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HomeMy WebLinkAboutEHPR-08-2022-41875.TIF THIS IS NOTA PERMIT Case# EHPR-08-2022-41875 Q' fi a CATAWBA COUNTY I IEALTI I DEPARTMENT' d 0 PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES 1842 SM Environmental Health Plan Review-OSWP IMPROVEMENT Pthed dake1 Applicant VINO PAUL,5980 WILLOWBOTTOM RD,HICKORY NC 28602 C:8284935654 ALLENPAULELECTRIC@GMAIL.COM Owner LANCE&ELIZABETH SHEALY, 1413 WINDEMERE LN,HICKORY NC 28602 C:8647044526 NAME TO APPEAR ON PERMIT Vino PAUL SITE ADDRESS: 1444 SI IADOWFAX WYND,FIICKORY NC 28602 PIN # 268902980427 NAME.of SUBDIVISION: DEERFIELD 4 Lot fE 9 Section/Block PROPERTY SIZE: Square Feet 57,934.80 Acres 1.33 • RE IONS: S NC-127 Hwy,left onto Deerfield Ln,road name changes to Fawn Trail,right onto Shirebourn,right onto Willowbottom Rd,right onto Shadowfax Wynd ARY CONTACT: Applicant SEWER TYPE: Septic Tank GALLONS PER DAY: 480 WATER SUPPLY: Private Well DESCRIBE WORK: IP to purchase property 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? No 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: New Structure STRUCTURE TYPE: PRIMARY RESIDENCE FACILITY TYPE: House OTHER DESCRIPTION: DESCRIPTION OF EXISTING STRUCTURES ON SITE(IF ANY) DIM EXISTING STRUCTURE: NUMBER OF EXISTING BEDROOMS: #OF OCCUPANTS: 5 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 69x44 home, 12x12 back porch 12x18 future shed # 4 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: YES Other described: chapplicaunn 08/08/2022 1 0:11 Page 1 of 3 $A �� THIS IS NOT A PERMIT Case# EHPR-08-2022-4 1 8 75 1d118, CATAWBA COUNTY HEALTH DEPARTMENT ~' PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES Ig 2 sw Environmental Health Plan Review-OSWP IMPROVEMENT Applicant VINO PAUL,5980 WILLOWBOTTOM RD,HICKORY NC 28602 C:8284935654 ALLENPAULELECTRIC(iPGMAIL.COM Owner LANCE&ELIZABETH SHEALY, 1413 WINDEMERE LN,HICKORY NC 28602 C:8647044526 NAME TO APPEAR ON PERMIT Vino PAUL SITE ADDRESS: 1444 SHADOWFAX WYND,HICKORY NC 28602 PIN# 268902980427 NAME of SUBDIVISION: DEERFIELD 4 Lot# 9 Section/Block PROPERTY SIZE: Square Feet 57,934.80 Acres 1.33 DIRECTIONS: 127 into Mt View,turn right onto Deerfield subdivision take road in,left to stop then right at first top then right at secound,lot on the right PRIMARY CONTACT: Applicant SEWER TYPE: Septic Tank GALLONS PER DAY: 480 WATER SUPPLY: Private Well DESCRIBE WORK: IP to purchase property 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? No 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: New Structure STRUCTURE TYPE: PRIMARY RESIDENCE FACILITY TYPE: House OTHER DESCRIPTION: DESCRIPTION OF EXISTING STRUCTURES ON SITE(IF ANY) DIM EXISTING STRUCTURE: NUMBER OF EXISTING BEDROOMS: #OF OCCUPANTS: 5 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 69x44 home, 12x12 back porch #OF NEW BEDROOMS:: 4 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: YES Other described: ehappli::atiir 08/05/2022 11:04 Page 1 of 3 C• CATAWBA COUNTY Case# EHPR-08-2022-41875 •(...., Public Health Department Subdivision DEERFIELD 4 Environmental Health DivisionPIN# 268902980427 PO Box 389, 100-A Southwest Blvd,Newton,NC 28658 w NAME ON PERMIT: (VINO PAUL),5980 WILLOWBOTTOM RD,HICKORY NC 28602 (Vino PAUL) Site Address: 1444 SHADOWFAX WYND,HICKORY NC 28602 Property Size: Square Feet 57,934.80 Acres 1.33 Directions: 127 into Mt Mew,turn right onto Deerfield subdivision take road in,left to stop then right at first top then right at secound,lot on the right 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: g-5.-- 2 . Signature of Applicant or Agent r If you need further information or assistance please call 828-465-8270 AREA1 FEENAME DATE FEE AMOUNT Improvement Permit Fee 08/05/2022 $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) chapplicariun 08/05/2022 11:04 Page 2 of3 . • a catawba county public health Application for Environmental Health Services THIS IS NOT A PERMIT Application is for: .14 New Construction 0 Existing Facility Improvement Permit ❑Authorization to Construct New Septic ❑ Septic Repair/Malfunction ❑ Septic Relocation ❑ Septic Expansion El Existing System Inspection or Reconnection • ❑New Well t ❑ Replacement Well El Well Abandonment ❑Well Repair I EII!LI 511 a a)< ����}� Properq Address Acres tr, 33 Subdivision p �EL Lot# D 'vin Directions to Property p e_ Describe work - %'7 7 j/ 7E'S 7, 77/_ l /97- -„,/� Applicant Name NO Applicant Address ‘O Phone OZ Owner ame - ti pEmai1 /e4) L e�Q2/C 7ifiA4L ,Cell (� Owner Address ! � �%� /I l Phone (N) L�jrs _!- E Emaill /` �nYContraor Name `` �,,// Contractor Address �i L iL014A_COOff J120 Mere 66 Phone I Email T Name to Appear on Permit? ❑ Owner Applicant ❑Contractor Who will be the Primary Contact? El Owner fh Applicant ❑ Contractor Proposed New Construction-Residential Primary Residence KNew Residen e ❑ Addition to Residence #of New Bedrooms*�' #of Occupants 5Project Description caU,e/ /2D e 14 `G Structure Dimensions,also sp fy dimensions of decks&porches 6 X win /Z� 2- ���( (Choose One) ❑Basement wl Space ❑ Slab If Basement, ill There eWater Using win In Basement ❑Yes ❑ No bezic Retaining Wall>2' ❑ Yes No Accessory Dwelling #of New Bedrooms*t #of Occupants Structure Dimensions (Choose One) ❑Basement E Crawl Space ❑ Slab If Basement,Will There Be Water Using Fixtures In Basement ❑Yes ❑ No Retaining Wall>2' ❑ Yes ❑ No Accessory Structure(s)Describe %) i n s ,'}L rr Structure(s)Dimensions a_X fg Plumbing El Yes No Describe Plumbing Needed (Choose One) ❑Ba ementCrawl Space ❑ Slab If Basement,Will There Be Water Using Fixtures In Basement ❑ Yes El No Retaining Wall>2' ❑ Yes( No Multi-Family Residence #of Apartments #Bedrooms per Apartment*t Total#Bedrooms in Structure*1. #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' ❑ Yes ❑ No Well Construction/Abandon ent/Repair Proposed Well Type 0 Individual Well 0 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? PA Yes ❑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 Structure Dimensions #of Bedrooms* #of Occupants Basement ❑Yes ❑ No Basement Plumbing ❑ Yes ❑ No Existing Water Supply CI Individual Well ❑ Shared Well—Number of Connections ❑Community Well ❑ Cotmty/City/Township Water Line Is a public water supply available? ** ❑ Yes No Commercial ❑Proposed New Constructio El 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 0 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 j (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. I the answer to any question is"yes",applicant must attach supporting documentation. El Yes l No Does the site contain any jurisdictional wetlands? ❑Yes I No Does the site contain any existing wastewater systems? ❑Yes 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? ❑Yes 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 ❑Alternative 0 Conventional 0 Innovative ❑Other 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 die 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.Pennits 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 r legal agent of th owner. Signature of Owner or Legal Agent f, Date 7._5 -2L Printed Name of Owner or Legal Agent P u e 7/h? -- Catawba County Environmental Health •1428 65.42 co \CZ) 1e 420 r)s9 •1413 r t � o J f :77,\1444 1603 p 210.42 ,a Sp •6106 • t2$04 111141. RD /99.09 Parcel: 268902980427, 6106 WILLOWBOTTOM tin=60ft RD 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 08/05/2022 Page 1 of 1 Parcel Report - Catawba County NC Parcel Information: Owner Information: Parcel ID: 268902980427 Owner: SHEALY LANCE DERRICK Parcel Address: 6106 WILLOWBOTTOM RD Owner2: SHEALY ELIZABETH LEE City: HICKORY, 28602 Address: 1413 WINDEMERE LN LRK(REID): 90666 Address2: Deed Book/Page: 3157/1990 City: HICKORY Subdivision: DEERFIELD 4 State/Zip: NC 28602-9216 Lots/Block: 9/ Last Sale: School Information: School District: COUNTY Plat Book/Page: 29/12 Elementary School: MOUNTAIN VIEW Legal: LOT 9 DEERFIELD PL 29-12 Middle School: JACOBS FORK Calculated Acreage: 1.330 High School: FRED T FOARD Tax Map: 002AB 01009 Township: BANDYS School Map State Road #: 2725 TaxNalue Information: Tax Rates(pdf) Zoning Information: City Tax District: All in County Zoning District: COUNTY County Fire District: MOUNTAIN VIEW Zoningl: R-40 Building(s) Value: $0 Zoning2: Land Value: $29,400 Zoning3: Assessed Total Value: $29,400 Zoning Overlay: WP-O Year Built/Remodeled: / 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 #: 3710268900J If available, Building Permits for this parcel. 2010 Census Block: 1020 Septic links are not permits. 2010 Census Tract: 011801 Septic Final Permits prior to 08/2018, contact Agricultural District: Environmental Health. Building Details WaterShed: WS-III Protected Area Voter Precinct: P24/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. 8/5/2022 Keshia Parris From: Greta Bumgarner Sent: Friday, August 5, 2022 2:24 PM To: Keshia Parris Cc: Katherine Smith Subject: RE: Address ? Yes,the PIN stays the same. I have updated the Address Points to show as follows: 1444 Shadowfax Wynd =the Primary/Active Address 6106 Willowbottom Rd=the Multiple/Retired Address It should process and show correctly for you on Monday. Have a Great Weekend, Greta Bumgarner, GISP Senior GIS Analyst Catawba County Government Center 25 Government Drive,Newton, NC 28658 Office 828.465.8368 I Mobile 828.234.6392 CatawboCountyNC.gov Catawba county MAKING. LIVING. MM. Email Confidentiality Notice All records of communications to or from this email address are public records resulting in monitoring and potential disclosure of this message to third parties upon request, unless an exception applies. This message may contain confidential information and is intended only for the individual named. If you are not the named addressee,you should not disseminate, distribute or copy this email. Please notify the sender immediately by email if you have received this email by mistake and delete it from your system. From: Keshia Parris Sent: Friday, August 5, 2022 2:15 PM To: Greta Bumgarner<GRETA@CatawbaCountyNC.gov> Subject: Address? Greta, This is the one I was talking to you about earlier today. LRK 9066. On the site map they are wanting to put the driveway going into the home off of Shadowfax Wynd. Will the parcel number stay the same? Right now it is coming up as 6106 Willowbottom Rd. Thanks, Keshia Parris Administrative Assistant I PO Box 389 125 Government Drive, Newton, NC 28658 (828) 465-8270 office (828) 465-8276 fax • https://www.catawbacountync.gov/county-services/environmental-health/ We want to hear from you. Please take a minute to take our customer service survey. English Queremos escuchar de usted. Tomese un minuto para realizar nuestra encuesta de servicio al cliente. Espanol Catawba county MAILING. LIVING. LETTER, Confidentiality Statement:The information contained in electronic transmissions is confidential and may be subject to protection under the law,including the Health Insurance Portability and Accountability Act(HIPAA).An electronic transmission is intended for the sole use of the individual or entity to whom it is addressed.If you are not the intended recipient,you are hereby notified that any use,distribution or copying of the message is strictly prohibited.If you received a message in error, please contact the sender immediately by replying to the e-mail and delete the material from any computer. 2 Keshia Parris From: itrequest@catawbacountync.gov Sent: Friday, August 5, 2022 2:38 PM To: Keshia Parris Subject: [Ticket-100866] has been updated. Ticket 100866 has been updated. Note Added By : Greta Bumgarner Note Added On : Aug 5 2022 2:36PM Note Type : Ticket Resolution Note Description : Keshia requested that the following changes be made on LRK: 90666: 1444 Shadowfax Wynd = the Primary/Active Address 6106 Willowbottom Rd=the Multiple/Retired Address Note Added By : Greta Bumgarner Note Added On : Aug 5 2022 2:36PM Note Type : Ticket Resolution Note Description : Keshia requested that the following changes be made on LRK: 90666: 1444 Shadowfax Wynd =the Primary/Active Address 6106 Willowbottom Rd= the Multiple/Retired Address i �4'A • CATAWBA COUNTY 100A SOUTHWEST BLVD NEWTON,NORTH CAROLINA 28658 RECEIPT 1.,�r PHONE:828.465.8399 Friday,August 5,2022 18 41 www.catawbacountync.gov PAYOR: PAUL,Vino PAYMENTS TRANSACTION NUMBER: TRC-4473 1 9 1 3-05-08-2022 PAYMENT DATE: 08/05/2022 PAYMENT TYPE: Credit Card INVOICE NUMBER ACCOUNT FEE NAME FEE AMOUNT 08-22-410100 I10-580200-663000 Improvement Permit Fee $150.00 TOTAL PAYMENTS: $150.00 EH PR-08-2022-41875 CASE TYPE: Environmental Health Plan Review WORK CLASS: OSWP SITE ADDRESS: 1444 SHADOWFAX WYND,HICKORY NC 28602 Applicant VINO PAUL,5980 WILLOWBOTTOM RD,HICKORY NC 28602 C:8284935654 ALLENPAULELECTRIC n,GMAIL.COM **NO PEOPLESOFT ACCOUNT ASSIGNED** Owner LANCE&ELIZABETH SHEALY, 1413 WINDEMERE LN,HICKORY NC 28602 C:8647044526 receipt 08/05/2022 11:03 Page 1 of 1