Loading...
HomeMy WebLinkAboutRBPR-07-2017-27011.TIFContractor Owner THIS IS NOT A PERMIT Case # RBPR-07-2017-27011 CATAWBA COUNTY HEALTH DEPARTMENT PLAN REVIEW APPLICNFION FOR ENVIRONMENTAL SERVICES Residential Building Plan Review - Modular AUTH CONST -NEW WELL *CLAYTON HOMES OF STATESVILLE, 2026 NORTHSIDE DR, STATESVILLE NC 28625 B:704-873-2547 C:7046778903 ABEESCG@AOL.COM N. JOAN WALLACE, 4300 WALLACE HOLLOW DR, HICKORY NC 28601 H:8282563500 C:8282287379 HOME8282563500 NAME TO APPEAR ON PERMIT *CLAYTON HOMES OF STATESVILLE SITE ADDRESS: 4347 WALLACE HOLLOW DR, HICKORY NC 28601 PIN # 372312864184 NAME of SUBDIVISION: NJOAN WALLACE Lot 1 Section/Block PROPERTY SIZE: Square Feet Acres 1.01 DIRECTIONS: Springs Rd, right on Section House, turn right on Horseshoe Bend Rd, turn left on 1 st road on left Wallace Hollar Rd, on right PRIMARY CONTACT: Applicant SEWER TYPE: Septic Tank GALLONS PER DAY: 360 WATER SUPPLY: Private Well DESCRIBE WORK: New, 30x72, modular home, 3 bedroom, no garage no basement 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? Yes Are there any easements or right-of-ways on this property? No APPLICATION FOR: STRUCTURE TYPE: FACILITY TYPE: Single Family Residence DESCRIPTION OF EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: NUMBER OF EXISTING BEDROOMS: New Structure PRIMARY RESIDENCE OTHER DESCRIPTION: # OF OCCUPANTS: 3 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 30x72 Modular with 6x6 front and rear decks # OF NEW BEDROOMS:: 3 BASEMENT? No BASEMENT FIXTURES? No Desired system types (Improvement Permit or Authorization to Construct): ACCEPTED. ALTERNATIVE: OTHER: INNOVATIVE: Other described' PLUMBING REQUIRED? Yes CONVENTIONAL: ANY: YES APPLICATION FOR WELL CONSTRUCTION PROPOSED WELL TYPE: Individual Well REPLACE WELL?: NO 19-ehapphcauon 07/19/2017 17 12 Page I of �A CATAWBA COUNTY case a RBPR-07-2017-27011 �t Public Health Department Subdivision N JOAN WALLACE 4 dy "1 Environmental Health Division r PO Box 389. 100-A Southwest Blvd, Newton. NC 28658 PIN# 372312864184 t 2 M NAME ON PERMIT: *CLAYTON HOMES OF STATESVILLE O, 2026 NORTHSIDE DR, STXI'ESVILLE NC 28625 `CLAYTON HOMES OF STA Site Address: 4347 WALLACE HOLLOW DR, HICKORY NC 28601 Property Size: Square Feet Acres 1 01 Directions: Springs Rd, right on Section House, turn right on Horseshoe Bend Rd, turn left on 1 st road on left Wallace Hollar Rd, on 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 labeling of all property lines and corners and making the site accessible sp thaa complipte sd v uation can be performed. Date: , , ( 9 - Zo 17 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 FEENAME DATE FEEAMOUNT Authorization to Construct Fee (New/Expansion) 07/19/2017 $150.00 Fee _ Well Permit & Inspection Fee 07/19/2017 5300 00 TOTAL FEES $450.00 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) L9 - chapplicauon 07/19/2017 17 12 Page 2 ol'4 THIS IS NO"F A PERD4IT CAA - - - - ------ ---- COUN' Y ,CATAWBA COUNTY HEALTH'I)EPARTMENT Application for Environmental Services Page 1 Improvement Permit ❑ Authorization to Coils ❑v Septic Repair ❑ Septic N'Ialfunction ❑ Septic Expansion ❑ New Well Permit U Replacement Well ❑ Well Abandonment ❑ Well Repair ❑ Existing System Inspection (Pre-Approval Required) ❑ Application is for New Construction ❑ Existing Facility ❑ Property Address ' (g11gre, 90lkAr D(-,Je- Subdivision A)r_ �-06ol Lot# 1 Acres 1 A 1 Section/Block/Phase Driving Directions to Property fr-o.� 4; f r:^CSIYJ� CTy �1 DA1 C'eed•ba1 dO( -4e 40-A '6110 t R•�ld av WJ,-Ses�c &,,tee Rd —1,i Leo W IJallAce ✓ 141- iw(. /J/ o.,-, A1941. NAME TO APPEAR ON PERMIT? ❑ Owner [Applicant ❑ Contractot Applicant Contact Information Name (�)Iar OA-. %��i+te B� rrf�.rc7✓.,/1,� 0 Address Zi,4'`!5,: Gi/ Ile- "Ce Z96,0 -s - Phone f/ X73- y -I Cell Phone 7Df/- G77 -X03 Owner Contact Information I Name )v�J jt)4 w�C Address 7/ 7Z Phone Contractor Contact Information Name .Xs Address o ,4(i/tfc*i �C "Ipal Cell Phone Phone I Cell Phone WHO WILL BE THE PRIMARY CONTACT? ❑ Owner Applicant ❑ Contractor Description of Existing Structures on Site _ # of Bedrooms *j'_ Structure Dimensions # of Occupants Basement ❑ Yes [--i No Basement Fixtures 0 Yes [C, No The Applicant shalt notify the local health department upon submittal of this application if any of the following apply to the property ipquestion. If the answer to any question is `'yes", applicant must attach supporting documentation. ® Yes F00 / Does the site contain any jurisdictional wetlands? I� Yes Does the site contain any existing wastewater systems? esa Is any wastewater going to be generated on the site other than domestic sewage? -lyes No Is the site subject to approval by any other public agency? Ll f;tTYes 0 No Are there atlasements or right of ways on this property? Describe t V Existing water supply in use Q Individual Well ❑ Community Well ❑ Semi -Public Well J ❑ 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 0 Alternative 0 Conventional 11 Innovative 0 Other L'T Any THIS [S NOT ANOPERN(IT CATAWBA- - --- --- - - - -- - cou Te CATAWBA COUN'T'Y HEALTH DEPARTMENT Application for Environmental Services Page 2 !'n6sed Facilit Type LV Primary Res Bence VNew �Residence ❑J Addition tp%esidence # of flew Bedrooms * j 3 Project Description dUC✓ /moo//k�Ar �lDt�tt Structure Dimensions # of Occupants ..3 Basement ❑ YcsLrkNo Basement Fixtures Yes No ❑ Accessory Structure(s) Describe # of New Bedrooms *'I, if applicable Structure Dimensions # of Occupants Accessory Dwelling ❑ Yes ❑ No Plumbing ❑ Yes ❑ No Describe Plumbing Needed ❑ Multi -Family Residence # Units 11 Bedrooms per Unit*j' 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 ❑ Other Facility Type Specify If Church # of Seats Kitchen ❑ Yes ❑ No If Daycare Specify Occupancy Application for Well Cons uction/Abandon men URepair 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 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. 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 lutes and corners and making the site accessible so that a complete site evaluation can be performed. Signature of Owner or Agent��� Date Y -Tr PF , Z01 —e Printed Name of Owner or Agen I Catawba County Environmental Health Parcel: 372312864184, 4347 WALLACE HOLLOW DR HICKORY, 28601 242.65 J4 1 in=40ft 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 07/19/2017 / / / / l 242.65 J4 1 in=40ft 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 07/19/2017 Parcel Report Page l of l Parcel Report - Catawba County NC Parcel Information: Parcel ID: 372312864184 Parcel Address: 4347 WALLACE HOLLOW DR City: HICKORY, 28601 LRK(REID): 404512 Deed Book/Page: Subdivision: N JOAN WALLACE Lots/Block: 1/ Last Sale: Plat Book/Page: 73/26 Legal: 1 PL 73-26 WALLACE HOLLOW DR Calculated Acreage: 1.010 Tax Map: Township: HICKORY State Road #: Tax/Value Information: Tax Rates(pdf) City Tax District: All in County County Fire District: ST STEPHENS Building(s) Value: $0 Land Value: $6,100 Assessed Total Value: $6,100 Year Built/Remodeled: / Current Tax Bill Miscellaneous: Building Permits for this parcel. Building Details WaterShed: Voter Precinct: P28 Parcel Report Data Descriptions List all Owners Deed History Report Owner Information: Owner: WALLACE N JOAN Owner2: Address: 4300 WALLACE HOLLOW DR Address2: City: HICKORY State/Zip: NC 28601 School Information: School District: COUNTY Elementary School: WEBB A MURRAY Middle School: ARNDT High School: ST STEPHENS School Map Zoning Information: Zoning District: COUNTY Zoningl: R-20 Zoning2: Zoning3: Zoning Overlay: Small Area: ST STEPHENS/OXFORD Split Zoning Districts: / Zoning Agency Phone Numbers Firm Panel Date: Firm Panel #: 2010 Census Block: 2017 2010 Census Tract: 010303 Agricultural District: Proximity Assessment Report This map/repon 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 © 2017, Catawba County Government, North Carolina All rights reserved. http://gis.catawbacountync.gov/noniaplparcel_report.plip?key=372312864184&typ=P 7/19/2017 CATAWBA COUNTY Public Health Department Environmental Health Division PO Box 389, 100-A Southwest Blvd, Newton, NC 28658 2 Case# IMPV-Il-2013-043542 Subdivision N JOAN WALLACE PIN# 372312854969 LOTH 1 NAME ON PERMIT: N. JOAN WALLACE, 2173 HORSESHOE BEND RD NE, HICKORY NC 28601 Site Address: WALLACE HOLLOW DR, HICKORY NC 28601 Property Size: Square Feet 43,599.20 Acres 1.0009 Directions: FROM SIRPINGS RD GO RIGHT ON SECTION HOUSE RD GO 8/10/ MI TURN RIGHT ON HORSESHOE BEND RD TURN LEFT ON 1ST RD TO LEFT LOT ON RIGHT Improvement Permit Facility: Primary Residence - House Permit Category: New Septic Bedrooms 3 WATER SUPPLY. Private Well Basement? Yes Basement Plumbing? No INITIAL SYSTEM SPECIFIC_ ATIONS Permit Valid: Expires In Five Years: _X_ No Expiration: Projected Daily Flow 360 g.p.d Proposed Wastewater System: 25% REDUCTION Type: HIG - OTHER NON -CONY TRENCH SYSTEMS Permit Conditions: _ REPAIR SYSTEM SPECIFICATIONS Repair System Required? Required Proposed Wastewater System: 50% REDUCTION Type: IVA - ANY SYSTEM WITH LPP DISTRIBUTION PUMP REOUIRED ***** OPERATOR REOUIRED Landscaping or other site alterations that potentially divert groundwater or surface water toward the septic system, or prevent proper drainage away from the septic system, including the direction of gutter flows or foundation drains, is not approved, and may result in failure to approve the initial system installation, or the suspension/revocation of exishnq permits The issuance of this permit by the Health Department docs not guarantee the issuance of other permits. It is the responsibility of the applicant/properly owner to insure that all Catawba County Planning/Zoning and Building Inspections requirements are met. This Improvement Permit is subject to revocation if the site plan, plat or the intended use changes, or if site conditions are altered. The Improvement Permit is not affected by a change in ownership of the property. This permit was issued in compliance with the provisions of the North Carolina 'Laws and Rules for Sewave Treatment and Dicnasal Systems' (15A NCAC I8A .1900). Neither Catawba County nor the Environmental Health Specialist warrants that the septic tank system will continue to function satisfactorily for any given period of time. Robbie Phelps 11/07/2013 A UTBOR[ZED STATE AGENT APPROVAL DALE Permit Expiration Date: 11/07/2018 No grodmg or construction oclrvn3+ is allowed in areas designated for snsrcm and repair without approval of the Health Deportment. E9 - chpernul 11/08/2013 11.35 Page I of 3 CATAWBA COUNTY Permit # VGZ Public Health Department Name y � Address .o. Environmental Health Division u PO Box 389, I OOA Southwest Blvd, Newton NC 28658 PINn 1841 su (828) 465-8270 Fax (828) 465-8276 TDD(828)465-8200 SITE PLAN A v Scale 1 :60 i to to Ajtr rj h 14 �- �y�h� `J (I u ovJ'9- �v� I W'v1 0 11 f✓ 1.y OV/ IMPV-11-13-043542 Joan Wallace Wallace Hollar Dr Lot I Department of Environment, Health, and Natural Resources Division of Environmental Health On -sit@ Wastewater Section SOIL/SITE EVALUATION for ON-SITE WASTEWATER SYSTEM Owner: Joan Wallace Address. Wallace Hollar Or Proposed Facility 3br Design Flow (.1949) 360 Location of Site Water Supply. ] Public [ x ] Individual [ x] Well Evaluation Method: [ ] Auger Boring [ x ] Pit Type of Wastewater' [ )Sewage [ ] Industrial Process Sheet, Property ID' Lot #' 1 File #. AppID: Applicant. Date Evaluated: Property Size' Property Recorded I ] Spring [ )Other [ ] Cut [ ] Mixed P R O SOIL MORPHOLOGY b F .1941 PROFILE FACTORS 1 .1940 .1942 L Landscape Horizon .1941 .1941 Soil .1943 .1956 .1944 Profile E Position/ Depth Structure/ Consistence Wetness/ Soil Sapro Restr Class # Slope°/ (IN.) Texture Mineralogy Color Depth (IN.) Class Horiz & LTAR 1 L, 5% 10-26 cl,sbk fr,ss,sp I 26 u 26+ I sap I fi I 2 10-48 I cl fr,s,sp I 48 0 3 3 I 0-12 cl,sbk fr,ss.sp 12-48 I I I I I scl+sap,sbk I I I I � fr,ss.sp I I I I � 48 0.3 Description I I I I I Initial System Repair System I I I I I Other Factors ( 1946)' (Available Space ( 1945) s s I Soil Evaluation By: Robbie Phelps System Types) 25% 50% I Others Present Site LTAR 0 3 0.3 I Site Classification ( 1948): PS Site Evaluation By Others Present COMMENTS: Landscaoe Position R -Ridge SS -Shoulder Slope LS -Linear Slope FS -Foot Slope NS -Nose Slope HS -Head Slope CC -Concave Slope CV -Convex Slope T -Terrace FP -Flood Plain Consistence Moist VFR-Very Friable FR -Friable FI -Firm VFI-Very Firm EFI-Extremely Firm Group Texture .1955 LTAR I S -Sand 1.2 - 0.8 LS -Loamy Sand II SL -Sandy Loam 0 8 - 0 6 L -Loam III SI -Silt 0 6 - 0 3 SICL-Silty Clay Loam CL -Clay Loam SCL-Sandy Clay Loam IV SC -Sandy Clay 0 4 - 0 1 SIC -Silty Clay C -Clay Consistence Wet NS -Nan -Sticky SS -Slightly Sticky S -Sticky VS -Very Sticky NP -Non -Plastic SP -Slightly Plastic P -Plastic VP -Very Plastic Mineraloev SEXP-Slightly Expansive EXP -Expansive �1tch of Soil Evaluation Locations Sheet. FILE i1: Structure SG -Single Grain M -Massive CR -Crumb GR -Granular SBK-Subangular Blocky ABK-Angular Blocky PL -Platy PR -Prismatic