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HomeMy WebLinkAboutEHPR-05-2022-40982.tif 4'A • THIS IS NOT A PERMIT Case# EHPR-05-2022-40982 Q" 11 CATAWBA COUNTY HEALTH DEPARTMENT �� PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES /g 2 sM Environmental Health Plan Review-Septic Malfunction AUTH CONST- SEPTIC MALFUNCTION Applicant DEBBI JETT,4429 MARION DR,TERRELL NC 28682 C:9253605388 DJETT45@SBCGLOBAL.NET SBCGLOBAL.NET Contractor MKB PLUMBING AND SEPTIC,8037 FAIRVIEW RD SUITE A,MINT HILL NC 28227 B:704634989 I MKBPLUMBING.REMODELING c YAHOO.COM NAME TO APPEAR ON PERMIT MKB Plumbing and Septic SITE ADDRESS: 4429 MARION DR,TERRELL NC 28682 PIN# 461601486499 NAME of SUBDIVISION: GABRIEL ACRES Lot# 23 Section/Block PROPERTY SIZE: Square Feet 37,897.20 Acres 0.87 DIRECTIONS: NC-150,right onto Kiser Island Rd,right onto Fieldstone Dr,left onto Beachwood Trail,road changes to Marion Dr, home is on the right PRIMARY CONTACT: Contractor SEWER TYPE: Septic Tank GALLONS PER DAY: 360 WATER SUPPLY: Private Well DESCRIBE WORK: replace septic tank 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? 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: PRIMARY RESIDENCE FACILITY TYPE: House OTHER DESCRIPTION: DESCRIPTION OF House EXISTING STRUCTURES ON SITE(IF ANY) DIM EXISTING STRUCTURE: 84x49 NUMBER OF EXISTING BEDROOMS: 3 #OF OCCUPANTS: 6 PROPOSED CONSTRUCTION BASEMENT? No BASEMENT FIXTURES? No PLUMBING REQUIRED? 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: YES Other described: .:L:1pli :dnm 05/10/2022 14:27 Page 1 of6 ��+• CATAWBA COUNTY Case# EHPR-05-2022 40982 Public Health Department r, 'r' 2 Subdivision GABRIEL ACRES Q Y Environmental Health Division PIN# 461601486499 PO Box 389, 100-A Southwest Blvd,Newton,NC 28658 NAME ON PERMIT: MKB PLUMBING AND SEPTIC ( ),8037 FAIRVIEW RD SUITE A,MINT HILL NC 28227 MKB Plumbing and Septic ( ) Site Address: 4429 MARION DR,TERRELL NC 28682 Property Size: Square Feet 37,897.20 Acres 0.87 Directions: NC-150,right onto Kiser Island Rd,right onto Fieldstone Dr,left onto Beachwood Trail,road changes to Marion Dr, home is on the 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: Signature of Applicant or Agent If you need further information or assistance please call 828-465-8270 AREAS **************************************************************************************.********************* FEENAME DATE FEE AMOUNT Authorization to Construct(Repair) Fee 05/10/2022 $150.00 TOTAL FEES S150.00 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) diapplii ali,m 05/10/2022 14:27 Page 2 of 6 a f 4 i catawba county (JOAO public health Application for Environmental Health Services THIS IS NOT A PERMIT Application is for: ❑New Construction Existing Facility . ❑Improvement Permit 0 Authorization to Construct ❑New Septic DirSeptic Repair/Malfunction ❑Septic Relocation ❑Septic Expansion ❑Existing System Inspection or Reconnection ❑New Well 0 Replacement Well ❑Well Abandonment ❑Well Repair Property Address Erq Qrl'or't Dr, `j-i>rre , .A/C_, -e• Acres •`;''')(. Subdivision LOW _ ,,// 1 Driving Directio to Property.4.. ._ i t c,r Cl t i)f- i�,S•�' t`�C LkS (��, ( ;y11 k (>r\iC' }' tc-Sh�\c k.Z C�"vkc) r h rIAi', l:c..�r f,� C'�h.. , CaS :r,• h,,r M V�I. C.3n> Describe work .2FIQC n �>C( 5[•'t03GSep •L +00Ic W1 � (i1as%)ew ►1K. Applicant Name De bb t ,.)z A-‘- Applicant Address t 3 72 L-e rl no, L o r1-e._ rr iv-e f ot'e C'/} 9y550 Phone Q, 5_36 5 g-g' I Cell Phone Owner Name Debbi Se -+- Owner Address 1‘3 7 . Lenr , L,, i€ Live re (4 qe.-/550 Phone 9'25-3 -5j3E' t Cell Phone f,25- 3(aO-538�' _ Contractor Name PI m b'n Un S License# Contractor Address 4 3 fa( view < v t C 1 $ 7 Phone 7O — G2 3€(— Q Cell Phone 7 _ _3 g'c.� I Name to Appear on Permit? .Owner ❑Applicant %Contractor Who will be the Primary Contact? 0 Owner ❑Applicant Contractor mk6 tyl l 1 ah60` COM Proposed New Construction-Residential Primary Residence ❑ New Residence 0 Addition to Residence #of New Bedrooms't #of Occupants Project Description Structure Dimensions,also specify dimensions of decks&porches Basement 0 Yes 0 No Basement Plumbing ❑Yes 0 No Accessory Dwelling #of New Bedrooms't #of Occupants Structure Dimensions Basement ❑Yes ❑No Basement Plumbing ❑Yes ❑ No Accessory Structure(s)Describe Structure(s)Dimensions Plumbing 0 Yes ❑No Describe Plumbing Needed Multi-Family Residence #of Apartments #Bedrooms per Apartment*t Total#Bedrooms in Structure•t #of Occupants Structure Dimensions Basement 0 Yes ❑ No Basement Plumbing ❑Yes 0 No Well Construction/Abandonment/Repair Proposed Well Type ❑ Individual Well ❑Semi-Public Well 0 Community Well Abandonment Type 0 Drilled 0 Bored ❑ Dug 0 Unknown Well Repair Requested ❑Yes 0 No Describe Will Certified Well Contractor Install Water Line or Electrical Line from Well Head to Pressure Tank?❑Yes 0 No catawbacountync.gov Environmental Health Catu,vbu County Government Center 25 Government Drive f PO Bar 389 I Newton NC 28658 1828.465.82)O rMHG,. , VU ' .x ;;A• y ,;„ A Existing Structures on Site Describe 1-t Ot)5p , Structure Dimensions H (-1 $`21-1 #of Bedrooms* 3 #of Occupants Basement 0 Yes cst No Basement Plumbing ❑Yes Et No Existing Water Supply Individual Well ❑Shared Well—Number of Connections 0 Community Well 0 County/City/Township Water Line Is a public water supply available?** ❑ Yes 171 No Commercial ❑Proposed New Construction 0 Existing/Change of Use ❑Repair Food Service Specify Type #Seats Dining Area(Sq.Ft.) #Employees per Shift #of Shifts Church #of Seats Daycare 0 Yes 0 No #of Children #of Employees per Shift #of Shifts Commercial Kitchen ❑Yes 0 No Residential Kitchen 0 Yes 0 No Daycare#of Children #of Employees per Shift #of Shills Business/Other Specify Type Structure Dimensions Retail Floor Space #of Employees per Shift #of Shifts 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 iErNo Does the site contain any jurisdictional wetlands? Yes info Does the site contain any existing wastewater systems? Yes N'No Is any wastewater going to be generated on the site other than domestic sewage? ❑Yes 1511•10 Is the site subject to approval by any other public agency? ❑Yes ®'fVo 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 0 Conventional 0 Innovative 0 Other /('�;Any *Any room that will be intended for sleeping at the time of construction or for future consideration should be 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. t 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. RETRIP 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 tong 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 l agent of the owner. "—7 Signature of Owner or Legal Agent Date Printed Name of Owner or Legal Agent Vebh/ J� 4-4- V L i r S w e • 3 ..‘.---.Y...... ....., ,_ • fix- St r i s I Catawba County Environmental Health PA .8489 M t. g iit '` •4415 z> y rc nd ,pi � ''`�xt�r 89 ', ` ,x , r1iw �0 80.84 ''. k ,:� ' Y,, 262.51 ' 1� 343.35 30.07 r s r 'p ys f 4 a'Fx; 197.13 •4435 30.07 h •4429 104.65- r, R ',ti 's `►.. 738� i.w w, N . • wrf �s� 1. 3 ' r,y ti L+s� ,,t{ :. m Cr' it • 8.';n 04 'AI,,?;,( J C ty `k 7 - F.i'9 3^1 f , r �y� Ih� 4t 41 . 1_Irk1ra A,, , ,,, ry -�,t :M ItiY 3' t. �Ai' t k•?L^4ar .. dt, y ti s.y }t Grk` 'y.t, ' 'a ;c. T, _, `+WW II Y:`rt1"44p^ti , ru a�'iF +b$ N �, ,, .„ a } t 7 " b#d Y N. I ITT d )* , x t '' t s t'' r, e ', ti ry t''l� '}l, ai �'yt lira , d , r� }r V Y t' ,r rtk' "1"'.. . cY,' S.40,1. .u::,&,0a s3� ... ..._i1`:.Ott/C ..P. .:, .' �.'L a.S: 3 i`t.. ..r`.•? ,.rl,�� '.E�wW �„+",,.e aY' :`:i�t,i9�;tt�.: ..a_�. . ' i.. s Y,, Parcel: 461601486499, 4429 MARION DR 1 in=60ft TERRELL, 28682 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 05/10/2022 Page 1of1 Parcel Report - Catawba County NC Parcel Information: Owner Information: Parcel ID: 461601486499 Owner: NEWCOMER STELLA A LIVING TRUST Parcel Address: 4429 MARION DR Owner2: NEWCOMER JAMES E TRUSTEE City: TERRELL, 28682 Address: 16425 GREENFARM RD LRK(REID): 14414 Address2: Deed Book/Page: 2011/1578 City: HUNTERSVILLE Subdivision: GABRIEL ACRES State/Zip: NC 28078-5201 Lots/Block: 23/ Last Sale: $80,000 on 1979-03-01 School Information: Plat Book/Page: 12/37 School District: COUNTY Legal: LOT 23 PL 12-37 Elementary School: SHERRILLS FORD Calculated Acreage: .870 Middle School: MILL CREEK Tax Map: 013CX 01004 High School: BANDYS Township: MOUNTAIN CREEK School Map State Road #: TaxNalue Information: Tax Rates(pdf) Zoning Information: City Tax District: All in County Zoning District: COUNTY County Fire District: SHERRILLS FORD Zoningl: R-30 Building(s) Value: $322,300 Zoning2: Land Value: $292,100 Zoning3: Assessed Total Value: $614,400 Zoning Overlay: CRC-O,WP-O,FPM-O Year Built/Remodeled: 1966/1987 Small Area: SHERRILLS FORD Current Tax Bill Split Zoning Districts: / Zoning Agency Phone Numbers Miscellaneous: Firm Panel Date: 2008-03-18 Building Permit Address Search for this parcel. Firm Panel #: 3710461600L If available, Building Permits for this parcel. 2010 Census Block: 5017 Septic links are not permits. 2010 Census Tract: 011504 Septic Final Permits prior to 08/2018, contact Agricultural District: Environmental Health. Building Details WaterShed: WS-IV Critical Area Voter Precinct: P41/Voting Map Parcel Report Data Descriptions idc. `\ O'\. t \e 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 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. ©2022, Catawba County Government, North Carolina. All rights reserved. 5/10/2022 C• CATAWBA COUNTY 100A SOUTHWEST BLVD NEWTON,NORTH CAROLINA 28658 RECEIPT (..) 105 0 PHONE:828.465.8399 Tuesday,May 10,2022 18 4 2 SM www.catawbacountync.gov PAYOR; MKB Plumbing and Septic MKB Plumbing and Septic PAYMENTS TRANSACTION NUMBER: TRC-39625064-10-05-2022 PAYMENT DATE: 05/10/2022 PAYMENT TYPE: Credit Card 289589604 INVOICE NUMBER ACCOUNT FEE NAME FEE AMOUNT 05-22-406240 n0-580200-663000 Authorization to Construct(Repair) S 150.00 Fee TOTAL PAYMENTS: $150.00 EHPR-05-2022-40982 CASE TYPE: Environmental Health Plan Review WORK CLASS: Septic Malfunction SITE ADDRESS: 4429 MARION DR,TERRELL NC 28682 Applicant DEBBI JETT,4429 MARION DR,TERRELL NC 28682 C:9253605388 DJETT45@SBCGLOBAL.NET Contractor MKB PLUMBING AND SEPTIC,8037 FAIRVIEW RD SUITE A,MINT HILL NC 28227 B:704634989I MKBPLUMBING.REMODELING@YAHOO.COM **NO PEOPLESOFT ACCOUNT ASSIGNED** receipt 05/10/2022 14:20 Page 1 of 1