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HomeMy WebLinkAboutEHPR-08-2016-24563.TIF Y A C-1; THIS IS NOTA PERMIT Case # EHPR-08-2016-24563 /6, 2 CATAWBA COUNTY HEALTH DEPARTMENT ❑' 0 - '"V PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES f ��� \842 sM Environmental Health Plan Review - OSWP ' IMPROVEMENT o ,ti Applicant COLDWELL BANKER MOUNTAIN VIEW (DENISE WRIGHT), 303 S BATTLEGROUND AV, KIN MOUNTAIN NC 28086 H:7047392220 C:7046922859 HOME:7047392220 DENISE.WRIGHTI aCOLDWELLBANKER.CC Land Owner FIRST NATIONAL BANK OF SHELBY NORTH CAROLINA, PO BOX 168, SHELBY NC 28151 Owner BANK OF OZARKS, PO BOX 670, MCDONOUGH GA 30253 B:7708980852 2119 NAME TO APPEAR ON PERMIT Bank of Ozarks SITE ADDRESS: 7575 TANGLE WOOD DR, VALE NC 28168 PIN # 267703442649 NAME of SUBDIVISION: CRABTREE ACRES Lot# 14 Section/Block PROPERTY SIZE: Square Feet 50,529.60 Acres 1.16 DIRECTIONS: Hwy 10, Right onto Brindle Path, Left onto Tanglewood& home is at the end of the road on the Right. PRIMARY CONTACT: Applicant SEWER TYPE: Septic Tank GALLONS PER DAY: 480 WATER SUPPLY: Public Water DESCRIBE WORK: IP for potential expansion of septic for sale of property.* Existing home is 4 Bedrooms & Septic is only sized for 3 Bedrooms. 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: 52x47 NUMBER OF EXISTING BEDROOMS: 3 #OF OCCUPANTS: 1 PROPOSED CONSTRUCTION #OF NEW BEDROOMS:: 1 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: 09-chapplicati,m 08/23/2016 08:44 Page I oto `—s',• CATANBA COUNTY Case# EHPR-08-2016-24563 • .7 rth iii y Public Health Department Subdivision CRABTREE ACRES • LIMA C -�, Y Environmental Health Division PIN!) 267703442649 / PO Box 389. 100-A Southwest Blvd,Newton.NC 28658 /841" t342 s. NAME ON PERMIT: BANK OF OZARKS ( ), PO BOX 670, MCDONOUGH GA 30253 Bank of Ozarks ( ) Site Address: 7575 TANGLE WOOD DR, VALE NC 28168 Property Size: Square Feet 50,529.60 Acres 1.16 Directions: Hwy 10, Right onto Brindle Path, Left onto Tanglewood & home is at the end of the road 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 identificat n nd I beling of all property lines and corners and making the site ssible so that a co p si,e.evaluation can be performed. Date: e?Jl to Signature of Applicant or Agent a fox An Environmental Health Specialist will contact you within 5 working days of plication date. If you need further information or assistance please call 828-466-7291 AREA2 ♦*****t4***t***tt***ttttt*t*tt*******444**t4*4*4***4*4*4*4tt*ttt*ttttttttttt t t*44*44444*44444*4444***4tt*4** ern n'n iriiirI 1 , „ fi. .01:: �i5,r„ Pt FEENA''METPi��lll(Q1.iVIu11116.Irr,,, . 4i,,ali;Vlil1JI :1 ,,,aauu�l l�L�if'inDATE ,1,: oiliFEF'_AMOUNT�(��( Improvement Permit Fee 08/22/2016 S150.00 4 ,1��,II� $111lilidflllotTOTAI1FEESI"I'l�l1r �,:vlillhmnl4liii;' I "1 5n,,., �� '1li;il!IllIiIIn� mn,lltll),IDI1Ilhs15000 .,;10,1 .1,t4tl , tt .„lUll 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) P9-chappl i calinn (18/23/2016 08:44 Page 2 u14 MEM 03;19/2016 13: 43 7047392202 CE MOUNTAIN VIEW PAGE 01/02 :ii A e 'AWB THIS IS NOT A PERMIT 7,4S cCE CATAWBA COUNTY HEALTH DEPARTMENT 'i' .0,7,,e.: -- Application for Environmental Services Page 1 Improvement Permit 0 Authorization to Construct❑ Septic Repair❑ Septic Malfunction❑ Septic Expansion ❑ New Well Permit❑ Replacement Well ❑ Well Abandonment❑ Well Repair ❑ Existing System Inspection (he-Approval Required) ❑ Application is for New Construction ❑ Existing Facility ❑ Property Address 7575 Tanglewood Dr Subdivision Crabtree Acres Vale, NC 28168 Lot# 14 Acres 1.16 Acres Section/Bloch/Phase Driving Directions to Property Hwy 10,TR Bridle Path,TL Tanglewood.Home at end on Fight. • NAME TO APPEAR ON PERMIT? 0 Owner ❑ Applicant ❑ Contractor Applicant Contact Information Name Bank of the Ozarks-Coldwell Banker Mountain view-Denise Wright S ', (J. \ i # dr to 1 14 Address303 S Battleground Ave Kings Mountain, NC 28086 CCInit Phone 704-739.2220 Cell Phone 704-692-2859 Owner Contact Information Name Bank of the Ozarks Address 1400 Zack Hinton Parkway;PO Box 6701 McDonough, GA 30253 Phone 770.898.0852 ext.2119 Cell Phone Contractor Contact Information Name Address Phone Cell Phone WHO WILL BE THE PRIMARY CONTACT? ❑ Owner 0 Applicant ❑ Contractor Description of Existing Structures on Site Home #of Bedrooms *f 4 Structure Dimensions #of Occupants Basement ❑ Yes 0 No Basement Fixtures ® Yes ;a 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. El Yes 10 No Does the site contain any jurisdictional wetlands? 0 Yes ICI No Does the site contain any existing wastewater systems? in Yes El No Is any wastewater going to be generated on the site other than domestic sewage? ® Yes El No Is the site subject to approval by any other public agency? C Yes fp No Are there any easements or right of ways on this property? Describe Existing water supply in use Er/Individual Well U Community Well Lf 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) 0 Accepted ❑ Alternative ®Conventional ❑ Innovative ❑ Other ❑ Any 08/19/2016 13: 43 7047392202 CB MOUNTAIN VIEW PAGE 02/02 C{ 1 THIS IS NOT A PERMIT cos : • CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Sen-ices Page 2 • Proposed Facility Type ❑H Primary Residence ❑ New Residence •❑ Addition to Residence # of New Bedrooms "i 4 Project Description Structure Dimensions #of Occupants • Basement ❑ Yes ❑® No Basement Fixtures n Yes ®No . Li Accessory Structure(s) Describe # of New Bedrooms *f if applicable . Structure Dimensions • # of Occupants Accessory Dwelling ❑ Yes ❑ No • Plumbing ❑ Yes ❑No Describe Plumbing Needed J Multi-Family Residence#Units #Bedrooms per Unitkfi Total#Bedrooms 'i Structure Dimensions • ❑ Food Service Specify Type # Seats Floor Space-Entire Food Service Facility (Sq Ft) #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 Weil Type ❑.Individual Well ❑ Semi-Public Well ❑ Community Well Abandonment Type ❑ Drilled ❑ Boxed ❑ 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. f If structure is plumbed but no bedrooms,calculated design flow is required. • r=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 Penults are transferrable. Permits may be revoked lithe information on this application, site plans or intended use changes for the proposed facility. 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 amnsolely 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,� - -1 • Signature of Owner or Agent{ /fo1 ( ��iVl�/1 Date � ] / Printed Name of Owner or Agent n l . ES Q L • Catawba County Environmental Health \-,/ \ rov 12 _...r. (70 N le....„111 • 92.34 37' .1 4 n Alll l ://7 � 1��i `li 14, 13 I r ....." ...... .. P .0 95.002 3 01,11 a' SSS �1�� 4•4101 j`y a� b 301 s '`79 ,11 .---44111V' N A J R i Ch �.'. ' .i\\\\\\\\\\\__ . ------------\\ i Parcel: 267703442649, 7575 TANGLEWOOD DR 1 in=60ft VALE, 28168 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 08/22/2016 Parcel Report Page 1 of 1 Parcel Report - Catawba County NC Parcel Information: Owner Information: Parcel ID: 267703442649 Owner: FIRST NATIONAL BANK OF SHELBY Parcel Address: 7575 TANGLEWOOD DR NORTH CAROLINA City: VALE, 28168 Owner2: LRK(REID): 100424 Address: PO BOX 168 Deed Book/Page: 3218/0252 Address2: Subdivision: CRABTREE ACRES City: SHELBY Lots/Block: 14/ State/Zip: NC 28151-0168 Last Sale: $21,500 on 2007-04-24 Plat Book/Page: 40/92 School Information: Legal: LOT 14 CRABTREE ACRES PLAT 40-92 School District: COUNTY CalculatedElementary School: BANOAK Acreage: 1.160 Middle School: JACOBS FORK Tax Map: Township: BANDYS High School: FRED T FOARD State Road #: 2089 School Map TaxNalue Information: Tax Rates(pdt) Zoning Information: City Tax District: All in County Zoning District: COUNTY County Fire District: COOKSVILLE Zoning/: R-40 Building(s) Value: $163,900 Zoning2: Land Value: $11,900 Zoning3: Assessed Total Value: $175,800 Zoning Overlay: WP-O Year Built/Remodeled: 2007/ Small Area: PLATEAU Current Tax Bill Split Zoning Districts: / Zoning Agency Phone Numbers Miscellaneous: Firm Panel Date: 2007-09-05 Building Permits for this parcel. Firm Panel #: 3710266600J Building Details 2010 Census Block: 1009 WaterShed: WS-II Protected Area 2010 Census Tract: 011802 Voter Precinct: P2 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 an 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. hap://gis.catawbacountync.gov/notnap/parcel_report.php?key=267703442649&typ=P 8/22/2016 • ��;! CATAWBA COUNTY �� Q mCase 4 WLS2007-00616 /.7,-":stAkA Public Health Depanen I Environmental Health Division Subdivision CRABTREE ACRES \-� W// PO Box 389,100-A Southwest Blvd,Newton,NC 28658 Sect/BL/Pb/Lot 4 14 w7- iej (528)465-8270 FAX(428)465-8276 'FDO(828)465-8200 PIN# 267703442649 • Applicant/Owner: PAUL AULBACH Site Address: 7575 TANGLEWOOD DR VALE Property size: SF 1.18 ACRES Directions: HWY IOW LF CAT SQUARE RD/TURN RT INTO CRABTREE SUBDIV/TURN RT ON TANGLEWOOD/ LAST LOT ON RIGHT EXISTING SEPTIC SYSTEM INSPECTION REPORT Site/System Diagram /1 l No 1 0 ia‘ial 1 Pau,aCf o 50,737c^` +p de.r' C/ Qr., 4)x ' pc-`rr. +n t'\5i-<I4 ,\ F -, `/l11f /1 r.t"( of t,i4“)e” It Sk0Ft)lna_ ) ps—tm..; k d 0356 e.11G,i.e.a 4,1 ileV Type of Facility: House X Mobile Home #Bedrooms ' Business Specify Other Specify Proposed Additions/Accessory Structures: 5 6 R No to Approved 1/1 Not Approved Reason Evidence of system malfunction: YES NOSystem T q e/Description fir`--c I Tri-^'-'c Authorized State Agent: DATE: q I?? ID ) C NOT FOR LOAN APPROVALForm E / /,' 3a CATAWBA COUNTYUtE-ALTH DEPARTMENT No 8 3 5 6 . Telephone (828)465-8270 TDD• (828) 465 ,202 -mitred Imp Print. ✓ A� ut�hn. to Const. r Print. Opr Print. L./Sys Type e.' Well Print. Well Rpr I/tmt. Owner/Agent .4 .O• Sp A/\, Phone , X� 1{7 7 Address 775 az-L1. 144• Subdivision ;DP it ' C Section/Block/Phase Lot# sat. `L Lot Size 1,1S* CDirections ("L3.J �� � -: • C, /ttits 6.61 t. 1 • ' _ . ' a ..• Lis �l u. Facility House 101,Mobile Home Business Multi-family Other. Tax Map or Pin Number. 7703 l �CyP Other Zoning Approval • .a . . ,. „ a J #Bedrooms —; #Seats #Employees Application Rate i I GPD Flow_,. ,_ _ Hot Tub or Spa yes/no Special Fixtures Basement yese 100% Repair Area 4Prno Basement Plumbing yes/no Water Supply. Private Well Public — Semi-Public ****h*******************�*************************************************************************************************** Type of System. Trench //Bed Pump Pump/Panel Panel LPP Other Septic Tank Size/OD® QIP? *l Pump Tank Size Nitrification Field. Total Square Feet !db Depth of Stone � Bed Size Trench Width -3 Total Length of All Trenches ,360 Number of Trenches Trench Length"7s/75 95 /75 / / Feet on Center Maximum Trench Depth Distance of Nearest Well *DO NOT INSTALL SEPTIC WHEN WET* *WELL RECORD REQUIRED AT COMPLETION* ***************************************************************************************************************************** y Topo 7 % Slope Texture Structure Clay Min. �/ Soil Wetness F1 l' " Soil Depth £ " Restric Hoz. a 2. " Available space eil,./no R / `7 6 Overall Class S '' U J ... .Comments , - -- --. ,..;r - -- __-.,_ __ ___ /---->Na...,,,,,„_ 0,7,_ /oaJ / i 97 �,'` " j7u 9 • . lid / � 3OP T? ge), Filter Required Riser required when tank is more than 6 inches deep. "NO GUARANTEE OR WARRANTY IS IMPLIED OR GIVEN AS TO THE PERFORMANCE OR LENGTH OF TIME THIS SYSTEM WILL FUNCTION** ****************i********************************************************************************************************** *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 protection from known possible sourcesofcontamination.aNo volume of water is guarantee �l any site by e Health Department. �/2 _ � e� `1' ' �t9" [�\-/5 Permit Date !l v 1j— I EHS 1/�L`r� _ t Owner/- gent r is ILO L Septic Tank Installed By f/u i '�A sin Date 9'1 ?- cO EHS / .;* Well Installed By 11 rout Approval Date Well Head Approval Date Date Sample Collected Date of Results Results ``_ FES White-Office Blue-Building Inspection Operation Permit Yellow'Owner/Agent Green-Building Inspection Authorization to Construct CATAWBA COUNTY � 100A SOUTHWEST BLVD ' a NEWTON, NORTH CAROLINA 28658 RECEIPT �!sn i1 PHONE: 828.465.8399 v w �.asvr Tuesday, August 23, 2016 /842 SM www.catawbacountync.gov PAYOR: Coldwell Banker Mountain View Coldwell Banker Mountain View(Wright, Denise) PAYMENTS TRANSACTION NUMBER: TRC-795977-23-08-2016 PAYMENT DATE : 08/23/2016 PAYMENT TYPE: Credit Card payment by phone from Denise INVOICE NUMBER FEE NAME FEE AMOUNT 08-16-331880 Improvement Permit Fee 5150.00 TOTAL PAYMENTS : $150.00 EHPR-08-2016-24563 CASE TYPE: Environmental Health Plan Review WORK CLASS: OSWP SITE ADDRESS: 7575 TANGLEWOOD DR, VALE NC 28168 Applicant COLDWELL BANKER MOUNTAIN VIEW, 303 S BATTLEGROUND AV, KINGS MOUNTAIN H:7047392220C:7046922859 DENISE.WRIGHTI@COLDWELLBANKER.COM ** NO PEOPLESOFT ACCOUNT ASSIGNED ** Land Owner FIRST NATIONAL BANK OF SHELBY NORTH CAROLINA, PO BOX 168, SHELBY NC 28151 Owner BANK OF OZARKS, PO BOX 670, MCDONOUGH GA 30253 B:7708980852 2119 receipt 08/23/2016 08:37 Page 1 of 1