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HomeMy WebLinkAboutEHPR-05-2016-23885.TIF THIS IS NOT A PERMIT Case # EHPR-05-20 1 6-23 8 8 5 R CATAWBA COUNTY HEALTH DEPARTMENT Do 0 e t1 , '' c PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES :es. •r . - \842 sM Environmental Health Plan Review - OSWP .-oz, • p a IMPROVEMENT- NEW WELL 0 ti : ko ag Owner CHRISTOPHER& KATIE TAYLOR, 6268 LONG ISLAND RD, H:8283151600 C:8283151602 HOME:8283151600 NAME TO APPEAR ON PERMIT Christopher & Katie Taylor SITE ADDRESS: 2257 GLOVIER RD, CATAWBA NC 28609 PIN # 379102750494 NAME of SUBDIVISION: Lot# 2 PT 3 Section/Block PROPERTY SIZE: Square Feet 523,155.60 Acres 12.01 DIRECTIONS: Take Hwy 10 toward downtown Catawba, Right onto Hudson Chapel Rd, Property is on the Left at the Corner of Glover Rd & Hudson Chapel Rd. If you reach Brown Chapel Rd you have gone too far. PRIMARY CONTACT: Owner SEWER TYPE: Septic Tank GALLONS PER DAY: 360 WATER SUPPLY: Private Well DESCRIBE WORK: lP Only at this time* Well is for livestock that will be moved onto property prior to building home. 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:: 51x35 #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: APPLICATION FOR WELL CONSTRUCTION PROPOSED WELL TYPE: Individual Well REPLACE WELL?: NO k9-chappliestion 05/17/2016 10:30 Page 1 of4 CATAWBA COUNTY Case fl EI-IPR-05-2016-23885 Cfth u2, Public Health Department Subdivision ,(3)1 I-7 Environmental Health Division PIN# 379102750494 PO Box 389, 100-A Southwest Blvd,Newton,NC 28658 Ig.2 SM NAME ON PERMIT: (CHRISTOPHER& KATIE TAYLOR), 6268 LONG ISLAND RD, ( Christopher& Katie Taylor) Site Address: 2257 GLOVIER RD, CAI'AWBA NC 28609 Property Size: Square Feet 523,155.60 Acres 12.01 Directions: Take Hwy 10 toward downtown Catawba, Right onto Hudson Chapel Rd, Property is on the Left at the Corner of Glover Rd & Hudson Chapel Rd. If you reach Brown Chapel Rd you have gone too far. 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 acce sig_ble so that a complete site evaluation can be performed. Date: 61 j Le Signature of Applicant or Agent fekr-, � ✓ An Environmental Health Specialist will contact you within 5 working days of application date. If you need further information or assistance please call 828-466-7291 AREA1 LE�IIionion IF— i� I vi,„ii M (tT�"'TI il�lire`{rlil i�t{'I I'�lili �!!I ingur TE Illl�I icL9-MOIUNT__ : i��61111��� r It� 11�M;,.6.illra�ll.M�iii fmylli��Ilt�ll�lapATE ,Lp, t� Improvement Permit Fee 05/17/2016 $150.00 Well Permit & Inspection Fee 05/17/2016 $300.00 i ,��Fi1iflj� 1�3 TOTAii1i'u ESI ; l�l �q �ihlillf"I�lilfkt�71!ifll'IUI�I9P�I�II�IIIiII�G�_ a 1 G4''�l P I - ,., [' � I IC �9 II IlII Illi I �$aso 00 �.3l�I�u u�w b u1.dt 11401111111511M10/ . tMJtC:,,,uti tatwW110121IAWl11111N111.1111,AM1,INHIN{4'1ti8'L.. .5116SP1* smut- 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) 19-ehapplication 05/17/2016 10:30 Page 2 of4 Katherine Harris From: Jonathan Greer Sent: Tuesday, May 17, 2016 10:46 AM To: Katherine Harris Subject: RE: Parcel ID# 379102750494 The home is more than 250 feet from the sewer line so we will not require connection. Thanks. From: Katherine Harris Sent: Tuesday, May 17, 2016 10:46 AM To: Jonathan Greer Subject: Parcel ID # 379102750494 Jonathan, I have a customer who is applying for a septic & well permit at the Parcel ID #379102750494, New address 2257 Glovier Rd. I show a sewer line running down Hudson Chapel Road. The home they are proposing will be 500+ feet from the road. I just want to make sure that it is okay for them to apply for septic on this property or if they will be required to connect to the sewer line. Thank you, Katherine Harris Administrative Assistant I Environmental Health Catawba County Public Health 100A Southwest Blvd Newton NC 28658 828-465-8270 828-465-8276 fax The information contained in electronic transmissions is confidential and may be subject to protection under the law,including the Health Insurance Portability and Accountability Act(HIPAA).An electronic transmission is intended for the sole use of the individual or entity to whom it is addressed.If you are not the intended recipient,you are notified that any use,distribution or copying of the message is strictly prohibited.If you received a message in error, please contact the sender immediately by replying to the email and delete the material from any computer. 1 CATAWBA THIS IS NOT A PERMIT �coun CATAWBA COUNTY HEALTH DEPARTMENT .,.„;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 Address Parcel#379102750494 Subdivision WLot# Acres -13 Section/Block/Phase Driving Directions to Property Take Highway 10 toward downtown Catawba and turn right onto Hudson Chapel rd property on the Left at the corner of Glovier and Hudson Chapel if you reach Brown Chapel rd you have gone too far NAME TO APPEAR ON PERMIT? ❑ Owner ❑ Applicant ❑ Contractor Applicant Contact Information Name Katie Taylor Address 6268 Long Island Rd Catawba Nc 28609 Phone Cell Phone 828-315-1602 Owner Contact Information Name Christopher and Katie Taylor Address 6268 Long Island rd Phone Cell Phone 828-315-1600 Contractor Contact Information Name Address Phone Cell Phone WHO WILL BE THE PRIMARY CONTACT? ❑ Owner ❑ Applicant ❑ Contractor Description of Existing Structures on Site V '1-}—r V , # of Bedrooms *j Structure Dimensions #of Occupants Basement ❑ Yes ❑ No Basement Fixtures a Yes ® 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. 0 Yes ID No Does the site contain any jurisdictional wetlands? CI Yes 13 No Does the site contain any existing wastewater systems? ID Yes 0 No Is any wastewater going to be generated on the site other than domestic sewage? ICI Yes 0 No Is the site subject to approval by any other public agency? ID Yes ID No Are there any easements or right of ways on this property? Describe Existing water supply in use Lf Individual Well L] Community Well LI Semi-Public Well ❑ County/City/Township Water Line Is a public water supply available? ** ❑ Yes MIo 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 �'l Any COUNTY A THIS IS COUNTY HEALTH DEPARTMENT Application for Environmental Services Page 2 Proposed Facility Type ❑ Primary Residence ❑ New Residence ❑ Addition to Residence # of New Bedrooms *t Project Description 3bd 2.5 bath home Structure Dimensions 51 X 35' # of Occupants 4 Basement ❑ Yes ❑ No Basement Fixtures ® Yes O; No U Accessory Structure(s) Describe #of New Bedrooms *t if applicable Structure Dimensions # of Occupants Accessory Dwelling ❑ Yes ❑ No Plumbing ❑ Yes ❑ No Describe Plumbing Needed Li Multi-Family Residence# Units #Bedrooms per Unit*t Total# Bedrooms *t Structure Dimensions ti Food Service Specify Type ft Seats Floor Space-Entire Food Service Facility (Sq Ft) # Employees per Shift #of Shifts Dining Area(Sq. Ft.) U 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 &AV /// .- Date 5- 17 - t tP Printed Name of Owner or Agent Valle.- T7 .J IUD Catawba County Environmental Health / ii , 1 f /` I E18)�1T,., N ea. N I 60 I W / I / P hhffjf CP PB . • L3 (519) I I h\ 1 f t f + 73 I o f f • I I f f (477) A. • I , • + ' 1 w 1 f CP I V I I I I C ' r • I . I\ ' 92,5 I 1 (357) • 60 Alk, HUDSON CHAPEL RD . EI Parcel: 379102750494, CATAWBA, 28609 1in=1OOft 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 05/17/2016 Catawba County Environmental Health i �1� i � a Jr Joi l'i} �, 212', -:... 1 1 ossig 180) 1 1 1 1 ` 1 1 1 47 1 %III%I o 1 i4,1 m Sj�1 A 1 c 0 1 1 Cy �1 I I 1 O I 1 1 1 1 1 ' I rCn r 1 + 11 4:3-4:0718c;%3 HUDSON C \1/4„ L..... 2) HAPEL RD - 047) I f10 :`wa li n, 7 Parcel: 379102750494, CATAWBA, 28609 1in=2OOft 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 05/17/2016 Parcel Report Page 1 of l Parcel Report - Catawba County NC Parcel Information: Owner Information: Parcel ID: 379102750494 Owner: TAYLOR CHRISTOPHER J Parcel Address: Owner2: TAYLOR KATIE A City: CATAWBA, 28609 Address: 6268 LONG ISLAND RD LRK(REID): 12995 Address2: null Deed Book/Page: 3334/0776 City: CATAWBA Subdivision: State/Zip: NC 28609-8972 Lots/Block: 2 PT 3/ School Information: Last Sale: School District: COUNTY Plat Book/Page: 6/21 Legal: LOT 2 PT 3 PT LONG LAND 1 5 PL 6-21 Elementary School: CATAWBA Middle School: MILL CREEK Calculated Acreage: 12.010 Tax Map: 012 Y 01022 High School: BANDYS Township: CATAWBA State Road #: 1004 Tax/Value Information: Tax Rates(pdf) Zoning Information: City Tax District: All in County Zoning District: COUNTY County Fire District: CATAWBA RURAL Zoningl: R-40 Building(s) Value: $0 Zoning2: LI Land Value: $65,100 Zoning3: null Assessed Total Value: $65,100 Zoning Overlay: WP-O Year Built/Remodeled: null/null Small Area: SHERRILLS FORD Current Tax Bill Split Zoning Districts: null/null Zoning Agency Phone Numbers Miscellaneous: Firm Panel Date: 2008-03-18 Building Permits for this parcel. Firm Panel #: 3710379100K Building Details 2010 Census Block: 1001 WaterShed: WS-IV Protected Area 2010 Census Tract: 011503 Voter Precinct: P21 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=379102750494&typ=P 5/17/2016 Y' CATAWBA COUNTY 100A SOUTHWEST A ��� NEWTON, NORTH CAROLINA 28658 � �f'' � RECEIPT s safe PHONE: 828.465.8399 vdw,�� Tuesday, May 17, 2016 /842 SM www.catawbacountync.gov PAYOR: Taylor, Christopher& Katie PAYMENTS TRANSACTION NUMBER: TRC-674146-17-05-2016 PAYMENT DATE : 05/17/2016 PAYMENT TYPE: Cash INVOICE NUMBER FEE NAME FEE AMOUNT 05-16-328438 Improvement Permit Fee SI50.00 *rrem 05) 16'328438yI�PUphp�r �.�"!0lig7"7"WellPe�mit,&Insp'e"ctlon°F..ee7C I11<.., c :"'$30000 TOTAL PAYMENTS : 5450.00 EHPR-05-2016-23885 CASE TYPE: Environmental Health Plan Review WORK CLASS: OSWP SITE ADDRESS: 2257 GLOVIER RD, CATAWBA NC 28609 Owner CHRISTOPHER& KATIE TAYLOR, 6268 LONG ISLAND RD, H:8283I516000:8283151602 ** NO PEOPLESOFT ACCOUNT ASSIGNED ** receipt 05/17/2016 10:29 Page 1 of I