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HomeMy WebLinkAboutEHPR-07-2016-24327.TIF sti$A •7., THIS IS NOT A PERMIT Case # EHPR-07-2016-24327 r" vitt ar►:` H CATAWBA COUNTY HEALTH DEPARTMENT ❑' a I ;o0 '-) '17,nce 7 PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES t '} i 1842 :M Environmental Health Plan Review - OSWP F u o `o A2 1 • IMPROVEMENT 0 . ' . o - o Owner RSH PROPERTIES L.P. (RICHARD HARWELL), 6726 GREEDY HWY, HICKORY NC 28602 C:8283244455 NAME TO APPEAR ON PERMIT RSH Properties L.P. (Richard Harwell) SITE ADDRESS: 4154 CLEAR SPRING DR,CLAREMONT NC 28610 PIN # 376304941498 NAME of SUBDIVISION: CROSSING CREEK Lot# 45 Section/Block PROPERTY SIZE: Square Feet 22,215.60 Acres 0.51 DIRECTIONS: Bunker Hill Rd from Claremont, Left onto Deal Rd & go about 1 mile, Right onto Crossing Creek, Last driveway on the Left, 2nd lot on the Right. PRIMARY CONTACT: Owner SEWER TYPE: Septic Tank GALLONS PER DAY: 360 WATER SUPPLY: Private Well DESCRIBE WORK: IP to re-designate the repair area & evaluate for potential septic easement for neighboring property. 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? Yes 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: Mobile Home OTHER DESCRIPTION: DESCRIPTION OF SW Mobile Home EXISTING STRUCTURES ON SITE(IF ANY) DIM EXISTING STRUCTURE: 14x60 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: YES Other described: 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 an labe'ng of all property lines and corners and making the site acces so that a complete to evaluation can be performed. Date: /�p�jl Signature of Applicant or Agent 4� 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 AREA2 *r*s************s**********a***************•*****rrs*********************s***c****xs********rsss************ E9-ehapplicarion 07/20/2016 08:15 Page 1 of 4 • CATAWBA COUNTY Case# EHPR-07-20 t 6-24327 4 ®y Public Health Department Subdivision CROSSING CREEK 2 �, Environmental Health Division PIN# 376304941498 's"' •® PO Box 389, 100-A Southwest Blvd,Newton.NC 28658 /; :w NAME ON PERMIT: RSH PROPERTIES L.P. ( RICHARD HARWELL), 6726 GREEDY HWY, HICKORY NC 28602 RSH Properties L.P. ( Richard Harwell) Site Address: 4154 CLEAR SPRING DR, CLAREMONT NC 28610 Property Size: Square Feet 22,215.60 Acres 0.51 Directions: Bunker Hill Rd from Claremont, Left onto Deal Rd & go about 1 mile, Right onto Crossing Creek, Last driveway on the Left, 2nd lot on the Right. FFEIVAME; �] Al ". t o- ac 5 .b 'i 1 ;p z -#` 'rFTrigiam '—ilagjaME4DATEctIlligifFEE AMOUNTi 1 Improvement Permit Fee 07/20/2016 $0.00 x„rf ri , ,:t445IXCEE-E-Stitiont2:,77 §a+."t t.>L .es.'i1)';lftta5Y $000{ ;3sad a t641` 41 a..i... ;'r•,.k ratv- vas,*=ri-ut s URNS,.,-A-F- a ,...sig,` FEES ARE NON-REFUNDABLE ONCE A SITE VISIT IS MADE OR WORK ON A PLAN REVIEW HAS COMMENCED SYSTEM REDESIGN AND/OR RETRIP WILL INCUR AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) E9-ehapplication 07/20/2016 08:15 Page 2 of 4 CATAWBA, THIS IS NOT A PERMIT counU .�",�, CATAWBA COUNTY HEALTH DEPARTMENT ..7.7.7.7,--L. Application for Environmental Services Page 1 Improvement Permit Authorization to Construct ❑ Septic Repair Ti Septic Malfunction Septic Expansion ❑ New Well Permit I I Replacement Well ❑ Well Abandonment IT Well Repair ❑ Existing System Inspection(Pre-Approval Required) _ Application is for New Construction ❑ Existing Facility IX Property Address t'/5-9" d/e#C see) / Subdivision G55,2,p a/c'e1. e/geto ro..0tr tic }ge,e) Lot# V, Acres e Sl Section/Block/Phase Driving Directions to Property 7/ 4.U& //J 1/ t2 90 /,0,/e7 Aix, r 0,;.C., . crevCSr�p9 i eret i / r., ..v_ .l e NAME TO APPEAR ON PERMIT? ycl Owner ❑ Applicant I I Contractor Applicant Contact Information Name Address Phone I Cell Phone Owner Contact Information Name 75// 0(ert� J. P g%'L' A-iwJJ f,%ue// Address /3);:/ 64.,,03.4,id enc A-' /f;C(<G/lr// ,o(i /;96/O Phone q,7�r 7 2 q___9 C,/5'$— II Cell Phone Contractor Contact Information Name Address Phone I Cell Phone WHO WILL BE THE PRIMARY CONTACT? 71,Owner ❑ Applicant ❑ Contractor Description of Existing Structures on Site $7)v97P/.v>St # of Bedrooms *j' 3 fit Structure Dimensions c— # of Occupants C.:— NSNS Basement n Yes 5 No Basement Fixtures ® Yes rj No r 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 SNo Does the site contain any jurisdictional wetlands? Yes ®No Does the site contain any existing wastewater systems? p Yes AJ`lo Is any wastewater going to be generated on the site other than domestic sewage? El Yes to Is the site subject to approval by any other public agency? ID Yes o Are there any easements or right of ways on this property? Describe Existing water supply in use Individual Well ❑ Community Well ❑ Semi-Public Well H County/City/Township Water Line Is a public water supply available? ** ❑ Yes 9-No If applying for an Improvement Permit or Authorization to Construct,Please Indicate Desired SystePPm Type(s): (systems can be ranked in order of your preference) Accepted 0 Alternative 0 Conventional 0 Innovative 0 Other YAny C ATM 7P. TI-ES IS NOT A PERMIT aunt Y__ l�& CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services Page 2 Proposed Facility Type ❑ Primary Residence n New Residence I I Addition to Residence ft of New Bedrooms *t Project Description Structure Dimensions #of Occupants Basement U Yes n No Basement Fixtures ® Yes ® No I-1 Accessory Structure(s) Describe # of New Bedrooms *t if applicable Structure Dimensions # of Occupants Accessory Dwelling ❑ Yes n No Plumbing n Yes ❑ No Describe Plumbing Needed Multi-Family Residence#Units #Bedrooms per Unit*j' 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.) 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 ❑ Yes ❑ No If Daycare Specify Occupancy Application for Well Construction/Abandonment/Repair Proposed Well Type ❑ Individual Well n Semi-Public Well Community Well Abandonment Type n Drilled n Bored ❑ Dug ❑ Unknown Well Repair Requested n 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 isnot 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. fr/cee of Owner or Agent / / -1 ,/ Date // /�6 Printed Name of Owner or Agent '- /29kite J W ‘Ut'/7 Catawba County Environmental Health _ 125.26 _ r 196.20 19 0.4~`� . _ T — CO10 _ SI ca 0 • •+ w fir," criN r m 7 0 El 7zfri 3 z 190 / k •W CD coo cotoC • 1 if\ . coN • 0 O i" N N ' 190 (1\\45 CRO'SING CREEK CR • Parcel: 376304941498, 4154 CLEAR SPRING lin=50ft DR CLAREMONT, 28610 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 07/20/2016 Parcel Report Page 1 of I Parcel Report - Catawba County NC Parcel Information: Owner Information: Parcel ID: 376304941498 Owner: KEY CHAD WINFIELD Parcel Address: 4154 CLEAR SPRING DR Owner2: City: CLAREMONT, 28610 Address: 132 BUFFALO WAY RD LRK(REID): 66939 Address2: Deed Book/Page: 3036/0712 City: STATESVILLE Subdivision: CROSSING CREEK State/Zip: NC 28677-8477 Lots/Block: 45/ Last Sale: School Information: Plat Book/Page: 23/248 School District: COUNTY Legal: LOT 45 CROSSING PL 23-248 Elementary School: OXFORD Middle School: RIVER BEND Calculated Acreage: .510 Tax Map: 2515 01045 High School: BUNKER HILL Township: CLINES School Map State Road #: 2457 Tax/Value Information: Tax Rates(pdf) Zoning Information: City Tax District: All in County Zoning District: COUNTY County Fire District: OXFORD Zoningl: R-30 Building(s) Value: $15,000 Zoning2: Land Value: $10,200 Zoning3: Assessed Total Value: $25,200 Zoning Overlay: DWMH-O,WP-O Year Built/Remodeled: 1994/ Small Area: ST STEPHENS/OXFORD Current Tax Bill Split Zoning Districts: / Zoning Agency Phone Numbers Miscellaneous: Firm Panel Date: 2007-09-05 Building Permits for this parcel. Firm Panel #: 3710376300J Building Details 2010 Census Block: 3022 WaterShed: WS-IV Protected Area 2010 Census Tract: 010101 Voter Precinct: P27 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=376304941498&typ=P 7/20/2016 **;Op. permit and/or Cert. Op. Required (Must be completed prior to final) C A T A W E A C O U N T Y H E A L T H D EPA R M E Na. ti (704) 465-8270 Lot Eval. Improve. Permit X Repair Permit Cert. of Comp. Permit Oper. Perm 4r�� � Owner/Agent Ga Ji dde. t Phone Address Subdivision Crc 551C�re tk. S-ct'on/Block/Phase Lot# ci Lot Sze I}rections: �Qct [flim .: u; arspir A,. .i eff �! , --Mair . / �-u-. o+ an, I by• Facility: House Mobile Home)( Business . Other: Tax'Flap # .2516 " /-44_6 Hulti-family_ Other . Zoning Approval # Z411,462!.6 -7q Bedrooms 3 Seats Employees . Application Rate 0' 4 GPD Flow .365 Hot Tub or Spa yes/eP Special Fixtures . 100% Repair Areaafts./no REPAIR NOTICE: Basement yestO Basement Plumbing yes/no . REPAIRS MUST BE WITHIN 30 DAYS OR Water Supply: Private k Public . DAYS FROM DATE OF PERMIT. Type of System: Trench k Bed Pump Pump/Panel Panel LPP Other Tank Size: Septic Tank /BOO Pump Tank Nitrification Field: Total Square Feet goo Depth of Stone/Z"':-.60 Bed Size Trench Width 3 Total Length of All Trenches .30 Number of Trenches 4114 Individual Trench Length7.5 /17 /11 / ? '/ n_ Feet on Center 7 ' Maximum Trench Depth 32 Distance of Nearest Well Lot Evaluation: Approved yes/no (Void After 24 months) Topa % Slope Sketch of lot Evaluation Site - Systemsylgi n - Final Textured a,Lk DO NOT y.1 INSTALL Structure - WHEN WET Clay Min. I Soil Wetness VT Soil Depth NI \V\\ A�0 Restric. Hoz. at " l \\ \\1- \ n Available space yes/no Overall Class S PS U \ ir•- - i."-/Comments: �� 14.: '!:. N. //; ••••Q ---- I � a • n I ,� 4C Cal Septic Tank Contractors MUST contact the I u_ Sanitarian BEFORE I changing permit. 1 rcSpVi.fI AQ-AU.- **NO GUARANTEE OR WARRANTY` S IMPLIED OR GIVEN 'IHROUGH THE ISSUANCE OF THIS PERMIT** **** ************** Permit Date • -•. J (Iiprove _. Pe •i•Az ter 60 months) 1 Owner/Agent\ 4 ..` Sanita • -. -. �.:� ' Installed By .At%-r 'it - Date - 7_9 Sanitarian lrii,/_.- ote any changes/information in red or by sketch om b- ) IF A jai' II HAS TO BE REDESIGNED AND/OR RETRIPS MADE TO THE PRI a!• , THERE IS AN ADDITIONAL $25 CHARGE. • White-Office Blue-Bldg Insp.Comp. -Yellow-Owner/Agent Green-Bldg.Insp.LP. FILED Catawba County (on Jul 22,2016 at 04:17:00 pm--) Excise Tar $30_00 (AT) pees ��Ckord kjv\frJtt INST.#12204 p� DONNA HICKS SPENCER, U ,,Wr Sf�'i n Du Register of de f (\ t7 N6 /� 0335E Ig 1860-1861 NORTH CAROLINA GENERAL WARRANTY DEED Excise Tax: S30.00 Recording Time,Book and Page: Tax Map No. 251501045 Parcel Identifier No: 376304941498 ✓Mail after recording to: James Russell Fleischer,309 Main St.NW,Suite B,Lenoir,NC 28645 This instrument was prepared by: James Russell Fleischer THIS DEED made this 15th day of July , 2016 by and between GRANTOR Chad Winfield Key Mailing Address:132 Buffalo Way Rd,Statesville NC 28677 j4 GRANTEE RSH Properties Family LP Property Address: 4154 Clear Spring Dr.,Claremont;NC 28610 Mailing Address:310 4th St SW Hickory NC.28602 The designation Grantor and Grantee as used herein shall include said parties,their heirs,successors,and assigns,and shall include singular,plural,masculine,feminine or neuter as equired by context. WITNESSETH,that the Grantor,for a valuable consideration paid by the Grantee,the receipt of which is hereby acknowledged, has and by these presents does grant,bargain,sell and convey unto the Grantee in fee simple,all that certain lot or parcel of land and more particularly described as follows: BEING all of Lot 45 as shown on the plat entitled"Crossing Creek"as surveyed by J.Mike Honeycutt,Registered Land Surveyor,dated June 10,1988,a copy of which plat is recorded in the office of the Register of Deeds of Catawba County in Plat Book 23 at Page 248,to which plat reference Is hereby made for a more particular description of same. The foregoing is subject to those restrictions contained in Deed Book 1569 at Page 141,Catawba County Registry. For reference to chain of title,see deed recorded in Deed Book 2943,Page 975,Catawba County Registry. All or a portion of the property hereinabove described was acquired by Grantor by instrument recorded in Book 30306 ,Page 712 Catawba County Registry. A map showing the above described property is recorded in Plat Book 23 ,Page 248 ,and referenced within this instrument. Does the above described property include the primary residence(yes/no)?No a TO HAVE AND TO HOLD the aforesaid lot or parcel of land and all privileges and appurtenances thereto belonging to the Grantee in fee simple. 1861 And the Grantor covenants with the Grantee,that Grantor is seized of the premises in fee simple,has the right to convey the same in fee simple,that title is marketable and free and clear of all encumbrances,and that Grantor will warrant and defend the title against the lawful claims of all persons whomsoever except for the exceptions hereinafter stated. Title to the property hereinabove described is subject to the following exceptions: IN WITNESS WHEREOF,the Grantor has hereunto set his hand and seal,or if corporate,has caused this instrument to be signed in its corporate name by its duly authorized officer(s),the day andan year first above written. Li"" (SEAL) (Entity Name) Chad Winfield Key By: (SEAL) Title: By: (SEAL) Title: (SEAL) NORTH CAROLINA CALDWELL COUNTY I certify that the following person(s)personally appeared before me this day,each acknowledging to me that he or she signed the foregoing drx,,r -•• Chad Winfield Key .Witness my hand and official stamp or seal,this the I!Tit—) day of My Commission E pires: CO(e cq I i g fff Notaryblic (� Print Notary Name: ArP & }- E[`i_cie REj�` ,. NORTH CAROLINA CALDW '4)UNT.Y9 I certify that the following person(s)ileloii.all��p e�d•befq�,9e this day,each acknowledging to me that he or she signed the foregoing document: - n'•, -� .Witness my hand and official i .. stamp or seal,this the da"/�04y,;••-.....•••' • YrrN.�0` My Commission Expires: Notary Public Print Notary Name: