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HomeMy WebLinkAboutEHPR-9-10-7260 (2).TIF � THIS IS NOT A PERMIT Case # EHPR - - 10 - 7260 ��� CATAWBA COUNTY H FALTH DEPARTMENT c)' 0 'C Plan Review Application for Environmental Services LS 42 5m Environmental Health Plan Review - OSWP EXS SYSTEM NAME TO APPEAR ON PERMIT JOHN KANE SITE ADDRESS: 3739 VICKERY DR, Maiden, NC Pin#: 367702883351 NAME of SUBDIVISION:GREY STONE PHASE II Lot# 32 Section/Block/Phase PROPERTY SIZE: Square Feet Acres 1.74 DIRECTIONS: HWY 16 S FROM BUFFALO SHOALS RD/ 2 MI TO LITTLE MTN AIRPORT RD TO GREYSTONE/ RT ON VICKERY DR/ GO TO END OF CUL DE SAC/ LAST DOUBLEWIDE ON LT APPLICANT OWNER CONTRACTOR JOHN KANE JOHN KANE SAME AS OWNER 3739 VICKERY DR 3739 VICKERY DR MAIDEN NC 28650 MAIDEN NC 28650 828- 465 -3485 828 - 465 -3485 PRIMARY CONTACT: Owner APPLICATION FOR: DIM EXISTING STRUCTURE: 28 X 56 EXISTING FACILITY TYPE: Mobile Home NUMBER OF EXISTING BEDROOMS: 3 SEWER TYPE: Septic Tank EXISTING WATER SUPPLY IN USE: Private Well CALCULATED DESIGN FLOW: WELL TYPE: Public water is * *NOT ** available for this property. PUBLIC WATER TYPE AVAILABLE: DESCRIBE WORK: 18 X 25' METAL CARPORT PROPOSED FUTURE ADDITIONS ADDING 8 X 25' ROOF OVER PORCH AND EXTENDED DOWN ON FRONT OF HOME OR IMPROVEMENTS: PROPERTY EASEMENTS: NO PROPOSED CONSTRUCTION PRIMARY RESIDENCE NEW RESIDENCE? # OF NEW BEDROOMS: # OF STRUCTURE OCCUPANTS: PROJECT DESC: PROJECT DIMENSION: BASEMENT? BASEMENT FIXTURES? ACCESSORY STRUCTURES DESCRIPTION: METAL CARPORT # OF NEW BEDROOMS: STRUCTURE DIMENSIONS: 18 X 25 ACC DWELLING? No PLUMBING? No # OF STRUCTURE OCCUPANTS: 09/10/10 15:55 v,A CATAWBA COUNTY Case # EHPR 9 10 7260 �' c Public Health Department ti ' A M t • Subdivision GREY STONE PHASE 11 Environmental Health Division -Plan Review In 0 I PO Box 389, 100 -A Southwest Blvd, Newton, NC 28658 Lot# 32 1 z3g�SM PIN# 367702883351 Applicant/Owner JOHN KANE, 3739 VICKERY DR, MAIDEN NC 28650 Site Address: 3739 VICKERY DR, Maiden, NC Property Size: SF 1.74 ACRES Directions: HWY 16 S FROM BUFFALO SHOALS RD/ 2 MI TO LITTLE MTN AIRPORT RD TO GREYSTONE/ RT ON VICKERY DR/ GO TO END OF CUL DE SAC/ LAST DOUBLEWIDE ON LT 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 representation by you of house or structure location should conform to applicable setbacks. Date: 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 -729 AREA1 Minimum Setbacks FEE NAME DATE AMOUNT BALANCE DUE Front 30 Side 15 Existing Tank Check Fee 09/10/2010 $80.00 $0.00 Rear 30 TOTAL FEES $80.00 $0.00 Side St Max Hght CHANGE WORK ORDER REQUIRING REDESIGN AND /OR RETRIP WILL INCURE AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) 09/10/10 15:55 � THIS IS NOT A PERMIT fi % CATAWBA COUNTY HEALTH DEPARTMENT ise y Application for Environmental Services Page 1 \4842 ,M Improvement Permit ❑ Authorization to Construct ❑ Septic Repair ❑ Septic Malfunction ❑ Septic Expansion ❑ New Well Permit ❑ Replacement Well ❑ Well Abandonment ❑ Well Repair ❑ Existing System Inspection (Pre- Approval Required) IN Application is for New Construction ❑ Existing Facility n Property Address 3739' V'GKeA 6R _ Subdivision 4/4 AC -A � , is 's° Lot # Acres Section/Block/Phase Driving Directions to Property , L 1 ` L' .So c _rA ��II -P,ea ,rL 6 u- Fps �}w / s1he 4 LS / - J 2_ fr2 t e S f h l � r Aid GC ,:J7 4) ttl e — fa'( — ( sp y a n e IL-i ITT 0,-1 (/ ! 6 I u Li= e._ Dw P 7, NAME TO APPEAR ON PERMIT? ' Owner ❑ Applicant ❑ Contractor Applicant Contact IInformation � V Name ,1314 k m Address 3 7 q V � c_ fe / d�,e Phone L/ ), g - , S 3 / 5 Cell Phone 607- 9,2f— 901' z Owner Contact Information Name Z Address c L� Phone Cell Phone Contractor Contact Information W Name Address = Phone Cell Phone WHO WILL BE THE PRIMARY CONTACT ?] Owner ❑ Applicant ❑ Contractor Description of Existing Structures on Site Ux,..5 4 t.Jl Yf O # of Bedrooms *t 3 Structure Dimensions 2 2C C # of Occupants 1• Basement ❑ Yes g No Basement Fixtures ❑ Yes f No Planned Future Additions o► Imnrov ments (Building Permit NOT requested at this time) or O Describe x 7 S Roe) C"(1(, • pat C..k cL _ n Proposed Future Structure I * imensions y�X' S # of Bedrooms if applicable p Z Are there easements or right -o -ways recorded on this property ❑ Yes E2 No Describe U Is a public water supply available on or adjacent to the above property ** ❑ Yes F5' No Check type available ❑ Community Well ❑ Semi- Public Well U County/City/Township Water Line Existing water supply in use a Individual Well ❑ Community Well ❑ Semi - Public Well ❑ County/City /Township Water Line ❑ I WOULD LIKE TO SCHEDULE A COMBINED FLAGGING AND SOIL EVALUATION (SEE COMBINED EVALUATION PROCEDUES) \ A • , THIS IS NOT A PERMIT t M a CATAWBA COUNTY HEALTH DEPARTMENT , © \1 Application for Environmental Services Page 2 • 84 tiM Proposed Facility Type n Primary Residence n New Residence n Addition to Residence # of New Bedrooms *t 1 Project Description Structure Dimensions # of Occupants Basement ❑ Yes ❑ No Basement Fixtures ❑ Yes ❑ No 117/Accessory Structure(s) Describe • £ 1 N • et, ,eztr # of New Bedrooms *1 if applicable Structure Dimensi.ns /)( 2 7 # of Occupants o Accessory Dwelling ❑ Yes [g-N' Plumbing ❑ Yes [Describe Plumbing Needed ❑ Multi- Family Residence # Units #Bedrooms per Unit *t Total # Bedrooms *t Structure Dimensions ❑ Food Service Specify Type # Seats Floor Space - Entire Food Service Facility (Sq Ft) # Employees per Shift # of Shifts Dining Area (Sq. Ft.) • Business Specific Type of Business Retail Floor Space # of Employees per Shift # of Shifts ❑ Other Facility Type Specify If Daycare Specify Occupancy Application for Well Construe on /Abandonment/Repair Proposed Well Type [I ndividual Well ❑ Semi- Public Well ❑ Community Well Abandonment Type n Drilled ❑ Bored ❑ Dug n Unknown Well Repair Requested ❑ Yes ❑ No Describe Calculated Design Flow, Commercial j' Additional information may be required to determine design flow from certain facilities. This value will be determined during consultation with on- site staff. *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 septic system size increase in the future. tlf structure is plumbed but no bedrooms, calculated design flow is required. ** If No, a well permit must be issued with the Authorization to Construct. 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. 4 CHANGE WORK ORDER REQUIRING REDESIGN AND /OR RETRIP WILL INCURE AN W ADDITIONAL CHARGE (SEE FEE SCHEDULE) 1 understand that this is a formal application for Environmental Services and authorize Catawba County Environmental 4. Health employees to go on this property for evaluation purposes. I certify the above information to be correct and understand 0 that an Improvement Permit issued as a result of this information is valid for 5 years or may be non - expiring under certain V specified conditions. Improvement Permits and Well Permits are transferrable, but may be revoked if this information, site W plans or intended use changes for the proposed facility. An Authorization to Construct issued by this department is valid for CO I• (5) five years from the date issued and is transf a le � Z Signature of Owner or Agent Z Printed Name of Owner or Agent Date ! -10 - !J Catawba County, North Carolina N This map product u'as prepared firm Ibe Catawba (ouuy, NC, Geographic Information System. Catawba County has mar le substantial efforts 10 ensure the crccroz1cy of location and labeling it farnumon A contained on this reap Catawba County promotes and recommends the independent verification of any data contained on th reap product by the user. The Couny of Crrlawha, its employees, agents and personnel disclaim, (Inc/ shall not he held hahle fin' any and all damages, loss or liability, whether direct, indirect or consequential which arises or mot arise from this map product 01' the use thereof by any person or entity. Legend Selected Parcel Number: 3677 -02 -53 -3351 1 inch = 40 feet Prepared for: • - N.... N., . (61•1' / . . • • : • )).._,- �� co ,, - - ' . , , . .....› . 7 , . . . ,... , „ ,i ..., .. . • q.'":1° . , .. . o p is- .0 v-- .... ...... . . . 576, ,q, if.. .... ,_. ..._ .... �, A , . • . / , . /4).. 1 - , :; i n -....., ,., i ,i. . , 4r .. ' k.' -, ---,.. . ...., 6 ...) ?., J I. „........„..) ... ( 9 c. , eil , ,A . _ . ..... ss 'N'N'N'N\s„.. N.N.,71...,, . , a 4.A ,.../_\./ 4 '140 / NNNNN:N..sNNNN. , THIS IS NOT A LEGAL DOCUMENT Thursday, September 09, 2010 02:30 PM / A,_ 1 / * * *Op Permit and /or Cert op Required L./(—Must be completed prior to final)* 0.5875 CATAWBA COUNT HEALTH DEPARTMENT (704) 465 -8270 Lot Eval L/ Permit f/ftepair Permit Cert of Comp Permit er Permit Owner /Agent /( 0 Re. 0 PC- - 2T /ES Phone Address 8 m O N 20E /21p , Subdivision 6 ,/6xCTh4 /6 C1141-R. (ITT? /1/, C , ,..v Ai a Section /Block /Phase_ Lot# 2 Lot Size /∎ 7/1cr?e..S Directions JA S Q 0A fro ,G / (= /WT. 141 0Pn,a7 21 Q .Arm _ �- ■ AJE SA R i, /o . C _ - S .577RA- /6:147 . 'Z n i) 467=7 «7- G(4 [ - !) F' - Si9(; . Facility: House Mobile Home 4,,-- Other: Tax Map # G/< -.-2- 7 Multi-family_ Other . Zoning Approval # z93M65/0 Bedrooms 3 Seats Employees Application Rate GPD Flow 36C) Hot Tub or Spa yes /ice pecial Fixtures 100% Repair Area /alt o REPAIR NOTICE: Basement yes /41P Basement Plumbing ye 4-,�. REPAIRS MUST BE WITHIN 30 DAYS OR Water Supply: Private Public DAYS FROM DATE OF PERMIT. f Type of System: Trench LA fed Pump sump /Panel Panel LPP Other Tank Size: Septic Tank / Pump Tank / O (____ Nitrification Field: Total Square Feet f 0 D of Stone A " - Bed Size Trench Width 3 ' Total Length of All Trenches 300 Number of Trenches ---✓ Individual Trench Lengt oo/ 00 //0d/ / Feet on Center`," Maximum Trench Depth .S -. Distance of Nearest Well .53. Lot Evaluation: Approve. I o (Void After 24 months) Topo /.Z % Slope Sketch of lot EvaluApton Site - System Design - Final Texture :c-4yez/ ,),, eV,G r,rav, ro La Structure .61.-04#'5 Q J v i \ \ ' Clay Min /.) / / / 1), Soil Wetness / / Soil Depth 4 l� " / / Restric Hoz at /fd2 " �'/ 1 Available space / / / 4r, ( / Overall Class �y U /. / / / .♦ , Comments • / / , ` r / ) ' / / _ _ � i / // �" Septic Tank Contractor.. \ Qt �o� MUST contact the Sanitarian BEFORE changing permit l99. aU Py- * *NO GUARANTEE OR WARRANTY IS IMPLIED OR GIVEN THROUGH THE ISSUANC OF THIS PERMIT ** Permit Date J ,/ /993 (Improvementt Permit oid after 60 months) Owner /Agent � � __!_/ - - _, /.. _ (y Sanitarian - / Installed B Vic:_ Nb - .S= % 1 Date a- Y Sanitarian _ 6 :_ __ (Note any changes /information in red or by sketch on back) * * * * * * *IF A PERMIT HAS TO BE REDESIGNED AND/OR RETRIPS MADE TO THE PROPERTY, THERE IS AN ADDITIONAL $25 CHARGE. Whites (lffira R1tia- Rlrlo. Tncn_ rmmn_ VallnTj- (Manor /Aocnt r'_roon -AlAn T.,n.. T D L 10 No addition, expansion, alteration or other repairs shall be made to the wastewater system without first obtaining an improvement permit from the Catawba County Health Dept in accordance with GS 130A -336 11 Failure to abide by the conditions and limitations contained in this permit may subject the Owner to an enforcement action in accordance with North Carolina General Statute 130A -18, 130A -22C, 130A -23, and /or 130A -25 12 In the event that the facilities fail to perform satisfactorily, including the creation of nuisance conditions, the Owner /Operator shall contact the Catawba County Environmental Health Section of the Health Dept within 48 hrs of discovering this failure or problem 13 A suitable cover, preferably fescue, shall be maintained over the drainfields Grassed areas shall be kept mowed and the clippings and other debris removed as needed to prevent thatch build -up No traffic (including parking of RV's, boats, trailers as well as other vehicles) or other equipment shall be allowed on the drainfields with the exception of mowing equipment 14 Non - biodegradable products (plastics, metals, etc ) chemicals (disinfectants, drain cleaners, acids, alkalies, pesticides, petroleum_products, etc ) or grease shall not be discharged into the septic system 15 The owner shall keep the plumbing system in the facility in good repair and eliminate leaks, drips, or excess flows as they are found Use of ultra low fixtures and conservative water use practices are recommened PERMIT ISSUED THIS THE /P2 DAY OF F0,743 , 1999 CATAWBA CO HEALTH DEPT Owner Signer ure ENVIRONMENTAL HEALTH SECT R S tax map # 6R -2 -74 I GENERAL CONDITIONS 1 This permit is effective only with respect to the number and type of proposed facilities and volume and nature of wastes specified 2 In the event that the facilities fail to perform satisfactorily, including the creation of nuisance conditions, the Owner /Operator shall take immediate corrective actions to correct the problem, including actions as may be required by the Catawba County Health Dept , such as the construction of or replacement of wastewater treatment or disposal facilities, upon receipt of a repair permit 3 The septage generated from this system shall be disposed of in accordance with Article 9 of Chapter 130A of the General Statutes and 15A NCAC 13B 0100 et seq and in a manner approved by the North Carolina Division Of Solid Waste Management 4 The issuance of this permit shall not relieve the Owner of the responsibility for damages to surface or groundwaters resulting from the operation of this system Neither does the issuance of this permit exempt the Owner from complying with any and all statutes, rules, regulations, or ordinances which may be imposed by other government agencies (local, state, and federal) which have jurisdiction 5 This permit may become suspended or revoked if the soils fail to adequately absorb and treat the wastes or if the facilities are not maintained and operated as designed The system must be operated and maintained in a manner which will not create a public health hazard or nuisance by surfacing of effluent or discharge directly into ground water or surface water any time during the operation of the system 6 Adequate measures shall be taken to divert stormwater from the disposal field area and to prevent wastewater runoff 7 Diversion or bypassing of the untreated wastewater from the treatment facilities is prohibited 8 Prior to the transfer of this land to a new owner, a notice shall be given to the new owner that gives full details about the system and the materials applied or incorporated at this site At the time of the sale of the property a new Operations Permit will have to be issued Operations permits are nontransferable. 9 The designated repair area shall be reserved for the installation of additional nitrification fields and is not to be covered with structures or impervious materials - r • OPERATIONS PERMIT FOR TYPE III WASTEWATER SYSTEM PERMIT NUMBER 05875 In accordance with the provisions of Article 11 of Chapter 130A, General Statutes of North Carolina as amended, and other applicable Laws and Rules PERMISSION IS HEREBY GRANTED TO Elaine McNeish CATAWBA COUNTY FOR THE operation of a wastewater collection, treatment, and disposal system to serve tax map # 6R -2 -74 pursuant to 15 A NCAC 18A 1900 et seq and in conformity with the application, improvement permit, and other supporting data subsequently filed and approved by the Catawba County Health Department and considered a part of this permit Facilities to be served (Address and specific type of facility) Elaine McNeish 3 3ci . Vickery Drive Newton- N.C. 28658 Type 3B The approved wastewater collection, treatment, and disposal system consists of (1) 1000 gal. septic tank (2) 1000 gal pump tank (3) 2 inch pressure manifold (4) conventional drainfield (3 trenches, 100 ft. x 3 ft) (5) The owner shall be subject to all applicable provisions of Article 11 of Chapter 130A of the General Statutes and 15A NCAC 18A 1900 et seq The owner is especially referred to Rules 1935 (31), 1937 (e), 1938 (g), 1945 (a,b), 1950 (a through i), 1961 (a through d), 1965, 1967, and 1968 The owner shall also be subject to the following specified conditions and limitations as they apply CATAWBA COUNTY NC - Parcel Report Information Regarding Selected Parcel(s) ' Parcel ID: • 3677 -02 -88 -3351 Name: KANE JOHN Name2: Address: 3739 VICKERY DR Address2: City: MAIDEN State: NC Zip: 28650 -9768 Account: 204284 Calc Acreage: 1.74 Tax Map: 006 K 02074 LRK: 92734 Deed Book: 2738 Deed Page: 1462 Subdivision Name: GREY STONE PHASE II Subdivision Block: Lots: 32 Plat Book: 31 Plat Page: 164 Building Number: 3739 Street Name: VICKERY DR Site Zip: 28650 Township: CALDWELL Fire Code: BANDYS City Code: COUNTY State Road: Total Bldgs Value: $69,000 Land Value: $12,600 Total Value: $81,600 Year Built: 2002 Year Remodeled: Last Sale Date: Last Sale Amount: Neighborhood: 122 Watershed: WS -IV Protected Area Watershed Split: NO Voter Precinct: P1 E911 District: COUNTY Zoning: R -40 Zoning2: Zoning3: Zoning Split: N Zoning Overlay: DWMH- O,WP -O Zoning District: COUNTY Split Zoning Dist: N Split Zoning Dist(1): 0 Split Zoning Dist(2): 0 School District: COUNTY Elementary School: BALLS CREEK Middle School: MILL CREEK High School: BANDYS School Split: NO P &Z Case Number: R -429 Census Tract 2010: 011501 Census Block 2010: 2029 Small Area Plan: SHERRILLS FORD Agricultural District: Printed: Thursday, September 09, 2010 02:09 PM CATAWBA COUNTY, NC FT T , 100-A South West Blvd Newton, NC 28658- PLAN RECEIPT (828)465 - 8399 Friday, September 10, 2010 j8 42 sM www.catawbacountync.gov Plan Case: EHPR -9 -10 -7260 Invoice Number: INV -9 -10- 266850 Environmental Health Plan Review Invoice Date: 09/10/2010 Site Address: 3739 VICKERY DR, Maiden, NC APPLICANT OWNER CONTRACTOR JOHN KANE JOHN KANE SAME AS OWNER 3739 VICKERY DR 3739 VICKERY DR MAIDEN NC 28650 MAIDEN NC 28650 828 - 465 -3485 828 - 465 -3485 Fee Name Fee Amount Existing Tank Check Fee Fixed $80.00 Total Fees Due: $80.00 PAYMENTS PAYER: JOHN KANE Date Pay Type Check Number Amount Paid Chang( 09/10/2010 Credit Card -1 $80.00 $0.00 Total Paid: $80.00 Total Due: $0.00 plan receipt 09/10/2010 11:21