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HomeMy WebLinkAboutEHPR-07-2022-41688.tif \ • THIS IS NOT A PERMIT Case# EHPR-07-2022-41688 cr r� � CATAWBA COUNTY HEALTH DEPARTMENT \V\ r I PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES 4847 ; tM Environmental Health Plan Review- Septic Malfunction • AUTH CONST-'SEPTIC MALFUNCTION Applicant LEVITATE MANAGEMENT INC,3102 KOOL PARK RD NE LOT 1,HICKORY NC 28601 B:8282165907 KOOLPARKMHPCGMAIL.COM Owner 3102 KOOL PARK ROAD NE TRUST, 1412 COLLIER ST A,AUSTIN TX 78704, Paid By KOOL PARK SERVICES•LLC, 15902 68TH AV CT E,PUYALLUP WA 98375 NAME TO APPEAR ON PERMIT LEVITATE MANAGEMENT INC SITE ADDRESS: 3102 KOOL PARK RD NE 3,HICKORY NC 28601 PIN# 372419517897 NAME of SUBDIVISION: Lot# Section/Block PROPERTY SIZE: Square Feet 540,144.00 Acres 12.4 DIRECTIONS: Springs Rd,left Kool Park Rd,mobile home park on left PRIMARY CONTACT: ' Applicant SEWER TYPE: Septic Tank GALLONS PER DAY: i 600 WATER SUPPLY: Community Well DESCRIBE WORK: Failing Septic see complaint EH-05-2022-9528 septic system serves lot 2 and 3 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: Mobile Home OTHER DESCRIPTION: DESCRIPTION OF lot 2 14x76 3br, lot 3 12x542 br EXISTING STRUCTURES ON SITE(IF ANY) DIM EXISTING STRUCTURE: NUMBER OF EXISTING BEDROOMS: 5 #OF OCCUPANTS: 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: chapplicni,m 07/19/2022 10:24 Page 1 of6 1,4 \ CATAWBA COUNTY Casey EHPR-07-2022-41688 alllitl •\ Public Health Department F L �Q 2 Subdivision 4 "-I Environmental Health Division �� Y PIN# 372419517897 / PO Box 389,100-A Southwest Blvd,Newton,NC 28658 /84 ' NAME ON PERMIT: LEVITATE MANAGEMENT INC ( ),3102 KOOL PARK RD NE LOT I,HICKORY NC 28601 LEVITATE MANAGEMENT INC Site Address: 3102 KOO1.PARK RD NE 3,HICKORY NC 28601 • Property Size: Square Feet 540,144.00 Acres 12.4 Directions: Springs Rd,left Kool Park Rd,mobile home park 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 , #?tiitYk4kFt5#•#kk#tit#Y4i#t#tt#tt####t####4#t##M##t##******YY****4*4****4**'*S*%}R#t#Riik#ittk#tt#kittf4i l:i t' .,. r f . ".4< f ti x' Y is s b s, t , ^ t°P '"'�FEENAME'.',° �' . 4 w+ , lit � - .e f� a,.y`DATE ram` FEE AMOUNT Authorization to Construct(Repair) Fee 07/18/2022 $450.00 , '1 5 TOTALFEES i r-i ;sw"*"rtry- .'CAP ''` rcW4145000 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) • clmppliaitlon 07/19/2022 10:25 Page 2 of 6 • r • RECEIVED JUL 1 8 2022 Catawba 'county public health Environmental Health Application.for Environmental'Health Services _G l/ Qc ,Lsb TfiIS IS NOT A.PERMIT _6 ((( u ,i57 a v.,m:sl;,?�S�lxu.,°�'lr,�t16,<.` t.s�)Shy'Apphcahltn�rsfur.4�a >`�+I��p' <New�Cunstruchon6;e�,a, rlr ? ❑ Improvement Permrt ❑ 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 3102 Kool Park Rd Ne Lot 3 , Hickory NC 28601 aq,4d Acres Subdivision Kool Park Mobile Home Park Lot# 3 • Driving'Directions to Property From Springs Rd, West on Kool Park Road 1 Mile, Homesite is on the right Describe work Repair septic for home on existing lot at lot 3 in mobile home park • 1 D Applicant Name Levitate Management LLC RoelfIt/Kf1 YBgala. LI&M Applicant.Address. 3102 Kool Park Rd NE#1, Hickory NC 28601 Phone 828-216-5907 Cell Phone Same Owner Name 3102 Kool Park Road NE Trust Owner Address Same Phone Cell Phone ContractorName Cool Park Pumping License# 1099i Contractor Address 1535 Victorian Hills Cir Conover NC 28613 Phone 828-217-1596 Cell Phone Name to Appear on Permit? Downer ®Applicant ❑Contractor Who will be the Primary Contact? ❑ Owner; ®Applicant ❑Contractor O t "d itnt e,,I PE wa 9 , i•�9 i q 1•l1 u ! Y y 't' Y , P, Primary Residence 0 New Residence ❑ Addition to Residence #of New Bedrooms St '#of Occupants Project Description ' .. Structure Dimensions,also specify dimensions of decks.&.porches Basement ❑Yes ❑ No Basement Plumbing ❑Yes ❑ No Accessory Dwelling #of New Bedrooms st #of Occupants. Structure Dimensions Basement ❑Yes 0 No Basements Plumbing ❑ Yes ❑ No Accessory Structure(s)Describe Structures)Dimensions Plumbing ❑Yes ❑No Describe Plumbing Needed Multi-Family Residence #of Apartments . #Bedrooms per Apartments'!" Total#Bedrooms in Structure•t #of Occupants Structure Dimensions Basement ❑Yes ❑•No Basement Plumbing ❑Yes ❑ No WelFConstruction/Abandonment7Re`tarr,� :"a,;yl ` t rl 3" e s h' ' ' ,' ` "tk +r !iH°! '€;r 'wi !'r.,r q Proposed Well Type ❑ Individual Well ❑ Semi-Public Well ❑ Community Well Abandonment Type ❑ Drilled ❑ Bored ❑ 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 catawbacountync.gov Environmental Health Catawba County Government Center 25 Government Drive I PO Box 389 I Newton NC 28658 1828.465.8270 ' • MAKING. LIVING. BETTER. • E bsttng Structut u...f itt Describe o1 3 bp- 1 Structure Dimensions #of Bedrooms * #of Occupants to 13 )i'3IZ I)v.''/ Q1 Basement 0 Yes, ❑ No Basement Plumbing 0 Yes 0 No pyikede/ttltL rExishngW....8.4a , ,t..'..lt _ .i)b a °Is: i w;i tt 'j j jiil3lPins :';`. ., si t''i t+Ua'!' .. ; rW..«i ir" at +Ut` 0 Individual Well ❑ Shared Well—Ntmtber of Connections "Community Well ❑ County/City/Township Water Line Is a public water supply available?** 0 Yes 0 No pm' rick: 1(lbw «Commercial, iks Proposed New Co struUtut �Existing/�Change of Use'❑& pa_ry� r*itat Food Service Specify Type #Seats Dining Area(Sq..Ft.) #Employeesper Shift #of Shifts Church #of Seats Daycare❑ Yes ❑No #of Children #of Employees per Shift #of Shills Commercial Kitchen ❑ 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) The Applicant.shall notify the local health department upon submittal of this applicationif any of thefollowing apply to theproperty in question. If the answer to any question;is"yes",applicant must attach supporting documentation. o Yes ®No Does the site containianyjurisdictional'wetlands? 12l Yes 0 No Does the site contaiivany existing wastewater systems? ❑Yes Cil)No Is any wastewater,going;to be generated on the site other than domestic sewage? o Yes L$No is the site subject to;approval by any other public agency? ❑Yes l3 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 ❑.Altemative 0 Conventional ❑Iiutovative 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.Theauimber of bedrooms will be confirmed by'rooms identified on floor plats as-a bedroom at the time of building permit issuance. This may prevent the need,for septic systenf expansion in the future. t If structure is plumbed but:has no bedrooms,calculated design Bow 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) Completed applications are valid fora period of 2;years. lmprovementPermits 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 revoked if the information on this application/site plan changes or if the:ntended use for the proposed facility changes.Permits may be revoked if site conditions are altered such that they effect permit conditions or'nstallation requirements. 1 have read this application and certify that the information provided herein is true,complete and correct. Authorized county and state officials aregranted right of entry-to'conduct necessary inspections to determine compliance with applicable laws and rules. 1 understand that I am solely responsible for the proper identification and labeling of all property lines and corners and making the site accessible so thata-complete site evaluation can be performed. The undersigned is the owner of the property or legalagent of the owner. Signature of Owner or Legal Agent 'I Doti , Manager Date 7/1 B/2022 Printed Name of Owner or Legal Agent Levitate Management LLC, by Frederick Akker as Manager • Catawba County Environmental Health W r+.55 •2915 Ty •302$ 4111 _ +, q at1/4' .4•3: S to 45 45 ,,? ' 1 ' . ,1 a , 4 (1 V C 2927 `02-08 311 0 •281io 103 ,pt 4%3102-47 (�� N Rs 3102.2 ' _102�5 �3102-0673102-69 ■ �j • ..3102 U • '# 2 •3121 1 ,. �3102-3 •• 3 44 4 ?6/ 0 " I t-,-., L . 1J31024 3102143 �310219 �j ° ?,y 4 /,/3112.66 3102-5 310242, A. 310 96 • m �/3/1/0022 6 3�03102 40 3102=50131g02-64 F0,0 • t C! 1. 3102-8 �3�2-39% •A,ir �� • ,1 !n'1 d. • 3102-51 �3102-9 (t 0<A • 9s •2918 ... /� 'se J , m d/3102.10 1% Q 3102-53 3102;1 U /� PO BOY #3102-60 /, ' 0102.11 1.0 V 4 i3102-12 iF Q 3102`53�3102-�9 0.90 63102.13 523102`4 V 3102-58 4,102-14 V 63102 93 %3102.54 29T 102'? • 31032 3102-57 HAlENE \2 \3102.56 • 3102-15� 3102-16• 3102 ; , 3102-55 8 • 3102-30 v •2840 CC 3102-17dy3102 ; �,/�l! 3102-I- �\\ �31.02-26 8 U gi 310127\ C" %3102-19 65102-28 31'_02 25 5.3 � 3102424\ 6 0102-20 3102423 G '3102=21 8 •= F4 444. • 104, •3220 43 A Parcel: 372419517897, 3102 KOOL PARK RD 1in=200ft NE HICKORY, 28601 • 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 07/19/2022 • Parcel Report - Catawba County NC Parcel Information: Owner Information: .Parcel ID: 372419517897 Owner: 3102 KOOL PARK ROAD NE TRUST Parcel Address: 3102 KOOL PARK RD NE Owner2: SMITH SCOTT ROYAL TRUSTEE City: HICKORY, 28601 Address: 1412 COLLIER ST STE A LRK(REID): 56171 Address2: Deed Book/Page: 3613/0178 City: AUSTIN Subdivision: State/Zip: TX 78704-2932 Lots/Block: / School Information: Last Sale: Plat Book/Page: School District: COUNTY Elementary School: SNOW CREEK Legal: Calculated Acreage: 12.400 Middle School: ARNDT High School: ST STEPHENS Tax Map: 165H 01001 School Map Township: HICKORY State Road #: 1400 Tax/Value Information: Tax Rates(pdf) Zoning Information: City Tax District: All in County Zoning District: HICKORY County Fire District: ST STEPHENS Zoning1: R-1 Building(s)Value: $85,400 Zoning2: Land Value: $260,800 Zoning3: Assessed Total Value: $346,200 Zoning Overlay: Year BuilURemodeled: / Small Area: 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 #: 3710372400J If available, Building Permits for this parcel. Septic 2010 Census Block: 1002 • links are not permits. 2010 Census Tract: 010301 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. • • KA •• CAI'AWBA COUNTY f ��\ IOOA SOUTHWEST BLVD NEWTON,NORTH CAROLINA 28658 RECEIPT 1-3 1109 ® ,�,C PHONE:828.465.8399 • Tuesday,July 19,2022 "-Ls42 sm www.catawbacountync.gov PAYOR: Kool Park Services LLC Kool Park Services LLC • PAYMENTS TRANSACTION NUMBER: TRC-43688556-19-07-2022 PAYMENT DATE: .07/19/2022 PAYMENT TYPE: Credit Card 292600093 INVOICE NUMBER ACCOUNT FEE NAME FEE AMOUNT 07-22-409281 110-580200-663000 Authorization to Construct(Repair) $450.00 Fee TOTAL PAYMENTS: S450.00 EHPR-07-2022-41688 CASE TYPE: Environmental Health Plan Review WORK CLASS: Septic Malfunction SITE ADDRESS: 3102 KOOL PARK RD NE 3,HICKORY NC 28601 Applicant LEVITATE MANAGEMENT INC,3102 KOOL PARK RD NE LOT I,HICKORY NC 28601 B:8282165907 KOOLPARKMHPnGMAIL.COM Owner 3102 KOOL PARK ROAD NE TRUST, 1412 COLLIER STA,AUSTIN TX 78704 Paid By KOOL PARK SERVICES LLC, 15902 68TH AV CT E,PUYALLUP WA 98375 **NO PEOPLESOFT ACCOUNT ASSIGNED** • • • • •receipt 07/19/2022 10:23 Page 1 oft