Loading...
HomeMy WebLinkAboutEHPR-04-2018-28949.TIF SVA THIS IS NOTA PERMIT Case# EHPR-04-2018-28949 f!� -3-3 CATAWBA COUNTY HEALTH DEPARTMENT '❑' �,T .+��Y�� L'Itt Y ^C PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES # � ! /g. 2 SY Environmental Health Plan Review- Septic Malfunction r'3 � Sq u4 , AUTH_CONST- SEPTIC MALFUNCTION `k ar Owner DOYLE STRIKER,2918 28TH S'I'NE,HICKORY NC 28601 41:4195692288 HOME:4195692288 NAME TO APPEAR ON PERMIT Doyle Striker SITE ADDRESS: 3624 33RD AVE PUNE, HICKORY NC 28601 PIN # 372416949307 NAME of SUBDIVISION: SPRINGWOOD PLAZA Lot# 22-25 Section/Block PROPERTY SIZE: Square Feet 19,602.00 Acres 0.45 DIRECTIONS: County Home Rd,left on Springs Rd,right on Sulphur Springs Rd,right on 33rd Ave PI NE,duplex on right PRIMARY CONTACT: Owner SEWER TYPE: Septic Tank GALLONS PER DAY: 480 WATER SUPPLY: Public Water DESCRIBE WORK: Water on ground 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: MULTI-FAMILY RESIDENCE FACILITY TYPE: Multiple Family Residence OTHER DESCRIPTION: DESCRIPTION OF 86x26 duplex EXISTING STRUCTURES ON SITE(IF ANY) DIM EXISTING STRUCTURE: NUMBER OF EXISTING BEDROOMS: 4 #OF OCCUPANTS: 8 PROPOSED CONSTRUCTION BASEMENT? No BASEMENT FIXTURES? No PLUMBING REQUIRED? ^ #OF MULTI-FAMILY UNITS: 2 BEDROOMS PER UNIT: 2 NEW MULTI-FAMILY BEDROOMS: 0 Desired system types(Improvement Permit or Authorization to Construct): ACCEPTED: ALTERNATIVE: CONVENTIONAL: OTHER: INNOVATIVE: ANY: YES Other described: chupplicmion 04/202018 10:5'1 Page 1 of 7 r1YP � THIS IS NOTA PERMIT Case# EHPR-04-2018-28949 .5/AQG d CATAWBA COUNTY HEALTH DEPARTMENT OWEI ��5- i EI ' 7 PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES t \842 sm Environmental Health Plan Review- Septic MalfunctionP rr + AUTH_CONST- SEPTIC_MALFUNCTION � +..T.. Owner DOYLE STRIKER,2918 28TH SL NE.HICKORY NC 28601 H:4195692288 HOME:4195692288 NAME TO APPEAR ON PERMIT Doyle Striker SITE ADDRESS: 3624 33RD AVE FL NE, HICKORY NC 28601 PIN # 372416949307 NAME of SUBDIVISION: Lot PLAZA Lot# 22-25 Section/Block B PROPERTY SIZE: Square Feet 19,602.00 Acres 0.45 DIRECTIONS: County Home Rd,left on Springs Rd,right on Sulphur Springs Rd,right on 33rd Ave PI NE,duplex on right PRIMARY CONTACT: Owner SEWER TYPE: Septic Tank GALLONS PER DAY: 480 WATER SUPPLY: Public Water DESCRIBE WORK: Water on ground 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: MULTI-FAMILY RESIDENCE FACILITY TYPE: Multiple Family Residence OTHER DESCRIPTION: DESCRIPTION OF 86x26 duplex EXISTING STRUCTURES ON SITE(IF ANY) DIM EXISTING STRUCTURE: NUMBER OF EXISTING BEDROOMS: 4 #OF OCCUPANTS: 8 PROPOSED CONSTRUCTION BASEMENT? No BASEMENT FIXTURES? No PLUMBING REQUIRED? #OF MULTI-FAMILY UNITS: 2 BEDROOMS PER UNIT: 2 NEW MULTI-FAMILY BEDROOMS: 4 Desired system types(Improvement Permit or Authorization to Construct): ACCEPTED: ALTERNATIVE: CONVENTIONAL: OTHER: INNOVATIVE: ANY: YES Other described: chapplicurion 04202018 10:43 Page 1 of 7 \7A CATA\\'BA COUNTY Case kJ El-IPR-04-2018-28949 • .T f n G Public Health Department Subdivision SPRINGWOOD PLAZA < 111�?'7 � Environmental health Division PIN# 372416949307 `k'd^ PO Box 389, 100-A Southwest Blvd,Newton,NC 28658 i; .2 ,. NAME ON PERMIT: (DOYLE STRIKER).2918 28TH ST NE,HICKORY NC 28601 ( Doyle Striker) Site Address: 3624 33RD AVE PL NE,HICKORY NC 28601 Property Size: Square Feet 19,602.00 Acres 0.45 Directions: County Home Rd,left on Springs Rd,right on Sulphur Springs Rd, right on 33rd Ave PI NE,duplex 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. Date: .20— ,/,e Signature ofApplicant or Agent ��t 10. - I1 you need further information or assistance please call 828-466-7291 AREA2 *4444*4i4i4i i****4*4444444#44*4*4*44*4*444444444444444Vii######4}*44144448444444***********4#4************** In IT,' FI:F:N,\NIE DrrF' t_�., ITA\Io _ Authorization to Construct(Repair)Fee 04/20/2018 $450.00_ TOTAL FEES S450.00 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) ahappliauuon 014/200018 10:40 Page 2 of7 /("+ A` I7L,; \\ t Rs' A THIS ISNOT APERMI1� (AUNTY CATlAWBACOUNTY HEALTH DEPARTMENT • N,,,ti., Application for Environmental Services Application is for: New Construction Existing Facility Improvement Permit Authorization to Construct New Septic Septic Repair/Malfunction I I Septic Relocation Septic Expansion Pl Existing System uspection or Reconnection New Well I I Replacement Well Well Abandonment Well Repair Property Address 3 ( QJ f i r PL NE Subdivision Lot# Acres Driving Directions to Property Ceara limn¢, paSic 7efA,, g ern�,•Qt�g••2•.Qr A d e ierN1' 7JJ c _RT. yet Applicant Contact Information Name Address Phone Cell Phone Owner Contact Information Nanec )(9c �• ..i . 4.. Address 019 es 4 Lik �. Phone 342_95-09a _ ' ,a � Cell Phone Contractor tontact information Name License # Address Phone Cell Phone Name to Appear on Permit? F,_KOwner Li Applicant Contractor Who will be the Primary Contact? ., Owner I I Applicant ❑ Contractor Existing Structures on Site? Yes No It yes, describe ft of Bedrooms ' !� ft of Occupants "R Structure Dimensions Basement n Yes I A-No Basement Plumbing Yes raiSTo Existing Water Supply? n Individual Well ❑ Community Well {-"County/City/Township Water Line Is a public water supply available? ** n Yes ❑ No Well Construction/Abandonment/Repair • Proposed Well Type I I Individual Well n Semi-Public Well n Community Well Abandonment ,Type Drilled Bored Dug Unknown Well Repair Requested Li Yes ❑No Describe Will Certified Well Contractor Install Water Line or Electrical Line from Well Head to Pressure Tank? I I Yes 0 No .j_• Fr-10\c}``,1' t THIS IS NOT A RERI�iiIT • coni,IY CATAWBA COUNTY HEALTH D H PA "`LI'M'{,NT .. ---- � ci,.,„�n:o1� Application for Environmental Services Proposed New Construction - Residential Primary Residence ❑ New Residence n Addition to Residence # of New Bedrooms *t Project Description Structure Dimensions # of Occupants Basement Yes [ No BasementPlumbing I I Yes ❑ No Accessory Structure(s)Describe Structure Dimensions Plumbing Yes ❑No Describe'Plumbing Needed Accessory Dwelling fl Yes No # of New Bedrooms *t # of Occupants Proposed New Construction - Commercial Food Service Specify Type #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 J No If Daycare, # of Children if Multi-Family Residence,#of Apartments #Bedrooms per Apartment*j Total #Bedrooms *1' 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 this application if any of the following apply to the property y question. If the answer to any question is "yes", applicant must attach supporting documentation. Eyes D-No Does the site contain any jurisdictional wetlands? © Yes ❑>To Does the site contain any existing wastewater systems? ❑ Yes B'No Is any wastewater going to be generated on the site other than domestic sewage? O Yes Eplo Is the site subject to approval by any other public agency? ❑ Yes No 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 ❑ OtherCKAny *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. RETRB'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. 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 avant of the owner. Signature of Owner or Legal Agent ( ;)t r - O A3Y ` Date S.,{Jt1 .�,Q,2Q__Q /g Printed Name of Owner or Legal Agent (� r Catawba County Environmental Health - 1 ----___/,I V 1 1 I ! 1 V l 1 1 1 I 99.97 _ 1 { 1 1 1 1 a I 1 1 1 V 1 { 1 l 4 l 33 12.9 N 32 31.12 35 35 33 85 cn 0 33RD AVE PL NE • I 23.1 �j10 35 35 35 25 I I 84.3 115.44 I I I I I _ --__ ..... __ I I 1 I I I I• I f I I . 0 ` Icy) I I I I I cn I I ..... i. cn co 171 En N. 1 I I 1 I I I 162.43 I I r l I I 1 I 1 I I 1 125 I I I I _ _ — _ I I I I f I I I 747 / I f !I I I 1 1 I I I f I I I I I I I g itair I I I r 1 _ + N / 1 - ` _ I I I f I 1 rte. , . Parcel: 372416949307, 3624 33RD AVE PL NE 1 in=50ft HICKORY, 28601 This map/report product was prepared from the Catawba County,NC Geospatial Informalion 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: 372416949307 Owner: STRIKER DOYLE C Parcel Address: 3624 33RD AVE PL NE Owner2: STRIKER PEGGY M City: HICKORY, 28601 Address: 3624 33RD AVE PL NE LRK(REID): 50246 Address2: Deed Book/Page: 3122/0822 City: HICKORY Subdivision: SPRINGWOOD PLAZA State/Zip: NC 28601-7721 Lots/Block: 22-25/ B Last Sale: $75,000 on 2012-04-16 School Information: School District: COUNTY Plat Book/Page: 13/42 Legal: LOT 22-25 SPRINGWOOD PL 13-42 Elementary School: SNOW CREEK Middle School: ARNDT Calculated Acreage: .450 Tax Map: 1412 09032 High School: ST STEPHENS Township: CLINES School Map State Road #: 2334 TaxNalue Information: Tax Rates(pdf) Zoning Information: City Tax District: All in County Zoning District: COUNTY County Fire District: ST STEPHENS Zoningl: R-20 Building(s) Value: $79,900 Zoning2: Land Value: $9,500 Zoning3: Assessed Total Value: $89,400 Zoning Overlay: Year Built/Remodeled: 1971/ Small Area: ST STEPHENS/OXFORD Current Tax Bill Split Zoning Districts: / Zoning Agency Phone Numbers Miscellaneous: Firm Panel Date: 2007-09-05 Building Permits for this parcel. Firm Panel #: 3710372400J Building Details 2010 Census Block: 1064 WaterShed: 2010 Census Tract: 010301 Voter Precinct: P33 Agricultural District: PROXIMITY Parcel Report Data Descriptions List all Owners Deed History Report Assessment Report This mapheport 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/nomap/parcel_report.php?kcy=372416949307&typ=P 4/20/2018 ( :.)0 P CArrYBA COUNTY HEALTH DEPARTMENT Telephone: (828)465-8270' TDD: (828)465-8200^ WLS # `tics—Ood7 7 Improvement Permit V AC Repa r Permit: / Operation Permit. I/ System TypdT4-Well Permit. Replacement Well Owner/Agent pi f/J 17,7-,4,wr_ Phone Address /5,S- Lt};tr.n., Alb- Lr Subdivision I..u:wk /L[. ra61 '2 Section/Block/Phase Lot# Lot Size t I.ly Directions: e„.-41 N„,/ M / Li an for.-gr 41�1) !St ,„ .1 4q. 111-45411f ati -51)r-d /1 V NE 1 /%9/J off /r Y. Property Address 16 7--Lf -WY 4vPi- ,fl ..' Facility: House if Mobile Home_ Business Multi-family Other: Pin Number SI a It (6 l If t o7 O Other . Zoning Approval # `1\ #Bedrooms t4 # Seats # Employees . Application Rate D. I GPD Flow Wu Hat Tub or Spa yes/no Special Fixtures Basement yes/r(§ . 100% Repair Area yes/no Basement Plumbing yes/no Water Supply: Private Well Public ✓ Semi-Public Type of System: Trench Bed V Pump Pump/Panel Panel LPP Other Septic Tank Size igl Pump Tank Size Nitrification Field: Total Square Feet ( 0 00 Depth of Stone 2Y4' Bed Size (0X5— I' Trench Width Total Length of All Trenches _ Number of Trenches Trench Length / / / / / Feet on Center Maximum Trench Depth Distance of Nearest Well *DO NOT INSTALL SEPTIC WHEN WET* *WELL RECORD REQUIRED AT COMPLETION* ******************1******************************************************************************************************** Topo % Slope Texture Structure Clay Min. Soil Wetness " Soil Depth t Sc Restric. Hoz. at " Available space yes/no • Overall Class S PS U • 'Comments: ` tin ..J G7 .--(0.4-y of M- T s 101017 I . * l to tC) • Filter Required Riser required when tank is more than 6 inches deep. *NO GUARANTEE OR WARRANTY IS MPLIED OR GIVEN AS TO THE PERFORMANCE OR LENGTH OF TIME THIS SYSTEM WILL FUNCTION* **************t************************•t*****************•*****Mt******t***********t*****t***************♦***t*t***** alallillaalangengarnitnan ®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 site by the Health Department n/e Permit Date ft/ o r EHS ✓l,(,t, l/'M�',.Z t Owner/Agen . Septic Tank Installed By tau, td/t onavr Date72 f� EHS �A+Y Well Installed By 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 4(-i14-s\- Ss C� CATAWBA COUNTY `� Gz100A SOUTHWEST BLVD NEWTON,NORTH CAROLINA 28658 RECEIPT 7i,,,,i.. .i-�: `HC PHONE: 828.465.8399 Friday,April 20,2018 842 5M e.c.na,vbaeonnt+me.Ee+- PAYOR: Striker.Doyle PAYMENTS TRANSACTION NUMBER: TRC-3443245-20-04-20 I 8 PAYMENT DATE: 04/20/2018 PAYMENT TYPE: Credit Card 202852787 INVOICE NUMBER FEE NAME FEE AMOUNT 04-18-352011 Authorization to Construct(Repair) 5450.00 Fee TOTAL PAYMENTS: 5450.00 EHPR-04-2018-28949 CASE TYPE: Environmental Health Plan Review WORK CLASS: Septic Malfunction SITE ADDRESS: 3624 3312D AVE PL NE.HICKORY NC 28601 Owner DOYLE STRIKER,2918 28TH ST NE. HICKORY NC 28601 11:4195692288 **NO PEOPLESOPT ACCOUNT ASSIGNED** receipt 11.1/202018 10:39 Page 1 of 1