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HomeMy WebLinkAboutEHPR-2-10-4042 (2).TIF ~A C THIS IS NOT A PERMIT Case # EHPR-2-10-4042 CATAWBA COUNTY HEALTH DEPARTMENT v `C Plan Review Application for Environmental Services Environmental Health Plan Review - OSWP SM 1842 IMPROVEMENT - AUTH CONST APPLICANT OWNER CONTRACTOR BANDYS CROSSROADS VOL FIRE DEPTBANDYS CROSSROADS VOL FIRE DEPT LOOPER & COMPANY, INC., DAVID E. 1611 BUFFALO SHOALS RD 1611 BUFFALO SHOALS RD 320 CATAWBA NC 28609 CATAWBA NC 28609 15th 828-324-1284 828-324-1284 HICKORY NC 28601- 828-324-1284 NAME TO APPEAR ON PERMIT BANDYS CROSSROADS VOL FIRE DEPT brandon@&tdbmpa`*7@04446839 SITE ADDRESS: 1611 BUFFALO SHOALS RD, Catawba, NC DIRECTIONS: HWY 16/ LT ON BUFFALO SHOALS RD/ GO 2.75 MI/ ON LT NAME of SUBDIVISION: Lot # Section/Block/Phase PROPERTY SIZE: Square Feet Acres 1.269 Date Platted/Recorded TYPE OF FACILITY: House Mobile Home Dimension of Structure 127 X 135 Bedrooms 0 Basement: No Water Using Fixtures in Basement: No. in Family Whirlpool Tub : Gal. Capacity: MULTIPLE FAMILY RESIDENCE: Units 1.00 Total Number of Bedrooms DAYCARE: Number of Children RESTAURANT: Seats Square Feet Dining Area Square Feet Foodstand/Meat Market Floor Space TYPE OF BUSINESS: Number of Employees 1st 2nd 3rd OTHER: (Specify) Do you aniticipate any additions to Facility? If so, describe: PHASE 771 AND PHASE 2 OFSNTE~W,rFIRE TSTATION. DEMO OF OLD STATION WILL HAPPEN AFTER PHASE 1 COMPLETED AND THEN Has any grading, CErllUVal~~tp~trcTitNi~t~s01f btt C1o4ie'to6Stale~47g~ooml6 Bed Sleeping Quarters If so, describe ~y Are there easements/right-of-ways recorded on this property? NO Type of Water Supply: Individual Well Community Well Municipal X Semi-Public 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 must obtain Zoning Approval prior to locating a home or structure on this property. Any representatio by you of house or structure location should conform to applicable setbacks. Date: 3-3-10 Signature of Applicant or Agent An Environmental Health Specialist will contact you within 2 working days of application date. If you need further information or assistance please call 828-466-7291 AREA 1 (FOR OFFICE USE ONLY) Zoning Approval: Yes No Zoning Approval UDO Zoning Form A Minimum Setbacks Front 45 FEE NAME ~ (+~J DATE AMOUNT Side 35 GC~ r" `cQ (to Rear 35 TOTAL FEES Max Hght *If a permit has to be redesigned and / or RETRIPS made to the property, there is an additional $60 charge 03/03/10 08:41 THIS IS NOT A PERMIT WLS # CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services Improvement Permit e Authorization to Construct Septic Repair ❑ Septic Expansion Existing Tank Check E] New Well Permit ❑ Replacement Well ❑ Well Abandonment E] 1. Name to Appear on Permit L Rr~ NePqr4".-r,r 2. Permit Requested By ~ Business Phone 42- AIRY Address Sao 1.5+h V-,o f SE AK$ 6001e-n Home Phone 92RAIN-117-3ILL 3. Property Owner Q.van eLrv,e Business Phone Address S tS 56-low Home Phone 4. Name of Subdivision Ba.rY's VOL- Ere Dt Lot # Section/Block/Phase Property Address _ 161 S 60, 3 Rea Ca a~N G aguay Directions to Property: 5. Property Size: Square Feet 71. 1. Acres Date Platted/Recorded 6. TYPE OF FACILITY: House Mobile Home Dimension of Structure Bedrooms* *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 system size increase in the future. Basement: yes/no Water Using Fixtures in Basement: yes/no No. in Family Whirlpool Tub yes/no Gallon Capacity MULTIPLE FAMILY RESIDENCES: Units Total Number of Bedrooms DAY CARE: Number of Children RESTAURANT: Seats Square Feet Dining Area -Square Feet Food stand/Meat Market Floor Space TYPE OF BUSINESS: i. Number of Employees 1 st 2nd rd OTHER: (Specify) • Q b ao {r`+ s 7. Do you anticipate any additions to Facility. Yes / If so, describe: 8. Has any grading, removal, or addition of soil been done to this property? Yes / If so, describe: 9. Are there easements/right-of-ways recorded on this property? Yes / o 10. Is a public water supply available on or adjacent to the above property? 'e / N Check type that is available: ] Community well [ ] Semi-public wel [ounty/City/Township water line **If No, a Well Permit must be issued with the Septic Permit.** 11. Well Type Applying For: [ ] individual well [ ] Community well [ ] Semi-Public well 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 valid for 5 years or may be non-expiring under certain specified conditions. Improvement Permits and Well Permits are transferable, but may be revoked if this information, site plans or intended use changes for the proposed facility. An 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 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. **IF A PERMIT HAS TO BE REDESIGNED AND/OR RETRIPS MADE TO THE PROPE TY, THERE IS AN ADDITIONAL CHARGE.** Date A.-M-10 Signature of Owner or Agent OfFce Use=0n1~ t. IMPROVEMENT PERMIT 11e CDP-File Number Catawba County Public Health Department Co6iity;IDINumberwLS20~9 Oo05:1~~Y~ I iY Environmental Health Division Evaluated~F,oA NEW: P O Box 389, 100-A Southwest Blvd Newton NC 28658 PERMIT VALID UNTIL ! 02/16/2014 Phone (828)-465-8270 Fax. (828) 465-8276 ❑ Open Fill Sheet *NOTE TO INSPECTIONS DIVISION: Building Permits cannot be issued with this Improvement Permit. Property Owner- BANDYS CROSSROADS Applicant BANDYS CROSSROADS Address 1611 BUFFALO SHOALS RD Address 1611 BUFFALO SHOALS RD City CATAWBA City CATAWBA State/Zip NC 28609 State/Zip NC 28609 Phone # Phone # Property Location & Site Information Address/Road Subdivision Phase- Lot- 1611 BUFFALO SHOALS RD CATAWBA INC Directions Structure OTHER *new Fire Dept* HWY 16 S/ LF BUFF SHOALS RD/ TRAVEL APPROX 3 MILES/ FIRE DEPT ON # of Bedrooms 0 LFBANDYS CROSSRD VOLUNTEER FIRE DEPT # of People ****'Joining lots/ tearing down old biding & septic/see -Water Supply PUBLIC map for new bld location*** may have up to 4 System Specifications Initial System *Site Classification PS Minimum Trench Depth. 1 8 Inches Design Flow- 4 0 Maximum Trench Depth- 2 4 Inches Soil Application Rate 0 3 Septic Tank; 1 5 0 0 Gallons 1-Piece DYes ~No *System Classification/Description Pump Required QYes O No N May Be Required TYPE III G OTHER NON-CONY TRENCH SYSTEMS N Pump Tank 1 5 0 0 Gallons . "Proposed System • 25% REDUCTION QYes ~ No 1-Piece Repair System Required DYes 0No 0No, but has Available Space Repair System `Site Classification PS Minimum Trench Depth' 1 8 Inches Soil Application Rate 0 3 Maximum Trench Depth. a 4 Inches *System Classification/Description Pump Required QYes O No k) May be Required TYPE III G. OTHER NON-CONV TRENCH SYSTEMS Pump Tank- Gallons s. 'Proposed System 25% REDUCTION Page 1 of 3 C ,Number' 26534 County ID Number WLS2009-00051 *Site Modifications No grading or construction activity is allowed in areas designated for system and repair without approval of Health Department *Permit Conditions The issu.ance of this permit by the Health Department in no way guarantees the issuance of other permits The permit holder is responsible for checking with appropriate governing bodies in meeting their requirements Prior to the issuance of the AC the existing well must be properly abandoned and the two parcels must be combined and recorded Plumbing elevation must correspond with trench depth and tank installation to avoid pump requirement. This permit is not intended for installtion purposes. The Improvement Permit shall be valid for 5 years from date of issue with a site plan (means a drawing not necessarily drawn to Site Plan scale that shows the existing and proposed property lines with dimensions, the location of the facility and appurtenances, the site for the proposed Wastewater system, and the location of water supplies and surface waters). Plat The Improvement Permit shall be valid without expiration with plat (means a property surveyed prepared by a registered land surveyor, drawn to a scale of one inch equals no more than 60 feet, that includes. the specific location of the proposed facility O and appurtenances, the site for the proposed Wastewater system, and the location of water supplies and surface waters. Plat also means, for subdivision lots approved by the local planning authority and recorded with the county register of deeds, a copy of the recorded subdivisions plat that is accompanied by a site plan that is drawn to scale). The Department and Local Health Department may impose conditions on the issuance and may revoke the permits for failure of the system to satisfythe conditions, the rules, or this article This permit is subject to revocation if the site plan, plat, or intended use changes (NCGS 130A-335(f)). The person owning or controlling the system shall be responsible for assuring compliance with the laws, rules, and permit conditions regarding system location, installation, operation, maintenance, monitoring, reporting, and repair (.1938(b)). Applicant/Legal Reps. Signature Required? OYe ,:::0 Applicant/Legal Reps Signature. Date c - ao(19 `Issued By 2246 - Megen McBride Date of Issue 0 a 1 6 -2 0 0 9 Authorized State Agent OValld without Expiration? OHand Drawing Import Drawing **Site Plan/Drawing attached.** Total Time.(HH:MM). 0 0 : 0 0 Page 2 of 3 CATAWPA COUNTY Case# WLS2009-00051 Public Health Department Subdivision • ~ G Environmental Health Division Sect/BL/Ph/Lot # r < PO Box 389, 100-A Southwest Blvd, Newton, NC 28658 PIN# t 2 s(828)465-8270 FAX(828)465-8276 TDD(828)465-8200 367904846839 Applicant/Owner BANDYS CROSSROADS VOLUNTEER FIRE DP Site Address: 1611 BUFFALO SHOALS RD CATAWBA NC Property Size: SF 1.54 ACRES Directions: *new Fire Dept* HWY 16 S/ LF BUFF SHOALS RD/ TRAVEL APPROX 3 MILES/ FIRE DEPT ON LFBANDYS CROSSRD VOLUNTEER FIRE DEPT *****Joining lots/ tearing down old blding & septiclsee map for new bld location*** may have up to 4 employees staying over night in future WELL ABANDONMENT PERMIT WELL TYPE (DRILLED, BO DUG, ETC): 30 ISSUE PERM I SUANCEDATE OWNE OR LEGAL REPRESENTATIVE DATE WELL ABANDONMENT INSPECTION 'FOP Y OF CASING MATERIAL REMOVED (BORED WELLS) YES NO WELL DISINFECTED DATE INITIALS • WELL FILLED WITH APPROVED MATERIAL DATE INITIALS (BORED OR DUG WELL ONLY) WELL GROUTED TO SURFACE (DRILLED WELLS ONLY) DATE INITIALS WELL CAPPED WITH CONCRETE DATE INITIALS WELL. ABANDONMENT REPORT RECEIVED DATE INITIALS PERSON ABANDONING WELL OWNER DATE CONTRACTOR DATE Wells shall be abandoned in accordance with all state and kcal regulations and rules. The Well Abandonment Report must be submitted to the Health Department within 30 days upon completion of a well abandonment. AUTHORIZED STATE AGENT COMPLETION DATE r ITidemarklForms yWLSApp. [p 02/02/09 13:57 00051 _ CDP!File Number 26534 County ID Number WLS2009 *Site Modifications No grading or construction activity is allowed in areas designated for system and repair without approval of Health Department *Permit Conditions The issuance of this permit by the Health Department in no way guarantees the issuance of other permits The permit holder is responsible for checking with appropriate governing bodies in meeting their requirements Prior to the issuance of the AC the existing well must be properly abandoned and the two parcels must be combined and recorded Plumbing elevation must correspond with trench depth and tank installation to avoid pump requirement. This permit is not intended for installtion purposes. ? The Improvement Permit shall be valid for5 years from date of issue with a site plan (means a drawing not necessarily drawn to Site Plan scale that shows the existing and proposed property lines with dimensions, the location of the facility and appurtenances, the a site for the proposed Wastewater system, and the location of water supplies and surface waters). Plat The Improvement Permit shall be valid without expiration with plat (means a property surveyed prepared by a registered land surveyor, drawn to a scale of one inch equals no more than 60 feet, that includes the specific location of the proposed facility O and appurtenances, the site for the proposed Wastewater system, and the location of water supplies and surface waters. Plat also means, for subdivision lots approved by the local planning authority and recorded with the county register of deeds, a copy of the recorded subdivisions plat that is accompanied by a site plan that is drawn to scale). The Department and Local Health Department may impose conditions on the issuance and may revoke the permits for failure of the system to satisfy the conditions, the rules, or this article This permit is subject to revocation if the site plan, plat, or intended use changes (NCGS 130A-335(f)). The person owning or controlling the system shall be responsible for assuring compliance with the laws, rules, and permit conditions regarding system location, installation, operation, maintenance, monitoring, reporting, and repair (.1938(b)). Applicant/Legal Reps Signature Required? Oyes ONO Applicant/Legal Reps Signature. Date. `Issued By 2246 - Megen McBride Date of Issue 0 a 1 6 / a 0 0 9 Authorized State Agent. OValid without Expiration? 01-land Drawing NImport Drawing} **Site Plan/Drawing attached.** Total Time.(HH:MM) 0 0 0 0 Page 2 of 3 NCDENR Division of'Envlronmental Health Date o a l © a l a e o 9 On-Site Wastewater Section Soil/Site Evaluation 'File# a 6 5 3 4 For On-Site Wastewater System PIN o 9 0 0 0 5 1 1Owner BANDYS CROSSROADS VOLUNTEER FIRE DP Proposed Facility OTHER Proposed Design Flow (.1949) a 4 o Location of Site 1611 BUFFALO SHOALS RD Property Size 1.54 Water Supply PUBLIC Evaluation Method Pit 1940 SOIL MORPHOLOGY Landscape Horizon 1941 Profile# POS Depth Other Profile (IN) Mineralogy Matrix Mottle Factors Slope Texture Structure Consistence Color Color 1 0-10 Sloan) gr fr ss sp 1942 Wet. 10-40 cl °!n sbk fr ss sp 1943 Depth 4 0 40+ n/a pl 1944 Rest GPS Horizon Saprolite 1947 Class ps Profile LTAR 0 3 a 0-10 sloan) gr fr ss sp 1942 Wet °!o 10-36 cl sbk fr ss sp 1943 Depth 4 8 36-48 1944 Rest. GPS Horizon Saprolite 48+ 1947 Class Ps Profile LTAR 3 0-10 sloarn gr Fr ss sp 1942 Wets 10-24 cl sbk fr ss sp 1943 Depth 3 a 24-32 1944 Rest GPS Horizon Saprolite 32+ 1947 Class Ps Profile LTAR 1942 Wet % 1943 Depth 1944 Rest. GPS Horizon Saprolite 1947 Class Profile 1942 Wet. 1943 Depth 1944 Rest GPS Horizon Saprolite 1947 Class Profile LTAR Available Space ( 1945) ps Other Factors( 1946) Ps Site Classification P5 Initial LTAR 0 3 Repair LTAR 0 3 Others Present Comments Pit 1 has SAP 40"+ (40" is very conservative, areas of the pit has CL to 60") Pit 2 has CL+SAP 36-48" and 48"+ SAP (mica). Pit 3 has CL+SAP 24-32" and 32"+ is SAP; at 48" SAP gets very hard and 'rock-like', Evaluated By Megen McBride Attach Image The "Open Drawing Form" button, opens the the drawing form. ` The "Import" button, attaches the drawing. or other image into the space below. Open Drawing Form t 3 Pro~osc ~ n i!Profile 1 X Y Z .'Profile 2 X Y Z Profile 3 U X Y Z Profile X Y Z Profile X Y Z Profile X Y Z Profile x Y Z Profile' X Y Z Profile x Y Z !Profile. X Y Z i'R A. / WBA COUNTY HEALTH DEPARTMENT PC)54(,d Telephone (828) 465-8270 TDD (828) 465-8200 WLS 1#,260:2 -DOV;zC, IP AC Rpr Print. ~ - Opr Print. Sys Type A/9- Well Prmt. Replacement Well Well Rpr Prmt. Ownek'g-ent V- Phone 9 / - a J/ J Address L~/~~ 1=F~Gn sSL~O/~LC /ZD~¢ Subdivision Q Section/Block./Phase Lot# Lot Size f ,Z/7/4e2t1.D[rections , Fj"i9l~~ ~ 7A GS 2,DAJp (--n i4OtP6e B X c.-E' Q /9-/V'S S/ ! -'9L yb 1/ /-S }S_ .~5- iw Property Address f 6 / / !=F~AGD S,40,9 GS 2p A4 Facility- House Mobile Homg__ Business Multi-family-- Other- Pin Number U Other 'OCi.P r U r P7-- Zoning Approval # I N Bedrooms /t Seats # Employees Application Rate GPD Flow Hot Tub or Spa yes rto pecial Fixtures Basement yes/~ 100% Repair Area-yeff~nm Basement Plumbing yes no Water Supply Pnvate Well Public Semi Public Type of System Trench Be,*- Pump Pump/Panel Panel -LPP - Other Septic Tank Size z W6Pump Tank Size Nitrification Field. Total Square Feet !-j 0 Depth of Stone /,Z' Bed Size -e S ' Trench Width - Total Length of All Tre hes Number of Trenches Trench Length F .-et on Center Maximum ench Depth Distance of Nearest Well *DO NOT INSTALL SEPTIC WHEN WET* *WELL RECORD REQUIRED AT COMPLETION* Topo % Slope Texture Structure I. Clay Min. Soil Wetness Soil Depth Restric Hoz at Available space yes/no Overall Class S PS U I 3 Comments I s~~Nc-may- _ I ~ I ~ I I I ® -c I F-yi~sra o! I ~~sct, I I Filter Required Riser required when I ~Li t/C- 'tank is more than 6 inches deep. 0' 1 **NO GUARANTEE OR WARRANTY IS IMPLIED OR GIVEN AS TO THE PERFORMANCE OR L SYSTEM WILL FUNGTKQN-** d3 LA r-f 0 S//-UPS *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 sources of contamination. No volume of water is guaranteed at any si e by the Health Department. Permit Date p EHS Owner/Agent s -ia4 Septic Tank Installed By pPE T 13=0 ,02 EHS Well Installed By OVlA Well Grout Approval Date Well Head Approval Date Date Sample Collected Date of Results Results EHS White Office Yellow - Owner/Agent Pink Building Inspection Authorization to Construct CATAWBA COUNTY HLALTH DEPARTMENT NEWTON, NORTH CAROLINA COMPLETION PERMIT FOR SEPTIC TANKS PERMIT # C- 659 DATE : OWNER ADDRESS,er(r7~ BUILDING CONTRACTOR SUBDIVISION LOCATION e-rte 145: R r}Juv, .`y`-/r ~~art~n~ ✓Sh.tiz;. n,i l J ; OT ullt-ll LOT SIZE BLOCK OR SECTION HOUSE ( ) MOBILE HOME ( ) BUSINESS ( ) OTHER (x FHA-VA LOAN ( ) SEPTIC TANK: (SIZE /00r) GALS) WATER SUPPLY: NO. BEDROOMS- NO FIXTURES 2 INDIVIDUAL ✓ PUBLIC GARBAGE DISPOSAL UNIT:YES NO IF WELL, TYPE: BORED DRILLED DUG AUTO WASHING MACHINE: YES ( ) NO DISTANCE FROM SEPTIC TANK OR NEAREST NITRIFICATION FIELD: -3 4 SQ.FT. POLLUTION: FT. 1) NUMBER OF LINES 3 SEPTIC TAN INS ALLED BY: 2) LENGTH AND WIDTH OF LINES Af y Jv j l 4 33 PERMIT FEE BED SYSTEM CERTIFICATE 0 COMPLETION BY: b) TRENCH SYSTEM ( ) a w 3) DEPTH OF STONE IN LINES REMARKS: ADEQUATE FALL (GRADE) ON: 1) BUILDING (HOUSE) SEWER LINE: YES (v) NO ( ) 2) NITRIF ATION LINES: DATE INSTALLED: G 1/7,9 YES ( NO ( ) SEPTIC TANK LAYOUT U W E-A H O O a a J ~ HEALTI , DEPARTMENT COPY Mike Cash From: Julia English Sent: Tuesday, February 16, 2010 3:03 PM To: EH Areal Subject: possible sewage complaint Received call today from Mr. Newton, stating that at the intersection of Sulpher Springs Rd and Snow Creek Rd there is a STRONG sewage odor. He suspects it is coming from a house (3726 Sulpher Springs Rd) across from the gas station or the gas station itself (3726 Sulpher Springs Rd). Ed said I should take his info and refer to you to check out. No complaint has been entered. Let me know what you find out. If septic is failing we will need to put in as complaint. John Newton 1060 18th Av NW Hickory, NC 28601 828-291-2911 Julia English Catawba County Public Health Environmental Health Division Phone 828-465-8270 Fax 828-465-8276 Email ienglish@catawbacountync.gov i - - ~ a~ I _ ~ A ml 4a~y S of - a a~ I ~ s ~ gga~ e~ I S II i I '~~a < I I• o ° 49 I In~ ~ I I I I I o a A I m i ° ~B g I ~ AIL J~ ~ -8 ~ I° I i ~ ~ I I f 8 I ~ I I L- ~ ~ III II I ~ ~ I ~ I ~ ~ 1 I I I I ~ I I I I L- --~IJ I I i I I ill I I I Y 1 1 ~1 I I i I / I ~I I °g I' Y € i3II I E. a o NO. > IL- - - 1 1 ~3J a _ I I I I I S m g s it I ICJ z® I I I I I I I I o ~G' f~l g I s f a g 8 g =d ~ ~ LL ~ m I H" I III ~ I em i I B NO o-~ s o a a% ST. STEPHENS FIRE DEPARTMENT m m cQ EQ,,EnTech 6151" BOB B/TT SPRINGS ROAD CONOVER, NORTH CAROLINA ~`~>60 Drawing Type Improvement Permit Date 0 a 1 6 9 Click below to import an image from an external location: Ip,. ~bi1~11A~ to Nod 2fj ~u Ke(~G~ioYt Cr~PPYOX. 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