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HomeMy WebLinkAboutEHPR-04-2018-28990.TIF ,1Y • THIS IS NOTA PERMIT Case# EF1PR-04-2018-28990 CATAWBA COUNTY HEALTH DEPARTMENT w3:1r f❑' , PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICESI I 1842 SAS Environmental Health Plan Review-OSWP •.03.M.;ro EXS SYSTEM • Ell- V.: . .o' 41/16 Patted eIa14N,,hJ Applicant JOHN VARNER„ C:8282384892 JPVARNER66aGMAIL.COM NAME TO APPEAR ON PERMIT John Varner SITE ADDRESS: 4025 W NC 10HWY.NEWTON NC 28658 PIN# 361903002270 NAME of SUBDIVISION: CHARLES S HOOVER I of d PT 6 Section/Block B PROPERTY SIZE: Square Peet 19,166.40 Acres 0.44 DIRECTIONS: Corner of Hwy 10 and Hickory Lincolnton Hwy PRIMARY CONTACT: Applicant SEWER TYPE: Septic Tank GALLONS PER DAY: 100 WATER SUPPLY: Public Water DESCRIBE WORK: Existing system inspection for opening of new construction business with 4 employees 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: `• NO STRUCTURE SELECTED" FACILITY TYPE: Business OTHER DESCRIPTION: DESCRIPTION OF business EXISTING STRUCTURES ON SITE(IF ANY) DIM EXISTING STRUCTURE: 70x40 NUMBER OF EXISTING BEDROOMS: #OF OCCUPAN PROPOSED CONSTRUCTION BASEMENT? No BASEMENT FIXTURES? No PLUMBING REQUIRED? EMPLOYEES PER SHIFT: NUMBER OF SHIFTS: TOTAL EMPLOYEES: \ 4 SEATING CAPACITY: TOTAL FLOOR SPACE(SQ FT): Desired system types(Improvement Permit or Authorization to Construct): ACCEPTED: ALTERNATIVE: CONVENTIONAL: OTHER: INNOVATIVE: ANY: Other described: chapplicauun 04126/2018 10:41 Page 1 oro yds •G THIS IS NOTA mom Case# EI-IPR-04-2018-28990 Q i', CATAWBA COUNTY HEALTH DEPARTMENT O' 41" .I. itt+ o° PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES }' r ti'r /842 v' Environmental Health Plan Review- OSWP T.* r7 EXS_SYSTEM 11 , Applicant JOHN VARNER.. C:8282384892 JPVARNER66aGMA1L.COM NAME TO APPEAR ON PERMIT John Varner SITE ADDRESS: 4025 W NC 10 HWY.NEWTON NC 28658 PIN # 361903002270 NAME of SUBDIVISION: CHARLES S HOOVER Lot d PT 6 Section/Block PROPERTY SIZE: Square Fect 19,166.40 Acres 0.44 DIRECTIONS: Corner of Hwy 10 and Hickory Lincolnton Hwy PRIMARY CONTACT: Applicant SEWER TYPE: Septic Tank GALLONS PER DAY: 100 WATER SUPPLY: Public Water DESCRIBE WORK: Existing system inspection for opening of new construction business with 4 employees 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: "NO STRUCTURE SELECTED** FACILITY TYPE: Business OTHER DESCRIPTION: DESCRIPTION OF business EXISTING STRUCTURES ON SITE(IF ANY) DIM EXISTING STRUCTURE: 70x40 NUMBER OF EXISTING BEDROOMS: #OF OCCUPANTS: 4 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 04252018 10:18 Page 1 of4 sy, • CATAWBACOUN7Y Cased EH PR-04-2018-28990 x F..�� L Public Health Department Subdivision CHARLES S HOOVER 6 , T ,� Environmental Health Division PIN,/ 361903002270 '4 PO Box 389, 100-A Southwest Blvd,Newton,NC 28658 . w NAME ON PERMIT: (JOHN VARNER).. (John Varner) Site Address: 4025 W NC 10 HWY,NEWTON NC 28658 Property Size: Square Feet 19,166.40 Acres 0.44 Directions: Corner of Hwy 10 and Hickory Lincolnton Hwy 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: L7.-02, — ,3 Signature of Applicant or Agent .. If you need further information or assist.)• please call 828-466-72' AREA2 444F44444444444444444*444+444444444444444444444444444444444444444444444444444#444444**4444444444444444444444 l FEENAVIE DATE FEEAAIOIINT Existing Tank Check Fee 04/25/2018 $80.00 1I 1 : TOTAL FEES ,r S8000 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 04/25/2018 10:18 Page 2 of Ay II �l.\ T \ THIS IS NOT A PERM T cour,zti __ CATAWBA COUNTY HEALTH- DEPARTMENT Application for Environmental Services Application is for: New Construction ' g Facility PI Improvement Permit Authorization to Construct ❑New Septic I ) Septic Repair/Malfunction Septic Relocation ❑ Septic Expansion 1,--Existing System Inspection or Reconnection I New Well Replacement Well Well Abandonment Well Repair Property Address 40-QS Cd Ali-/D1-14 JL Subdivision A Or_ I - L C G.: A Lot`# / Acres Driving Directions to Property (ap,_M a o F ILU3A �l) r/i,krz�/ ,,in/'e Applicant Contact information Name ilia itNeA Address ( 8/ cPhiw :SG/2G7 /\/etth4L-3 /&1 C 071?(' Phone Cell Phone 6 K Z/415) Owner Contact Information Name Address Phone Cell Phone Contractor Contact Information Name License # Address Phone Cell Phone Name to Appear on Permit? ❑ Owner t Contractor Who will be the Primary Contact? ❑ Owner ❑Applicant ❑ Contractor Existing Structures on Site? [_Yes- j No If yes, escribe #of Bedrooms * #of Occupants Structure Dimensions rl >LIC Basement Yes No Basement Plumbing Yes _I No Existing Water Supply? Individual Well n Community Well fy/City/Township Water Line Is a public water supply available? *4' JJYes No Well Construction/Abandonment/Repair Proposed Well Type ❑ Individual Well ❑ Semi-Public Well I I Community Well Abandonment Type Drilled ❑ Bored Dug Unknown Well Repair Requested ❑ Yes [1 No Describe Will Certified Well Contractor Install Water Line or Electrical Line front Well Head to Pressure Tank? ❑Yes ❑No 1 �.) _ THIS IS NOT A PERMITou In CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services �'—"' .IartM1 Cn.olinu Proposed New Construction " Residential Primary Residence ❑ New Residence n Addition to Residence # of New Bedrooms *t Project Description Structure Dimensions #of Occupants Basement LJ Yes ❑ No Basement Plumbing n Yes _ No Accessory Structure(s) Describe Structure Dimensions Plumbing I P Yes ❑No Describe Plumbing Needed Accessory Dwelling _ Yes No # of New Bedrooms 41 # of Occupants Proposed New Construction - Commercial Fond 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 ,.4QrrL, a DAC e Structure Dimensions Retail Floor Space #of Employees per Shift #of Shifts If Church# of Seats Commercial Kitchen ❑ Yes LJ No If Daycare,# of Children ifMulti-FamilyResidence,# 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 estion. If the answer to any question is "yes"applicant must attach supporting documentation. ❑ YYee -- n " Does the site contain any jurisdictional wetlands? ?ties Does the site contain any existing wastewater systems? O Yes LI-Nb"— Is any wastewater going to be generated on the site other than domestic sewage? ❑ Yes S4 oo Is the site subject to approval by any other public agency? O Yes ro 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 0 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. 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. EETRIP TO TILE PROPERTY AND/OR SYSTEM REDESIGN WILL INCUR AN ADDTTIONAL 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 revolted 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 conTecr. 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 malting the site accessible so that a complete site evaluation can be performed. The undersigned is the owner of the p -rty eLal ag - of the owner. Signature of Owner or Legal Agent �• • Date I/p7S- /5 Printed Name of Owner or Legal Ag- t C-70/1J Catawba County Environmental Health Y , / / a- / ,166.60/ N / , / I / 60 / r / / (127) / / / \\*1 N / I. 0 Z / n / 2 C / 73 in ! = ^O (205) t) it g • N \ .. r i (81) � ) (127) xi --5 .. I r z i n 28.30 0 II 433) 7.80 ) 41 • • (35) • / Parcel: 361903002270, 4025 W NC 10 HWY 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 04/25/2018 • Parcel Report Page 1 of 1 • Parcel Report - Catawba County NC Parcel Information: Owner Information: Parcel ID: 361903002270 Owner: HERNANDEZ SALVADOR Parcel Address: 4025 W NC 10 HWY Owner2: HERNANDEZ CYNTHIA J City: NEWTON, 28658 Address: 3621 COSTNER DR LRK(REID): 2186 Address2: Deed Book/Page: 3408/1179 City: VALE Subdivision: CHARLES S HOOVER State/Zip: NC 28168-7599 Lots/Block: PT 6/ B Last Sale: $72,000 on 2017-05-19 School Information: School District: COUNTY Plat Book/Page: 9/93 Legal: LOT PT 6 PL 9-93 Elementary School: BLACKBURN Middle School: JACOBS FORK Calculated Acreage: .440 Tax Map: 002DJ 02003 High School: FRED T FOARD Township: JACOBS FORK School Map State Road #: 10 Tax/Value Information: Tax Rates(pdf) Zoning Information: City Tax District: All in County Zoning District: COUNTY County Fire District: PROPST Zoningl: RC Building(s) Value: $43,000 Zoning2: Land Value: $13,400 Zoning3: Assessed Total Value: $56,400 Zoning Overlay: ED-O Year Built/Remodeled: 1944/ 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 #: 3710361900J Building Details 2010 Census Block: 1011 WaterShed: 2010 Census Tract: 011702 Voter Precinct: P3 Agricultural District: PROXIMITY 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 ventication 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?key=361903002270&typ=P 4/25/2018 CATAWBA-LINCOLN-ALEXANDER DISTRICT HEALTH DEPARTMENT HICKORY, N. C.—NEWTON, N. C.—LINCOLNTON, N. C.—TAYLORSVILLE, N. C. Phones Diamond 5-3883 INgersol 4-2011 REgent 5-5521 MEIrose 2-3101 PERMIT TO INSTALL SEPTIC TANK ;Le?. , — pg(te satiERMIT DATE fel icen.21,./ 19 Owner Address Cie -- Tenant Address Installed by. ,5,klitt.d. -./. etfc;e::? # 4 A Location of Property (:// -17as' -L - / e A /c. Kind of tank /1-2-"L1/4---- Si ,Ste Length of trench ndi NOTIFY HEALTH DEPARTMENT AT LEAST EIGHT HOURS BEFORE TANK IS TO BE INSPECTED Final Inspection . .16 Approved ter Disapproved ( ) ' Remarks: ? . tJc e•-•e• tver,t, I 47//".>:749?:eti First five feet of line from outlet from house should be of cast iron soil pineE • -64-1-ZdA , Sanitarian. Sketch of tank and line showing dis- tance from dwelling and well on subject property and on adjoining property. • cCCATAWBA COUNTY IOOA SOUTHWEST BLVD NEWTON,NORTH CAROLINA 28658 RECEIPT �P PHONE: 828 465.8399 v�sv '`� Wednesday,April 25,2018 44, 18 411 1st"; www.eatawbacountync.gov PAYOR: Varner.John PAYMENTS TRANSACTION NUMBER: TRC-3480645-25-04-2018 PAYMENT DATE: 04/25/2018 PAYMENT TYPE: Credit Card 203103708 INVOICE NUMBER FEE NAME FEE AMOUNT 04-18-352202 Existing Tank Check Fee $80.00 TOTAL PAYMENTS: $80.00 EHPR-04-2018-28990 CASE TYPE: Environmental Health Plan Review WORK CLASS: OSWP SITE ADDRESS: 4025 W NC 10 HWY.NEWTON NC 28658 Applicant JOHN VARNER.. C:8282384892 JPVARNERO6aGMAILCOM **NO PEOPLESOFT ACCOUNT ASSIGNED** receipt 04252018 1O1 7 Page I of I