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HomeMy WebLinkAboutEHPR-06-2022-41236.tif g'A • THIS IS NOT A PERMIT Case# EHPR-06-2022-41236 CATAWBA COUNTY HEALTH DEPARTMENT O PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES Ig. 2 sM Environmental Health Plan Review-Septic Malfunction AUTH CONST- SEPTIC MALFUNCTION Applicant STEPHANIE,BLIZZARD,2102 SIPE RD,CONOVER NC 28613 C:8283124487 STEPI IANIEBLIZZARD.1(ci)GMAIL.COM Contractor COOL PARK PUMPING, 1535 VICTORIAN HILLS CIR,CONOVER NC 28613 C:8282171596 OTIIER:828-256-2926 41SENHOUR@GMAIL.COM NAME TO APPEAR ON PERMIT Stephanie Blizzard SITE ADDRESS: 2102 SIPE RD,CONOVER NC 28613 PIN# 372308980024 NAME of SUBDIVISION: Lot# 4__ Section/Block PROPERTY SIZE: Square Feet 142,876.80 Acres 3.28 DIRECTIONS: Section House Rd, right Sipe Rd,house on left PRIMARY CONTACT: Contractor SEWER TYPE: Septic Tank GALLONS PER DAY: 480 WATER SUPPLY: Public Water DESCRIBE WORK: tank only tank lid is cracked falling in 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: 63 x 46 NUMBER OF EXISTING BEDROOMS: 4 #OF OCCUPANTS: PROPOSED CONSTRUCTION BASEMENT? Yes 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: ahapplicali,m 06/02/2022 14:03 Pagc 1 of6 .ty%fie CATAWBA COUNTY Case# EliPR-06-2022-41236 (b. t l Public Health Department Subdivision d -i "3 Environmental Health Division PIN# 372308980024 PO Box 389,100-A Southwest Blvd,Newton,NC 28658 w NAME ON PERMIT: (STEPItANIE BLIZZARD),2102 SIPE RD,CONOVER NC 28613 (Stephanie Blizzard) Site Address: 2102 SIPE RD,CONOVER NC 28613 Property Size: Square Feet 142,876.80 Acres 3.28 Directions: Section House Rd,right Sipe Rd,house 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 AREA2 FEENAME DATE FEE AMOUNT Authorization to Construct(Repair)Fee 06/02/2022 $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) chapplicauun 06/02/2022 14:03 Page 2 of 6 _kik, a Evy\e VW_ rAC atav►rba county t(1,�,� I G�. public health 4i)36) !/` I a al< On I L.f Application for Environmental Health Services ( THIS 1S NOT A PERMIT Application is for: 0 New Construction ❑EristingFacility ❑Improvement Permit ❑Authorization to Construct 1 ❑New Septic Septic Repair/Malfunction 0 Septic Relocation ❑Septic Expansion ❑Existing System Inspection or Reconnection ❑New Well 0 Replacement Well 0 Well Abandonment 0 Well Repair Property Address 210 Z f>>P c, RA-. Co n ov e-✓ [;C 2. (o L g Acres Subdivision Lots Driving Directions to Property 9(11-1Qn 1,10l �C it , un p .r nn 11)(-' W. hou it on left— Describe work KC. )L a l e. :it'...e+t C- fa_in >' Applicant Name a ()ha r1 I e- t3ILZ.Z.a y'2.-.. Applicant Address 21 QL S ; e. Rd , eL7,pt Dyer ni-_, L S 13 Phone a .k i 2- Q'7 Email 7*.p.{ ia D Iei_j)l 17 Z a i'a. I o 9 ?all• `i iYi Owner Name ,;(1iY1t1 aS Q.}?tcv&J Owner Address Phone Email _Contractor Name (fU I Pa ? Pu i'Y)p ii)Q_ — Set 2btn1'i - Contractor Address ,JJ Phone 8-7 k- . 11- ! :-a -1 G� _.- _., Email `1_1 Sc:r llow'{f O nac..2'. CO 011 Name to Appear on Permit? 0 Owner 0 Applicant Q C ntr4etor Who will be the Primary Contact? ❑Owner ❑Applicant atontraelor Proposed New Construction-Residential Primary Residence ❑ New Residence ❑ Addition to Residence q of New Bedrooms•t #of Occupants Project Description Structure Dimensions,also specify dimensions of decks&porches Basement 0 Yes ❑ No Basement Plumbing ❑Yes ❑ No Accessory Dwelling r of New Bedrooms of tr of Occupants Structure Dimensions _ Basement ❑Yes 0 No Basement Plumbing ❑Yes ❑ No Accessory Structure(s)Describe Structure(s)Dimensions Plumbing ❑Yes 0 No Describe Plumbing Needed Multi-Family Residence a of Apartments aBedrooms per Apartmcnt•t Total d Bedrooms in Structure'+ s of Occupants Structure Dimensions Basement ❑Yes ❑ No Basement Plumbing 0 Yes 0 No Well Construction/Abandonment/Repair Proposed Well Type ❑ lndisidual Well 0 Semi-Public Well ❑Community Well Abandonment Type ❑ Drilled ❑ Bored 0 Dug 0 Unknown Well Repair Requested ❑Yes ❑No Describe Will Certified Well Contractor Install Water Line or Electrical Line from Well}lead to Pressure Tank?❑Yes ❑No catawbacountyuc.gov Environmental Health tot,v;t:: J.Lily l.•:.. .,'',.:17 (emit 25 Go. r 1: .,. I PO Boa 389 I tii:Kton NC 2865B i 8? S "?-r: MAKING. LIVING. BETTER. Existing Structures on Site 1,� Describe 2_ s-to.►y12vick, home,, Structure Dimensions a of Bedrooms' ii $of Occupants 2- Basement [v'Yes ❑ No Basement Plumbing 0 Yes Q"No Existing Water Supply ❑Individual Well 0 Shared Well Number of Connections 0 Community Well EountyiCityiTownship Water Line Is a public water supply available?•' ❑ Yes 0 No Commercial 0 Proposed New Construction 0 Existing!Change of Use 0 Repair Food Service Specify Type #Seats Dining Area(Sq.Ft.) I` #Employccs per Shift #of Shifts Church #of Seats Daycare❑Yes 0 No it of Children #of Employees per Shift of Shifts Commercial Kitchen 0 Yes ❑No Residential Kitchen 0 Yes 0 No Daycare tt of Children a of Employees per Shift __ #of Shifts Business/Other Specify Type___ _ Structure Dimensions Retail Floor Space a of Employees per Shift 4 of Shifts Other Information Calculated Design How,Commercial+ ___(This value will be determined by EH staff) The Applicant shalt 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 (H"No Does the site contain any jurisdictional wetlands? ❑Yes I No Does the site contain any existing wastewater systems? ❑Yes eNo Is any wastewater going to be generated on the site other than domestic sewage? ❑Yes L9/'No Is the site subject to approval by any other public agency? ❑Yes t_7 No Arc 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 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 Authonzation to Constrict. RETRIP TO THE PROPERTY AND/OR SYSTEM REDESIGN WILL INCUR AN ADDITIONAL CHARGE ISEE FEE SCHEDUI.EI Environmental Health soilisitc 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 arc 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;sitc plan changes or if the intended use for the proposed facility changes.Permits may be revoked if site conditions arc 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 arc 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 t(i i) � _ r Date�j-Z`2 2—Printed Name of Owner or Legal Agent ( r 1,,r el pi -__cei Catawba County Environmental Health • , 8384 30.95 s I.:'•' 410.04 6156 • 204 41'. \ •2102 Z 2 Ill ,1 0024 ...I O .4 \ � r • { 09) CO N tf 8955 7913 1 •2132 y . 64 221) 142.12 188.72 106.45 SIPS R4 -o co Z. {165) to (4381 Zti 1s _ - \ ',-, .112093 13 _ cf -\ - t _ \ .2119 • • k 2672 Parcel: 372308980024, 2102 SIPE RD 1 in=100ft CONOVER, 28613 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 06/02/2022 Parcel Report - Catawba County NC Parcel Information: Owner Information: Parcel ID: 372308980024 Owner: BLIZZARD PHILLIP A Parcel Address: 2102 SIPE RD Owner2: BLIZZARD STEPHANIE D City: CONOVER, 28613 Address: 2102 SIPE RD LRK(REID): 63369 Address2: Deed Book/Page: 3254/0930 City: CONOVER Subdivision: State/Zip: NC 28613-8820 Lots/Block: 4/ School Information: Last Sale: School District: COUNTY Plat Book/Page: 25/91 Elementary School: SNOW CREEK Legal: TR 4 PLAT 25-91 Middle School: ARNDT Calculated Acreage: 3.280 Tax Map: 2100 00006E High School: ST STEPHENS Township: CLINES School Map State Road #: 1492 TaxNalue Information: Tax Rates(pdf) Zoning Information: City Tax District: All in County Zoning District: COUNTY County Fire District: ST STEPHENS Zoning1: R-20 Building(s) Value: $298,600 Zoning2: Land Value: $34,000 Zoning3: Assessed Total Value: $332,600 Zoning Overlay: Year Built/Remodeled: 1992/ Small Area: ST STEPHENS/OXFORD 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 #: 3710372300J If available, Building Permits for this parcel. Septic 2010 Census Block: 2002 links are not permits. 2010 Census Tract: 010303 Septic Final Permits prior to 08/2018, contact Agricultural District: Environmental Health. Building Details WaterShed: Voter Precinct: P29/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. {_ : ; 3d ° 04482 CATAWBA CDUNTY '' HE`ALTH DEPART NT ' (704) 465-8270 Lot Eval. / improve. Permit y Repair Permit Cert. of Comp. Permit Oper. Permit Owner/Agent /epai-;-4 JB Y►�P l r:(,Q�i�'- .---�i (_ Phone LI 9 S `l5 i.F a- Address R -/ /"�9x� . trill,, b- -cP./4C, 1.ea-/ Subdivision Section/Block Lot# Lot Size 3- 74/ Directions: Cc9t vac 6mk.. Ail - t,C,k / `7" Facility: House 47M4obile Home Business . Other: Zoning AperpiaJ64/no # 15-6 lW Multi-family Other . 100% Repair Areano Bedrooms Seats Employees . GPD Flow e) Application Rate Hot Tub or •a yes/no Special Fixtures . REPAIR NOTICE: REPAIRS MUST BE WITHIN Basement 0/no Basement Plumbing es no . 30 DAYS OR DAYS FROM DATE OF Water Supp y: Private Public . PERMIT. * Type of System: Trench[/ Bed Pum/p//��. Pump/Panel Panel LPP Other Tank Size: Septic Tank /OOO 9d ? M.-ii Pump Tank Nitrification Field: Total Square Feet /r10O Depth of Stone /dl/ Bed Size Trench Width 3 Total Length of All Trenches L/DD Number of Trenches L� Individual Trench Length /y) IfN / //'}}Feet on Center y/r Maximum Trench Depth 2CC r/ Distance of Nearest Well A/f Lot Evaluation: Approved yes/no (Void After 24 months) Topo 3'-S Slope Sketch of lot Evaluation Site - System Design - Final = Texture /3 / Structure ��,('> �, , l�n..444:4 .: Al er - • • - • 1 -z �r 1-,; - .- Clay Min. /' // wX°4`" , Soil Wetness 6/j/3 " y 3X /oa `, Soil Depth /�� " — ,.r�`¢'" ` Restric. Hoz. at 1� Available space 6y /no '�_ . \ Overall Class S U Comments: • z -, rn ,p-' ,/ Cam'. G ,t, A &r�B-(1-L /� - C., oC. **NO GUARANTEE OR WARRANTY IS IMPLIED OR GIVEN THROUGH .THE'ISSUANCE OF THIS PERMIT** Permit Date .—a 6 `7-9 (Improvement Permit void after 60 months) Owner/Agent . _ Sani rian _ Q.2t_.� • S� Installed By Date ;(1 1.San tartan _ (No a any changes/i formation in red or by sketch on bak) White-Office Blue-Bldg. Insp. Comp. Yellow-Owner/Agent Green-Blame nsp. I.P. �A �� CATAWBA COUNTY „{„ a 100A SOUTHWEST BLVD j NEWTON,NORTH CAROLINA 28658 RECEIPT f,� i.�+ PHONE:828.465.8399 �:.,� Thursday,June 2,2022 1$42 sM www.catawbacountync.gov PAYOR: Blizzard,Stephanie PAYMENTS TRANSACTION NUMBER: TRC-40955997-02-06-2022 PAYMENT DATE: 06/02/2022 PAYMENT TYPE: Credit Card 290755938 INVOICE NUMBER ACCOUNT FEE NAME FEE AMOUNT 06-22-407258 110-580200-663000 Authorization to Construct(Repair) $150.00 Fee TOTAL PAYMENTS: S150.00 EHPR-06-2022-41236 CASE TYPE: Environmental Health Plan Review WORK CLASS: Septic Malfunction SITE ADDRESS: 2102 SIPE RD,CONOVER NC 28613 Applicant STEPHANIE BLIZZARD,2102 SIPE RD,CONOVER NC 28613 C:8283124487 STEPHANIEBLIZZARD.1@GMAIL.COM **NO PEOPLESOFT ACCOUNT ASSIGNED** Contractor COOL PARK PUMPING, 1535 VICTORIAN HILLS CIR,CONOVER NC 28613 C:8282171596 4ISENHOUR@GMAIL.COM receipt 06/02/2022 14:02 Page I of l