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HomeMy WebLinkAboutEHPR-05-2022-40957.TIF „pP` �� THIS IS NOTA PERMIT Case# EHPR-05-2022-40957 Q �� CATAWBA COUNTY HEALTH DEPARTMENT PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES t8 2 SM Environmental Health Plan Review-Septic Malfunction AUTH CONST- SEPTIC MALFUNCTION Applicant DEBBY HARWELL,3882 MT OLIVE CHURCH RD,NEWTON NC 28658 C:7044080853 HARWELL77@GMAIL.COM NAME TO APPEAR ON PERMIT Debby Harwell SITE ADDRESS: 3882 MT OLIVE CHURCH RD,NEWTON NC 28658 PIN# 366902753181 NAME of SUBDIVISION: Lot 4 Section/Block PROPERTY SIZE: Square Feet 29,185.20 Acres 0.67 DIRECTIONS: Mt Olive Church,on left just past Fox Dairy Rd PRIMARY CONTACT: Applicant SEWER TYPE: Septic Tank GALLONS PER DAY: 240 WATER SUPPLY: Public Water DESCRIBE WORK: tank cracked, requesting new drainfield also 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: 36 x 46 NUMBER OF EXISTING BEDROOMS: 2 #OF OCCUPANTS: 2 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: chapplication 05/06/2022 14:34 Page 1 of 6 4yj,' • CATAWBA COUNTY Case# EHPR-05-2022-40957 Uty' i.IL• 2 Public Health Department Subdivision Q /:) Environmental Health Division PIN# 366902753181 PO Box 389,100-A Southwest Blvd,Newton,NC 28658 ;Et S. NAME ON PERMIT: (DEBBY HARWELL),3882 MT OLIVE CHURCI I RD,NEWTON NC 28658 (Debby Harwell) Site Address: 3882 MT OLIVE CHURCH RD,NEWTON NC 28658 Property Size: Square Feet 29,185.20 Acres 0.67 Directions: Mt Olive Church,on left just past Fox Dairy Rd 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. �boZ�- Signature of Applicant or Agent l +; J, /-(6,,,,,Jeg Date: � � g PP g � 'C If you need further information or assistance please c, 1 828-465-8270 AREA3 FEENAME DATE FEE AMOUNT Authorization to Construct(Repair)Fee 05/06/2022 $300.00 TOTAL FEES $300.00 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) chapplication 05/06/2022 14:34 Page 2 of 6 (4. ) Catawba county public health Application for Environmental Health Services THIS IS NOT A PERMIT Application is for: ❑New Construction ❑Existing Facility ❑Improvement Permit uthorization to Construct ❑New Septic eptic Repair/Malfunction ❑ Septic Relocation ❑ Septic Expansion ❑Existing System Inspection or Reconnection ❑New Well ❑Replacement Well ❑ Well Abandonment ❑ Well Repair Property Address .378a2 Mks Ol ve ( u ccl. Ai. 2 /Ue(xi •-t /✓e o?' -e g Acres i22s4 Subdivision Lot# Driving Directions to Property Describe work Applicant Name / \--LkTwe .1 Applicant Address ,3g8,a /11.-/-, O t ve C ) /Ue n, /Vc? a284,.5 8' Phone 76'/-1-6 8'D g 5 3 Email r-v.,e l(�7 e J `•�, co m- Owner Name p ry d Debbr (-tarty e I Owner Address Phone 500('"Le Email Contractor Name Contractor Address Phone Email Name to Appear on Permit? ❑Owner J Applicant ❑Contractor Who will be the Primary Contact? ❑Owner Applicant ❑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 ❑Yes ❑ No Basement Plumbing ❑Yes ❑ 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 ❑Yes ❑No Describe Plumbing Needed Multi-Family Residence #of Apartments #Bedrooms per Apartment*t Total#Bedrooms in Structure*j' #of Occupants Structure Dimensions Basement ❑Yes ❑ No Basement Plumbing ❑Yes ❑ No Well Construction/Abandonment/Repair Proposed Well Type ❑ Individual Well ❑Semi-Public Well ❑Community Well Abandonment Type ❑ Drilled 0 Bored ❑ Dug ❑ Unknown Well Repair Requested 0 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 Cotawbu County Government Center 25 Government Drive I PO Box 389 I Newton NC 28658 1828.465.8270 MAKING,, I,IVI4G.. BETTER.. .Existing Structures on Site i'' ' Describe Structure Dimensions l(' (X --,#of Bedrooms* 02 —#of Occupants oZ -Basement E Yes gi No Basement Plumbing El Yes JR] No Existing Water Supply ❑Individual Well ❑ Shared Well-Number of Connections ❑ Community Well County/City/Township Water Line Is a public water supply available?** Yes El No Commercial El Proposed New Construction El Existing/Change of Use ❑ Repair Food Service Specify Type #Seats Dining Area(Sq.Ft.) #Employees per Shift #of Shifts Church #of Seats Daycare El Yes El No #of Children #of Employees per Shift #of Shifts Commercial Kitchen El Yes El No Residential Kitchen ❑Yes ❑No Daycare#of Children #of Employees per Shift #of Shifts 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) ('he 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 NI.No Does the site contain any jurisdictional wetlands? ,Yes 0 No Does the site contain any existing wastewater systems? ❑Yes I No Is any wastewater going to be generated on the site other than domestic sewage? 0 Yes .No Is the site subject to approval by any other public agency? `❑Yes 181 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) ❑Accepted 0 Alternative ❑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) 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 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 j 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 g• /(�u� Date -s`to /2Oe2�_ Printed Name of Owner or Legal Agent t , ( ehby E• !`T 4l�'W e II Catawba County Environmental Health to os PI COilliii to (97) w 0 198.660y�� G r• CD 60.61 •3882' 6r'ro S. (144) to Clto, 7j 3 199.87 o j „ ., , p '$i. J „,✓ 0 235.90 E =y t. (236) Parcel: 366902753181, 3882 MT OLIVE 1 in=50ft CHURCH RD 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 2021 Catawba County NC 05/06/2022 5/6/22,2:23 PM Parcel Report Parcel Report - Catawba County NC Parcel Information: Owner Information: Parcel ID: 366902753181 Owner: HARWELL DON E Parcel Address: 3882 MT OLIVE CHURCH RD Owner2: HARWELL DEBORAH B City: NEWTON, 28658 Address: 3882 MOUNT OLIVE CH RD LRK(REID): 201156 Address2: Deed Book/Page: 3322/0327 City: NEWTON Subdivision: State/Zip: NC 28658-8225 Lots/Block: / School Information: Last Sale: $80,000 on 2015-12-21 School District: COUNTY Plat Book/Page: Elementary School: BALLS CREEK Legal: Middle School: MILL CREEK Calculated Acreage: .670 High School: BANDYS Tax Map: Township: CATAWBA School Map State Road #: 1802 TaxNalue Information: Tax Rates(pdf) Zoning Information: City Tax District: All in County Zoning District: COUNTY County Fire District: BANDYS Zoningl: R-40 Building(s) Value: $65,100 Zoning2: Land Value: $11,900 Zoning3: Assessed Total Value: $77,000 Zoning Overlay: DWMH-O Year Built/Remodeled: 1951/ Small Area: BALLS CREEK 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 #: 3710366900J If available, Building Permits for this parcel. Septic 2010 Census Block: 3004 links are not permits. 2010 Census Tract: 011402 Septic Final Permits prior to 08/2018, contact Agricultural District: Environmental Health. r Building Details WaterShed: y O C Voter Precinct: P1/Voting Map 1 �� 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=366902753181&type=u 1/1 V,A CATAWBA COUNTY ir:FII% 100A SOUTHWEST BLVD NEWTON,NORTH CAROLINA 28658 RECEIPT okr .tt1''1) air PHONE:828.465.8399 J Friday,May 6,2022 18 42 sm www.catawbacountync.gov PAYOR: Harwell,Debby PAYMENTS TRANSACTION NUMBER: TRC-39396056-06-05-2022 PAYMENT DATE: 05/06/2022 PAYMENT TYPE: Credit Card 289454415 INVOICE NUMBER ACCOUNT FEE NAME FEE AMOUNT 05-22-406097 I I0-ssozoo-663000 Authorization to Construct(Repair) $300.00 Fee TOTAL PAYMENTS: $300.00 EHPR-05-2022-40957 CASE TYPE: Environmental Health Plan Review WORK CLASS: Septic Malfunction SITE ADDRESS: 3882 MT OLIVE CHURCH RD,NEWTON NC 28658 Applicant DEBBY HARWELL,3882 MT OLIVE CHURCH RD,NEWTON NC 28658 C:7044080853 HARWELL77@GMAIL.COM **NO PEOPLESOFT ACCOUNT ASSIGNED** receipt 05/062022 14:34 Page 1 of 1