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Home My WebLink AboutEHPR-6-11-11199.TIF A ` ��' C�� THIS IS NOT A PERMIT Case # EHPR-6-1 1-1 1 1 99 F�� „ _ �� '� a CATAWBA COUNTY HEALTH DEPARTMENT c� `e�"-� �� '�' Plan Review Application for Environmental Services I�g�2 sM Environmental Health Plan Review - OSWP EXS SYSTEM N TO APPEAR ON PERMIT Timothy Knopp s�TE a��RESS: 1784 REDBERRY LN, Conover, NC Pir�: 374307782336 NAME of SUBDIVISION:STRAWBERRY FIELD PHASE 2 Lot # 2( Section/BloclJPhase PROPERTY SIZE: Square Feet Acres 0.61 DIRECTIONS: I-40 TO 16N / LF ON CB FARM RD / RT INTO STRAWBERRY FIELD / LOT # 26 ON LEFT BOTTOM OF HILL APPLICANT OWNER CONTRACTOR Timothy Knopp Timothy Knopp 1784 Redberry LN 1784 Redberry LN Conover NC 28613-8135 Conover NC 28613-8135 828-23 8-2012 828-23 8-2012 PRIMARY CONTACT: Owner APPLICATION FOR: Existing Structure DIM EXISTING STRUCTURE: 20 x 35 EXISTING FACILITY TYPE: House NUMBER OF EXISTING BEDROOMS: 3 SEWER TYPE: Septic Tank NUMBER OF EXISTING OCCUPANTS: 2 EXISTING WATER SUPPLY IN USE: Public Water CALCULATED DESIGN FLOW: Public water is *"NOT** available for this property. PUBLIC WATER TYPE AVAILABLE: County/City/Township Water DESCRIBE WORK: 12 x 20 uncovered deck addition to existing deck DESCRIPTION OF Single Family Dwelling EXISTING STRUCTURES ON SITE (IF ANY) PROPERTY EASEMENTS: none PROPOSED CONSTRUCTION PRIMARY RESIDENCE NEW RESIDENCE? Add/Alt to Residence # OF NEW BEDROOMS: 0 # OF STRUCTURE OCCUPANTS: PROJECT DESC: Uncovered deck addition to existing deck PROJECT DIMENSION: 12 x 20 BASEMENT? No BASEMENTFIXTURES? No I understand that this is a formal application for a well permit, Improvement permit or Authorization to Construct a ground absorption sewage disposal system to serve the above described facility on this property and authorize Catawba County Health Department employees to go on this property for evaluation purposes. I certify the above information to be correct and understand that an Improvement Permit issued as a result of this information is transferable and may be eligible for a non-expiring date, but may be revoked if this information, site plans or intended use changes for the proposed facility. A Well Permit and Authorization to Construct issued by this department is valid for (5) five years from the date issued and is not transferable. Note: You mttst obtain 7oning Approval prior to locating a home or slruelure on this property. Any representation by you of house or structure localion should conform to applicable setbacks. Date: �� `� �f Signature of Applicant or Agent �� An Environmental Health Specialist will contact you withi 2 rkin days of application date. If you need further information or assistance please call 828-466-729 ] AREA2 **************�*******�***********************************************�******�*************�**************�*********** Minimum Sethaeks Front: 30 Side: 15 Rear: 30 Side St: Max Height: 06/08/ 1 1 I 5:50 ��A , CATAWBA COUNTY , � Case # EHPR-6-1 1-11 199 U Public Health Department �,e' , �. Subdivision STRAWBERKY FIELD PHA , j Environmental Health Division - Plan Review v°' '�.��' PO Box 389, 100-A Southwcs[ E31vd, Newton, NC 28658 Lot# Z6 Ig42 �M Y1N# 374307782336 Applicant/Owner Timothy Knopp, 1784 Redberry LN, Conover NC 28613 Site Address: 1784 RED[3ERRY LN, Conover, NC Property Size: SF 0_61 ACRES Directions: I-40 TO 16N / LF ON CB FARM RD / RT INTO STRAWBGRRY PIGLD / LOT # 26 ON LGFT BOTTOM OF HILL FEE NAME DATE AMOUNT BALANCE DUE Existing Tank Check Fee 06 /08/201 1 $80.00 $0.00 TOTAL FEES $80.00 $0.00 CHANGE WORK ORDER REQUIRING REDESIGN AND/OR RETRIP WILL INCURE AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) 06/08/I I 15:50 ��,� THIS IS NOT A PERMIT , � � � � � caTawBa couN�y xEaLTx DEraRTM�NT L; %/l''��// ///�� Application for Environmental Services Page 1 J P L� �` j $ 4 `L se� Improvement Permit ❑ Authorization to Construct ❑ Septic Repair ❑ Septic Matfunction ❑ -�� Septic Expansion ❑ New Well Permit ❑ Replacement Well ❑ Well Abandonment ❑ - Well Repair ❑ Existing System Irispection (Pre-Approval Required) ❑ Application is for New Construction ❑ Existing Facility ❑ Property Address S� �/JP, � �-h Subdivision �t V t� �1 2 3 Lot # Acres SectionBlocWPhase Driving Directions to Property � � W v a NAME TO APPEAR ON PERMIT? �Owner ❑ Applicant ❑ Contractor O Applicant Contact Information V Name �.,,�.t 1- C��,..�r.a W Address m � Phone Cell Phone � Owner Contact Information � Name � � Z Address �� L � r (, � Phone �, � Cell Phone �Z�- 23 � � 2 � Contractor Contact Information W Name � Address � = Phone Cell Phone F� Z WHO WILL BE THE PRIMARY CONTACT? �Owner ❑ Applicant ❑ Contractor � Description of Existing Structures on Site � 1v1 � Q # of Bedrooms *�' Structu Dimensions � J�� # of Occupants 2 � Basement ❑ Yes No E3asement Fixtures ❑ Yes � No � Planned Future Additions or lmproveme�lts (Building Permit NOT requested at this time) OC Describe � Proposed Future Structure Dimensions # of Bedrooms *�' if applicable � Are there easements or right-of-ways recorded on this property ❑ Yes '�No Describe Is a public water suppfy available on or adjacent to the above property ** Yes ❑ No Check type availabfe ❑ Community Well ❑ Semi-Public Well ❑ County/City/Township Water Line Existing water supply in use ❑ Individual Well ❑ Community Well ❑ Semi-Public Well �'County/City/Township Water Line ❑ I WOULD LIKE TO SCHEDULE A COMBINED FLAGGING AND 50IL EVALUATION (SEE COMBINED E VAL U ATION PROCEDUES) ,�� THIS IS NOT A PERMIT , � �� 3 � ' CATAWBA COUNTY HEALTH D�PARTIVIENT � .� �� Application for Environmental Services Page 2 �$4`L sM Proposed Facility Type � ❑ Primary Residence ❑ New Residence � Addition to Residence # of New Bedrooms *�' L�' � Project Description �er;k �i(j�( -___ Structure Dimensions �Z �` 2d # of Occupants U ;� Basement ❑ Yes �No Basement Fixtures ❑ Yes ,�Io ❑ Accessory Structure(s) Describe # of New Bedrooms *�' if applicable Structure Dimensions # of Occupants Accessory Dwelling ❑ Yes ❑ No Plumbing ❑ Yes ❑ No Describe Plumbing Needed ❑ Multi-Family Residence # Units #Bedrooms per Unit*�' Total # Bedrooms *�' 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 Em pe r S hift # of Shifts ❑ Other Facility Type Specify 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 �' 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. T.he 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. �'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. Note: You must obtain Zoning approval prior to locating a home or structure on this property. Any representation by you of house or structure location conform to applicable setbacks. � CHANGE WORK ORDER REQUIRING REDESIGN AND/OR RETRIP WILL INCURE AN � ADDITIONAL CHARGE (SEE FEE SCHEDULE) � I understand that this is a formal application for Environmental Services and authorize Catawba County Environmental a � Health employees to go on this property for evaluation purposes. I certify the above information to be correct and understand 0 that an Improvement Permit issued as a result of this information is valid for 5 years or may be non-expiring under certain V specified conditions. [mprovement Permits and Well Permits are transferrable, but may be revoked if this information, site W plans or intended use changes for the proposed facility. An Authorization to Construct issued by this department is valid for m � (5) five years from the date issued and is not transferable � Signature of Owner or Agent � Printed Name of Owner or Age t o Date (�,- ( � Catawba County, North Carolina N This map prodr�c[ was prepared jrom the Catawbu Cotnaty, NC, Geographrc /njarmation Systens. Catawba Cormry hns mnde substantinl efjorts ro enst�re !he accuracy of location and labeling informarion contained on this mnp. Cntawba Counry promo�es nnd recammends the independen� verification ofnny dala contained on Ghis map prodr�ct by �he user. Tke Countv ofCatuwba, its employees, agen/s and personnel disclainr, and shal7 no1 be held liable for arry and nll dnmages, loss or liabilrry, whether direct, indirect or consequenlial which arises o�� may arise from Ihis mup producl or �he use lhereoJby nny person or entrry. Legend Selected Parcel Number: 3743-07-78-2336 1 inch = 60 feet Prepared for: � � '��,,. ��;�� '� � � °�� '�< "' ��; � , � � " Y .LL �� . n 9 � � � " a � . �� A � �� : � . �, � � ��, �, �� y �� u k � � � ��" �mn,� � � �/ i� ��4��0�� .� �� , � ` � , � '�,� ' �� r � � w��; ��' �� ' � , : f y �k ,, / �� , � � . ��k. ° .. T- p � ;; � : � �� i � �`� a CO�`��!�O�Ek�RURAL F � �� °�ti �� '� �� ' � � ,: � 31A O�CF4R��w�IRE �a� � " , � 1 24A ��' �` "a �'��,� A*�, �'�t� �,� ,��:�` � "�� : *�' i< < �� „2n€� �.'- � � � ��'�� _�, � � � �� : � 521 � ` � � � � � p , 30 �a , ° � /.. � � �m h �� .. �. �0: 9 6 m � ` '" u � °��. L�� '4 ; / .�,�i? '4 �` I , i�� W. �.: � �l 8 , P � a, � �". \. � � °� �� , �`�_ 4, . ( I a °. �'� �`J � ` � x ,� . a µ � `� A. � 4 � h � X t�� F �� ♦"� ` � � �``�.�� .�� ,� , 4 �. �G�� `�� `� �� `�. 49. � �;� �.� i �j 26 � p � .�� ' � �� . `� '� , � " � � � � �. � R �, � � .� /�, �� ; �,�� `� 1� �rR20 �� .39A C(��N0�4.ER,RURAL F1�R�E �� `� �--�'�`°�, � �' � � �fi� �� ; .2�AOXFc:�RD`F�F� ��, �,;� a � * �"� ; ; �S9 � ''� '� ''�,� � �,; � � 4 i r& t 4v� fg [ � � � , � 5 �'�� " V ��; , 2`�336 } �� "��'� �� °� � �� -� � � �+ �� " �i , ' �� ''� �� . Y I �'� ��/ � �'� v- � 1 » , , , . . � � � . , i k � 4 � �+. � �o- l „ �, t �� t xL �,/� . � � : ; � � < � � � . � ." � � � `, � �1+3+ �� _ ' � ` r � � , �_ , , � � �� .� 154.20 � g � �� F ` 5T� {� d � �M �"�° � f � � � ' � 4 ��. t ?. k „ �"�d4 � _ x '� � � � �� °� � , '�4 � �R=20 °�� `4 °�_� �� _ � ` ; '4� � � � "�� " � � `�"'`�, 1 �'' 0� � y t IAP a ti �' \ � � , � � , �+ ' � � :y 4 " �� ' V i � ��, ` 2 �%� L� � E � * � " 1c 4 � �� ' n � � y � � ,� � ., � � s ' �" r � LJ � ��1, i�� , `;; �(9a � � � � z � � �� ) � :� �� "ka�`�m^�,., R � : . 4 y �'�. 1� �" : � � W �* Y h �. �� y' ` n, t y � � ' ��'*�4 ��} - a ��- � q � ` ' � _ ' ° 'y f a�� y � a ^ r � . � _.,_...._.....�,. �,.__ �..�...e.._/� �yu ��'�:.v.W�'"`^=,..... � .__,......,.,�.e...a'ol� � �� THIS IS NOT A LEGAL DOCUMENT ��.� , � ' ;= � Tuesday, June 07, 2011 03:41 PM �� "��'�% �. :�� "°�, � � _�� SL MI 1 i ,� '' � CATA�VVBA C�?UN'TY �ALTH DEPt��T'1VIEIVT rw�� Telephone (828) 455-8270 TDD (828) 465-8200 WLS � 2D19y = fj(� � 6� Improvement Permit �AC Y Repair Pe it._ Operation ermit. ✓ System Type� Well Permit. Replacement Well .Owner/Agent r �n Phone Address .1 wa t{ Subdivision - a , 'd . ' ection/B]oclJPhase Lot11 `1.6 Lot Sile O� b/ Directions �,,� r� "�. LN o � Property Address t� e�r L�S/ Facility House_� Mobile Home Business Multi-family Other• Pin Number '�� a Other Zoning Approval N f€ Bedrooms '�j # Seats !/ Employees Application Rate D,� GPD Flow �6 0 Hot Tub or Spa yes/no Speciai Fixtures Basemen }t�/no 100% Repair Area yes/no Basement Plumbing yes/no Water Supplv• Private Well . Public Semi-Public *******************�*****************s*********a******�*******************************�**************�****rs**�********* Type of System: Trench � Bed Pump�_ Pump/Panel Panel LPP Other 2S �,,c7'�i�w Septic Tank Size � bO D Pump Tank Size �litrification Field: Total Square Feet �� o� Depth of Stone � Bed Size Trench Wid�h �`�� Total Length of All Trenches 3 �o Number of Trenches � Trench Length �) /�/ 7�/ �5 /_/_ Feet on Center "1 Maximum Trench 17epth � 6 �� Distance of Nearest Well *DO NOT INSTALL SEPTIC WHEN WET* *WELL RECORD REQUIRED AT COMPLETION* **:*�******«**************�*********«*****��**********�************�******�************�*�********************************* Topo % Slope � Texture � Structure � Clay Min. �� Soil Wemess " � Soil Depth " � c 'a Restric Hoz. at " � f$� � �-� _ /S�� Available space yes/no � , Overall Class S PS U • � �S. � \ � � � � � \ � -; Comments. '��','� � � „ �� _ � `= t� � � �� j � � � � ; �,� "7 E.� . � � ' ��,Il..OVV- % � I � b.�vl� Y � ,�-� �`` � �\ c-r �J �1�d � �' � s � . s-�� , � \ �� I � I ` I � �. � .� I � � i '�I` �.tP..c ��'�i'�- �'�tuh 1 to1(/� �.-i •1 " / H- o f.,c� � �JMYn.t. � � � .�N�ll 5.��,� J' ,�.�n � Filter Re uired � 9 -- � v' f� �� 1, - u�-r' Riser required when � , / � tank is more than 6 � � -- r .s - � ' n�+�t �lw-h..�fi Ci v inches deep. � � s(f f�o�.� Ah W� l� **NO GUARANTEE OR WARRANTY IS IMPLIED OR GIVEN AS TO THE PERFORMANCE OR LENGTN OF TIME THIS SYSTEM WILL FUNCTION** *�********�***�******�************�*****�****s****�s*****************s******�************�*************�********s�*�+*� 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 sources of contamination. No volume of water is guaranteed at ny�,s ite by the Health De ar•tment. �� - Permit Date �1 -- 5 Dl; 0 //� �' ,J EHS Owner/Agent( /�L '/ Septic Tank Installed By �;•b /3� ,� Date - Z--'�-0 G EHS �� Well Installed By Well Grout Approva Date Well Head Approval Date Date Sample Collected Date of Results Results EHS White - Office Yellow Owner/Agent Pink - Building lnspection Authorization to Construct .�� caTAwsA coulvTY, Nc � �, 1 oo-A soUth west Bl�d PLA N RECE/ P� � F--j Newton, NC 28658- U :'';+ �� (828)465-8399 Wednesday, June 8, 2011 �► I8 4 Z sM www.catawbacountync.gov P�an �ase: EHPR-6-1 1-1 1 1 99 �nvoice Number: INV-6-11-276199 Environmental Health Plan Review Invoice Date: 06/08/2011 Site Address: 1784 REDBERRY LN, Conover, NC APPLICANT OWNER CONTRACTOR Timothy Knopp Timothy Knopp 1784 Redberry LN 1784 Redberry LN Conover NC 28613-8135 Conover NC 28613-8135 828-23 8-20 I 2 82 8-23 8-2012 Fee Name Fee Amount Existing Tank Check Fee Fixed $80.00 Total Fees Due: $80.00 PAYMENTS PAYER: Timothy Knopp Date Pay Type Check Number Amount Paid ChangE 06/08/2011 Credit Card -1 $80.00 $0.00 Total Paid: $80.00 Total Due: $0.00 plan rece,i�=t 06/08/201 I 15:46