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HomeMy WebLinkAboutEHPR-08-2016-24616.tif CA e� THIS IS NOT A PERMIT Case# EHPR-08-2016-24616 lll rkl CATAWBA COUNTY HEALTH DEPARTMENT ��• 'D . 11atil PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES ,•842 ski Environmental Health Plan Review - OSWP AlsAre o G • IMPROVEMENT . o Applicant ROCKY CANTRELL, 4361 WHITENER RD, HICKORY NC 28602 B:8283975700 C:828-381-6792 NAME TO APPEAR ON PERMIT Rocky Cantrell SITE ADDRESS: 4361 WHITENER DR, HICKORY NC 28602 PIN # 278110278070 NAME of SUBDIVISION: Lot# Section/Block PROPERTY SIZE: Square Feet 240,886.80 Acres 5.530 DIRECTIONS: Henry River Rd South, left onto Costner Rd, 1/4 mile turn right on Whitener Dr, fo through gate, pass barn turn left go up hill. PRIMARY CONTACT: Applicant SEWER TYPE: Septic Tank GALLONS PER DAY: 360 WATER SUPPLY: Public Water DESCRIBE WORK: IP to designate septic easement area.. 3 new RV sites in Burke Co. septic in Catawba Co. Originally applied for EHPR-11-2014-20430 see that case for fee per MM 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? Yes Is the site subject to approval by any other public agency? No Are there any easements or right-of-ways on this property? Yes Property Easements Description: Road to new sites APPLICATION FOR: New Structure STRUCTURE TYPE: ** NO STRUCTURE SELECTED ** FACILITY TYPE: Other OTHER DESCRIPTION: 3 RV sites DESCRIPTION OF RV camp ground EXISTING STRUCTURES ON SITE(IF ANY) DIM EXISTING STRUCTURE: NUMBER OF EXISTING BEDROOMS: #OF OCCUPANTS: PROPOSED CONSTRUCTION BASEMENT? No BASEMENT FIXTURES? PLUMBING REQUIRED? EMPLOYEES PER SHIFT: NUMBER OF SHIFTS: TOTAL EMPLOYEES: SEATING CAPACITY: TOTAL FLOOR SPACE (SQ FT): Desired system types (Improvement Permit or Authorization to Construct): ACCEPTED: ALTERNATIVE: CONVENTIONAL: OTHER: INNOVATIVE: ANY: Other described: E9-chapplication 08/29/2016 12:23 Page 1 o14 ypACATAWBA COUNTY Case# EHPR-08-2016-24616 ale; Public Health Department Subdivision d 0/ K Environmental Health Division PIN# 278110278070 PO Box 389, 100-A Southwest Blvd,Newton,NC 28658 l;.2 w NAME ON PERMIT: (ROCKY CANTRELL), 4361 WHITENER RD, HICKORY NC 28602 ( Rocky Cantrell) Site Address: 4361 WHITENER DR, HICKORY NC 28602 Property Size: Square Feet 240,886.80 Acres 5.530 Directions: Henry River Rd South, left onto Costner Rd, 1/4 mile turn right on Whitener Dr, fo through gate, pass barn turn left go up hill. 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. 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 �11,, nrv)M di,i 1 s ^1; i r w �`�iI i��lh 4 - . _I{aC II�IIP1I it� f �G!tjl In ;l�;= IIL; LiLFEFNAME 11 'rr, i l �1 ;nil)Ult utililliiLd DATE I{Is uljrFEElAMOUNTL: Improvement Permit Fee 08/29/2016 $150.00 bb1lj gTOTAL°;FEESL.tdIlf�llil.l.......................... �° t i.. ��ai lil�� r:' I4111I JC� jjS150°0011 �� ��1;.P t uuJJOtiil'I�IWiI'�SWIP 1111ya,E»" 'x.t v tiUWP'ar ,. �. AWbmlu ilu�ia� ]WOWIBL'W3ht1LA-..�)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) NY-chappl[cation 08/29/2016 12:23 Page 2 of 4 veCATAWBA COUNTY Case# EHPR-08-2016-24616 ih i 2 Public Health Department Subdivision < ;R Ey H Environmental Health Division PIN# 278110278070 '41- PO Box 389, 100-A Southwest Blvd, Newton,NC 28658 /8.2 iv NAME ON PERMIT: (ROCKY CANTRELL), 4361 WHITENER RD, HICKORY NC 28602 ( Rocky Cantrell) Site Address: 4361 WHITENER DR, HICKORY NC 28602 Property Size: Square Feet 240,886.80 Acres 5.530 Directions: Henry River Rd South, left onto Costner Rd, 1/4 mile turn right on Whitener Dr, fo through gate, pass barn turn left go up hill. ��'1 CATAWBA COUNTY, NC Environmental Health Boundaries r' i el\... t - A� � s hi :L4 ' E 0 =re' r , 40'1 HIPHOftt* Wp l % L! r µl R r r VY rA. R"w1u'EIIA2.,P .,}r` 1o.rr�1 N ON rt', I GVy � ili. , 4+' r:c` 9 �, � bn . .ii, r Wae;PfA yA m 77,144, & ( 1!I :Th::, � • .. tppNWWW ':n x tx; ' � \ i ! `N11 s/ ljK ' iw 14;5 /, �)tk • `.At�� �� � � r ';:rA' . 'f+�'r, aa,,•s<+.,+y,+K'wn.�,.aa� ' I'.,,�'�,�f�/:.Y.�/ ' , , • J/ 1 rif /!% :d t�,, 1 l( W '`ISE eoew..a .. S Your application for Environmental Health (EH) services has been assigned to AREA2 An Environmental Health Specialist(EHS) working in this area will contact you within five business days of receip by the EH Division. If you are not contacted within this time, or if you would like to leave a message with an EHS, please call (828) 466-7291. Be sure to first state your ease number from the top right corner of your application, and clearly state, your name, area number, and a number where you can be reached during normal business hours. E9-ehapplicatinn 08/29/2016 12:23 Page 3 of �8 CATAWBA COUNTY Case# EHPR-08-2016-24616 ,Q' �G Public Health Department Subdivision < *col *fit Environmental Health Division PIN# 278110278070 call- / PO Box 389, 100-A Southwest Blvd.Newton,NC 28658 !84 sw NAME ON PERMIT: (ROCKY CANTRELL),4361 WHITENER RD, HICKORY NC 28602 ( Rocky Cantrell) Site Address: 4361 WHITENER DR, HICKORY NC 28602 Property Size: Square Feet 240,886.80 Acres 5.530 Directions: Henry River Rd South, left onto Costner Rd, 1/4 mile turn right on Whitener Dr, fo through gate, pass barn turn left go up hill. Catawba County Environmental Health Application,Evaluation,and Permitting Procedures For Septic Systems and Well Construction A. Applications 2. Prior to the lot evaluation,you must notify the I. Complete applications must be submitted for Environmental Health Specialist assigned to your case, Improvement Permit(IP),Authorization to Construct(AC), that all required preparations are complete. The or Well Permit as applicable for proposed use.The owner Environmental Health Specialist will visit the lot to flag or his authorized agent must sign all applications. areas where"soil test"holes or pits are to be dug for the 2. The current fee foreach permit must be paid at the time soil evaluation. Test holes or pits shall be dug in the the application is submitted. Applications will not be following manner: accepted until all fees are paid. a. Holes or pits must be located as near as possible to 3. Complete applications must be accompanied by a plat the previously placed flags. prepared by a surveyor on a scale of no less than 1"=60', b. Holes or pits must be a minimum of 40 inches deep or a site plan prepared by the applicant. A separate plat 4 feet long,and 2 feet wide with sloped or stepped or site plan must be submitted for each lot application. access in and out.For safety reasons,at no time Plats or site plans must show all proposed property lines, should the pit be deeper than 44 inches. lot corners, home locations,all roads, bodies of water c. After holes or pits are dug,the applicant will notify (creeks,streams,lakes,ponds),existing wells within 200', the Environmental Health Specialist and an evaluation all lot dimensions,easements,and right of ways. date(s)will be scheduled. "Post holes"are not 4. Applications will be considered on a first-come,first-serve acceptable for a soil evaluation. basis and will be activated only when complete d. Exceptions to item 2.c.,will be granted if a backhoe applications are received. Incomplete applications will pit evaluation has been previously scheduled with the not be activated. Environmental Health Specialist evaluating your lot. B. Evaluations 3. The soil site evaluation will be conducted by evaluating 1. All lots must be properly prepared for evaluation in the each previously dug hole or pit in the manner prescribed following manner: by current state rules. A soil profile from each will be a. All lots must be fully accessible. Access roads must be described on a soil evaluation form for each lot ' at least"roughed in." Overgrown or very thickly application submitted. The soil.evaluation form will wooded lots must be adequately cleared prior to include,but not be limited to,the following: evaluation to allow for proper access. a. Soil profile description to include soil depth and b. All lot corners must be true corners(iron pins,axles characteristics etc.)and must be marked and readily indentified in b. Topographical features the field. All lot sidelines are to be flagged or strung c. Usable soil areas and locations the entire length and width of the lot. Exceptions to d. Possible system type(s) flagging lot sidelines may be made if all corners can be e. Problems and/or unsuitable characteristics seen from any part of the lot. f. Determination of suitability for system and repair c. Proposed"cut out"lots must be marked as indicated areas on site plan or plat for IP only and will be required to 4. Well construction applications will be evaluated based be surveyed and recorded at the Register of Deeds on required location criteria as established by state well before an AC will be issued. regulations. d. All home sites and accessory structures(garages,out- D. Notification buildings, pools,etc)as indicated on the plat must be The Environmental Health Specialist, upon completion of staked or flagged on the lot at the time of permits for approved lots,etc.,shall notify the owner or evaluation. ' applicant(as indicated on the application)when permit(s)are completed. Denial letter(s)explaining reasons for the denial Improperly prepared lots will not be evaluated and and addressing the appeal process will be issued in a timely will be placed in an inactive status. Applications will manner when lots are not approved for system installations. be reactivated when all required preparations are complete. These procedures will be required for all applications subject to approval under the current North Carolina Laws and Rules Note:Additional fees and delays may be incurred by for Sewage Treatment and Disposal Systems(15A NCAC 18A the applicant if the lot has not been properly .1900)and North Carolina Well Construction Standards(15A prepared for evaluation or if Items are not flagged NCAC 2C.0100) on site,indicated on the site plan,or subsequently changed. E9-ehapplication 08/29/2016 12:23 Page 4 of 4 CATAWBA i-IIS IS NOT A PERMIT COUNTYf <,• � CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services Page 1 Improvement Permit Authorization to Construct D Septic Repair n Septic Malfunction Septic Expansion ❑ New Well Permit❑ Replacement Well ❑ Well Abandonment ❑ Well Repair n Existing System Inspection (Pre-Approval Required) ❑ ;lee.) is for New Construction ❑ Existing Facility ❑ Property Address /{�/p ) t,(,A1 fetier /)ri'ut Subdivision 1 ' C/tak j f(` ,9 troop-2 Lot# Acres Section/BlockdPhase Driving Directions to Property binFi &Pk fe r- A S ou4 - Fv in le + r;n fie-, Coca rlr r �f I 1(( m ( e rr� �, �k- u/ ,'h a �4-e nv G1 6 41- e k cI ozir O cc,c bo(R �-{ti t r f 4-- Cj o U P h� NAME TO APPEA*'ON PERMIT? Rj Owner fl Applicant E. Contractor Applicant Contact Information / /Is+ � /5Campgfriend Name %c c CO-H-ft ( Address { 'WIiAi e �r�� ^ It 4 roc -)g;t0d9- �Fvnpn/`ql Phone 3sr/r079a cel] Phone Owner Contact Info/r�mation Name (.\� C ' / Address 430 WL �e/o r C u'e Y�t cL JC a 20)- Phone el Cell Phone >,<a-�''3 g7-6,7?2, Contractor Contact Information Name Address Phone Cell Phone WHO WILL BE THE PRIMARY CONTACT? ❑ Owner D Applicant ❑ Contractor Description of Existing Structures on Site # of Bedrooms *t Structure Dimensions # of Occupants Basement ❑ Yes ❑ No Basement Fixtures Q Yes la 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. Yes 75..No Does the site contain any jurisdictional wetlands? $Yes ®No Does the site contain any existing wastewater systems? -C Yes II No Is any wastewater going to be generated on the site other than domestic sewage? ri Yes lit,No Is the site subject to approval by any other public agency?,71 A Yes p(f No Are there any easements or right of ways on this property? Describe‘ffle S(-fes 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 Cl Alternative ❑ Conventional ❑ Innovative ❑ Other ❑ Any C A rTHIS IS NOT A PERMIT COUNTYL�V V 1JL 1 CATAWBA COUNTY HEALTH DEPARTMENT N,„n;o,;„,o Application for Environmental Services Page 2 Proposed Facility Type ❑ Primary Residence n New Residence ❑ Addition to Residence # of New Bedrooms Project Description -3 ' -_ J S s Structure Dimensions # of Occupants Basement ❑ Yes ❑ No Basement Fixtures ® Yes DI No [ Accessory Structure(s) Describe #of New Bedrooms *t if applicable Structure Dimensions_ #of Occupants Accessory Dwelling ❑ Yes n No Plumbing ❑ Yes ❑ No Describe Plumbing Needed H 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) # Employees per Shift #of Shifts Dining Area(Sq. Ft.) Business Specific Type of Business Retail Floor Space #of Employees per Shift # of Shifts n 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 n Community Well Abandonment Type ❑ Drilled ❑ Bored ❑ Dug ❑ Unknown Well Repair Requested ❑ Yes ❑ No Describe Calculated Design Flow, Commercial 1. 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. 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 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 7-at-3 — J,-p/ Date. 3-91-( ( 0 Printed Name of Owner or Agent' (L.,( Ca v$ft Catawba County Environmental Health x ---"N-_____ i r rJ Liz I \\ r.......aitili alit ere: 1 kik ci q Iti 4 IN % 1111 0 0 N /I/--1055 !f JW4 1035 Nit ' ''''' ,.,...„..........___,Y %.26 1St 11111141 g85 _ . e sr • y�iS�Nt�O ' - - •4361 � ' r r h f J r */A• rTarkr Parcel: 278110278070, 4361 WHITENER DR lin=150ft 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 08/29/2016 Catawba County Environmental Health 11/4 //77/ / /I \toss r 2i,„ Iv _ _ as kg r ^ 9.02a IIIr f 1 J Ace i � 1OO , i J 1 c,�w (561/a IP 0 ns ) Ca) I 111i.,0 Parcel: 278110278070, 4361 WHITENER DR lin=60ft 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 08/29/2016 Parcel Report Page 1 of 1 Parcel Report - Catawba County NC Parcel Information: Owner Information: Parcel ID: 278110278070 Owner: CANTRELL ROCKY EUGENE Parcel Address: 4361 WHITENER DR Owner2: CANTRELL EUGENIA H City: HICKORY, 28602 Address: PO BOX 11017 LRK(REID): 90856 Address2: null Deed Book/Page: 2790/0481 City: HICKORY Subdivision: null State/Zip: NC 28603-6402 Lots/Block: null/ null Last Sale: $82,500 on 2006-10-27 School Information: Rat Book/Page: School District: HICKORY Legal: WHITENER DR Elementary School: SOUTHWEST Middle School: GRANDVIEW Calculated Acreage: 5.530 Tax Map: 178H 01021A High School: HICKORY Township: HICKORY School Map State Road #: 1206 Tax/Value Information: Tax Rates(pdt) Zoning Information: City Tax District: All in County Zoning District: HICKORY County Fire District: MOUNTAIN VIEW Zoningl: R-1 Building(s) Value: $17,400 Zoning2: null Land Value: $28,900 Zoning3: null Assessed Total Value: $46,300 Zoning Overlay: null Year Built/Remodeled: null/null Small Area: null Current Tax Bill Split Zoning Districts: null/null Zoning Agency Phone Numbers Miscellaneous: Firm Panel Date: 2007-09-05 Building Permits for this parcel. Firm Panel #: 3710278100J Building Details 2010 Census Block: 2050 WaterShed: null 2010 Census Tract: 011101 Voter Precinct: P19 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=278110278070&typ=P 8/29/2016