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HomeMy WebLinkAboutEHPR-04-2018-28977.TIF • THIS IS NOTA PERMIT Case# EHPI2-04-2018-28977 3 ® � CATAWBA COUNTY HEALTH DEPARTMENT ❑' i �I •0 ` PLAN REVIEW APPLICATION EOR ENVIRONMENTAL SERVICES 4.t • Ig. 2 sY Environmental Health Plan Review-OSWI' •N' • ABANDONMENT a • ti. Applicant WOODLAND ESTATES MOBILE HOME PARK (KATHY HATCH).3987 SECTION HOUSE RD. HICKORY NC 28601 B:8283581999 C:8284857372 Owner WOODLAND ESTATES MOBILE HOME PARK LLC,6400 TELEGRAPH RD SUITE 2000, BLOOMFIELD HILLS MI 48301 NAME TO APPEAR ON PERMIT Woodland Estates Mobile Home Park LLC SITE ADDRESS: 3987 SECTION HOUSE RD,HICKORY NC 28601 PIN# 373317024103 NAME of SUBDIVISION: Lot# Section/Block _ PROPERTY SIZE: Square Feet 1,075,932.00 Acres 24.7 DIRECTIONS: Springs Rd, right on Section House Rd,approx 2 miles on left,well is behind lot 37A in enclosed building PRIMARY CONTACT: Applicant SEWER TYPE: Public Sewer GALLONS PER DAY: WATER SUPPLY: Public Water DESCRIBE WORK: WELL ABANDONMENT ONLY 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? No Are there any easements or right-of-ways on this property? No APPLICATION FOR: STRUCTURE TYPE: "NO STRUCTURE SELECTED** FACILITY TYPE: Other OTHER DESCRIPTION:Mobile Home Park DESCRIPTION OF EXISTING STRUCTURES ON SITE(IF ANY) DIM EXISTING STRUCTURE: NUMBER OF EXISTING BEDROOMS: It OF OCCUPANTS: PROPOSED CONSTRUCTION EMPLOYEES PER SHIFT: NUMBER OF SHIFTS: TOTAL EMPLOYEES: SEATING CAPACITY: TOTAL FLOOR SPACE(SQ FT): Desired system types(Improvement Permit or Authorization to Construct): ACCEPTED: ALTERNATIVE: CONVENTIONAL: OTHER: INNOVATIVE: ANY: Other described: APPLICATION FOR WELL ABANDONMENT ABANDONMENT TYPE: Bored ehapplication 04/24/2018 13:23 Page 1 o19 ,y,: CATA BA COUNTY Case ti EH PR-04-2018-28977 ,Z' ai ,� Public Health Department Subdivision < .y y Environmental Health DivisionIP, PIN# 373317024103 PO Bos 389, 100-A Southwest Blvd,Newton,NC 28658 • w NAME ON PERMIT: WOODLAND ESTATES MOBILE HOME PARK LLC ( ).6400 TELEGRAPI-I RD SUITE 2000.13LOOMFIELD HILLS MI 48301 Woodland Estates Mobile Home Site Address: 3987 SECTION HOUSE ItD.HICKORY NC 28601 Property Size: Square Feet 1,075,932.00 Acres 24.7 Directions: Springs Rd, right on Section House Rd,approx 2 miles on left,well is behind lot 37A in enclosed building 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 slate 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: y-t? v-,?0/8 Signature of Applicant or Agent /1/2:1-- If LIf you need further information or assistance please call 828-4 6-7291 AREA2 ******4******$4,444*,$•4**+*ilii,*********tt**********4,**t*44**44*****t8*t*4t*/********t*****4t*#**•***•*Y♦ -FEENANIL- DUI: I I EAMOUNT I Well Abandonment Fee 04/24/2018 $100.00 -,_..-- TOTAL FEES e - - 5100.00 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) ehapplication 04/2412018 13:23 Page 2 of9 c Ar�� C A THIS IS NOT A PERMIT . 1\?/ cou�v�COUNTY • • CA AWBA COUNTY HEALTH DEPART 1l ENT ;r_-__�\ Application for Environmental Services Application is for: New Construction Existing Facility U Improvement Permit Authorization to Construct I )New Septic Septic Repair/Malfunction Septic Relocation Septic Expansion Existing System Inspection or Reconnection I I New Well I I Replacement Well Well Abandonment Well Repair Property Address 3 9ef 7 Scc_4;Qa }k ( /ate' Subdivision /» Hu a , n/C- 4g4p/ Lot# Acres Driving Directions to Property .7-4/2-4) 1AI1O PAOPE217Y a re) LCf-7 OF Fn-n-1? V /AJO O><—_ QA 7 4,-- ✓p lLcaT .37A et., -JM/a s t 0 au,/�,t/ Applicant Contact Information Name KA-rn'y /—fa-ycH GrJDOD/a an F_>" 4TES /YI t1P Address j 7 55.6riOit/ /1pgcc go /J,•e/tc2�. NC- d r�lGo/ Phone 8 B - 35g • /999 Cell Phone 5-2 • ` ,c5 - 737 Owner Contact Information Name 74 vs,Qs roA/ Address (r_yap j?/£6/�_F_'r/ ,CJ 5N / Cell �/#—n( ./vt///:/,k firq Phone �r� - -, , - CPhone Contractor Contact information Name License# Address Phone Cell Phone Name to Appear on Permit? Owner n Applicant n Contractor Who will be the Primary Contact? H Owner ❑ Applicant n Contractor Existing Structures on Site? ❑ Yes J I No If yes, describe #of Bedrooms * of Occupants StructureDimensions Basement ❑ Yes I I No Basement Plumbing Yes No Existing Water Supply? Individual Well Community Well n County/City/Township Water Line Is a public water supply available? ** ( es ❑ No Well Construction/Abandonment/Repair Proposed Well Type IJ Individual Well trAtSemi-PublicWell Community Well Abandonment Type [ Drilled gThored n Dug o [ Unknown Well Repair Requested n Yes n No Describe Will Certified Well Contractor Install Water Line or Electrical Line from Web I-Iead to Pressure Tank? 0 Yes I I No im '+rir \ m / THIS IS NOT A PERMIT con1L ���i� �,� ;y. CATAWB COUNTY HEALTH 'DEPARTMENT rounr� � . ------ _._.: , :,,,„� -o�;�=� Application for Environmental Services Proposed New Construction Residentia' Primary Residence I New Residence ❑ Addition to Residence # of New Bedrooms '"i• Project Description Structure Dimensions # of Occupants Basement Yes ❑ No Basement Plumbing n Yes LI No Accessory Structure(s) Describe Structure Dimensions Plumbing ❑ Yes ❑ No Describe Plumbing Needed Accessory Dwelling ❑ Yes LI No #of New Bedrooms *i• # of Occupants Proposed New Construction - Commercial Food Service Specify Type # Seats Floor Space-.Entire Food Service Facility (Sq. Ft.) #Employees per Shift ft of Shifts Dining Area(Sq. Ft.) Business/Other Specify Type Structure Dimensions Retail Floor Space #of Employees per Shift #of Shifts If Church #of Scats Commercial Kitchen U Yes l I No If Daycare,# of Children If Multi-Family Residence,# of Apartments //Bedrooms per Apartment*t Total#Bedrooms *'j Other Information Calculated Design Flow, Commercial t (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 in question. if the answer to any question is"yes",applicant must attach supporting documentation. ❑ Yes CJ(No Does the site contain any jurisdictional wetlands? VYes ❑ To Does the site contain any existing wastewater systems? ❑ Yes ITV-No Is any wastewater going to be generated on the site other than domestic sewage? ❑ Yes No is the site subject to approval by any other public agency? ❑ Yes Q 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 0 Alternative ❑ Conventional ❑ Innovative ❑ Other ❑ 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. I- If structure is plumbed but has no bedrooms,calculated design flow will be determined by EH Staff. ** No,a well permit must be issued with the Authorization to Construct. RETRU'TO THE PROPERTY AND/OR SYSTEM REDESIGN WILL INCUR AN ADDITIONAL CHARGE(SEE FEE SCII13DULE) 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 revolted if site conditions arc altered such that they effect permit conditions or installation requirements. T 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 o• legal age' of the owner. Signature of Owner or Legal Agent Date `y-,,? Printed Name of Owner or Legal Agent Catawba County Environmental Health 7 ' I e76 . 0116 046 77 e1,17 445Ni e78 418 ` 079 °119 • 025, a80 f«, 043 81 a4 < V 0.1 °1.21h 027 e82 341 0122 a28 83 a40 01.239` e84 039 Ni, 430 085 ° 8 • 031 86 i37B ~ f % 032 368 •3863 033 %El % (Ne/./ o34A . 6h 0 0348 a. 035A *3851 �o36A QO • ` / �� •a�� �ti0 611 / 37A Q 17 iM li `IC• p0� �f p •3843 �'� • �1Os ii, 11.er-\\Ne"\\1. . Parcel: 373317024103, 3987 SECTION HOUSE 1 in=100ft RD HICKORY, 28601 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 04/24/2018 Catawba County Environmental Health 0 • , tip • a 4,,,, :r 4' 4, 4 t^w A• A '# ' ifs- 3 =.74 e • ' (11 r c i`r>`.,s 31 SFr t 4 32 ,, , 0 / e Q.1i1/ 4810 4000 ` 9 ,s et � 1 39 , . YaG.0 I,,, , , ,� S� gf [514 41:1 11.1 irs 4; zML1: COLONIALL•N 96co�.. �4.0 .:.3‘,161,1-1V-4(62 ° '. ' g% Parcel Report Page I of 1 Parcel Report - Catawba County NC Parcel Information: Owner Information: Parcel ID: 373317024103 Owner: WOODLAND ESTATES MOBILE HOME Parcel Address: 3987 SECTION HOUSE RD PARK LLC City: HICKORY, 28601 Owner2: LRK(REID): 56624 Address: 6400 TELEGRAPH RD STE 2000 Deed Book/Page: 3203/1510 Address2: Subdivision: City: BLOOMFIELD HILLS Lots/Block: / State/Zip: MI 48301-1758 Last Sale: School Information: Plat Book/Page: Legal: 3987 SECTION HOUSE RD School District: COUNTY Calculated Acreage: 24.700 Elementary School: WEBB A MURRAY Middle School: ARNDT Tax Map: 166H 02001 Township: HICKORY High School: ST STEPHENS State Road #: 1491 School Map Tax/Value 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: $183,900 Zoning2: Land Value: $350,500 Zoning3: Assessed Total Value: $534,400 Zoning Overlay: FPM-O Year Built/Remodeled: / 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 #: Building Details 2010 Census Block: 2050 WaterShed: 2010 Census Tract: 010303 Voter Precinct: P28 Agricultural District: Parcel Report Data Descriptions List all Owners Deed History Report Assessment Report This map/report product vias 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. ©2018, Catawba County Government, North Carolina. All rights reserved. http://gis.catawbacountync.gov/nomap/parcelreport.php?key=3733 17024103&typ=P 4/24/2018 ti, CATAWQACOUNTY 100A SOU HWEST BLVD NEVTON,NORTH CAROLINA 28658 RECEIPT PHONE: 828.465.8399 C Tuesday,April 24,2018 \842 SM w.eata,vbaeonnt nc.gov PAYOR: Woodland Estates Mobile Home Park Woodland Estates Mobile Home Park(Hatch. Kathy) PAYMENTS TRANSACTION NUMBER: TRC-3474855-24-04-2018 PAYMENT DATE: 04/24/2018 PAYMENT TYPE: Credit Card 203056108 INVOICE NUMBER FEE NAME FEE AMOUNT 04-18-352147 Well Abandonment Fee S 100.00 TOTAL PAYMENTS: $100.00 EHPR-04-2018-28977 CASE TYPE: Environmental Health Plan Review WORK CLASS: OSWP SITE ADDRESS: 3987 SECTION HOUSE RD, HICKORY NC 28601 Applicant WOODLAND ESTATES MOBILE HOME PARK.3987 SECTION HOUSE RD. HICKORY NC 28601 11:8283581999C:8284857372 **NO PEOPLESOF TACCOUNT ASSIGNED** Owner WOODLAND ESTATES MOBILE HOME PARK LLC,6400 TELEGRAPH RD SUITE 2000,BLOOMFIELE HILLS MI 48301 receipt 04/24/20IS 13:23 Page 1 of 1