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HomeMy WebLinkAboutEHPR-08-2016-24450.TIF •G THIS IS NOTA PERMIT Case # EHPR-08-2016-24450 < ",x"°i i CATAWBA COUNTY HEALTH DEPARTMENT ❑Pa .o -10' PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES � l 1842 SAS Environmental Health Plan Review - OSWP si_tre o o rc 4 r REPLACE WELL , „ Owner BARRY KIM BAKER, 4591 ENOCH DR, SHERRILLS FORD NC 28673 H:8284782649 C:7046216304 HOME:8284782649 NAME TO APPEAR ON PERMIT BARRY KIM BAKER SITE ADDRESS: 4581 ENOCH DR, SHERRILLS FORD NC 28673 PIN # 460602781164 NAME of SUBDIVISION: ENOCH AND INA SIGMON ESTATE Lot# 13 Section/Block A PROPERTY SIZE: Square Feet 20,908.80Acres 0.48 DIRECTIONS: Hwy 150 East, Right onto Slanting Bridge Rd &go about 1.5 miles, Right onto Enoch Dr,The residence is the last house on the Right. PRIMARY CONTACT: Owner SEWER TYPE: Septic Tank GALLONS PER DAY: WATER SUPPLY: Private Well DESCRIBE WORK: Revised 8/12/16 - Updated Address/Info. - Replacement well will be located on vacant lot beside the home with same owner. Home is located beside lot on 4591 Enoch Dr. Replacement Well* No Water* Owner owns lot beside of the house (4581) Well &well house is on that 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? 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: Existing Structure STRUCTURE TYPE: ** NO STRUCTURE SELECTED ** FACILITY TYPE: House OTHER DESCRIPTION: DESCRIPTION OF Vacant Lot w/Well House EXISTING STRUCTURES ON SITE(IF ANY) DIM EXISTING STRUCTURE: NUMBER OF EXISTING BEDROOMS: 0 #OF OCCUPANTS: PROPOSED CONSTRUCTION BASEMENT? No BASEMENT FIXTURES? No PLUMBING REQUIRED? Desired system types (Improvement Permit or Authorization to Construct): ACCEPTED: ALTERNATIVE: CONVENTIONAL: OTHER: INNOVATIVE: ANY: Other described: APPLICATION FOR WELL CONSTRUCTION PROPOSED WELL TYPE: Individual Well REPLACE WELL?: YES F9-ehapplicaiion 08/122016 09:59 Page 1 of 4 _ CATAWBA COUNTY Case at EHPR-08-2016-24450 Public Health Department Subdivision ENOCH AND INA SIGMON ESl < „pie " Environmental Health Division PINE 460602781164 PO Box 389. 100-A Southwest Blvd,Newton,NC 28658 1£342 im NAME ON PERMIT: ( BARRY KIM BAKER), 4591 ENOCH DR, SHERRILLS FORD NC 28673 ( BARRY KIM BAKER) Site Address: 4581 ENOCH DR, SHERRILLS FORD NC 28673 Property Size: Square Feet 20,908.80 Acres 0.48 Directions: Hwy 150 East, Right onto Slanting Bridge Rd &go about 1.5 miles, Right onto Enoch Dr, The residence is the last house on the Right. 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 l 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: 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 AREA1 f '.illilvir: ,f:''I i �� IIP , � �� 16 _N "'itii l:1 171I1��71 {f{1Il j��l�r1�I�.y:.. f ( :'i �,.FEENAME )L�iI�.IIlI1�Cd�i'.. lau:���++�� .>-, , " yuju ,,iiDATE fIIh fldilil!JFEEI+AMOUNT..liu, Well Permit& Inspection Fee 08/04/2016 $300.00 air I { . l " 530000nl?Elf : a Iu1U:' • Ira:Ld11ining15ti adu. �t w ILW:.iifLli6d!aG :aIW1111:14N0iA'I ,M atiIIII1dIdIlIILa.I - •- 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) 09-ehapplication 08/12/2016 09:59 Page 2 o14 13A THIS IS NOT A PERMIT Case# EHPR-08-2016-24450 Q CATAWBA COUNTY HEALTH DEPARTMENT EL K4: % PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES { 184Z/�^� Environmental Health Plan Review - OSWP _ �o x REPLACE WELL I, Owner BARRY KIM BAKER, 4591 ENOCH DR, SHERRILLS FORD NC 28673 H:8284782649 C:7046216304 HOME:8284782649 NAME TO APPEAR ON PERMIT BARRY KIM BAKER SITE ADDRESS: 4591 ENOCH DR, SHERRILLS FORD NC 28673 PIN # 460602781043 NAME of SUBDIVISION: ENOCH AND INA SIGMON ESTATE Lot# 13 Section/Block A PROPERTY SIZE: Square Feet 20,908.80 Acres 0.48 DIRECTIONS: Hwy 150 East, Right onto Slanting Bridge Rd & go about 1.5 miles, Right onto Enoch Dr, The residence is the last house on the Right. PRIMARY CONTACT: Owner SEWER TYPE: Septic Tank GALLONS PER DAY: 240 WATER SUPPLY: Private Well DESCRIBE WORK: Replacement Well* No Water* Owner owns lot beside of the house (4581) Well &well house is on that 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: House OTHER DESCRIPTION: DESCRIPTION OF House & Garage EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: House 56x43, Garage 28x30 NUMBER OF EXISTING BEDROOMS: 2 ft 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: APPLICATION FOR WELL CONSTRUCTION PROPOSED WELL TYPE: Individual Well REPLACE WELL?: YES 19-chapplication 08/04/2016 16:17 Page 1 of 4 t:.„ti,A • CATAWBA COUNTY Case# EHPR-08-2016-24450 Q � .2, Public Health Department Subdivision ENOCH AND INA SIGMON ES1 Environmental Health Division PINY "fie- 460602781043 PO Box 389. 100-A Southwest Blvd,Newton.NC 28658 2g.2 o NAME ON PERMIT: (BARRY KIM BAKER),4591 ENOCH DR, SHERRILLS FORD NC 28673 ( BARRY KIM BAKER) Site Address: 4591 ENOCH DR, SHERRILLS FORD NC 28673 Property Size: Square Feet 20,908.80 Acres 0.48 Directions: Hwy 150 East, Right onto Slanting Bridge Rd &go about 1.5 miles, Right onto Enoch Dr, The residence is the last house on the Right. 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 labe ing of all property lines and corners and making the site accessiblesoa cgmplete site value f�`can be performed. Date: e( �T -7Qf6 SignahmeofApplicant orAgent / i An Environmental Health Specialist will contact you within 5 worCng days of application date. 1f you need further information or assistance please call 828-466-7291 AREA1 , ; Ih � ' II 11l ' ,l� '1,tt%Jilt' JLiti1FEi. EMOUN11 Well Permit & Inspection Fee 08/04/2016 $300.00 1,EE III'U'11i IE),TOT. iiiFE,ESk dii+a aii. l.-Cn)im,,,I,:- 1111I'iMill{ 1ililiII111ti if$300,00g Lit n t ,dglUiIW.„ -1Y1e11111W1E iLsu i tr ll=dditl!Wll"viiW111L'II42WLN4AIAI& !e'Il4l..xIli h._IOJI:CI, - .. FEES ARE NON—REFUNDABLE ONCE A SITE VISIT IS MADE OR WORK ON A PLAN REVIEW HAS COMMENCED SYSTEM REDESIGN AND/OR RETRIP WILL INCUR AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) E9-ehapplicatin m 08/04/2016 16:17 Page 2 o14 CATAWBA. This IIS IS NOT A PERMIT \amu,,, vvVV 11�� CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services Page 1 Improvement Permit 5 Authorization to Construct 5 Septic Repair 5 Septic Malfunction 5 Septic Expansion 5 New Well Permit 5 Replacement Well X.Wcll Abandonment ❑ Well Repair ❑ Existing System Inspection (Pre-Approval Required) n Application is for New Construction ❑ Existing Facility' * Property Address 95`9/ E/UJCH 102- Subdivision !1 5/YeZaC/GCS KD, /VC Zg673 Lot# Acres .ems 7— Section/Block/Phase Driving Directions to Property libly /SO To SLANT/406 B2l iGE- ,E?0 ALD flit/ 216MT *j 4PP,Cvu//74-T6cy 1 A / S ,,,i k tit EAJOG H- ,at e i UE To-N 'EIGHT. 2 es i PEivo is /45r /71,6 OSE oti Thi&- 2/G.14T NAME TO APPEAR ON PERMIT? 5 Owner n Applicant 5 Contractor Applicant Contact Information Name Address Phone Cell Phone • Owner Contact Information • Name 84gty Kell 8AKtC.. lAC Address 95V/ alacH. Lien/c She,Wct1 iAD,/tic Zgb 73 Phone 8Z8 1,1 79 2IV9 CWIMIone 7pq-62/ --630hi) • Contractor Contact Information — Name _ Address Phone Cell Phone WHO WILL BE THE PRIMARY CONTACT? 5 Owner n Applicant ❑ Contractor Description of Existing Structures on Site #005E AND 6-49-46-5- * 42AG-E* #of Bedrooms *t Z- Structure Dimensions #of Occupants / Basement ❑ Yes ✓r No Basement Fixtures ® Yes lErNo The Applicant shall notify the local health department upon submittal of this application if any of the following apply to the property in question. If the answer to any question is "yes", applicant must attach supporting documentation. ® Yes Yes ®No C Yes E$ Does the site contain any jurisdictional wetlands? Does the site contain any existing wastewater systems? Jo Is any wastewater going to be generated on the site other than domestic sewage? ® Yes 'No Is the site subject to approval by any other public agency? �'Ses ®No Are there any easements or right of ways on this property? Describe Qowc4 /WC (Do/cc c to Existing water supply in use [L]individual Well ❑ Community Well 5 Semi-Public Well 5 County/City/']ownship Water Line Is a public water supply available? ** 5 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) 0 Accepted ❑ Alternative ❑ Conventional 0 Innovative ❑ Other 0 Any CATAWBA THIS IS NOT A PERMIT COUNTY VV_-J CATAWBA COUNTY H EALTH DEPARTMENT er, Application for Environmental Services Page 2 Proposed Facility Type ❑ Primary Residence n New Residence n Addition to Residence #of New Bedrooms *t Project Description Structure Dimensions #of Occupants Basement n Yes ❑ No Basement Fixtures ® Yes ® No ❑ Accessory Structure(s) Describe #of New Bedrooms *t if applicable Structure Dimensions #of Occupants Accessory Dwelling ❑ Yes ❑ No Plumbing Yes ❑ No Describe Plumbing Needed ❑ Multi-Family Residence # Units #Bedrooms per Unit*t Total #Bedrooms *j Structure Dimensions ❑ Food Service Specify Type # Seats Floor Space-Entire Food Service Facility (Sq Ft) # Employees per Shift # of Shifts - Dining Arca (Sq. Ft.) ❑ Business Specific"type of Business Retail Floor Space # of Employees per Shift #of Shifts , • D. Other Facility Type Specify If Church#of Seats Kitchen n Yes ❑ No If Daycare Specify Occupancy Application for Well Construction/Abandonment/Repair Proposed Well TypeIndividual Well ❑ Semi-Public Well [ Community Well Abandonment Type ❑ Drilled n 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 he 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 ](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 cal2a/uz�j /C �� SG Date 0/20/‘Printed Name of Owner or Agent d3/9R/2-7 /1c-;nj a 4KEZ Catawba County Environmental Health 2Jo .�, 11 a Jed s i d & f Jg• r 41 i1/44 _ 45.00 RNA /1) N 1-' I 785 �/f _ - - - - 7�U ----..\\I\ JSL JOif 0 _iv N too / , 1 6c ot fu 27.60 23565 129,00 �'' '� . O 450 lips li ft l: je it 1 ' rpf, l�il !�' f' Parcel: 460602781043, 4591 ENOCH DR 1 in=50ft 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 08/04/2016 Parcel Report Page 1 of 1 Parcel Report - Catawba County NC Parcel Information: Owner Information: Parcel ID: 460602781043 Owner: BAKER BARRY KIM Parcel Address: 4591 ENOCH DR Owner2: City: SHERRILLS FORD, 28673 Address: 4591 ENOCH DR LRK(REID): 19385 Address2: Deed Book/Page: 1283/0989 City: SHERRILLS FORD Subdivision: ENOCH AND INA SIGMON State/Zip: NC 28673-9213 ESTATE Lots/Block: 13/A School Information: Last Sale: School District: COUNTY Plat Sale: age: 15/13 Elementary School: SHERRILLS FORD BookMiddle School: MILL CREEK Legal: LOT 13 PL 15-13 Calculated Acreage: .480 High School: BANDYS Tax Map: 018CX 01013 School Map Township: MOUNTAIN CREEK State Road #: TaxNalue 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: $135,000 Zoning2: Land Value: $15,400 Zoning3: Assessed Total Value: $150,400 Zoning Overlay: CRC-O,WP-O Year Built/Remodeled: 1981/1994 Small Area: SHERRILLS FORD Current Tax Bill Split Zoning Districts: / Zoning Agency Phone Numbers Miscellaneous: Firm Panel Date: 2007-09-05 Building Permits for this parcel. Firm Panel #: 3710460600J Building Details 2010 Census Block: 4045 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. All rights reserved. http://gis.catawbacountync.gov/nomap/parcel_report.php?key=460602781043&typ=P 8/4/2016 S\3A CATAWBA COUNTY Case# EPHR-I-10-3443 Q' : ',�"`. Public Health Department Subdivision ._ Environmental Health Division Section/BI/Phil.ot# '4,7"1 PO Box 389, IOOA Southwest Blvd,Newton NC 28658 PIN# I8 42 sN (828)465-8270 Fax (828)465-8276 TDD(828)465-8200 toy-3y-�-IC- Ltt3S Applicant/Owner Barry Baker 6 Site Address: 4591 Enoch Dr, Sherrills Ford Property Size: Directions: EXISTING SYSTEM INSPECTION REPORT Site/System Diagram �Sv Q b -a c J � P TJ () (‘ t ° 9 n Co Co y C- EiC3— (11,4 S. t` Type of Facility: House ® Mobile Home ❑ //Bedrooms 2 Business 11 Specify Other n Specify Proposed Additions/Accessory Structure: 28 x 10 cantilevered porch Approved Not Approved ❑ Reason Evidence of System Malfunction�(/: YES E NO ® System Type/Description 2a-gravel bed /i� � /1-17 1-29-10 AUTHORIZED STATE AGENT APPROVAL DATE NOT FOR LOAN APPROVAL r.mocumenisand Settings,;engIlsh'LocalSatingsVremporaryInternet Files\Conten[.Outlook\PP83W9G6\EXISTING TANK CHECK I-10-3443.docx p,A CATAWBA COUNTY j� O� 100A SOUTHWEST BLVD 4-' .t Y NEWTON, NORTH CAROLINA 28658 RECEIPT va ,etp�►e, PHONE: 828.465.8399 O �r 'vase Thursday, August 4, 2016 1842 sM www.catawbacountync.gov PAYOR: BAKER, BARRY KIM PAYMENTS TRANSACTION NUMBER: TRC-766609-04-08-2016 PAYMENT DATE : 08/04/2016 PAYMENT TYPE: Check 4862 INVOICE NUMBER FEE NAME FEE AMOUNT 08-16-331281 Well Permit& Inspection Fee $300.00 TOTAL PAYMENTS : $300.00 EHPR-08-2016-24450 CASE TYPE: Environmental Health Plan Review WORK CLASS: OSWP SITE ADDRESS: 4591 ENOCH DR, SI-IERRILLS FORD NC 28673 Owner BARRY KIM BAKER, 4591 ENOCH DR, SI-IERRILLS FORD NC 28673 H:8284782649C:7046216304 ** NO PEOPLESOFT ACCOUNT ASSIGNED ** receipt 08/04/2016 16:16 Page 1 of 1