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HomeMy WebLinkAboutEHPR-04-2016-23697.TIF THIS IS NOT A PERMIT Case # EHPR-04-2016-23697 f CATAWBA COUNTY HEALTH DEPARTMENT D f a IFICOSY W 1. PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES '' rt /842 shy Environmental Health Plan Review - OSWP of ro 413 r: IMPROVEMENT -d 69 Contractor MICHAELATHANAS R.ASSOCIATES (GARY MCNEELY), 561 ENNIS RD, WEDDINGTON NC C:7043101832 Owner LEAH DEVLIN,2319 CHURCHILL RD, RALEIGH NC 27608 C:919-696-7095 NAME TO APPEAR ON PERMIT Leah Devlin SITE ADDRESS; 7948 KEISTLERS STORE RD, SHERRILLS FORD NC 28673 PIN # 460604902708 NAME of SUBDIVISION: FRED MCCALL UNREC Lot# 30 Section/Block PROPERTY SIZE: Square Feet 34,412.40 Acres 0.79 DIRECTIONS: Hwy 150 East, Right Slanting Bridge Rd, Left Keistler Store Rd, At end of Rd on Left. PRIMARY CONTACT: Contractor SEWER TYPE: Septic Tank GALLONS PER DAY: 480 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? Yes Property Easements Description: Septic Easement- See Plat 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:: 60x60 #OF NEW BEDROOMS:: 4 BASEMENT? No BASEMENT FIXTURES? No PLUMBING REQUIRED? Desired system types(Improvement Permit or Authorization to Construct): ACCEPTED: ALTERNATIVE: CONVENTIONAL: OTHER: YES INNOVATIVE: ANY: Other described: PPBPS f9-ehapplication 04/20/2016 1523 Page 1 of 4 ,v,A , • CATAWBA COUNTY Case n EHPR-04-2016-23697 T 6 Public Health Department Subdivision FRED MCCALL UNREC 2 ',S; Environmental Health Division PIN# 460604902708 ,,`�Y. PO Box 389, 100-A Southwest Blvd.Newton.NC 28658 /8.2 w NAME ON PERMIT: (LEAH DEVLIN), 2319 CHURCHILL RD, RALEIGH NC 27608 ( Leah Devlin) Site Address: 7948 KEISTLERS STORE RD, SHERRILLS FORD NC 28673 Property Size: Square Feet 34,412.40 Acres 0.79 Directions: Hwy 150 East, Right Slanting Bridge Rd, Left Keistler Store Rd, At end of Rd 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 so that a complete site evaluation can be performed. Date: `//Zcyzo/4 Signature of Applicant or Agent _,adja _ - An Environmental Health Specialist will contact you within -work ng days or app ' ation date. If you need further information or assistance please call 828-466- 'I AREA1 i F M l ` { ' ll ENA' E Er led � WatG9Jlfi PA hi l l ;�llii DATE11:1c iii EE'AMOUNTmli Improvement Permit Fee 04/20/2016 $150.00 ,,'1111.... .l, fI11 -�,TOTALFEESuf'��llu.li ` IiIl1l;IlyllliiI�llll�ll ��li11(j14Nr,1111;lk 'I't�t$150`00'.r Ili��ii ItlJj 41191EIIIl ildhf' • '4 lillnULl lllitttWIWgf' • iigurniA". 'dtill1LaNILILa�_1 • ;..,, 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-chappl ion ion 04/20/2016 15:23 Page 2 of 4 CATAWCATAWBA THIS IS NOT A PERMIT E�11�12- C�O BA CATAWBA COUNTY HEALTH DEPARTMENT 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 Address`/Cpeeistler Store Rd rip Fred McCall Sherrills Ford Lot# 3o Acres 0-19 4- Section/Block/Phase Driving Directions to Property Hwy 150 E,TR Slanting Bridge,TL Keistler Store,at end on left NAME TO APPEAR ON PERMIT? ❑ Owner LI Applicant ❑ Contractor Applicant Contact Information Name Leah Devlin Address 2319 Churhill Rd, Raleigh, NC 27608 Phone Cell Phone Owner Contact Information Name Address Phone Cell Phone Contractor Contact Information Name Gary McNeely-Michael Athanas&Associates Address 561 Ennis Rd, Weddington, NC 28173 Phone 704-310-1832 Cell Phone WHO WILL BE THE PRIMARY CONTACT? ❑ Owner ❑ Applicant D Contractor Description of Existing Structures on Site JOCC \V ( (9-\-- # of Bedrooms *t Structure Dimensions #of Occupants Basement ❑ Yes ❑ No Basement Fixtures Q Yes at 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 ID No Does the site contain any jurisdictional wetlands? ® Yes No Does the site contain any existing wastewater systems? ❑ Yes 0 No 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? 4 Yes 0 No Are there any easements or right of ways on this property? Describe Existing water supply in use Li Individual Well Li Community Well ❑ Semi-Public Well ❑ County/City/Township Water Line Is a public water supply available? ** ❑ Yes S 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 tikOther op,(3/5 ❑ Any 0Arran 1JA THIS IS NOT A PERMIT cr,unTV CATAWBA COUNTY HEALTH DEPARTMENT � ��„, ��,,,--,;� Application for Environmental Services Page 2 Proposed Facility Type ❑ Primary Residence ❑ New Residence El Addition to Residence ft of New Bedrooms *t 4 Project Description New' f/oc.g-e_ Structure Dimensions Lo rx 6 0 / # of Occupants I Basement ❑ Yes ❑ No Basement Fixtures ® Yes ® No U Accessory Structure(s) Describe ft of New Bedrooms *t if applicable Structure Dimensions # of Occupants Accessory Dwelling ❑ Yes n No Plumbing ❑ Yes ❑No Describe Plumbing Needed ❑ Multi-Family Residence# Units #Bedrooms per Unit*j' Total # Bedrooms *t Structure Dimensions U Food Service Specify Type # Seats Floor Space -Entire Food Service Facility (Sq Ft) ft Employees per Shift #of Shifts Dining Area(Sq. Ft.) Li Business Specific Type of Business Retail Floor Space #of Employees per Shift if 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 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. Signature of Owner or Ago Date V/2°7Z64 4mlgllr Printed Name of Owner or Agent 4, J L �/u IA d,• .- Ts.":/c(1"--:- Sow_ MICHAEL ATHANAS &ASSOCIATES LICENSED SOIL SCIENTIST 561 Ennis Rd. Weddington, NC 28173 (704)576-3887 Reference: Data Sheet for Fred McCall Property Lot 30 House Footprint: 60' x 60' Building Setbacks: 30' front, 15' side Water Source: Private well Number of Bedrooms: 4/480 GPD Proposed LTAR: 0.25 GPD/FT2 Proposed System Type: PPBPS Proposed Repair System Type: PPBPS Distribution: Low Pressure-CVB Flow per Orifice: 0.59 GPM Orifice Size: 3/16" System Flow: 44.3GPM Dosing Volume: 270 gallons Pump Run Time: 6.1 minutes Elevation Head: Friction Head: 6.3' Pressure Head: 2' Total Dynamic Head: Supply Line Length: 160' (2"PVC) Septic/Pump Tank Size: 1000/1000 gallons Proposed Trench Bottom: 36" Line Design Length # of Panels Actual Length Elevation Orange 1 47' White 2 73' Red 3 65'160' 15114 144' Pink 4 55'/50' 13/12 135' Yellow 5 50'/40' 12/9 109' Orange 6 87' White 7 66' Red 8 40' Pink 9 21' le- -7004y Sc. "i ` 1 „ y0 , deTa '~9F:£O V� 3 t�s o W� ````■ sti !0 .\ a ri n 11C FIELD 0, SEP Nj FOP ■ EgSr)NEpF ._ 2 / pOR 6 gap Sr / / / / t / di. �\ N.2_,,,,...9'39 34� 11�� ;"e'`%; / 1 V> `' pphi' \9 I / 3 9.0 l fib® �-1'' `� =(V `. N / / ■ I I I`t -}- 16- `�' M ; • I I of O n n 44 10 t 1 •• 04 M I J AitCl:�%; I W E.-1 y w ti 3 �o E�`�a . H w t O Ct r- /m of ! ..." '" Q Cs- co N O OQ '<> .t 1 I Li 4 co ^ E ?:v - 1 1 r:7;.:. 3 1 1 `._ M 1 1 h V Y ; o1 t Iliiiii.im: P. I 1 I I ci P' \ ''nod'+r:_: I I L �g +• 1 { F" �b `Y �i O• . .ai I I • R/µ' +. / I 0 KEISTLERS STORE RD ° ,/ E EOP "� l6 $ L5 cA L9 j EOP • E°P '7.- SR #1899 60' PUBLIC R/W R� • __— • Rey re DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES Sheet I of 2 DIVISION OF ENVIRONMENTAL HEALTH PROPERTY ID/I:McCall lot 30_ ON-SITE WASTEWATER SECTION COUNTY:Catawba SOIL/SITE EVALUATION for ON-SITE WASTEWATER SYSTEM OWNER:_Leah Devlin APPLICATION DATE ADDRESS: DATE EVALUATED: PROPOSED FACILITY: 4 bdrm PROPOSED DESIGN FLOW(.1949): 480 GPD PROPERTY SIZE: 0,79 AC LOCATION OF SITE:_Kiestler Store Rd PROPERTY RECORDED: 2016 WATER SUPPLY: E Private ❑Public E-Well ❑ Spring ❑Other EVALUATION METHOD: E Auger Boring ❑Pit 0 Cut TYPE OF WASTEWATER: E Sewage ❑Industrial Process ❑Mixed • P • o SOIL MORPHOLOGY OTHER: F (.1941) PROFILE FACTORS 1 <.1940' L LANDSCAPE HORIZON - E' POSITION/ DEPTH .1942 PROFILE # SLOPE% (IN•) •1941 .1941 SOIL .1943 ;1956 .1944 CLASS STRUCTURE/ CONSISTENCE/ WETNESS/ SOIL SAPRO RESTR &LTAR • TEXTURE MINERALOGY COLOR DEPTH CLASS HORIZ. LS 8% 0-50 RCSBK FR SS SP SEXP Few YB 48" N/A N/A PS 0.25 • ' 1 LS 8% 0-6 BrCLWSBK FR SSSI'SEX!' 48" N/A N/A PS 0.25 6-48 RCSBK FR SS SP SEXY F-C YB 2 • LS 8% 0-24 RCSBK ER SS SP SEXP N/A 48" N/A PS 0.3 2448 R CL 513K FR SS SP SEXP F-C SAL' 3 LS 8% 0-10 Br SCUM,GR VFRSSSP 48" N/A N/A PS 0.25 10-48 RCSBK FR SS SP SEXP F-C S'B�n 35' 4 DESCRIPTION INITIAL SYSTEM REPAIR SYSTEM OTHER FACTORS(.1946): SITE CLASSIFICATION(.1948): PS Available Space(.1945) 960 FT2 1 002 FT2 EVALUATED BY: MA&A System Type(s) PPBPS PPBPS OTHER(S)PRESENT: Site LTAR 0.25 0.25 COMMENTS: SOIL/SITE EVALUATION Sheet 2 of j2 (Continuation Sheet) DEPARTMENT OF ENVIRONMENT PROPERTY ID#: MCCALL LOT 30 AND NATURAL RESOURCES DATE OF EVALUATION: DIVISION OF ENVIRONMENTAL HEALTH COUNTY: CATAWBA • • • • SOIL MORPHOLOGY OTHER F (.1941) PROFILE FACTORS .1940 �L LANDSCAPE HORIZ .1942 POSITION/ ON .1941 .1941 SOIL -,1943 .1956 ,1944 PROFILE tt SLOPE% DEPTH STRUCTURE/ CONSISTENCE/ WETNESS/ SOIL SAPRO RESTR CLASS TEXTURE MINERALOGY COLOR DEPTH CLASS HORIZ &LIAR (IN.) • LS 4% 0-6 Br CL WSBK FR SS SP SEXP N/A 48" N/A PS 0.3 6-36 R C SBK FR SS SP SEXP 5 36-48 R CL WSBK FR SS SP SEXY' F-C SAP LS 4% 0-22 Br CL WSBK FR SS SP SEXP 48" N/A N/A PS 0.275 Mn 22-36 R C SBK FR SS SP SEXP 6 36-48 R CL WSBK FR SS SP SEXP • COMMENTS: Catawba County Environmental Health a S u ) `� y ; 149,4 1101 4'i '9Q it'41 i 16C) o o ,� 0 N$ 1. iivy, ii; IL ..... p. I �i ' I)1' 2 a" 'INII f a sfro 7940 i �(. _,. (284) •1 IP i AY 6to N 7J(1t / 0 A r 71 f Z 1n- — m (62) if, (250) - - ...., - - - A- - - _ 07941 4 \ 5.00 17-K5 120.17 Parcel: 460604902708, 7940 KEISTLERS 1 in=60ft STORE RD SHERRILLS FORD, 28673 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 04/20/2016 Parcel Report Page 1 of 1 Parcel Report - Catawba County NC Parcel Information: Owner Information: Parcel ID: 460604902708 Owner: DEVLIN LEAH MCCALL Parcel Address: 7940 KEISTLERS STORE RD Owner2: MCCALL JANET P LIVING TRUST City: SHERRILLS FORD, 28673 Address: 2319 CHURCHILL RD LRK(REID): 19598 Address2: null Deed Book/Page: 3137/1261 City: RALEIGH Subdivision: FRED MCCALL UNREC State/Zip: NC 27608-2003 Lots/Block: 29-30/ null Last Sale: School Information: Plat Book/Page: School District: COUNTY Legal: LOT 29 & 30 Elementary School: SHERRILLS FORD Middle School: MILL CREEK Calculated Acreage: 1.550 Tax Map: 01 SEX 01030 High School: BANDYS Township: MOUNTAIN CREEK School Map State Road #: 1899 Tax/Value Information: Tax Rates(pdf) Zoning Information: City Tax District: All in County Zoning District: COUNTY County Fire District: SHERRILLS FORD Zoningl: R-30 Building(s) Value: $52,100 Zoning2: null Land Value: $39,500 Zoning3: null Assessed Total Value: $91,600 Zoning Overlay: CRC-O,WP-O Year Built/Remodeled: 1890/1963 Small Area: SHERRILLS FORD 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 #: 3710460600J Building Details 2010 Census Block: 4035 WaterShed: WS-IV Critical Area 2010 Census Tract: 011504 Voter Precinct: P41 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. 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NC :8650 T 4060 DAsS RD —. s Deco BOOK /0<-400-6 00-ssOD v 047E "AAA By 4 - CATAWBA COUNTY 100A SOUTHWEST BLVD QJLLa NEWTON, NORTH CAROLINA 28658 RECEIPT -V-7 h PHONE: 828.465.8399 K Zli�s / Wednesday, April 20, 2016 84'/ sn www.catawbacountync.gov PAYOR: Michael Athanas &Associates Michael Athanas& Associates(McNeely, Gary) PAYMENTS TRANSACTION NUMBER: TRC-658872-20-04-2016 PAYMENT DATE : 04/20/2016 PAYMENT TYPE: Check 1371 INVOICE NUMBER FEE NAME FEE AMOUNT 04-16-327432 Improvement Permit Fee $150.00 TOTAL PAYMENTS : S150.00 EFIPR-04-2016-23697 CASE TYPE: Environmental Health Plan Review WORK CLASS: OSWP SITE ADDRESS: 7948 KEISTLERS STORE RD, SHERRILLS FORD NC 28673 Owner LEAH DEVLIN, 2319 CHURCHILL RD, RALEIGH NC 27608 C:919-696-7095 Contractor MICHAELATHANAS &ASSOCIATES, 561 ENNIS RD, WEDDINGTON NC 28163 C:7043101832 ** NO PEOPLESOFI'ACCOUNT ASSIGNED ** receipt 04/20/2016 15:23 Page I of I