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HomeMy WebLinkAboutEHPR-07-2016-24357.TIF 13A - • THIS IS NOTA PERMIT Case # EHPR-07-2016-24357 GH CATAWBA COUNTY HEALTH DEPARTMENT El o ' El �;Y ti .�_ Cr ,(� 7 PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES it 'ti 842 4 Environmental Health Plan Review - Septic Malfunction • •a: 3• p 1 ..p Z, .1- r 1el AUTH_CONST- SEPTIC_MALFUNCTIONJ ali (c2C)41\ 151 k 2I.Iro-- MokeriThe Owner JAMES CARTER, 1933 WOODRIDGE DR, HICKORY NC 28602 1-1:8282287088 C:828228707I HOME:8282287088 NAME TO APPEAR ON PERMIT James Carter SITE ADDRESS: 1933 WOODRIDGE DR, HICKORY NC 28602 PIN # 279119527261 NAME of SUBDIVISION: WOODRIDGE Lot# 35 Section/Block PROPERTY SIZE: Square Peet 16,988.40 Acres 0.39 DIRECTIONS: Hwy 127 South, Left onto Woodridge Dr& go to the Stop Sign, house is on the Right on Corner. PRIMARY CONTACT: Owner SEWER TYPE: Septic Tank GALLONS PER DAY• WATFa cI iooi v• r,ommunity It DESCRIBE WORK 9/12/16 - Old repair permit(624 from 1989) Repair installed new bed & allowed to feed the old one as well. Disconnected the original system & no longer failing. Not issuing a repair permit at this time.J - a er iso rouna- 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: House OTHER DESCRIPTION: DESCRIPTION OF House EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: 70x48 NUMBER OF EXISTING BEDROOMS: 3 #OF OCCUPANTS: 2 PROPOSED CONSTRUCTION BASEMENT? Yes BASEMENT FIXTURES? Yes 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 and labeling of all property lines and corners and making the site accessible so that a complete site evaluation cart be performed. Date: Signature of Applicant or Agent 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 Et)-ehappli cat ion 09/12/2016 14:29 Page 1 of 7 eliPL U7- 2or6 - Z43s-7 Catawba County Environmental Health 1A600 DS 92 \ ki., tr c3c3 • 10 Ls ova A • rs o tb • 1491 44 •. t y` ` . t tiC) SO4 P--• Y ti 94.62 yam. Gr ei A. rn e 84.7 142'90 / 141.05 Parcel: 279119527261, 1933 WOODRIDGE DR 1in=40ft HICKORY, 28602 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 09/12/2016 4..‘v,A • THIS IS NOT A PERMIT Case # EI-IPR-07-2016-24357 e AtiGG CATAWBA COUNTY HEALTH DEPARTMENT El r T 0 Ifl:" PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES 4. _ 1842 s^ Environmental Health Plan Review - Septic Malfunction A 4 47 . { AUTH CONST- SEPTIC_MALFUNCTION 0 o Owner JAMES CARTER, 1933 WOODRIDGE DR, HICKORY NC 28602 H:8282287088 C:8282287071 HOME:8282287088 NAME TO APPEAR ON PERMIT James Carter SITE ADDRESS: 1933 WOODRIDGE DR, HICKORY NC 28602 PIN # 279119527261 NAME of SUBDIVISION: WOODRIDGE I of# 35 Section/Block PROPERTY SIZE: Square Feet 16,988.40 Acres 0.39 DIRECTIONS: Hwy 127 South, Left onto Woodridge Dr& go to the Stop Sign, house is on the Right on Corner. PRIMARY CONTACT: Owner SEWER TYPE: Septic Tank GALLONS PER DAY: 360 WATER SUPPLY: Community Well DESCRIBE WORK: Water is on the ground' 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: House OTHER DESCRIPTION: DESCRIPTION OF House EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: 70x48 NUMBER OF EXISTING BEDROOMS: 3 #OF OCCUPANTS: 2 PROPOSED CONSTRUCTION BASEMENT? Yes BASEMENT FIXTURES? Yes 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 an les. I understand that I m solely responsible for the proper identificatiop-2nd labeling of a)Iproperty lines and corners and making the site accessible o that a com „Lb uation can be performed. Date: /— LL 5 l(O Signature of Applicant or Agent � ? ) An Environmental Health Specialist will contact you Nvi working days of application date. If you need further information or assistal please call 828-466-7291 AREA2 1)9-ehapplication 07/25/2016 09:52 Page I of 7 atsr- CATAWBA COUNTY Case# EHPR-07-2016-24357 Q' i�G Public Health Department Subdivision WOODRIDGE 4 1Fl — Environmental Health Division 0 PIN# 279119527261 'var- PO Box 389. 10(I-A Southwest Blvd,Newton. NC 28658 /g42 ,. NAME ON PERMIT: (JAMES CARTER), 1933 WOODRIDGE DR, HICKORY NC 28602 ( James Carter) Site Address: 1933 WOODRIDGE DR, HICKORY NC 28602 Property Size: Square Feet 16,988.40 Acres 0.39 Directions: Hwy 127 South, Left onto Woodridge Dr&go to the Stop Sign, house is on the Right on Corner. it '��l r h I�CA�", l ''i'C' TA',. r a ,.imiNVPI(" Ni i "TN I ' 'iva 1 n r I l tt — ��FEENA�ME, i''iLi�Ijj IIIi:�u i utu. ii��,lir1,!,, i;,r :,.iiDATE CI ,, P { Iii I Ji EEE AMOUNT ryAuthorization to Construct(Repair) Fee 07/25/2016 5300.00 t1'W11 T,07tALFtES • Itll�:' 1 lrigiilli illiilil �, I�lIi�I1�h iI(1IIIII�iIlIiS300t00 r,, VII!';Iatl(t' il'. re t,t10;11.21; .i..,SilSstiE1A.tJvI ;n "w4lf4Vii66„ "nvUilfli9 miGJIthma 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) 89-chapplirrtion 07/25/2016 09:52 Page 2 of7 CATAWBA THIS IS NOT A PERMIT COUNTY CATAWBA COUNTY HEALTH DEPARTMENT _. ►• „o„„�,,�� Application for Environmental Services Page 1 Improvement Permit❑ Authorization to Construct ❑ Septic Repair ❑ Septic Malfunction Septic Expansion E New Well Permit❑ Replacement Well ❑ Well Abandonment Well Repair ❑ Existing System Inspection (Pre-Approval Required) ❑ Application is for New Construction ❑ Existing Facility Property Address /933 (c (id'/Q.c- C 2711 , Subdivision /*t e' y N.G<' 2 2ina_ - Lot# Acres / SectionlBlocklPhase Driving Directions to Property /,2 7 3 7q h e r ( 0,U ? 10o ci/Ccifc A' &o % S %ry civa, X oti g.,4T G NAME TO APPEAR ON PERMIT? Owner ❑ Applicant ❑ Contractor Applicant Contact Information foorrmation f/m Name Je S ( AR7 c Address M f3 !i-"O 0,17 0/45, /)z? /--/lcetc't ALC • 2,06e - Phone S' fl - 2z9 *.)11$ Xell Phone Ai/fC f2V_2-2-5-- 7(77/ Owner Contact Information Name Address Phone Cell Phone Contractor Contact Information Name Address Phone Cell Phone WHO WILL BE THE PRIMARY CONTACT? Owner ❑ Applicant Ti Contractor Description of Existing Structures on Site le # of Bedrooms *1- 3 Structure Dimensions # of Occupants Basement I Yes ❑ No Basement Fixtures a Yes .R No The Applican shall notify the local health department upon submittal of this application if any of the following apply to the property Ti question. If the answer to any question is "yes", applicant must attach supporting documentation. ®yes No Does the site contain any jurisdictional wetlands? 6 Yes ® No Does the site contain any existing wastewater systems? es >^-,b c Is any wastewater going to be generated on the site other than domestic sewage? ® Yes +', . Is the site subject to approval by any other public agency? IC Yes if No Are there any easements or right of ways on this property? Describe Existing water supply in use • H Individual Well community Well ❑ Semi-Public Well ❑ County/City/Township Water Line Is a public water supply available? **1Yes ❑ 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) 0 Accepted 0 Alternative ❑ Conventional 0 Innovative 0 Other L9--Any CATAWBA THIS IS NOT A PERMIT •�cou�n1T`v ®ate CATAWBA COUNTY HEALTH DEPARTMENT ® Application for Environmental Services Page 2 Proposed Facility Type ❑ Primary Residence [ New Residence ❑ Addition to Residence #of New Bedrooms *f Project Description Structure Dimensions # of Occupants Basement ❑ Yes ❑ No Basement Fixtures ® Yes ® No ❑ Accessory Structure(s) Describe #of New Bedrooms *f if applicable Structure Dimensions #of Occupants _ Accessory Dwelling ❑ Yes ❑ No Plumbing ❑ Yes ❑ No Describe Plumbing Needed E. 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) It 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 f 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. f 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 — , Date Printed Name of Owner or Agent It iotia a r%. Catawba County Environmental Health ` Yp \\\ o0 .v0� , 139 50 ...is, ,,„.., c9 1P• 0 IL...111% 00• 0 OC is 45' �0 0 11 o ' 8 ,° 1120' 1.115 •2• Cr 7 \"0 11Q �`9Sooh --- S t941111111....„_7(442.41119141.05 °o \1/21-N—'------7 • Parcel: 279119527261, 1933 WOODRIDGE DR lin=50ft HICKORY, 28602 This map/report product was prepared from the Catawba County,NC Geospatial Information Services. Catawba County has made substantial effons 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 07/25/2016 Parcel Report Page 1 of 1 Parcel Report - Catawba County NC Parcel Information: Owner Information: Parcel ID: 279119527261 Owner: CARTER JAMES CLARENDON Parcel Address: 1933 WOODRIDGE DR Owner2: City: HICKORY, 28602 Address: 1933 WOODRIDGE DR LRK(REID): 64372 Address2: Deed Book/Page: 2831/1995 City: HICKORY Subdivision: WOODRIDGE State/Zip: NC 28602-5593 Lots/Block: 35/ Last Sale: $146,000 on 2007-04-26 School Information: School District: COUNTY Plat Book/Page: 15/4 Elementary School: MOUNTAIN VIEW Legal: LOT 35 35 PL 15-4 WOODRIDGE PL Middle School: JACOBS FORK 15-4 Calculated Acreage: .390 High School: FRED T FOARD Tax Map: 219H 01035 School Map Township: HICKORY State Road #: 2505 TaxNalue Information: Tax Rates(pdf) Zoning Information: City Tax District: All in County Zoning District: COUNTY County Fire District: MOUNTAIN VIEW Zoning1: R-20 Building(s) Value: $130,100 Zoning2: Land Value: $15,700 Zoning3: Assessed Total Value: $145,800 Zoning Overlay: WP-O Year Built/Remodeled: 1975/ Small Area: MOUNTAIN VIEW Current Tax Bill Split Zoning Districts: / Zoning Agency Phone Numbers Miscellaneous: Firm Panel Date: 2007-09-05 Building Permits for this parcel. Firm Panel #: 3710279100J Building Details 2010 Census Block: 2034 WaterShed: WS-III Protected Area 2010 Census Tract: 011102 Voter Precinct: P23 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=279119527261&typ=P 7/25/2016 CATAWBA COUNTY HEALTH DEPAKIIENPJ „ Lot EvaluationImrovement Permit Repair Permit ((// unpletion Permit O 2 Omer/Agent d-Q r� Phone , <^'-46S.-ads) Address 3At. Subdivision �h7T /1 �/ Section/Block Lot # c3 S Lot Size ' ' - ' Directions: '"'1' ". -lcfribtd p • Facility: House. Mobile Hare_ Business_ : Other: Zoning Approval yes/no # Multi-family Other : 100% Repair Area yes/no Bedrocrns33 Baths Seats Employees : GPD Flow Application Rate Garbage Disposal Special Fixtures : REPAIR M7rICE: REPAIRS MUST BE WITHIN 30 Basement yes/no Basegent Plumbing yes/no : DAYS ORDAYS FRIM OF PERMIT. Water Supply: Private Public / 2� vmn^�e **************************************r***yF ****** Type of System: Trench Bed System Other (Specify,) Tank Size: Septic Tank ,rGSef(ti, Pump Tank Nitrification Field: Total Square Feet <SO Depth of Stone 4 Bed Size '/O X ', c Trench Width Total Length of All Trenches Number of Trenches Individual Trench Length / / / / Feet on Center Maximum Trench Depth • i - - Distance to Nearest Well ‘15-0 Lot Evaluation: Approved ' Disapproved_ Sketch of Lot Evaluation Site - System Design - Final — • A • P413):11 31./ 9i1111111111 ildlk 614- i 'Wig IP 1 . 391450 4°11 J' v ' CO • /0 � . .ia � I i She. I U (45-€..(45-€.. \ Q 45 1 / .r • \ ` ,S ' O I .Permit Date 5/3 17F�1 (Lot Evaluation and Improvement Pe � t void after' 36 months) Owner/Agent / Sanitarian _A.2_2 1 /�p, t /,A., Installed By /91, L2$-* ye 1 j ee a -1 Date 3- ./ r Sanitarian /`, (Note any changes/information in red or by sketc/on •ack) Topo S PS U Drainage S PS U Depth S PS U RestrictiveHoz. S PS U Space S PS U Soil S PS U 'III Loans: Sandy Clay, Silt, Clay, Silty Clay .6-.4_ Na Clays: Sandy, Silty, Clay .4-.2 WHITE-OFFICE COPY ' " YELLOW-OWNE WAGENT cOPY • I' A gA - CATAWBA COUNTY OH IOOASOUTHWESTBLVD NEWTON, NORTH CAROLINA 28658 RECEIPT -V►ePHONE: 828.465.8399 U 1; l WI `C Monday, July 25, 2016 1842 sm www.catawbacountync.gov PAYOR: Caner, James PAYMENTS TRANSACTION NUMBER: TRC-749861-25-07-2016 PAYMENT DATE : 07/25/2016 PAYMENT TYPE: Check 1256 INVOICE NUMBER FEE NAME FEE AMOUNT 07-16-330843 Authorization to Construct (Repair) 5300.00 Fee TOTAL PAYMENTS : $300.00 EHPR-07-2016-24357 CASE TYPE: Environmental Health Plan Review WORK CLASS: Septic Malfunction SITE ADDRESS: 1933 WOODRIDGE DR, HICKORY NC 28602 Owner JAMES CARTER, 1933 WOODRIDGE DR, HICKORY NC 28602 11:8282287088C:8282287071 ** NO PEOPLESOFT ACCOUNT ASSIGNED ** receipt 07/25/2016 09:52 Page 1 of 1