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HomeMy WebLinkAboutEHPR-05-2022-41149.tif A • TIIIS IS NOT A PERMIT Case# EHPR-05-2022-41149 " �' 11 CATAWBA COUNTY I IEALTI I DEPARTMENT '109 PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES /8 2 sM Environmental Health Plan Review-Septic Malfunction AUTH CONST- SEPTIC MALFUNCTION Applicant CHRIS DAVIDSON,3778 MATTINGLY DR,HICKORY NC 28602 H:9106609442 HOME:9106609442 CHRISD9174@YAHOO.COM NAME TO APPEAR ON PERMIT Chris Davidson SITE ADDRESS: 3778 MA'I'TINGLY DR,I IICKORY NC 28602 PIN# 371009150284 NAME of SUBDIVISION: HIDDEN CREEK ESTATES PHASE III Lot# 45 Section/Block PROPERTY SIZE: Square Feet 16,117.20 Acres 0.37 DIRECTIONS: River Rd onto Hidden Creek Cir left Mattingly Dr,right on Mattingtly Dr property on left PRIMARY CONTACT: Applicant SEWER TYPE: Septic Tank GALLONS PER DAY: 360 WATER SUPPLY: Community Well DESCRIBE WORK: Tank only. EMERGENCY APP LARGE HOLE IN GROUND 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 resdience EXISTING STRUCTURES ON SITE(IF ANY) DIM EXISTING STRUCTURE: 60 x 54 NUMBER OF EXISTING BEDROOMS: 3 #OF OCCUPANTS: 3 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: ehapplium,.n 05/25/2022 12:08 Page I of(' 0CATAWBA COUNTY Case# EHPR-OS-2022-4 1 1 49 Public Health Department Subdivision HIDDEN CREEK ESTATES PHA: (17,,.:4, 371009150284 Environmental Health Division PINfI PO Box 389,100-A Southwest Blvd,Newton,NC 28658 NAME ON PERMIT: (CHRIS DAVIDSON),3778 MATTINGLY DR,I IICKORY NC 28602 ( Chris Davidson) Site Address: 3778 MATTINGLY DR,HICKORY NC 28602 Property Size: Square Feet 16,117.20 Acres 0.37 Directions: River Rd onto Hidden Creek Cir left Mattingly Dr,right on Mattingtly Dr property 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 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 • AREA/I FEENAME DATE FEE AMOUNT Authorization to Construct(Repair) Fee 05/25/2022 $150.00 TOTAL FEES $150.00 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) aLnhpliiaw.0 05/25/2022 12:08 Page 2 of 6 catawba county public health I Lq Application for Environmental Health Services THIS IS NOT A PERMIT Application is for: ❑New Construction (7�Existing Facility ❑Improvement Permit p ❑Authorization to Construct ZNew Septic (Septic Repair/Malfunction ❑ Septic Relocation ❑Septic Expansion ❑Existing System Inspection or Reconnection ❑New Well ❑ Replacement Well ❑ Well Abandonment ❑ Well Repair Property Address 7 7 .44 q`H7 i,/1 ✓� ffic,ko^y c .Nc Z?(oO 2 Acres Q. 37 Subdivision //,We(eit Ci'eerrc ES r c PAGse 3 Lot# 415" Driving Directions to Property -5v&l%vis 1 4 iS iheX Aive-e/' Roc? Describe work S&pffic. ` tc Wcc5 Gd I arSec� 1 20 St e •qua+ h6) e %4 yaie( "1_I.4 . DLLs Applicant Name Chris lit via so() Applicant Address 3 77 13 .A4 at-4-1--in 51 ( D r^;ve 1.-1 e-kor y t )VC. 2 g coo 2- Phone 10 - 6260- g4/4/2 Email c.hf i sd 4/74 Q t ctPt . r. Owner Name Owner Address Phone Email Contractor Name Contractor Address Phone Email Name to Appear on Permit? ❑Owner ['Applicant 0 Contractor Who will be the Primary Contact? 0 Owner [Applicant 0 Contractor 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 ❑ Yes ❑ No Basement Plumbing ❑Yes ❑ No Accessory Dwelling #of Ncw Bedrooms*t #of Occupants Structure Dimensions Basement ❑Yes ❑No Basement Plumbing ❑Yes 0 No Accessory Structure(s)Describe Structure(s)Dimensions Plumbing ❑Yes 0 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 ❑Ycs 0 No Well Construction/Abandonment/Repair Proposed Well Type ❑ Individual Well ❑Semi-Public Well ❑Community Well Abandonment Type D Drilled ❑ Bored 0 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?0 Yes 0 No cat awbacountync.gov Environmental Health Catawba County Government Center 25 Government Drive I PO Box 389 I Newton NC 28658 1828.465.8210 MAKING. LIVING. BETTER . Existing Structures on Site Describe :J;ny/e Tern /c j home Structure Dimensions/(o y3 s #of Bedrooms* 3 #of Occupants 3 Basement ❑Yes ErNo Basement Plumbing ❑Yes El No Existing Water Supply ❑Individual Well ❑ Shared Well—Number of Connections [+Community Well El County/City/Township Water Line Is a public water supply available? ** Er Yes ❑No Commercial ❑Proposed New Construction ❑Existing/Change of Use ❑Repair 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 ❑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) The Applicant shall notify the local health department upon submittal of this application if any of the following apply to the property in question. Iflhe answer to any question is"yes",applicant must attach supporting documentation. ❑Yes NI No Does the site contain any jurisdictional wetlands? Nji(Yes l$No Does the site contain any existing wastewater systems'? ❑ Yes Colo Is any wastewater going to be generated on the site other than domestic sewage? 0 Yes Er No Is the site subject to approval by any other public agency? ❑ Yes GrNo 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) 0 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) Environmental Health soil/site evaluations require digging,augering,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 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( �'d ''t • aZ ieese"" Date 72 d 2 2 Printed Name of Owner or Legal Agent @catawba countyGeospatial VAtINb 'MN(' 'WIN Information Services Real Estate Search 9Q Op �cb NZ' row 37 .cD7 46 102.23 2.78 38 •o •ASS 45 t.s,�. ,r •669, ,g • / 96, P ( 'x7c' cb 44 96 68.77 Mq' c< 2q 99...\\ \ 108.63 w _1: 1 in=40ft Parcel: 371009150284, 3778 MATTINGLY DR HICKORY, 28602 Owners: DAVIDSON CHRISTOPHER RYAN, DAVIDSON OLINDA Owner Address: 3778 MATTINGLY DR Values - Building(s): $137,300, Land: $16,500, Total: $153,800 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 nsnron-yo Catawba County Environmental Health s -....� 77�7 `' _ ? •3886 0 ,` . •3756 ___870_,___ °j •3874 1:1°° rs --�� , - .,� 02.23 ■ 11278 K.. •3772 ''-� Y I 6..9 761.0. 49 98 U4 •3778 s? 3�96 -865,_- _ `S IS 68.77 Ns.`' ,. 10so7 44 J �`. �.N.__ W�R�4 •yo •37~8 •3773 '- ,„"w. - - 108.63 e. -860 ��► •3781 181.29 `� •3790 Parcel: 371009150284, 3778 MATTINGLY DR 1in=50ft 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 05/25/2022 Parcel Report - Catawba County NC Parcel Information: Owner Information: Parcel ID: 371009150284 Owner: DAVIDSON CHRISTOPHER RYAN Parcel Address: 3778 MATTINGLY DR Owner2: DAVIDSON OLINDA City: HICKORY, 28602 Address: 3778 MATTINGLY DR LRK(REID): 600333 Address2: Deed Book/Page: 3719/0257 City: HICKORY Subdivision: HIDDEN CREEK ESTATES PHASE State/Zip: NC 28602-9771 III School Information: Lots/Block: 45/ School District: COUNTY Last Sale: $275,000 on 2022 01 25 Elementary School: BLACKBURN Plat Book/Page: 33/121 Middle School: JACOBS FORK Legal: PLAT 33-121 LOT 45 HIDDEN CREEK High School: FRED T FOARD ESTATES Calculated Acreage: .370 School Map Tax Map: 187H 10011 Township: HICKORY State Road #: 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: $137,300 Zoning2: Land Value: $16,500 Zoning3: Assessed Total Value: $153,800 Zoning Overlay: ED-O Year Built/Remodeled: 1993/ 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 #: 3710371000J If available, Building Permits for this parcel. Septic 2010 Census Block: 2070 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. r / 06151 ***Op. Permit and/or Cert. Op. Required " (Must be completed prior to final) C Pt.TAWBA COUNTY 14EA1,TH DEPA T•I-fENT , ,,../ (704) 465-8270 Lot Eval. Improve. Permit'' Repair Permit Cert. of Comp. Permi Oper. Permit Owner/Agent c &u P � Phone 3, 6 -- �77 Address �-0, /- -I ?Q Subdivision iyei [ Section/Block/Phase Lot#_ Lot Siz 7 Directions: c I- Facility: House (/ Mobile Home Business . Other: Tax Map # (?O1Y ' Multi-family, Other . Zoning Approval # 7-9 3 Oilfr,..51--.2.-6,48. Bedrooms Seats Employees . Application Rate t I GPD Flo4530 Hot Tub or Spa es/no Special Fixtures . 100% Repair Areagr/no REPAIR NOTICE: Basement yes( Basement Plumbi g yes/no . REPAIRS RUST BE WITHIN 30 DAYS OR Water Supply: Private Public [ . DAYS FROM DATE OF PERMIT. Type of System: Trench/./1;ed Pump Pump/Panel Panel LPP Other Tank Size: Septic Tank l 01(Yee ( Pump Tank Nitrification Field: Total Squ Feet 7 0 0 Depth of Stone be/ Bed Size Trench Width /r Total Length of All Trenches 270 0 Number of Trenches i " Individual Trench Length / 1`/ 2/x / Feet on Center 97 Maximum Trench Depth Distance of Nearest Well A///7- Lot Evaluation: Approved yes/no (Void After 24 months) Topo % Slope Sketch of lot Evaluation Site - System Design - Final Texture /5— 7 _ ... Structure ir l3 ! -.M -1.o AI 4 , Clay Min. Soil Wetness Soil Depth Restric. Hoz. at " 5"6V 5 f Available space yes/no � � 4t,:t Overall Class S PS U 0 Comments: 0N, ' q35t 1__ 'Xd /1!ft4.__ .2,W . Septic Tank Contractors MUST contact the , Sanitarian BEFORE i I i 7 changing permit. **NO GUARANTEE OR WARRANTY IS IMPLIED OR GIVEN THROUGH THE ISSUANCE OF THIS PERMIT** Permit Date )--1 :- Q.3 (Improvement Permit void a ter 60 months) ,=•#'. Owner/Agent / an tarian Installed By ( Date/ t,Sanitarian s�,- ( ote an angs/informatio i red or by sketc '_,on b ck) IF A PERMIT HAS TO E REDESIGNM A103/O11 RETRIPS MADE TO..THE; PROPERTY. THERE IS AN ADDITIONAL $25 CHARGE. r`,.• '" White-Office Blue-Bldg. Insp. Comp. Yellow-Owner/Agent ..een-Bldg. Insp. I .P. • CAI'AWBA COUNTY `� G I00A SOUTHWEST BLVD • : NEWTON,NORTH CAROLINA 28658 RECEIPT oafil O PHONE:828.465.8399 Wednesday,May 25,2022 18 42 $M www.catawbacountync.gov PAYOR: Davidson,Chris PAYMENTS TRANSACTION NUMBER: 'I'RC-40483658-25-05-2022 PAYMENT DATE: 05/25/2022 PAYMENT TYPE: Credit Card 290289549 INVOICE NUMBER ACCOUNT FEE NAME FEE AMOUNT 05-22-406937 110-580200-663000 Authorization to Construct(Repair) S150.00 Fee TOTAL PAYMENTS: S150.00 EHPR-05-2022-41149 CASE TYPE: Environmental Health Plan Review WORK CLASS: Septic Malfunction SITE ADDRESS: 3778 MATTINGLY DR,HICKORY NC 28602 Applicant CI IRIS DAVIDSON,3778 MATTINGLY DR,I IICKORY NC 28602 H:9106609442 CHRISD9174 a YAHOO.COM **NO PEOPLESOFT ACCOUNT ASSIGNED** receipt 05/25/2022 12.07 Page 1 of