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HomeMy WebLinkAboutEHPR-07-2016-24326.TIF ..„113A CC THIS IS NOT A PERMIT Case # EHPR-07-2016-24326 ,��,,,,� ., CATAWBA COUNTY HEALTH DEPARTMENT �� 611.." .0 v 4 -c. PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES I .1.151 F 1842 SM Environmental Health Plan Review - OSWP • o .'Fr IMPROVEMENT 1 • • T Applicant CHRIS& TIFFANY ALLEN, 2492 S 1950, WEST SYRACUSE UT 84075 C:2072528922 Contractor *SW ASSOCIATES, INC (STANFORD WHITTINGTON), 735 11TH AVE BLVD SE, HICKORY NC 28602 B:828-327-8627 C:8283124026F:828-327-4941 ANNETTEnSWASSOCIATESINC .COM Land Owner CHARLES& MICHELLE POOVEY, 1914 HUNSUCKER DR, CLAREMONT NC 28610 NAME TO APPEAR ON PERMIT Chris & Tiffany Allen SITE ADDRESS: 3450 MULL CREEK LN, CLAREMONT NC 28610 PIN # 376206492261 NAME of SUBDIVISION: DEER CREEK Lot# 30 Section/Block PROPERTY SIZE: Square Feet 262,231.20 Acres 6.02 DIRECTIONS: 1 40 East to Exit 135 toward Claremont, Left onto N Oxford School Rd, Left onto Centennial Blvd, Left onto Bunker Hill School Rd, Left onto Mull Creek Ln, Lot is in the curve. PRIMARY CONTACT: Contractor SEWER TYPE: Septic Tank GALLONS PER DAY: 480 WATER SUPPLY: Private Well 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:: House w/attached garage 90x45 #OF NEW BEDROOMS:: 4 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: 139-chapplication 07/20/2016 08:41 Page 1 of r ACATAWBA COUNTY Case/I EHPR-07-2016-24326 Public Health Department Subdivision DEER CREEK ; 01 4 Environmental Health Division PIN# 376206492261 t PO Box 389, 100-A Southwest Blvd,Newton,NC 28658 1,R.2 ,. NAME ON PERMIT: (CHRIS&TIFFANY ALLEN),2492 S 1950, WEST SYRACUSE UT 84075 ( Chris & Tiffany Allen) Site Address: 3450 MULL CREEK LN, CLAREMONT NC 28610 Property Size: Square Feet 262,231.20 Acres 6.02 Directions: 140 East to Exit 135 toward Claremont, Left onto N Oxford School Rd, Left onto Centennial Blvd, Left onto Bunker Hill School Rd, Left onto Mull Creek Ln, Lot is in the curve. 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 identificd labeling of all property lines and corners and making the site acc-- ible so that a complete site evaluation can be performed. Date: �i �' i � .4, Signature of Applicant or Agent f .. ' AL. I Ada An nvironmental Health Specialist will contact you within working says of application date. If you need further information or assistance please call 828-466-7291 AREA2 E " rl - - _-'— v:,,,,, ,i' ' • 1 rrr ��I1iI!1h ' ''"�nE1!1r TUfP-' 1EENAMJk;', i__ 61+i` .,a:a.hull h4: uDATE FEAMONT Improvement Permit Fee 07/19/2016 $150.00 rEcNr i li .�IITOTAL FEES I6 1 ii11 1 !itr:,P,, I "'r'1 /illi.i :1...illit4 `r,'{lltiI'! iiiiISI50 00 :1" i14 n'1I'iH(+'" 1 tittatitl0 ilttlks' ._..:45 A11 tuisns .i.. u.t t d A 11 i`.11'JJ.!..G11Iulliu ..a inatilOWR dma_ FEES ARE NON-REFUNDABLE ONCE A SITE VISIT IS MADE OR WORK ON A PLAN REVIEW HAS COMMENCED SYSTEM REDESIGN AND/OR RETRIP WILL INCUR AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) 119-ehapplicatinn 07/20/2016 08:41 Page 2 of4 q� 7g� - Z32Co CATAWBA THIS IS NOT A PERMIT COUNTY -- CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services Page 1 Improvement Permit Authorization to Construct Septic Repair E Septic Malfunction II Septic Expansion New Well Permit❑ Replacement Well ❑ Well Abandonment ❑ Well Repair ❑ Existing System Inspection (Pre-Approval Required) ❑ Application is for New Construction rsi Existing Facility ❑ Property Address 3450 Mullcreek Ln Subdivision Deer Creek Claremont, NC 28610 Lot# 30/B Acres 6.02 Section/Block/Phase Lot 30 30B PL 19-169 Driving Directions to Property I 40 E to Exit 135 toward Claremont,Right onto N Oxford SI, Left onto Centennial Blvd, Left on to Mullcreek Lane. NAME TO APPEAR ON PERMIT? ❑ Owner I Applicant ❑ Contractor Applicant Contact Information Name Chris&Tiffany Allen Address2492 S. 1950 W. Syacuse UT 84075 Phone(207)252-8922 Cell Phone Owner Contact Information NameCharles&Michelle Poovey Address 1914 Hunsucker Dr. Claremont. 28610 Phone Unknown I Cell Phone Contractor Contact Information Name' 'hf 5Dq'00_25 Tht. _ Address '7) /�u AVZ Vd c r k GIGO M, NG ag&0ca- Phone 8;g-,3A7- 8Ili'' J Cell Phone g4$-3/a -VOA& WHO WILL BE THE PRIMARY CONTACT? ❑ Owner Applicant 34 Contractor Description of Existing Structures on Site Na #of Bedrooms *f 4 Structure Dimensions #of Occupants Basement ❑ Yes ® No Basement Fixtures ® 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. ri Yes ®No Does the site contain any jurisdictional wetlands? ® Yes ® No Does the site contain any existing wastewater systems? D Yes ®No Is any wastewater going to be generated on the site other than domestic sewage? El Yes ®No Is the site subject to approval by any other public agency? El Yes C 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 0 Alternative 0 Conventional 0 Innovative 17 Other 'G] Any CATAWBA THIS IS NOT A PERMIT COUNTY CATAWBA COUNTY HEALTH DEPARTMENT ,y„,d,,, Application for Environmental Services Page 2 Proposed Facility Type El .t , ,� Primary Residence Igl New Residence� ❑ Addition/,,n' 2 to Residence # of New Bedrooms st Project Description Nu 4t ofiM. 2- tIAAA , COO gl} <. Structure Dimensions qQ'L x 45 W N of Occupants Basement ❑ Yes /0 No Basement Fixtures ® Yes a No 'U Accessory Structure(s) Describe N of New Bedrooms 'f if applicable Structure Dimensions if of Occupants Accessory Dwelling ❑ Yes ❑ No Plumbing ❑ Yes 0 No Describe Plumbing Needed ❑ Multi-Family Residence N Units #Bedrooms per Unit't Total# Bedrooms •t Structure Dimensions Lf Food Service Specify Type N Seats Floor Space-Entire Food Service Facility (Sq Ft) N Employees per Shift N of Shifts Dining Area(Sq. FL) ❑ Business Specific Type ofUusiness Retail Floor Space N of Employees per Shift N of Shifts 0 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 0 Community Well Abandonment Type ❑ Drilled 0 Bored ❑ Dug 0 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 daring 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 chances 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 t am solely responsible for the proper identification and labeling of all property lines and corners and making die site accessible so that a complete site evaluation can be performed. Signature of Owner or Agent i,I, odtor__ Date Palk)Printed Name of Owner or Agent I l CATAWBA Geospatial Real Estate Search < : Information Services s;:.jam 1 i'~/ 71 l) `. ill 5 t /i 7 1 1 ct L 5/i .4L Lc o.. y i'LL.!--'-'—:-H' .:,Th-C,, --/i i ts\Isii\ki r, 6 —. - .� ;,.!: -,-.....„ \\? \ f oocc ota-Gro;lll 73s. 11' , ::: c ../ 7—; i t .NN \ \ N VE r'N >.\\\.. __,......_ , ..„,....„ ou.,„...„. . ....... a .. , ........ �tr w ..--,...„ SLE lin=150ft s Parcel: 376206492261, 3450 MULL CREEK LN CLAREMONT, 28610 Owners: POOVEY CHARLES KEVIN, POOVEY MICHELLE M Owner Address: 1914 HUNSUCKER DR Values - Building(s): $0, Land: $48,300, Total: $48,300 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 07/1912016 Catawba County Environmental Health ,M i, m M ,.. 1 / 7"------------"" / l IJ 1i I i i (I/7 -..,,,, u M vi co �i ) . — \1/41 N 11111101/4aietill r pp. _ : Parcel Report Page 1 of 1 Parcel Report - Catawba County NC Parcel Information: Owner Information: Parcel ID: 376206492261 Owner: POOVEY CHARLES KEVIN Parcel Address: 3450 MULL CREEK LN Owner2: POOVEY MICHELLE M City: CLAREMONT, 28610 Address: 1914 HUNSUCKER DR LRK(REID): 68151 Address2: Deed Book/Page: 2844/0626 City: CLAREMONT Subdivision: DEER CREEK State/Zip: NC 28610-8255 Lots/Block: 30/ B Last Sale: School Information: School District: COUNTY Plat Book/Page: 19/169 Legal: LOT 30 30B PL19-169 DEER CREEK PL Elementary School: CLAREMONT Middle School: RIVER BEND 19-169 Calculated Acreage: 6.020 High School: BUNKER HILL Tax Map: 3311 02030 School Map Township: CLINES State Road It: 2453 TaxNalue Information: Tax Rates(pdf) Zoning Information: City Tax District: All in County Zoning District: CLAREMONT County Fire District: CLAREMONT RURAL Zoningl: R-1 Building(s) Value: $0 Zoning2: Land Value: $48,300 Zoning3: Assessed Total Value: $48,300 Zoning Overlay: Year Built/Remodeled: / Small Area: Current Tax Bill Split Zoning Districts: / Zoning Agency Phone Numbers Miscellaneous: Firm Panel Date: 2007-09-05 Building Permits for this parcel. Firm Panel #: 3710376200J Building Details 2010 Census Block: 3004 WaterShed: WS-IV Protected Area 2010 Census Tract: 010102 Voter Precinct: P6 Agricultural District: Proximity Parcel Report Data Descriptions List all Owners Deed History Report Assessment Report This map/report product was prepared from the Catawba County,NC Geospatial Information Services.Catawba County has made substantial efforts to ensure the accuracy of location and labeling information contained on this map or data on this report.Catawba County promotes and recommends the independent verification of any data contained on this map/report product by the user.The County of Catawba,its employees,agents,and personnel,disclaim,and shall not be held liable for any and all damages,loss or liability,whether direct,indirect or consequential which arises or may arise from this map/report product or the use thereof by any person or entity. ©2016, Catawba County Government, North Carolina. All rights reserved. http://gis.catawbacountync.gov/nomap/parcel_report.php?key=376206492261&typ=P 7/19/2016 CATAW$A COUNTY HEALTH DEPARTMENT P 06- Telephone: (828)465-8270 TDD: (828)465-8200 WLS 1 O Z - o 0s6Z IP $. AC )K Rpr. Print. 0 r. Prmt S,Ys. Type Well Print I _Replacement Well Well Rpr. Prmt. Owner/Agent m Dfy+ Phone Address I Subdivision raw. Section/Block/Phase Lott/ L•t fSize — Directions: ala �� �r a'©Z� 2 ?' &. &1 - 0 • 4:..� ( ' 134 , ,_ . i yn�� (2,� -5-*-rte _ - /_ Property Address 345 o Mud �� 0 2�0 - : f t. 44 aCtunrat - Facility: House X '•.ii a , :1 ., Multi-family . Other: Pin Number 271 z O!*9 2.2Z / Other . Zoning Approval # N Bedrooms a - eat W 7 ployees . Application Rate 0,35 GPD Flow IBD Hot Tub or Spa yes/e3 Special Fixtures Basement yes/no . 100% Repair Area yes/no Basement Plumbing yes& Water Supply: Private Well X Public Semi-Public *************************************************************************************************************************** Type of System: Trench Bed Pump Pump/Panel Panel -LPP Other Septic Tank Size /COO Pump Tank Sizer Jo 00 Nitrification Field: Total Square Feet /370 Depth of Stone 1z/nr� Bed Size Trench Width 3 --Pt. Total Length of All Trenches 957 Number of Trenches ..s Trench Length '15 )0/ftp/ 7Z/_ Feet on Center 9 Maximum Trench Depth 3(o Distance of Nearest Well SD-1'f. *DO NOT INSTALL SEPTIC WHEN WET* *WELL RECORD REQUIRED AT COMPLETION* *************************************************************************************************************************** Topo 2 % Slope - Texture — CM- piece Structure \ f I r -h c Clay Min.i ; ( 1 — dfot �tr G(z5 rt YJ �" Soil Wetness — Soil Depth �- J —« Restric. Hoz. atm \ O Available space /no y ' Overall Class S PS U ‘[...\(o'o , I 6o- 11512'Comments: J 'A . . `� J L____\ °!2 (Zerq. b 0 tm Filter Required kr more ed tan when jiC: tank is more than 6 inches deep. **NO GUARANTEE OR WA' ' •NTY IS IMPLIED OR GIVEN AS TO THE PERFORMANCE OR LENGTH OF TIME THIS SYSTEM WILL FUNCTION" *************************************************************************************************************************** *Improvement Permit has no expiration date and is transferable, but may be revoked if site plans or intended use changes for the proposed facility. An Authorization to Construct is valid for(5) five years from date issued and is not transferable. Well Permit valid for 5 years provided site conditions do not change. Well location, installation, and protection must meet state and local regulations, and must be inspected and approved by a representative of the Catawba County Health Department before'any portion of the installation is put into use. The siting of the well by the Health Department staff is to provide prot• tion from .own possible sources of contamination. No volume of water is guaranteed at any site by the Health Department. Afr Permit Date31-0 Z EH �1- Owner/Agent' _ '1 Septic Tank Install. By / Date EHS Well Installed ByWell Grout Approval Date Well Head Approv Date Date Sample Collected Date of Results Results EHS White-Office Yellow-Owner/Agent Pink-Building Inspection Authorization to Construct .y �'A CO CATAWBA COUNTY f--, u�i� 100A SOUTHWEST BLVD NEWTON, NORTH CAROLINA 28658 INVOICE/RECEIPT d =AIeaPA6PHONE: 828.465.8399 U aa' Lr' C Wednesday, July 20, 2016 x 78 4r2, SM www.catawbacountync.gov Invoice Number: 07-16-330676 Invoice Date: 07/20/2016 EHPR-07-2016-24326 CASE TYPE: Environmental Health Plan Review WORK CLASS: OSWP SITE ADDRESS: 3450 MULL CREEK LN, CLAREMONT NC 28610 Applicant CHRIS & TIFFANY ALLEN, 2492 S 1950, WEST SYRACUSE UT 84075 C:2072528922 Land Owner CHARLES & MICHELLE POOVEY, 1914 HUNSUCKER DR,CLAREMONT NC 28610 Contractor *SW ASSOCIATES, INC, 735 11TH AVE BLVD SE, HICKORY NC 28602 8:828-327-8627C:8283124026F:828-327-4941 ANNETTEaSWASSOCIATESINC.COM ACCOUNT: 6421 PAYOR: "SW ASSOCIATES, INC FEES EHPR-07-2016-24326 FEE AMT DUE AMT Improvement Permit Fee 07/20/2016 $150.00 SI 50.00 FEES: $150.00 $150.00 TOTAL FEES : $150.00 5150.00 • invoicereceipt 07/20/2016 08:39 Page 1 of 1