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Home My WebLink AboutEHPR-6-11-11209.TIF �� C�� THIS iS NOT A PERMIT Case # EHPR-6-11-11209 � �� " ��`� � CATAWBA COUNTY HEALTH DEPARTMENT c�.� ,� .',��: `�' Plan Review Application for Environmental Services 1842 Sti Environmental Health Plan Review - OSWP IMPROVEMENT - AUTH CONST - NEW WELL NAME T APPEAR ON PERMIT JOSHUA BAUMGARNER SITE ADDRESS: 2544 3STH AV PL NE Hickory, NC Pin#: 372410355365 NAME of SUBDIVISION: Lot# 2 Seclion/Block/Phase PROPERTY SIZE: Square Feet Acres 2.44 DIRECTIONS: SPRINGS RD/ KOOL PARK RD/ CONTINUE TO 1 ST STOP LIGHT / RT 28TH ST BESIDE CHURCH / CONTINUE STRAIGHT / LEFT 35TH AVE PL (road unmarked--small paved road on left) GO TO END OF PAVEMENT / LOT ON LEFT APPLICANT OWNER CONTRACTOR JOSHUA BAUMGARNER JOSHUA BAUMGARNER 2612 35TH AVE PL NE 2612 35TH AVE PL NE HICKORY NC 28601 HICKORY NC 28601 828-312-7843 828-312-7843 PRIMARY CONTACT: Owner APPLICATION FOR: New Construction DIM EXISTING STRUCTURE: EXISTING FACILITY TYPE: N/A NUMBER OF EXISTING BEDROOMS: SEWER TYPE: Septic Tank NUMBER OF EXISTING OCCUPANTS: EXISTING WATER SUPPLY IN USE: Private Well CALCULATED DESIGN FLOW: 360 Public water is *'`NOT** available for this property. PUBLIC WATER TYPE AVAILABLE: DESCRIBE WORK: 1 STORY DWELLING W/ UNFINISHED BASEMENT PROPERTY EASEMENTS: NONE PROPOSED CONSTRUCTION PRIMARY RESIDENCE NEW RESIDENCE? New Residence # OF NEW BEDROOMS: 3 # OF STRUCTURE OCCUPANTS: 2 PROJECT DESC: SINGLE FAMILY DWELLING W/ UNFINSHED BASEMENT PROJECT DIMENSION: 28 X 50 BASEMENT? Yes BASEMENT FIXTURES? No APPLICATION FOR WELL CONSTRUCTION/ABANDONMENT/REPAIR PROPOSED WELL TYPE: Individua( Wel( ABANDONMENT TYPE: WELL REPAI REQUESTED? 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 norrexpiring 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 must obtain 7oning Approval prior lo locating a home or struclure on this property. Any representalion by you of house or structure location should conform to applicable setbacks. Date: ( Signature of Applicant or Agent � �l � An Environmental Hea(th Specialist will contact you withir� 2 workin ys of application date. If you need further information or assistance please call 828-466-7291 AREA2 ****�******************************�**************************************************�********�********************** Minimum Setbacks Front: 30 Side: 15 Rear: 30 Side St: Max Height: 06/08/ 1 1 09:00 ��,� , CATAWBA COUNTY Case # EHPR-6-1 1-11209 � G Public Health Department ` �' �� a Environmental Health Division - P�an Review Subdivision � �� :`$ `�" PO Box 389, 100-A Southwest Blvd, Newton, NC 28658 Lot# 2 �Hq2 sM PIN# 372410355365 ApplicantlOwner JOSHUA BAUMGARNER, 2612 NE 35TH AVE PL, HICKORY NC 28601 Site Address: 2544 35TH AV PL NF, Flickory, NC Property Size: SF 2.44 ACRES Directions: SPRINGS RD/ KOOL PARK RD/ CONTINUG TO ( ST STOP LIGHT / RT 28TH ST BESIDG CHURCH / CONTINUE STRAIGHT / LEFT 35"[�hI AVE PL (road unmarked--small paved road on left) GO TO END OF PAVEMENT / LOT ON LGFT FEE NAME DATE AMOUNT BALANCE DUE Authorization to Construct Fee (New/Expansion) Fee 06/08/2011 $150.00 $0.00 [mprovement Permit Fee 06/08/2011 $I50.00 $0.00 Well Permit & Inspection Fee 06/08/201 1 $300.00 $0.00 TOTAL FEES �600.00 $0.00 CHANGE WORK ORDER REQUIRING REDESIGN AND/OR RETRIP WILL INCURE AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) 06/08/I 1 09:00 �a�A THIS IS NOT A PERMIT ��,� �� CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services Page 2 1 842 sM Proposed Facility Type �] Primary Residence ❑ New Residence ❑ Addition to Residence # of New Bedrooms *�' �J Project Description N�W �OYY1P Structure Dimensions a LS X' �t, # of Occupants p� Basement � Yes ❑ No Basement Fixtures ❑ Yes � No ❑ 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* j' Total # Bedrooms *�' Structure Dimensions ❑ Food Service Specify Type # Seats Fioor Space -Entire Food Service racility (Sq Ft) # Employees per Shift # of Sl�ifts Dining Area (Sq. Ft.) ❑ Business Specific Type of Business Retail Floor Space # of � mployees per Shift # 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. 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. j'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 should conform to applicable setbacks. 0 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 c Health employees to go on this property for evaluation purposes. I certify the above information to be correct and understand O C that an lmprovement Permit issued as a result of this information is valid for 5 years or may be non-expiring under certain specified conditions. Improvement 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 tr sferabl�e � Signature of Owner or Agent � ✓�� Printed Name of Owner or Agent `' � (' Date {o l ;5 f �j `a �A � THIS IS NOT A PERMIT �,�' � � CATAWBA COUNTY HEALTH llEP�RTMENT ¢ � �'$ �c Application for Environmental Services Page 1 1 $4 2 sM Improvement Permit ❑ Authorization to Construct � Septic Repair ❑ Septic Malfunction ❑ Septic Expansion ❑ New Well Permit � Replacement Well ❑ Well Abandonment ❑ Well Repair ❑ Existing System Inspection (Pre-Approval Required) ❑ Application is for New Construction � Existing Facility ❑ Property Address oZ�J�}�{ 35� ��, . P� , �'� Subdivision I i(`�_, (vC� o� �'S(aD � Lot # Acres o� • i - ! 4 n SectionBlock/Phase Driving Directions to Property �=fp,ti.. SDr;ny� KOad -}-u b� KDO�.. (��J��< r�;.+,°.�,�� -o �-5+ s�-��a i;�►��- +�P.� }��, ��.-� o„�o ag=s-�. b�sj�.� 0 Gln��c h. Ln,-�-�;n�e Skr��yv�� {� �}-�,�rr� Ic?�+-+ D.n�-� ��5 �� ►�� 1.�k�icl� � iS U� mc.�ed I Sr�+il ,�a„ec� c�n Ie�f, q �nd o-� �a�,,��.P.. �„d pm�e , o�, ie� � a NAME TO APPEAR ON PERMIT? Owner ❑ Applicant ❑ Contractor O Applicant Contact Information V Name � . W Address rt� � p,- �, �;� C � m � Phone Cell Phone _ -� g 4 j Owner Contact Information � Name z Address � Phone Cell Phone � Contractor Contact Information v Name N �u - � Address � = Phone Cell Phone � Z WHO WILL BE THE PRIMARY CONTACT? (�] Owner ❑ Applicant ❑ Contractor � Description of Existing Structures on Site �� Q # of Bedrooms *�' Structure Dimensions # of Occupants I Base ment ❑ Yes ❑ No Basement Fixtures ❑ Yes ❑ No � Planned Future Additions or Improvements (Building Permit NOT requested at this time) � 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 supply available on or adjacent to the above property ** ❑ Yes No Check type available ❑ 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 SOIL EVALUATION (SEE COMBINED EVALU PROCEDUES) Cataw�� t� N�rth �arolina N This map prodiret wcrs prepared jrom the Catawba Coiinry, NC, Ceogrnphic /nfnrmatro�i Sys(em. Catnwhn Caunty has made .�z�b.riniuial e Jjorrs ro ensiu e[he nccurncy o flocation and (afieling information contnined ora thi.r map. Catmvha Cnzo�ty promoles and recom�nends the independen! verifrcation of any � dala coiatai�aed on lhis �nap product by die v�.rer. T77e Co��nty of Cntc��bn, f!s employees, agen[s nnd personnel drsclain:, nnd sha71 not fie held linble jor any and aA dnmages, (oss or liabiliN, whether di� ec�, i»direct or con.requenlinl which arises a� nuiv orise fi om this map prodt�ct or the use �hereoJ by any person or entily. LegQnd Sclected Parcel Number: 3724-10-35-5365 � 1 inch =]00 fect Prepared for: i ' , ' N : ...... .._ ...; .. ; r , � . _... .... . ... ..... , . ; .. ; ! F . ; . . �, ... ....... � , , , : ..... ... � ; ' ` . I � . . � ; ,: : � .' � � � . ' ....... 2 �I�� r j , 3 2.04A r � F�r'r j . 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'. .' �.�,.�.._. ......... ...... �. � .� , „ ....__ , � � � . , F . , t ..�� . � . ... \ / _ \ � i ' � ��' THIS IS NOT A LEGAL DOCUMENT �, Wednesday, June 08, 20l 1 08:43 AM �t ��A c c��w�� cou��rv ��r�� ' � � � �� w.��': �� 1�� : ,�� : ;��9 �i P. O. Box 389 Phone: 828-4C5-8380 PE�II'I' N�: ZON�Z-6-11-1�741 ] OOA Southwest Blvd FAX: 828-4(�-8484 APPLIED: 06/08/201 1 1��'1 Ncwton, North Carolina 286�8 ISSUED: 06/08/20 ]] l� SM www.catawbacountync.gov FXPtRES: 12/0�/2011 Catawba County Internet Citizen Aceess Portal: energov.eatawbacountync.gov/capJ APPLICANT OWNER CONTRACTOR JOSI iUA BAUMGARNER .IOSHUA BAUMGARNER 2612 35TH AV� PL NT 2612 35TH AVE PL Nr H[CKORY NC 28601 I-fiCKORY NC 2860] P. 828-312-7843 P• �� 2-784 ****** NO CONTRACTOKS A5S►GNED ****** PiZOPERTY ID#: 3 O��S3�S . STREET ADDRESS: 2544 3SI'I-1 AV PL NE, ilickory, NC LOT# 2 PROJEC'I' DF,SCR.IPTION: 1 STORY DWELI,ING W/ UNFINISfI�D BnSrMENT COMMEN"I�S: N�W SINGL� FAMILY DWELLING � FLOOD ZON�? OWNER TYPE: Residential (Private) 100 YEAR FI,OOD ZONE PLAIN? No LAND OWNER: PLOOD PLAiN, STRUCTURF_.? No REQU[RLD S�TBACKS FRONT: 30.00 RFAR: 30.00 COR.NER: SIDG: 15.00 MnX I tEIGHT: 45 1. I3efore an inspection can be mlde by the Building Inspection OfFce, the applicant must pull a string to designate the side antl rear property lines where thc structure is beiag placed or conslructed. � 2. Home shall be placed on the lot in harmony with the site-built slructures, or have the front door face tl�e road frontage. FEE DESCRIPTION DATE FEE AIVIOUNT Residential Zoning Fee 06/08/2011 $25.00 � TOTAL �'E�S $25.00 The ao��licant herebvi certifies that all inform�tion and attachmentS to this ('erti�cate of 7oning Com piliance are true and correct and acknowledees that th�s permrt was issued on the b�sis of the inf'ormation required herein The applieant fitrther acknowledges that any construc�ion, � � � alteration or addition which differs from this application shall bc subjcct to removal or alteration so as to bring said structure into conformance with thc �� spceifications and standards of �he Catawba County 7oning Ordinance. Such corrective action shall be �t the expense of the applicant. �� It is thc responsibility of Applicant to comply with all existing decd restrictions pertaining to the property. Issuance of this permit is not certification of �� such compliance and does not relieve Applicant of the dury to eomply. . **This Zoning A�+thorization (R) Permit shall expire six months from the date of issuancc unless a uil�ing p rn�it is s recl and remains activ l ' 1� , Gt��o l�:c .- -z! ,. �� : < :� �� L�� APPLICAN"I' NAMG ( INTED) AP'LICAN'I' ST ATURE ZONING APPROVED [3Y COMF'ANY NnM� "**** ZONING FEES ARE NON-REFUNllASL� *x*** ;' "'�� 06/08/201 I 08:59 Page I �f 1� .�� caT�wBa covNTY, Nc ��w ,� '°°-A S°ut" west B'�d pLAN RECEIPT r-� Newton, NC 28658- � � r o �' (828)465-8399 Wednesday, June 8, 2011 �� j g 4 Z sM www.catawbacountync.gov P�an case: EHPR-6-11-11209 �nvoice Number: INV-6-11-276176 Environmental Health Plan Review Invoice Date: 06/08/2011 Site Address: 2544 NE 35TH AV PL, Hickory, NC APPLICANT OWNER CONTRACTOR JOSHUA BAUMGARNER JOSHUA BAUMGARNER 2612 NE 35TH AVE PL 2612 NE 35TH AVE PL HICKORY NC 28601 HICKORY NC 28601 828-3 828-312-7843 Fee Name Fee Amount Improvement Permit Fee Fixed $150.00 Well Permit & Inspection Fee Fixed $300.00 Authorization to Construct Fee Adjustable $150.00 (New/Expansion) Fee Total Fees Due: $600.00 PAYMENTS PAYER: JOSHUA BAUMGARNER Date Pay Type Check Number Amount Paid ChangE 06/08/2011 Credit Card -1 $600.00 $0.00 Total Paid: $600.00 Total Due: $0.00 pi,m rc:cei3�t 06/08/201 I 09:00