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HomeMy WebLinkAboutEHPR-04-2018-28951.TIF TRIS IS NOTA PERMIT Case# EHPR-04-2018-28951 [� G r k M CATAWBA COUNTY HEALTH DEPARTMENT i +'� (—) Mpg. PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES 41 � �ti: 1842 su Environmental Health Plan Review- Septic Malfunction } .;N•‘Ot ir' AUTH_CONST- SEPTIC MALFUNCTION •'k ' Ya• y� r1 •r�.ahFv'�r Owner DAVID BEARD,6633 MAPLE KNOB CT. DENVER NC 28037 0:8282388098 NAME TO APPEAR ON PERMIT David Beard SITE ADDRESS: 3000 STARTOWN RD,NEWTON NC 28658 PIN # 372011552431 NAME of SUBDIVISION: LEE CLINE Lot# 15 Section/Block D PROPERTY SIZE: Square Feet 20,037,60 Acres 0.46 DIRECTIONS: Startown rd,past Putnam Piano on right PRIMARY CONTACT: Owner SEWER TYPE: Septic Tank GALLONS PER DAY: 360 WATER SUPPLY: Public Water DESCRIBE WORK: System failing-being pumped often 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? No Is the site subject to approval by any other public agency? No Are there any easements or right-of-ways on this property? No APPLICATION FOR: Existing Structure STRUCTURE TYPE: PRIMARY RESIDENCE FACILITY TYPE: House OTHER DESCRIPTION: DESCRIPTION OF house EXISTING STRUCTURES ON SITE(IF ANY) DIM EXISTING STRUCTURE: 42x39 NUMBER OF EXISTING BEDROOMS: 3 #OF OCCUPANTS: 5 PROPOSED CONSTRUCTION BASEMENT? No BASEMENT FIXTURES? No PLUMBING REQUIRED? Desired system types(Improvement Permit or Authorization to Construct): ACCEPTED: ALTERNATIVE: CONVENTIONAL: OTHER: INNOVATIVE: ANY: Other described: • ehapplication 04/20/2018 12:03 Page t of ��_� • CATA\\'BACOUNTY Cased El-Wit-04-2018-2895115 Grin . Public Health Department Subdivision LEE CLINE < rl�®y Environmental health Division PING 372011552431 rb' PO Boa 389, 100-A Southwest Blvd,Newton,NC 28658 / 2 :. NAME ON PERMIT: (DAVID BEARD).6633 MAPLE KNOB CT. DENVER NC 28037 ( David Beard) Site Address: 3000 STA RTOWN RI),NEWTON NC 28658 Property Size: Square Feet 20.037,60Acres 0.46 Directions: Startown rd.past Putnam Piano on right Completed applications are valid for a period of 2 years.Improvement Permits are valid:with complete site plan=60 months(5 years):with complete plat =without expiration. An Authorization to Construct will remain valid as long as the Improvement Permit is valid.An Authorization to Construct issued for septic repair is valid for 60 months(5 years).Permits may be revoked if the information on this application/site plan changes or if the intended use for the proposed facility changes. Permits may be revoked if site conditions are altered such that they effect permit conditions or installation requirements 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. The undersigned is the owner of the property or legal agent of the owner. Li': 201— ( d Signature olApplicant or Agent Date: i w If you need further information or assistance please call 828-466-7291 AREA2 ♦144414444444441444444444444444444444444444#444444441444 144444444444444}4445444444444444 tktt4444444444444444 FIi.NAiII`: ._ _D\II. sFEE AMIOUNI „j Authorization to Construct(Repair) Fee ^ 04/20/2018 5300.00 r' '1'O'I'AL FEES 5300.00 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) elmpplicaiion 04/20/2018 12:03 Page 2 o17 (fl A ria 4,4, j i� ';, THIS IS NOT A PERMIT ` NTY :" CATAWBA HEALTH DEPARTMENT COUNTY COUNTYI' No, « ca.17�; .; Application for Environmental Services Application is for: New Construction Existing Facility Improvement Permit [H Authorization to Construct INew Septic FVSeptic Repair/Malfunction Septic Relocation Septic Expansion LI Existing System Inspection or Reconnection I New Well Replacement Well Well Abandonment Well Repair Property Address 3000 S\-ur'\-ow rV IZCA. Subdivision �&bko& NC Wig- , Lot# Acres • 7,5- Driving 3Driving Directions to Property 5\xInY Gvtyy a IW'Sk ?GS Rak4Wen ' (c n0 Applicant Contact Information Name texJi& Lz2 ZQ.ofci Address .tea • '' 6,633 I/ e kind C-t-, Denver, n ( ).` 1.317 Phone Eae- 3g-- S-07I Cell Phone 2-2R- k- LO/pr Owner Contact Information ry Name ��OVIJ Etc_ s3ec.rU Address 6613 Eve kviob L t- 'Den ✓zi:Lc. ;Zip/7 Phone 8:2 ,Q3 g-- i?7 Cell Phone 8-2x"- 23 gr- 3Vft Contractor Contact Information Name License # Address • Phone Cell Phone Name to Appear on Permit? vner Applicant ❑ Contractor Who will be the Primary Contact? ID-Owner Applicant Contractor Existing Structures on Site? 0 Yes , No If yes. describe ����'e l _ # of Bedrooms * # of Occupants S Still • ure Dimensions �C ) Basement _ Yes \No Basement Plumbing L] Yes No t Existing Water Supply? 1 Individual Well Community Well ounty/City/Township Water Line Is a public water supply available? ** Yes n No Well Construction/Abandonment/Repair Proposed Well Type I individual Well ❑ Semi-Public Well _ Community Well Abandonment Type ❑ Drilled n Bored Dug ,D Unknown Well Repair Requested I I Yes H No Describe Will Certified Well Contractor Install Water Line or Electrical Line from Well Head to Pressure Tank? LI Yes No A�I� `rr�� j tt /\ '[HIS IS NOT A PERMIT c:oum CATAWBA COUNTY HEALTH ID PAR`d'1iIiENT Application for Environmental Services Proposed New Construction - Residential Primary Residence _ New Residence Addition to Residence if of New Bedrooms *i Project Description Structure Dimensions # of Occupants Basement fl Yes No Basement Plumbing Yes [1 No Accessory Structure(s) 'Describe Structure Dimensions Plumbing Yes fl No Describe'Plumbing Needed Accessory Dwelling I Yes No ft of New Bedrooms *j # of Occupants Proposed New Construction - Commercial Food Service Specify Type ft Seats Floor Space -Entire Food Service Facility (Sq.Ft.) #Employees per Shift #of Shifts Dining Area (Sq. Ft.) Business/Other Specify Type Structure Dimensions Retail Floor Space #of Employees per Shift # of Shifts • If Church#of Seats Commercial Kitchen _ Yes U No If Daycare,ft of Children If Multi-Family Residence,# of Apartments #Bedrooms per Apartment*j Total#Bedrooms *t Other Information Calculated Design Flow, Commercial j (This value will be determined by EH staff) The Applicant shall notify the local health department upon submittal of tins application if any of the following apply to the property question. If the answer to any question is "yes";applicant mast attach supporting documentation. ❑ YesUr o Does the site contain any jurisdictional wetlands? [Sties ❑ No Does the site contain any existing wastewater systems? ❑ Yes g-i-Ro Is any wastewater going to be generated on the site other than domestic sewage? ❑ Yes Ekii4ro is the site subject to approval by any other public agency? ❑ Yes ei10 Are there any easements or right of ways on this property? Describe 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 ❑ Alternative ❑ Conventional ❑ Innovative ❑ Other El Any *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 floor plans as a bedroom at the time of building permit issuance. This may prevent the need for septic system expansion in the future. j If structure is plumbed but has no bedrooms, calculated design flow will be determined by EH Staff **If No,a well permit must be issued with the Authorization to Construct. RETRlP TO THE PROPERTY AND/OR SYSTEM REDESIGN WILL INCUR AN ADDITIONAL CHARGE(SEE FEE SCHEDULE) Completed applications are valid for a period of 2 years. Improvement Permits are valid: with complete site plan=60 months(5 years);with complete plat=without expiration. MI Authorization to Construct will remain valid as long as the Improvement Permit is valid.An Authorization to Construct, issued for septic repair is valid for 60 months(5 years).Permits may be revoked if the information on this application/site plan changes or if the intended use for the proposed facility changes.Permits may be revolted if site conditions are altered such that they effect permit conditions or installation requirements. 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. The undersigned is the owner of the property or le_ agent of, owner. Signature of Owner or Legal Agent / / Date cc)0( Printed Name of Owner or Legal Agent ♦Vi . e. ta Catawba County Environmental Health • v Illik •-7 CS st.e I II I lippo , eo,ed-- '' A r/0 2007.---- • . a : . 0 rn CD C, cO CP O o 1 0 Ele\ „'0 0 200 • \ . • o Parcel: 372011552431 , 3000 STARTOWN RD lin=50ft NEWTON, 28658 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 04/20/2018 Parcel Report Page 1 of 1 Parcel Report - Catawba County NC Parcel Information: Owner Information: Parcel ID: 372011552431 Owner: BEARD DAVID L Parcel Address: 3000 STARTOWN RD Owner2: City: NEWTON, 28658 Address: 6633 MAPLE KNOB CT LRK(REID): 38928 Address2: Deed Book/Page: 2871/1149 City: DENVER Subdivision: LEE CLINE State/Zip: NC 28037-5018 Lots/Block: 15/ D Last Sale: $105,000 on 2006-11-30 School Information: School District: COUNTY Plat Book/Page: 10/58 Elementary School: STARTOWN Legal: Middle School: MAIDEN Calculated Acreage: .460 Tax Map: 075N 01077 High School: MAIDEN Township: NEWTON School Map State Road #: 1005 TaxNalue Information: Tax Rates(pdf) Zoning Information: City Tax District: All in County Zoning District: COUNTY County Fire District: HICKORY RURAL Zoningl: R-20 Building(s) Value: $88,700 Zoning2: Land Value: $12,400 Zoning3: Assessed Total Value: $101,100 Zoning Overlay: Year Built/Remodeled: 1974/2006 Small Area: STARTOWN Current Tax Bill Split Zoning Districts: / Zoning Agency Phone Numbers Miscellaneous: Firm Panel Date: 2007-09-05 Building Permits for this parcel. Firm Panel #: 3710372000J Building Details 2010 Census Block: 2002 WaterShed: 2010 Census Tract: 011701 Voter Precinct: P34 Agricultural District: 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,disclairn,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. N -6004 http://gis.catawbacountync.gov/nomap/parcel_report.php?key=372011»2431&typ=P 4/20/2018 ,?'A C CATAWBA COUNTY LT/Anci 100A souTIl WEST BLVD NEWTON.NORTH CAROLINA 28658 RECEIPT r'°""" rol PHONE:H 828.465.8399 U @r,A�j►v 7 Friday,April 20,2018 1 42 SM wv w.catawbacountync.gov PAYOR: Beard,David PAYMENTS TRANSACTION NUMBER: 'IRC-3444140-20-04-2018 PAYMENT DATE: 04/20/2018 PAYMENT TYPE: Credit Card 202861082 INVOICE NUMBER FEE NAME FEE AMOUNT 04-18-352018 Authorization to Construct(Repair) $300.00 Fee TOTAL PAYMENTS: $300.00 EHPR-04-2018-28951 CASE TYPE: Environmental Health flan Review WORK CLASS: Septic Malfunction SITE ADDRESS: 3000 smicroWN RD,NEWTON NC 28658 Owner DAVID BEARD.6633 MAPLE KNOB CF, DENVER NC 28037 C:8282388098 ** NO PEOPLESOFT ACCOUNT ASSIGNED** receipt 01/22012018 12:01 Page I of I