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HomeMy WebLinkAboutEHPR-06-2022-41519.tif 1F'A • THIS IS NOTA PERMIT Case# EHPR-06-2022-4 1 5 1 9 �' G CATAWBA COUNTY HEALTH DEPARTMENT d G PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES 1842 sM Environmental Health Plan Review- Septic Malfunction AUTH CONST- SEPTIC MALFUNCTION Applicant DEENA WALKDEN,PO BOX 340256,AUSTIN TX 78734 B:6056465563 DEENA.WOODLANDLEASING rr GMAIL.COM Contractor LOOSE ENDS REPAIR (BRANI)ON MARTIN),6499 GEORGE HILDEBRAN SCHOOL RD,HICKORY NC 28602 B:8282174138 Paid By URI MINKOFF,404 EDGEWOOD AV,CLEARWATER FL 33755 NAME TO APPEAR ON PERMIT Deena Walkden SITE ADDRESS: 5441 EDEN LN,CONOVER NC 28613 PIN# 373408778578 NAME of SUBDIVISION: Lot# Section/Block PROPERTY SIZE: Square Feet 234,352.80 Acres 5.38 DIRECTIONS: Springs Rd,left Turtle Dove Rd,right Eden Ln,left to stay on Eden Ln,home on left PRIMARY CONTACT: Contractor SEWER TYPE: Septic Tank GALLONS PER DAY: 360 WATER SUPPLY: Public Water DESCRIBE WORK: current system failing reconnect to different septic system 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? Yes Property Easements Description: driveway APPLICATION FOR: Existing Structure STRUCTURE TYPE: PRIMARY RESIDENCE FACILITY TYPE: Mobile Home OTHER DESCRIPTION: DESCRIPTION OF 14 x 68 EXISTING STRUCTURES ON SITE(IF ANY) DIM EXISTING STRUCTURE: NUMBER OF EXISTING BEDROOMS: 3 #OF OCCUPANTS: 4 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: �6n�,pli�:;ron 06/30/2022 14:24 Page 1 of 6 .41B: • CATAWBA COUNTY Case# EHPR-06-2022-4 1 5 19 .1, Public Health Department 2 Subdivision H Environmental Health Division "� : PIN# 373408778578 PO Box 389,100-A Southwest Blvd,Newton,NC 28658 18 su NAME ON PERMIT: (DEENA WALKDEN),PO BOX 340256,AUSTIN TX 78734 ( Deena Walkden) Site Address: 5441 EDEN LN,CONOVER NC 28613 Property Size: Square Feet 234,352.80 Acres 5.38 Directions: Springs Rd,left Turtle Dove Rd,right Eden Ln,left to stay on Eden Ln,home 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 #######444##4#i FEENAME DATE FEE AMOUNT Authorization to Construct(Repair) Fee 06/30/2022 $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) _L::pplic:!is•u 06/30/2022 1424 Page 2 of 6 , , , Catawba county public health Application for Environmental Health Services I ,��I (� � THIS IS NOT A PERMIT (./ Ott Application is for: 0 New Construction 0 Existing Facility ❑ Improvement Permit Authorization to Construct :New Septic ®Septic Repair/Malfunction ❑ Septic Relocation ❑ Septic Expansion ❑ Existing System Inspection or Reconnection ❑ New Well ❑ Replacement Well ❑Well Abandonment ❑Well Repair Property Address 5441 Eden Lane,Conover NC 28613 Acres Subdivision Conover MHP Lot# Driving Directions to Property Describe work Need to reroute the septic lines to a different septic tank Applicant Name Deena Walkden Applicant Address PO BOX 340256,Austin,TX 78734 Phone605-646-5563 Email deena.woodlandleasing@gmail.com Owner Name Uri Minkoff Owner Address 404 Edgewood Ave,Clearwater, FL 33755 Phone Email Contractor Name Brandon Martin Contractor Address Phone Email Name to Appear on Permit? ®Owner ®Applicant ®Contractor Who will be the Primary Contact? 0 Owner ®Applicant ®Contractor Proposed New Construction-Residential Primary Residence 0 New Residence ❑ Addition to Residence #of New Bedrooms *t #of Occupants Project Description Structure Dimensions,also specify dimensions of decks&porches (Choose One) ❑Basement ❑Crawl Space ❑ Slab If Basement,Will There Be Water Using Fixtures In Basement ❑Yes ❑ No Retaining Wall>2' ❑ Yes ❑ No Accessory Dwelling #of New Bedrooms*t #of Occupants Structure Dimensions (Choose One) ❑Basement ❑Crawl Space ❑ Slab If Basement,Will There Be Water Using Fixtures In Basement ❑Yes ❑ No Retaining Wall>2' 0 Yes ❑ No Accessory Structure(s)Describe Structure(s)Dimensions Plumbing ❑ Yes ❑No Describe Plumbing Needed (Choose One) ❑Basement ❑Crawl Space ❑ Slab If Basement,Will There Be Water Using Fixtures In Basement ❑Yes ❑ No Retaining Wall>2' ❑ Yes ❑ No Multi-Family Residence #of Apartments #Bedrooms per Apartment*t 'Total#Bedrooms in Structure*t #of Occupants Structure Dimensions (Choose One) ❑Basement ❑Crawl Space ❑ Slab If Basement,Will There Be Water Using Fixtures In Basement ❑Yes El No Retaining Wall>2' ❑ Yes El No Well Construction/Abandonment/Repair Proposed Well Type ❑ 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 ❑No Environmental Health Catawba County Government Center, 25 Government Drive I P0. Box 389, Newton, NC 28658 Phone: (828)465-8270 I Fax: (828)465-8276 I EHAdmin@CatawbaCountyNC.gov Existing Structures on Site Describe 5441 Eden Lane, Conover NC 28613 Structure Dimensions Mobile home #of Bedrooms* 3 #of Occupants 4 Basement ❑Yes ® No Basement Plumbing El Yes ® No Existing Water Supply El Individual Well ❑ Shared Well—Number of Connections El Community Well ®County/City/Township Water Line Is a public water supply available? ** ® Yes El No Commercial El 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 El No #of Children #of Employees per Shift #of Shifts Commercial Kitchen ❑Yes ❑No Residential Kitchen ❑ Yes El 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. If the answer to any question is"yes",applicant must attach supporting documentation. ❑Yes 0 No Does the site contain any jurisdictional wetlands? Yes ll•No Does the site contain any existing wastewater systems? 0 Yes 0 No Is any wastewater going to be generated on the site other than domestic sewage? 0 Yes 0 No Is the site subject to approval by any other public agency? ❑Yes 0 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) 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 arc altered such that the effect ermit 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/agentt of the owner. P�-Signature of Owner or Legal Agent tfa— (�4217e4 G¢JZ Date 06.29.2022 Printed Name of Owner or Legal Agent Deena Walkden • Catawba County Environmental Health / / / I / f 5475 ' / 5743 •5475 / •5469 / / / / / / `547� / ``�474 / �/ / / / / --a5467 / 5.470 5461 / / / / / •54.64 / / `--463 /' /I �5466 57 / Zr/ •5460 _54 I/4 T5459 / / ^` ;V�i ri •5455 i 1 , / `15452 I •5458 •5449 / / I I / ���Jll 5451 / � � � ' 5443 / r 1 ��48 ' Fp N� / 5445 5d4/71 5437 LN \ r / •5442 r �j3 �26 54337 �� r 1 •5429 \ I 1?7 4 4 •5428 1 cow r oo' / 1 I 5333 •54`2 51 / I i ,.� // / `� / N 6248 •54 I / /r '1 _ / l • / / •1256 v •5421 1 / / (N.! / 773 •1246 / / /5.720 i9283 •5419 / / / lb kp Ott / / 3.45 / Rp r7,7J / / / 97.66 co` •51 / J/ /6 ?Jo Parcel: 373407688038, CONOVER, 28613 1in=80ft 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 06/30/2022 Parcel Report - Catawba County NC Parcel Information: Owner Information: Parcel ID: 373407688038 Owner: MUNOS MOISES PENA Parcel Address: Owner2: ALONSO JESSIKA RAMIREZ City: CONOVER, 28613 Address: 1318 TURTLE DOVE RD LRK(REID): 52097 Address2: Deed Book/Page: 3462/0499 City: CONOVER Subdivision: State/Zip: NC 28613-8551 Lots/Block: / School Information: Last Sale: $12,000 on 1988-06-01 School District: COUNTY Plat Book/Page: Elementary School: LYLE CREEK Legal. Middle School: RIVER BEND Calculated Acreage: 4.520 High School: BUNKER HILL Tax Map: 1500 00047 Township: CLINES State Road #: 1512 TaxNalue Information: Tax Rates(pdf) Zoning Information: City Tax District: All in County Zoning District: COUNTY County Fire District: ST STEPHENS Zoningl: R-20 Building(s) Value: $0 Zoning2: Land Value: $38,100 Zoning3: Assessed Total Value: $38,100 Zoning Overlay: Year Built/Remodeled: / 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 #: 3710373400J If available, Building Permits for this parcel. Septic 2010 Census Block: 1059 links are not permits. 2010 Census Tract: 010301 Septic Final Permits prior to 08/2018, contact Agricultural District: PROXIMITY Environmental Health. Building Details WaterShed: Voter Precinct: P29 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. - s3A CATAWBA COUNTY 100A SOUTHWEST BLVD acLiNEWTON,0 7 I NORTH HONE: 828.465(8399A 28658 RECEIPT V� Thursday,June 30,2022 I8 4'Vs M www.catawbacountync.gov PAYOR: Minkoff,Uri PAYMENTS TRANSACTION NUMBER: TRC-42583346-30-06-2022 PAYMENT DATE: 06/30/2022 PAYMENT TYPE: Credit Card 291856358 INVOICE NUMBER ACCOUNT FEE NAME FEE AMOUNT 06-22-408617 110-580200-663000 Authorization to Construct(Repair) S300.00 Fee TOTAL PAYMENTS: $300.00 EHPR-06-2022-41519 CASE TYPE: Environmental Health Plan Review WORK CLASS: Septic Malfunction SITE ADDRESS: 5441 EDEN LN,CONOVER NC 28613 Applicant DEENA WALKDEN,PO BOX 340256,AUSTIN TX 78734 B:6056465563 DEENA.WOODLANDLEASING@GMAIL.COM GMAIL.COM Paid By URI MINKOFF,404 EDGEWOOD AV,CI,EARWATER FL 33755 **NO PEOPLESOFT ACCOUNT ASSIGNED** Contractor LOOSE ENDS REPAIR,6499 GEORGE HILDEBRAN SCHOOL RD,I IICKORY NC 28602 B:8282174138 receipt 06/30/2022 14:23 Page I of 1