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HomeMy WebLinkAboutEHPR-05-2022-40949 e. THIS IS NOT A PERMIT Case# EHPR-05-2022-40949 CATAWBA COUNTY HEALTH DEPARTMENT PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES I8 2 sm Environmental Health Plan Review-Septic Malfunction AUTH CONST- SEPTIC MALFUNCTION Owner CARMEN MCGEE, 1343 HIDDEN CREEK CIR,HICKORY NC 28602 C:8285821860 NAME TO APPEAR ON PERMIT Carmen McGee SITE ADDRESS: 1343 HIDDEN CREEK CIR,HICKORY NC 28602 PIN# 371009060613 NAME of SUBDIVISION: HIDDEN CREEK ESTATES Lot# 3 Section/Block PROPERTY SIZE: Square Feet 16,552.80 Acres 0.38 DIRECTIONS: River Road,Hidden Creek Development,3rd on right PRIMARY CONTACT: Owner SEWER TYPE: Septic Tank GALLONS PER DAY: 360 WATER SUPPLY: Community Well DESCRIBE WORK: tank only cracked 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 residence EXISTING STRUCTURES ON SITE(IF ANY) DIM EXISTING STRUCTURE: 30 x 49 with att 23x23 garage NUMBER OF EXISTING BEDROOMS: 3 #OF OCCUPANTS: 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: Other described: ehapplication 05/06/2022 08:56 Page I of 6 CATAWBA COUNTY Case# EHPR-05-2022-40949 Irk Public Health Department Subdivision HIDDEN CREEK ESTATES Environmental Health Division P1N# 371009060613 PO Box 389,100-A Southwest Blvd,Newton,NC 28658 su NAME ON PERMIT: (CARMEN MCGEE), 1343 HIDDEN CREEK CIR,HICKORY NC 28602 (Carmen McGee) Site Address: 1343 HIDDEN CREEK CIR,HICKORY NC 28602 Property Size: Square Feet 16,552.80 Acres 0.38 Directions: River Road,Hidden Creek Development,3rd on 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. 4 7/ Date: 2 Signature of Applicant or Agent If you need further information or assistance please call 828-465-8270 AREA1 FEENAME " RATS,;; yEE 1MOUNT Authorization to Construct(Repair)Fee r 05/06/2022 S150.00 £ 3 4 J£ £££E £� £ Y iI l I£ C 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 05/06/2022 08:54 Page 2 of6 (' ) Catawba county public health Application for Environmental Health Services THIS IS NOT A PERMIT Application is for: ❑ New Construction A Existing Facility ❑ Improvement Permit 0 Authorization to Construct ❑New Septic QrSeptic Repair/Malfunction ❑ Septic Relocation El Septic Expansion 0 Existing System Inspection or Reconnection El New Well ❑ Replacement Well ❑ Well Abandonment ❑Well Repair Property Address 13 4 N eri C eek_ A re ke$ Acres 430 Subdivision t{tC.4C1E41 Ci eV Lot#— —�- DrivingDirections to Property 'V 21 . r S Q}� tP 1 NI tI t1�►e lets � . • ` - 1 -Se an e 6911+ r Describe work \a e e sep t c T1 e.t Qv 1n p Q i•ti CY IAS It t ill t f1 D jd tall Applicant Name 1 Pp at YY1Q-�l �C �'1e e Applicant Address 13 43 N i GLitilof eel. e t de Phone I Cell Phone 5g2.- i 3-60 Owner Name tuft* M t✓Ciee Owner Address 13 43 (-I C a d tvl Greek C. rely. Phone Cell Phone 5 8-? - M d Contractor Name ( earge. lc AM License# Contractor Address RA-. ('"Z &mt qg tiicktyN 2 go6Z Phone Cell Phone 3g\-2102 Name to Appear on Permit'' wner ❑Applicant ❑Contractor Who will be the Primar:s Contact? Owner 0 Applicant 0 Contractor Proposed New Construction-Residential Primary Residence ❑ New Residence ❑ Addition to Residence #of New Bedrooms*t #of Occupants Project Description Structure Dimensions,also specify dimensions of decks&porches Basement 0 Yes ❑ No Basement Plumbing ❑Yes 0 No Accessory Dwelling #of New Bedrooms*f #of Occupants Structure Dimensions Basement ❑Yes 0 No Basement Plumbing ❑Yes ❑ No Accessory Structure(s)Describe Structure(s)Dimensions Plumbing ❑Yes ❑No Describe Plumbing Needed Multi-Family Residence #of Apartments #Bedrooms per Apartment*t Total#Bedrooms in Structure*t #of Occupants Structure Dimensions Basement ❑ Yes ❑ No Basement Plumbing ❑Yes ❑ No Well Construction/Abandonment/Repair Proposed Well Type 0 Individual Well ❑ Semi-Public Well ❑Community Well Abandonment Type ❑ Drilled ❑ Bored El Dug ❑ Unknown Well Repair Requested ❑Yes ❑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 Catawba County Government Center 25 Government Drive I PO Box 389 I Newton NC 28658 1828.465.8270 MAKING. LIVING. BETTER. Existing Structures on Site Describe ge ,c�exl{t cd ‘Of IC Structure Dimensions d' ''t'4 q' 3tx, 23 #of Bedrooms* #of Occupants Cp Basement ❑ Yes No Basement Plumbing [4Yes d No avo lift ct +700 1 Existing Water Supply ❑ Individual Well ❑ Shared Well—Numbcr of onnections 2/Community Well 0 County/City/Township Water Line Is a public water supply available?** 0 Yes No Commercial ❑ Proposed New Construction ❑ Existing/Change of Use epair Food Service Specify Type #Seats Dining Area(Sq.Ft.) #Employees per Shift #of Shifts Church #of Seats Daycare❑ Yes ❑No #of Children #of Employees per Shift #of Shifts Commercial Kitchen ❑ Yes ❑No Residential Kitchen El Yes ❑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 stall) The APPlicant shall notify the local health department upon submittal of this application if any of the following apply to the property in question. Ifpe answer to any question is"yes",applicant must attach supporting documentation. ❑Yes 0 No Does the site contain any jurisdictional wetlands? )(Yes No Does the site contain any existing wastewater systems? ❑Yes 4o 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 ❑No Arc there any easements or right of ways on this properly? Describe If applying for an Improvement Permit or Authorization to Construct,Please Indicate Desired System Type(s): (systems call be ranked in order of your preference) ❑ Accepted 0 Alternative 0 Conventional 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 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 Constrict 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. Signature of Owner or Legal Agent (,J)Ujfl't Date 5- 3-2 2 I Printed Name of Owner or Legal Agent Car m Nl G. 1 Catawba County Environmental Health •4033ch 115.ai I 41::::1 `2090 p`4 r 4(' 71 •1353 (ZJ 'Ji rt:". y 4 ;x44---C > 1- 9�Or ,c 740 193 0 4 4;4 . 120. ., ` •1336. 4, Arex �ryII 7qs 07 /42:49 I k 1/2 Parcel: 371009060613, 1343 HIDDEN CREEK 1in=50ft CIR HICKORY, 28602 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 05/06/2022 5/6122,8.47 AM Parcel Report Parcel Report - Catawba County NC Parcel Information: Owner Information: Parcel ID: 371009060613 Owner: CASTANEDA KAYLA DANIELLE Parcel Address: 1343 HIDDEN CREEK CIR Owner2: City: HICKORY, 28602 Address: 1343 HIDDEN CREEK CIR LRK(REID): 90407 Address2: Deed Book/Page: 3600/0929 City: HICKORY Subdivision: HIDDEN CREEK ESTATES State/Zip: NC 28602-9706 Lots/Block: 3/ School Information: Last Sale: $186,500 on 2018-06-22 School District: COUNTY Plat Book/Page: 24/87 Elementary School: BLACKBURN Legal: LOT 3 PLAT 24-87 Middle School: JACOBS FORK Calculated Acreage: .380 High School: FRED T FOARD Tax Map: 187H 09023 Township: HICKORY School Map State Road #: 2900 TaxNalue Information: Tax Rates(pdf) Zoning Information: City Tax District: All in County Zoning District: COUNTY County Fire District: MOUNTAIN VIEW Zoningl: R-20 Building(s) Value: $148,500 Zoning2: Land Value: $16,700 Zoning3: Assessed Total Value: $165,200 Zoning Overlay: ED-O Year Built/Remodeled: 1989/ Small Area: MOUNTAIN VIEW Current Tax Bill Split Zoning Districts: / Zoning Agency Phone Numbers Miscellaneous: Firm Panel Date: 2007-09-05 Building Permit Address Search for this parcel. Firm Panel #: If available, Building Permits for this parcel. Septic 2010 Census Block: 2066 links are not permits. 2010 Census Tract: 011102 Septic Final Permits prior to 08/2018, contact Agricultural District: Environmental Health. Building Details WaterShed: Voter Precinct: P23/Voting Map 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 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. gis.catawbacountync.gov/nomap/parcel_report.php?key=371009060613&type=u 1/1 ', CATAWBA COUNTY HEALTH' DEPARTMENT PERMIT # 03894 - -,COMP.LETION PERMIT i'3` OWNER OR CONTRACTOR: C��., ,,4 DATE: g--/q-k7 ADDRESS: PHONE: LOCAT I ON: S,_re_p_ i 1 p, SUBDIVISION: /`1Q.4„.„ aev j-LOT: '3 SECTION OR BLOCK: LOT SIZE: House ( Mobile Home ( ) Business ( ) Other ( ) . Flow Rate: gpd Bedrooms: Bathrooms : L, Special Fixtures : Other: Basement - Yes ( ) No ( J F1'xture in basement-Yes ( ) No ( ) Garbage Disposal Unit: Yes ( ) No �-)� ""'' Water Supply: Private ( ) Public ( TANK SIZE: J 0 a gallons Distance from septic tank or nearest source of NITRIFICATION FIEL pollution: Number of lines: -3 FINAL APPROVAL OF THIS SEPTIC TANK SYSTEM SHALL IN Length and width of lines NO WAY BE TAKEN AS A GUARANTEE THAT THE SYSTEM WILL (a) Bed•System FUNCTION SATISFACTORILY FOR ANY GIVEN PERIOD OF (b) Trench System 36" x /6 D TIME. or Trench Sys. 30" x DATE INSTALLED: a--- f'--p Total Sq. Ft. ?(�p Depth of Stone / " INSTALLED BY: rAit/A.A., REMARKS: SANITARIAN: • SITE AND SEPTIC TANK LAYOUT VI A " a ) ' .‘41:51' . • i • i , \ ‘47 1 r HEALTH DEPARTMENT COPY • 44 CATAWBA COUNTY ,E.Ts,' Ink100A SOUTHWEST BLVD 1-1 NEWTON,NORTH CAROLINA 28658 RECEIPT i � PHONE:828.465.8399 Friday,May 6,2022 18 42 su www.catawbacountync.gov PAYOR: McGee,Carmen PAYMENTS TRANSACTION NUMBER: TRC-39370449-06-05-2022 PAYMENT DATE: 05/06/2022 PAYMENT TYPE: Credit Card • 289431414 INVOICE NUMBER ACCOUNT FEE NAME FEE AMOUNT 05-22-406044 110-580200-663000 Authorization to Construct(Repair) S150.00 Fee TOTAL PAYMENTS: $150.00 EHPR-05-2022-40949 CASE TYPE: Environmental Health Plan Review WORK CLASS: Septic Malfunction SITE ADDRESS: 1343 HIDDEN CREEK CIR,HICKORY NC 28602 Owner CARMEN MCGEE, 1343 HIDDEN CREEK CIR,HICKORY NC 28602 C:8285821860 **NO PEOPLESOFT ACCOUNT ASSIGNED** receipt 05/06/2022 08:53 Page I of l