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HomeMy WebLinkAboutRBPR-12-2021-39575.tif tl,Ai THIS IS NOTA PERMIT Case# RBPR-12-2021-39575 dCATAWBA COUNTY HEALTH DEPARTMENT PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES /842 sM Residen 'al Bu' ' ' w-Building New IMPROVEMENT-AUTH CONST- EXPANSION-C6 I 1bJ23 A.eo, sad ABANDONMENT Owner DAVID HEDGES,PO BOX 1146,DAVIDSON NC 28036 C:704-363-8989 IIEDGESUSA a GMAIL.COM NAME TO APPEAR ON PERMIT David Hedges SITE ADDRESS: 8245 LYMNOS LN,SHERRILLS FORD NC 28673 PIN# 461601187705 NAME of SUBDIVISION: RALPH M SIGMON Lot# 15 Section/Block A PROPERTY SIZE: Square Feet Acres 0.59 DIRECTIONS: NC10 Left on Rosenwald School Rd,Straight on Lowrance rd,L Slanting Bridge Rd,L on Drena Dr,Ron Lymnos Ln, Lot on Left PRIMARY CONTACT: Owner SEWER TYPE: Septic Tank ALLONS PER DAY: 360 WATER SUPPLY: Private Well SCRIBE WOR . 8/10/23 revised to 40x24 home with 3 bedrooms,24 x 36 garage only no bedrooms. Septic expansion needed, permit on file is for 2 bedrooms. 6/8/23 Revised to 40 x 24 home 2 bedrooms, 24 x 36 garage attached with breezeway with 1 bedroom in loft 2/17/22 Revised for a Well Abandonment Previous Description: New 30x60 SFD with 30x20 Screened Porch,with 3 Bedrooms, No Basement, New 28x 36 Accessory Dwelling(Garage with Loft apartment)with One Bedroom& Bathroom, Kitchenette 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? Yes Are there any easements or right-of-ways on this property? No APPLICATION FOR: New Structure STRUCTURE TYPE: PRIMARY RESIDENCE FACILITY TYPE: Single Family Residence OTHER DESCRIPTION: DESCRIPTION OF Vacant Lot EXISTING STRUCTURES ON SITE(IF ANY) DIM EXISTING STRUCTURE: NUMBER OF EXISTING BEDROOMS: #OF OCCUPANTS: 4 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 40 x 24 SFD,garage 24 x 36 #OF NEW BEDROOMS;,; 3 ASEMENT? No BASEMENT FIXTURES? No PLUMBING REQUIRED?Yes Desired system types(Improvement Permit or Authorization to Construct): ACCEPTED: ALTERNATIVE: CONVENTIONAL: YES OTHER: INNOVATIVE: ANY: Other described: APPLICATION FOR WELL ABANDONMENT ABANDONMENT TYPE: Bored chapplication 08/10/2023 16:55 Page 1 of 8 1f CATAWBA COUNTY Cam p RBPR•12-202!-39575 ^C�w�i11 i+f Public Health Department !l' Subdivision RALPH M SIGMON s Environmental Health Division PiNA 461901187705 ��.4 PO Box 389, 100-A Southwest Blvd.Newton,NC 28658 � w NAME ON PERMIT: (DAVID HEDGES),PO BOX 1146,DAVIDSON NC 28036 (David Hedges) Sits Address: 8245 LYMNOS LN,SHERRILLS FORD NC 28673 Property Seta: Square Feet Acres 0.59 Directions: NC10 Left on Rosenwald School Rd.Straight on Lowrance rd,L Slanting Bridge Rd.L on Drone Dr,R on Lymnos Ln, Lot on Left 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 Aut orizatlon 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 dtenges 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,compete and correct Authorized county and state olficiels are granted right of entry to conduct necessary Inspections to determine compliance with applicable laws and rubs. I understand that I am solely responsible for the proper identification and labeling of all property lines end 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: riii/104,5)'\ Signature of Applicant or Agent /� If you need further information or assistance please call 828-465-8270 AREAS MAUS: 30'from 760 contour line YEJM$ RATE FEE AMOUNT Authorization to Construct Fee(New/Expansion) 12/14/2021 5300.00 Fee Improvement Permit Fee 12/14/2021 S150,00 Well Abandonment Fee 02/17/2022 S100 00 TO 1�A1.FEES 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) rL1ppG.pp.m oa/10a023 16 ss r.se 2 of Ocatawba county C"'Na1°' ReaI Estate Search MAKING. MING. Mill. Information Services 51127 '2s 4<: ' 'AP c$23 30 ft3, 17 iLcill 5ft Cy �� �,ti�`5�L4t ft'�����r 1 Aill\ �IP ' 4ft 4• ft'�+ s .fir A. 7696 K . ' . : H \\\ W h0 P. \ 11 i5ii N we 1 in=61Ift S Parcel: 461601187785, $245 LYMN•S LN SHERRILLS FORD, 28673 Owners: AtPAINPRIEMItaliairt Owner Address. Values - iuilding(s): $1,500, Land: $161,311, Total: $162,$fl This map/report product was prepared from the Catawba County, NC Ge.spatial Information Services. Catawba County has made substantial efforts is 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 2121 Catawba County NC ; ij, - e r . �i: ■• ■ "0:40 ■.• t r 'r i . . ■ ' r �` ■ i ■ ■ r!■ i ■ ■ ■ ■In JO M7M . II • 0_18 :S_E ilie$Iele_110111 11 . - i ■ ■ ■ i11 eh " II II i I 1 ■ '■ ■ 11111111118111 �• ■ ■ t ■ ■ ■ �!i �11-11-18-8 ■ r ■ ■ !. 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"r ! inRi■ r■ U ■ i �l� ,ir�■a tt`$Y■ ■ r X ■ ■ ' ■ ut . a .�'r ■ ■ ■ ■ 1 ,c� r IlimMes 11 No .�. .■. . . . ,.IN ram■, THIS IS NOT A FERMI"I' Case# RERPR-12-2021-39575 CAfAW1BA COUNTY 11LACUI DEPAK'l'MEN'1' "' ' PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES Residential Building Plan Review- Building New IMPROVEMENT- AUTH_CONST-ABANDONMENT RPuisto tilis1)3 Owner DAVID III:D(iEiS,PO BOX I14h.DAVIDSON NC 28036 C:704-363-8989 I Il l)(il:SUSA a GMAII..COM NAME TO APPEAR ON PERMIT David Hedges SITE ADDRESS: 8245 LYMNOS LN,SI IERKILLS FORD NL'28673 PIN # 461601197705 RALPH M 51GMON 15 ScctinNNkxk A !NAME ofSURDIYISION: I.ot M ._ PROPERTY SIZE: Square Fret Aires 0 59 DIRECTIONS: NC10 Left on Rosenwald School Rd,Straight on Lowrance rd.L Slanting Bridge Rd.I.on Dena Dr,R on Lymnos Ln, Lot on Left PRIM Y CONTACT: Owner SEWER TYPE: Septic Tank GALLONS PER DAY: 480 WATER SUPPLY: Private Well DESCRIBE WORK: 8/23 Revised to 40 x 24 home 2 bedrooms.24 x 36 garage attached with breezeway with 1 bedroom in loft 2/17/22 Revised for a Well Abandonment Previous Description. New 30x60 SFD with 30x20 Screened Porch,with 3 Bedrooms, No Basement, New 28x 36 Accessory Dwelling (Garage with Loft apartment)with One Bedroom&Bathroom, Kitchenette $ITE 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 Yes Is the site subject to approval by any other public agency? Are there any easements or right-of-ways on this property? No APPLICATION FOR: New Structure STRUCTURE TYPE: PRIMARY RESIDENCE FACILITY TYPE: Single Family Residence OTHER DESCRIPTION: DESCRIPTION OF Vacant Lot EXISTING STRUCTURES ON SITE(IF ANY) DIM EXISTING STRUCTURE: NUMBER OF EXISTING BEDROOMS: �____—y___*OF OCCUPANTS: 4 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:) 40 a 24 SFD,garage 24 x 36 OF NEW BEDROOMS) 3 BASEMENT'? No BASEMENT FIXTURES? No PLUMBING REQUIRED?Yes Desired system types(Improvement Permit orAuUwnration to Construct) CONVENTIONAL YES ACCEPTED. ALTERNATIVE OTf IER: INNOVATIVE: ANY: Other described APPLICATION FOR WELL ABANDONMENT ABANDONMENT TYPE: Bored .x,uM,.1179 14 So Pape I or 6 (.tea Rl3PR-12-2021-39575 � j "Tty�'t public I lculth Department Sulklivtsion RALPH M SIGMON IQr • Lmtronmentnl Ilcalth Division PINS 461601187705 LN`),1tNr-A knrthecsl Blvd,/ '4 t'n.NC ?Mh>It IR)NuN ;.a . NAME ON PERMIT: ( DAVIT)III:D(i1 S),I'O ItUX I146,DAVIDSON NC'211030 ( David Hedges) Site Address: 82.15 LYMNOS 1.N.S111•ItRtl.l.S l'Olil)NC'2073 059 Property Size: .;yuarr 1 cei AcrcN Directions: NC O Left on Rosenwald School Rd,Straight on Lowrance rd,L.Slanting Bridge Rd,L on Drena Dr,R on Ly►nnos La, IotonIeft Completed appticatrons ere wad for a period of 7 years improvement Peim.ts we valid with complete site plan m 80 months(5 yearst,with comptele plat without expiration An A,thorIZatwn to Construct will remain valid as long es the improvement Permit is valid.An Authorization to Construct issued for septic cepau n vaid km 60 months(5 years) Permits may be revoked if the information on this epphcabonlsute plan changes or if the intended use for the proposed facility changes Permits may be revoked if site coedit ors are altered such that they hated permit condrtlona or inslatleton requirements .!ave read mis application end certify trial the mforrrahon provided herein rs Vue complete and correct Aulhonzed County and slate off Oats are ;ranted right of entry to conduct necessary inspections to determine compl once with applicable laws and rules I understand that I am solely responscde for the proper identification and labeling oo all properly tines and corners and making the site access-ble so that a complete site evaivahon can be performer the ndersrgned is the owner of the property or'iege agent of the owner / l Signaturef Applicant or Agent / �Lh Dale' 064 •; �✓ ) ? of I f t uu nerd further information or assistance please call 828-465.8270 AREAS SETBACKS: 30'from 760 contour line FEENAME DAl'I FEE AMOUNT Authorization to Construct Fee(New/Expansion) 1211412021 S3o0 00 Fee Improvement Permit Fee 12'14,21121 S15000 VVell Abandonment Fee 0211712022 S100.00 TOTAL FEES SS50.00 FEES ARE NON-REFUNDABLE ONCE A SITE VISIT IS MADE OR WORK ON A )'LAN REVIEW HAS COMMENCED SYSTEM REDESIGN AND/OR RETRIP WILL INCUR AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) n6'n*1il21 14 cii )'cute 2 ur a Catawba county public he. lth Application for Environmental Health Services THIS IS NOT A PERMIT Application is for. ikess Construction:7 ❑Existing Facility ►`i improvement Permit � p (�Authorizsttion to Construct �' ■New Septic ❑Septic Repair/Malfunction eptie Relocation ":14eeptic Expansion ❑Existing System.inspection or Reconnection i ❑Neww'Well ❑Replacement Well 0 Well Abandonment a Well Repair Property Address + 1 Acres r S' Subdi�'isionn al _ Lot# _ .w Driving l3i +ectinns to Prop`rtY A fh .., e,r)a 1), ,,,i l _ f-- :pane .)�°, 1. UesCriile wont ( ��1 re frrr !L tAte i� f4>? 3 £ .. Cirrr ? Pam. lift _._,....M. r—Applicant Name ,.t. Applicant Address ,fir , , rs. . �i4 ; .7rt, ` Phone a _ _ Email ;laic e 1 Owner Name 5 p.c. -- Owner Address Phone _..�..._ ._.. �..,.�.. T Email�..�.._..._..�....... .�.._..--1 Contractor Name t 1`►ue_ . .. . .. ..w.. . Contractor Address PhoneE:txtAi! Name to Appear on Permit? E.Qwncr (Applicant ( 'contractor T � Who will he the Primary Contact? Rowney ( .Applicant It Contractor l' : ,l w et ttru n» *dent a[ ., .; �._. . Primary Residence New Residence 0 Addition to Residence r of New Hedroosni,' �MT_ M tt of Occupants. .:a_. Project Description f• •t ,;,C f E A h a-.aa,_t:::e ` i..Ci 44 .S' , Structure Dimensions,also specify dimensions of decks&porches_ t( dot y07 `te,,isle_ (Choose One) 0 Basement Ca Crawl Space 0 Slab If Basement,Will There Be Water Using Fixtures In Basement 0 Yes 0 No Retaining Wail 2' ❑ Yes gi No _ Accessory Dwelling #of New Bedrooms"t _ _ it of Occupants ._ Structure Dimensions µ w ..,_.. _•,„_ (Choose One) 0 Basement 0 Crawl Space 0 Slab if Basement,Will There Be Water Using Fixtures in Basement 0 Yes 0 No Retaining Wall a 2' 0Yes 0 No .. _. . ._. Accessory Structure(r)Describe.. - w. ,, Structure(s)Dimensions Plumbing ❑Yes 0 No Describe Plumbing Needed (Choose One) ❑Basement 0 Crawl Space ❑ Slab tf 13asen.ient,Will There Be Water Using Fixtures In Basement 0 Yes 0 No Retaining Walla 2' 0 Yes 0 No Multi-Family Residence #of'Apartments.�,. w#Bedrooms per Apartment's Total#Bedrooms in Structure"t_ ,#of Occupants_.__ Structure Dimensions _ _ __ __ (Choose One) 0 Basement [j Crawl Space`❑ Slab If Basement,Will There Be Water Using Fixtures In Basement 0 Yes 0 No Retaining Wall>2' 0 Yes 0 No I Well Caustructlan/Abandonntent/Repair Proposed Well Type 0 Individual Well ❑Semi-Public Well 0 Community Well Abandonment Type 0 Drilled 0 Bored 0 Dug 0 Unknowns`r S 7° Well Repair Requested 0 Yes 0 No Describe Will Certified Well Contractor install Water Line or Electrical Line from Well Head to Pressure Tank?0 Yes 0 No Environmental Health Catawba County Government Center, 25 Government Drive ! P©. Box 389, Newton, NC 28658 Phone: (828)465-8270 j Fax: (828)465-8276 1 EHAdmin@CatawbaCountyNC,gov •- . •I , • 1. , _ _ . ., r� Structures on Site _._. Describe .._ . ._ o _ ._ .. Structure Dimensions______ f 4 of Bedrooms* _ _ .. #of Occupants. .�.�._._ f Basement 0 Yes 0 No Easement Plumbing 0 Yes 0 No l Existing Water Supply ..w w..._. p„lndividual Well ❑Shared Well-Number of Connections 0 Community Well 0 County/City/Township Water Line s Is a public water supply available?** 0 Yes (I No ' <•omMercial 0 Pro New Construction 0 Existing clone of use 0 Repair Proposed . ., �.�. _..._.._.. w Food Service Specify Type _ _ . _ w.._ I #Seats..w.,...,..,.._,.. _ Dining Area(Sq.Ft.)_ram__ 1 #Employees per Shill. ._ram ... if of Shifts�,..._..:.,w......:......�. Church #of Seats Daycare 0 Yes 0 No #of Children 4 of Employees per Shift 4 of Shifts Commercial Kitchen ❑Yes El No Residential Kitchen 0 Yes 0 No Daycare#of Children ,.ra,,_,._ #of Employees per Shift_. H of Shifts______ Business/Other Specify Type Structure Dimensions , Retail Floor Space.,,.,._..._.,.__.._,.#of Employees per Shift_. #of Shifts.r,,,.. . Other Inforwatlon Calculated Design Flow,Commercial f (This value will be determined by EH staff) I 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. CI Yes tif No Does the site contain any jurisdictional wetlands? la Yes 0 Na Does the site contain any existing wastewater systems? fir ni Vie►4, O Yes IX No Is any wastewater going to be generated on the site other than domestic sewage? 0 Yes 14 No Is the site subject to approval by any other public agency? D Yea 51 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) Q Accepted ©Alternative litConventional 0 Innovative 0 Other 0 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 fur septic system expansion in the future. f 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. RETIfl TO TUEP[.OPERTTY AND/OR SYST R."DESIGN WILL INCUR AN ADDITIONAL CRAM-if(SEE FEE SCHEEI L 1 Environmental Health soil/site evaluations require digging,angering,and/or probing into the ground.Property owner/applicant is responsible for marking all underground utilities,including but not limited to;underground power,cable,telephone,gas,water lines,and irrigation systems/sprinkler systems.Catawba County Environmental Health is not responsible for damage to unmarked utilities. 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 rrnuirements i I have read this application and certify that the information provided herein is true,complete and correct. Authorized county and state f 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 l accessible so that a complete site evaluation can be performed. 3 The undersigned is the owner of the property or legal agent of the owner. Signature of Owner or Legal Agent.,,,,,. ,, �.:. :.. Date ....0 .f 4x.: . . r Printed Name of Owner or Legal Agent ctc�lei.... 7,,.,i/. .c- ..._ W.... ..,_,....,w.............._,..,_.........,..,..... ... ..,w... PP(. \)N catawba count U d CUb llC1' Has,,,, „Y:N, ,,,.:y Information Services Heal estate Search 5827 '2s •oa Ni r "3 cb 6823 / 3o \f-t\-;/\\ 00 5ft 0 e� g `fie3 6p r' ti 4 ft ° °` 40 f - / 7 •oo �� /6• l„ 7696 J 0 . (0 1.. J.'s' D 'CO 8588 N w-.4.E 1 in=60ft S Parcel: 461601187705, 8245 LYMNOS LN SHERRILLS FORD, 28673 Owners: AUSTIN HILLARY A, Owner Address: 1525 LUDWIG RD Values - Building(s): $1,500, Land: $161,300, Total: $162,800 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 2021 Catawba County NC