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HomeMy WebLinkAboutRBPR-07-2022-41613.TIF • THIS IS NOT A PERMIT Case# RBPR-07-2022-41613 w.. CATAWBA COUNTY HEALTH DEPARTMENT PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES 18 w Residential Building Plan Review-Manufactured Home NEW WELL - EXS SYSTEM Applicant CLAYTON HOMES#81 (UNLICENSED GC-BILLING ACCT), 1230 CONOVER BLVD W,CONOVER NC 28613 B:8284653450 C:8283083200 JOSHUA.FOUNTAIN@CLAYTONHOMES.COM Contractor CLAYTON HOMES#81 (UNLICENSED GC-BILLING ACCT), 1230 CONOVER BLVD W,CONOVER NC 28613 B:8284653450 C:8283083200 JOSHUA.FOUNTAIN@CLAYTONHOMES.COM Owner GAVIN GRIFFIN,2826 COMMUNITY RD,CLAREMONT NC 28610 C:8283523474 NAME TO APPEAR ON PERMIT Clayton Homes #81 (unlicensed GC- billing Acct) SITE ADDRESS: 2826 COMMUNITY RD,CLAREMONT NC 28610 PIN# 375302873534 NAME of SUBDIVISION: Lot# Section/Block PROPERTY SIZE: Square Feet Acres 0.95 DIRECTIONS: Hwy 16 N;Right Shook RD, Left Community,lot on Left PRIMARY CONTACT: Applicant SEWER TYPE: Septic Tank GALLONS PER DAY: 240 WATER SUPPLY: Private Well DESCRIBE WORK: New 2 bedroom Double Wide Manufacture home w/2-6x6 decks front/back 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? Yes Are there any easements or right-of-ways on this property? No APPLICATION FOR: New Structure STRUCTURE TYPE: PRIMARY RESIDENCE FACILITY TYPE: Mobile Home OTHER DESCRIPTION: DESCRIPTION OF single wide MH will be removed EXISTING STRUCTURES ON SITE(IF ANY) DIM EXISTING STRUCTURE: 14x70 NUMBER OF EXISTING BEDROOMS: 2 #OF OCCUPANTS: 4 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 28x56;2-6x6 decks #OF NEW BEDROOMS:: 2 Desired system types(Improvement Permit or Authorization to Construct): ACCEPTED: ALTERNATIVE: CONVENTIONAL: OTHER: INNOVATIVE: ANY: YES Other described: APPLICATION FOR WELL CONSTRUCTION PROPOSED WELL TYPE: Individual Well REPLACE WELL?: NO ehapplication 07/11/2022 12:15 Page I of') • �g \ CATAWBA COUNTY Case# RBPR-07-2022-41613 �*�� Public Health Department Subdivision Environmental Health Division PIN# 375302873534 �-\\ PO Box 389, 100-A Southwest Blvd,Newton,NC 28658 NAME ON PERMIT: CLAYTON HOMES#81 (UNLICENSED GC-BILLING ACCT) ( ), 1230 CONOVER BLVD W,CONOVER NC 28613 Clayton Homes#81 (unlicensed Site Address: 2826 COMMUNITY RD,CLAREMONT NC 28610 Property Size: Square Feet Acres 0.95 Directions: Hwy 16 N;Right Shook RD,Left Community,lot 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: 3" II- ZZ Signature of Applicant or Agent 'fir_ If you need further information or assistance please call 828-465-8270 AREA2 SETBACKS: Underpinning-undecided but vinyl not acceptable FEENAME DATE FEE AMOUNT Existing Tank Check Fee 07/11/2022 $80.00 Well Permit&Inspection Fee 07/11/2022 S300.00 TOTAL FEES S380.00 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) ehappl ic3tion 07/11/2022 12:15 Page 2 of 3 ��P�Z a't-ao�a - lt� . , . a catawba county 13 public health Application for Environmental Health Services THIS IS NOT A PERMIT Application is for: ❑New Construction ❑ Existing Facility ❑ Improvement Permit 0 Authorization to Construct ❑New Septic ❑ Septic Repair/Malfunction ❑ Septic Relocation ❑ Septic Expansion Existing System Inspection or Reconnection [,f New Well El Replacement Well ❑ Well Abandonment ❑ Well Repair Property Address 1,J2.12 COtYtrnunii) (+.d Clnr•nnont- tic 20010 Acres Subdivision Lot# Driving Directions to Property Describe work Applicant Name Clayton Homer of mow Applicant Address Ino t,anover g.wci i (ontver, nlc 2P310t3 Phone l,glM) 4125- 3450 Email IiCO'1\ 6 t;lhyl'orOno . co+.., Owner Name (70tvin (Mr' Owner Address L2Wo LOrr"An‘ty la Ctostmortt,NC I.b410 Phone (eze) 351- 3 4}y Email Contractor Name Clmihn *YAM o4' (onoYQY Contractor Address tZbo COWN/Y 8lIci W COYtovci, NC 2V1913 Phone (02.0 465- 3y5o Email h'Coe/e Cosytvr, hco e4. Ohl Name to Appear on Permit? ❑ Owner El Applicant ❑Contractor Who will be the Primary Contact? El Owner [l Applicant El Contractor Proposed New Construction-Residential Primary Residence [l New Residence ❑ Addition to Residence #of New Bedrooms*1. 'a Z #of Occupants 4 Project Description 1..tp(Q (V1Y(Im \a,(, With am a 4.41,4m, Structure Dimensions,also specify dimensions of decks&porches LPj X EA, / 2. 0 x .0 = 'I2 Sc1. k (Choose One) ❑Basement ❑Crawl Space ❑ Slab If Basement,Will There Be Water Using Fixtures In Basement ❑Yes ❑ No Retaining Wall>2' ❑ Yes El No Accessory Dwelling #of New Bedrooms*t #of Occupants Structure Dimensions (Choose One) ❑Basement ❑Crawl Space 0 Slab If Basement,Will There Be Water Using Fixtures In Basement ❑ Yes ❑ No Retaining Wall>2' ❑ 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 0 No Multi-Family Residence #of Apartments #Bedrooms per Apartment*t Total#Bedrooms in Structure*t #of Occupants Structure Dimensions (Choose One) 0 Basement 0 Crawl Space ❑ Slab If Basement,Will There Be Water Using Fixtures In Basement ❑Yes ❑ No Retaining Wall>2' ❑ 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 El Yes El No Describe Will Certified Well Contractor Install Water Line or Electrical Line from Well Head to Pressure Tank?[ Yes El No Environmental Health Catawba County Government Center, 25 Government Drive I PO. Box 389, Newton, NC 28658 Phone: (828)465-8270 I Fax: (828)465-8276 I EHAdmin@CatawbaCountyNC.gov • Existing Structures on Site Describe 14 X 1Q SW Structure Dimensions #of Bedrooms * #of Occupants Lt Basement ❑ Yes 171 No Basement Plumbing ❑ Yes [l No Existing Water Supply ❑Individual Well IY1 Shared Well—Number of Connections z ❑ Community Well ❑County/City/Township Water Line Is a public water supply available? ** ❑ 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. If the answer to any question is"yes",applicant must attach supporting documentation. DJ Yes MI No Does the site contain any jurisdictional wetlands? Old Yes 0 No Does the site contain any existing wastewater systems? q Yes d No 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? 0 Yes an 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 0 Conventional 0 Innovative ❑Other l!(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 Date `7- Printed Name of Owner or Legal Ag • catawba county Geospatial MAKING. LIVING. �rr,r�. Information Services Real Estate Search k'" 204.8 1,4 rt(P it)9 Za x ,t I ! SUS 7o r-e 017 Woq 04' N.,.A' o{ill r 00 COMMUNITY RD W E 1 in=60ft 5 Parcel: 375302873534, 2826 COMMUNITY RD CLAREMONT, 28610 Owners: GRIFFIN GAVIN DOUGLAS, Owner Address: 2826 COMMUNITY RD Values - Building(s): $0, Land: $12,800, Total: $12,800 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 narznr9n99 • Parcel Report - Catawba County NC Parcel Information: Owner Information: - 1 owners Parcel ID: 375302873534 Owner: GRIFFIN GAVIN DOUGLAS Parcel Address: 2826 COMMUNITY RD Owner2: City: CLAREMONT, 28610 Address: 2826 COMMUNITY RD LRK(REID): 66082 Address2: Deed Book/Page: 3719/0464 City: CLAREMONT Subdivision: State/Zip: NC 28610-9677 Lots/Block: Y/ School Information: Last Sale: School District: COUNTY Plat Book/Page: 27/12 Elementary School: OXFORD Legal: Calculated Acreage: .950 Middle School: RIVER BEND High School: BUNKER HILL Tax Map: 2400 00002B Township: CLINES School Map State Road #: 1710 TaxNalue Information: Tax Rates(pdf) Zoning Information: City Tax District: All in County Zoning District: COUNTY County Fire District: OXFORD Zoning1: R-30 Building(s)Value: $0 Zoning2: Land Value: $12,800 Zoning3: Assessed Total Value: $12,800 Zoning Overlay: DWMH-O,WP-O 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 #: 3710375300J If available, Building Permits for this parcel. Septic 2010 Census Block: 2011 links are not permits. 2010 Census Tract: 010101 Septic Final Permits prior to 08/2018, contact Agricultural District: PROXIMITY Environmental Health. Building Details ��11 WaterShed: WS-IV Protected Area E1,1 5-f Sic /itSp Voter Precinct: P27/Voting Map $80 p B 'e 2t/Dspo Parcel Report Data Descriptions Minor Subdivision: ERIC B BUMGARNER P&Z Case Number: �n i Die 1 , $3Q b Mobile Home Park: E911 District: COUNTY ( Vc�W 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. T. • CATAWBA COUNTY HEALTH DEPARTMENT Lot Evaluation Improvement Permit X Repair Permit Ccrrpletion Fermi ' { 0 Owner/Agent /`,L1477244114-) Phone Address Subdivision Set}on/ lock Lot Lot Size Direct ions: -/y 8,�. , J Gt .� > - d- ice 07.. . Facility: House Mobile Hare>C Business ' Other: Zoning Approval /no # 13 a 6 7 Multi-family Other : 100% Repair Area()no Bedroans 3 Baths Seats Employees : GPD Flow Application Rate Garbage Disposal Special Fixtures : REPAIR NDTICE: REPAIRS MUST BE WITHIN 30 Basement yes/P5b Basement Plumbing yes/0 : DAYS OR DAYS Hsi DATE OF PERMIT. Water Supply: Private Public s* ******************* **********i***LALAAA ******************* ***t***,tit Type of System: Trench X Bed System_ Other (Specify) Tank Size: Septic Tank /0(,b Pump Tank Nitrification Fiel(d�: Total Square Feet 73') Depth of Stone /Z " Bed Size Trench Width 3 £'Ir Total Length of All Trenches c2,5O Number of Trenches off- • - Individual Trench Length/c//Z.5/ / / Feet on Center 9 Maximum Trench Depth o?'/ Distance to Nearest Well 4- 50 424, Lot Evaluation: Approved X Disapproved ******************-r*t****-****** h********************************************************* Sketch of Lot Evaluatf&3 (� System Design - Final / fD `0` ( 1{iol,4rr,e AUA- le. InTQcep7Iii- 5v J , . h�i1 1 I dra��► he Y��ar�� / 1 ( 1 ro-t,�,.Q- Waite re-!Phis t ,r (f peele• I I _ _ _____._._l___, .__. i (yule 1 I r I l-o Uye 1 ' f� I I — Q • \CI '"c:''' ( l c l Permit Date /i m D 9 D (Lot Evaluation and Improvement Pe vo /a 6 mon•hs) Owner/Age n t� ��) San it ar Installed / By /�! / Zawl (24.0,14:/ Date A ZJ 2�Sanitari (Note any c ges/informatio red or by sketch an ack) Topo S PS U Drainage S PS U Depth S PS U Restrictive Hoz. S PS U Space S PS USoi1 S PS U III Loams: Sandy Clay, Silt, Clay, Silty Clay ;6-.4 Ilia Clays: Sandy, Silty, Clay .4-.2 WHITE•OFFICE COPY YELLOW•OWNER/AGENT COPY