FEE AMOUNT 04-16-327262 Well Abandonment Fee $100.00 04T16%327,26 R SZ"m r”711Well'Ag donrngf!Fee11c "likii,':`11111.. " ;0'$100:00 TOTAL PAYMENTS : $200.00 EHPR-04-2016-23660 CASE TYPE: Environmental Health Plan Review WORK CLASS: OSWP SITE ADDRESS: 2611 OLD CONOVER STARTOWN RD,NEWTON NC 28658 Applicant QUANTUM SOLUTIONS OF NA, LLC, 1901 CONOVER BLVD E A, CONOVER NC 28613 H:8286157500C:7049293778 ** NO PEOPLESOFT ACCOUNT ASSIGNED ** Owner QUANTUM SOLUTIONS OF NA, LLC, 1901 CONOVER BLVD E A,CONOVER NC 28613 14:8286157500C:7049293778 receipt 04/15/2016 I I:12 Page I of I