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HomeMy WebLinkAboutEHPR-08-2022-41877.TIF , tiii, THIS IS NOT A PERMIT Case# EHPR-08-2022-41877 CATAWBA COUNTY HEALTH DEPARTMENT p) PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES g_42 sM Environmental Health Plan Review-Septic Malfunction AUTH CONST- SEPTIC MALFUNCTION Owner LORRIE LAWRENCE,PO BOX 558,CATAWBA NC 28609 C:8282285759 LORRIELAWRENCE@BELLSOUT.NET BELLSOUT.NET NAME TO APPEAR ON PERMIT Lorrie Lawrence SITE ADDRESS: 7710 MARYS DR,CATAWBA NC 28609 PIN# 470004524525 NAME of SUBDIVISION: Lot# 1 Section/Block PROPERTY SIZE: Square Feet 104,544.00 Acres 2.4 DIRECTIONS: Hwy 10 to Murrays Mill Rd to Sherrills Ford Rd to Hopewell Ch Rd to Marys Drive,home is on the right PRIMARY CONTACT: Owner SEWER TYPE: Septic Tank GALLONS PER DAY: 360 WATER SUPPLY: Private Well DESCRIBE WORK: repair septic lines, sewage on the ground near drainfield lines,well is shared with 1033 Melvin Lane 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 home EXISTING STRUCTURES ON SITE(IF ANY) DIM EXISTING STRUCTURE: 34x64 NUMBER OF EXISTING BEDROOMS: 3 #OF OCCUPANTS: 2 PROPOSED CONSTRUCTION #OF NEW BEDROOMS:: 3 BASEMENT? Yes BASEMENT FIXTURES? Yes 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: chaP7 ii.:atiun 08/05/2022 11:24 Page I orb -14V'' • CATAWBA COUNTY Case# EHPR-08-2022-41877 C •�•ft Public Health Department Subdivision d H Environmental Health Division PINk 470004524525 PO Box 389, 100-A Southwest Blvd,Newton,NC 28658 / 2 sw NAME ON PERMIT: (LORRIE LAWRENCE),PO BOX 558,CATAWBA NC 28609 (Lorrie Lawrence) Site Address: 7710 MARYS DR,CATAW BA NC 28609 Property Size: Square Feet 104,544.00 Acres 2.4 Directions: Hwy 10 to Murrays Mill Rd to Sherrills Ford Rd to Hopewell Ch Rd to Marys Drive,home is 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 isis thehe owner of the property or legal agent of the owner. Date: b/e�/;6I,WeZ Signature of Applicant orAger�h ff If you need further information or ass' ance ase call 8-4 -8270 AREA3 FEENAME, DATE FEE AMOUNT Authorization to Construct(Repair) Fee 08/05/2022 $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) dugilicari,m 08/05/2022 11:24 Page 2 016 Catawba county pu:ilic: health Application for Environmental Health Services THIS IS NOT A PERMIT Application is for: ❑New Construction Existing Facility ❑Improvement Permit Lr(Authorization to Construct ❑New Septic a Septic Repair/Malfunction ❑Septic Relocation ❑ Septic Expansion El Existing System Inspection or Reconnection ❑ New Well ❑Replacement Well ❑Well Abandonment ❑Well Repair Property Address (olb moor(�S �TiYe �1, l'0AcitAno.. 4IL Acres 3.5' Subdivision II Lot# Driving Directions to Property 14 w Y ID 1--0IY1 urrr i(t -vD er►i IDS IrOrn eti 40 kkp�iJAp(l(ntecr - ec td 4p +� C r S 17r t 1/2� Describe work l'U1D,► r52��iG \ r e=`, Se , ¢rth ra} [ o:It l e(Q. Applicant Name \n,rrt e Applicant Address 7'710 pmari :Ye /e O $tom i55ce C[\tt 060, l�L agto0q� Phone Sc* - Gj` 7°rn 1 Email kbrr,&kaar [�e, Sa2�kcAdth ne+ Owner Name LI4r,ne, txx1zr2.r�� Owner Address '-rim coo rwi -fir;v'� 1 Qo Pr�t_ oak( ge ( O Phone C 01 ac -•6'1, i9 Email \t cr c ,re rC'Q ti.N3Aksne f Contractor Name Contractor Address Phone Email Name to Appear on Permit? V.Owner El Applicant ❑ Contractor Who will be the Primary Contact? [6wner El Applicant ❑ Contractor Proposed New Construction-Residential Primary Residence El 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 0 Yes E] No Retaining Wall>2' ❑ Yes ❑ 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' 0 Yes 0 No Accessory Structure(s)Describe Structure(s)Dimensions Plumbing El Yes ❑No Describe Plumbing Needed (Choose One) ❑Basement 0 Crawl Space 0 Slab If Basement,Will There Be Water Using Fixtures In Basement ❑Yes ❑ No Retaining Wall>2' 0 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 ❑ No Retaining Wall>2' 0 Yes 0 No Well Construction/Abandonment/Repair Proposed Well Type El Individual Well ❑ Semi-Public Well ❑Community Well Abandonment Type El Drilled El 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?El Yes El No Environmental Health Catawba County Government Center, 25 Government Drive I PO. Box 389, Newton, NC 28658 Phone: (828) 465-8270 Fax: (828)465-8276 I EHAdmin@CatawbaCountyNC.gov Existing Structures on Site Describe 3 64rad It I h 1pal Structure Dimensions Sq Y9/ #of Bedrooms* 1j #of Occupants a Basement '`Yes El No Basement Plumbing 'Yes ❑ No LAD Br Existing Water Supply ❑ Individual Well Shared Well—Number of Connections A ❑Community Well ❑County/City/Township Water Line Is a public water supply available?** ❑ Yes ❑v'�to ,b'33 I�le1 V i n L.Q r>✓ 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 Stricture 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. I fhe answer to any question is"yes",applicant must attach supporting documentation. ❑ s No Does the site contain any jurisdictional wetlands? la Yes WNo Does the site contain any existing wastewater systems? 0 Yes C"No Is any wastewater going to be generated on the site other than domestic sewage? 0 Yes ®'No Is the site subject to approval by any other public agency? 0 Yes IgliNo 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 ❑Conventional 0 Innovative 0 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 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 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 prope or legal agent of the owner. Signature of Owner or Legal A Date 9 3/.,0?o{ Printed Name of Owner or Legal A t LOrri p L )r r)e.e.—, Catawba County Environmental Health 206.52 4.5413 '7C? (Orb' 00 T, 77 •1033 OP r O ch 9cq� O Of° (r)h. 9j S y(e1\ ,� ' oo (,y •7710 575.72 MARYS DR 817.67 •7651 I •7631 Parcel: 470004524525, 7710 MARYS DR 1 in=80ft CATAWBA, 28609 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. Cnnvrinht 7021 Catawha(nunty NC Page 1 of 1 Parcel Report - Catawba County NC Parcel Information: Owner Information: Parcel ID: 470004524525 Owner: LAWRENCE LORRIE M Parcel Address: 7710 MARYS DR Owner2: City: CATAWBA, 28609 Address: PO BOX 558 LRK(REID): 302347 Address2: Deed Book/Page: 3380/1511 City: CATAWBA Subdivision: State/Zip: NC 28609-0558 Lots/Block: 1/ School Information: Last Sale: Plat Book/Page: 76/86 School District: COUNTY Elementary School: CATAWBA Legal: LOT 1 PLAT 76-86 Middle School: MILL CREEK Calculated Acreage: 2.400 High School: BANDYS Tax Map: Township: CATAWBA School Map State Road #: TaxNalue Information: Tax Rates(pdf) Zoning Information: City Tax District: All in County Zoning District: COUNTY County Fire District: SHERRILLS FORD Zoningl: R-40 Building(s) Value: $73,700 Zoning2: Land Value: $17,300 Zoning3: Assessed Total Value: $91,000 Zoning Overlay: CP-O,WP-O Year Built/Remodeled: 1970/ Small Area: SHERRILLS FORD Current Tax Bill Split Zoning Districts: / Zoning Agency Phone Numbers Miscellaneous: Firm Panel Date: Building Permit Address Search for this parcel. Firm Panel #: If available, Building Permits for this parcel. 2010 Census Block: 1038 Septic links are not permits. 2010 Census Tract: 011503 Septic Final Permits prior to 08/2018, contact Agricultural District: Environmental Health. Building Details WaterShed: WS-IV Protected Area Voter Precinct: P21/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 • CATAWBA COUNTY HEALTH DEPARTMENT NEWTON, NORTH CAROLINA COMPLETION PERMIT FOR SEPTIC TANKS PERMIT # C— 282 DATE : 6- 2 7I OWNER L �A Cvilou, isG�'Ld A ADDRESS • 2- Ar 251 04ec/i-a. BUILDING CONTRACTOR 7- SUBDIVISION LOCATION Sp y/, - P. LOT # LOT SIZEre5 BLOCK OR SECTION HOUSE ( ) MOBILE HOME ( ) BUSINESS ( ) OTHER ( ) FHA-VA LOAN ( ) SEPTIC TANK: (SIZE GALS) WATER SUPPLY: NO. ' BEDROOMS NO FIXTURES INDIVIDUAL PUBLIC GARBAGE DISPOSAL UNIT:YES ( ) NO ( ) IF WELL, TYPE : BORED DRILLED DUG AUTO WASHING MACHINE : YES ( ) NO ( ) DISTANCE FROM SEPTIC TANK OR NEAREST NITRIFICATION FIELD: SQ.FT. POLLUTION: FT. 1) NUMBER OF LINES SEPTIC TANK INSTALLED BY : 2) LENGTH ANDDTH 0 fiLTES PERMIT FEE $ (J to a) BED SYSTEM ( ) CERTIFICATE 0 COHPLETION BY: - b)_ TRENCH SYSTEM ( ) . .. 3) DEPTH OF STONE IN LINES REMARKS : - ADEQUATE FALL (GRADE) ON: 1) BUILDING (HOUSE) SEWER LINE : YES ( ) NO ( ) 2) NITRIFICATION LINES : DATE INSTALLED: YES ( ) NO ( ) SEPTIC TANK LAYOUT Er2;\ \ w • O 0 a a HEALTH DEPARTMENT COPY ,'' •� i! CATAWBA COUNTY HEALTH DEPARTMENT A , 1 t IMPROVEMENT PERMIT FOR SEPTIC TANKS Permit No. 9 0 4 6 N OWNER 4--Et„ j -G' c-t__-g( J DATE tJ -e-..Q 15 (f�99 ADDRESS OF OWNER / i Q f g 2.5- J. yi C . PHONE f F�? NAME OF CONTRACTOR ADDRESS LOCATION c..% _ 272142 .4_ /6? 10.._ ,ALP/ �V A - 4k:; "-i— SUBDIVISION LOT NO. SECTION OR BLOCK LOT SIZE FHA, VA LOAN HOUSE &MOBILE HOME ( ) BUSINESS ( ) OTHER ( ) ® ' SEPTIC TANK YOUT NO. BE ROOMS 0 NO. FIXTURES .(/) GARBAGE DISPOSAL UNIT: YES ( ) NO � �az.__ PLUMBING UNDER BASE NT FLOOR: YES X NO ( ) > > + SIZE OF TANK ' /000LIQUID GALLONS ,O�x2y NITRIFICATION F ELD: 59°1-fr - If-/ 1. Number of lines — 1 IgteP"° 2. Length and width df li s: , C�illf f'�`"'"` �j� a. Bed. System ' '7( ...2 .a. ft. A.""`'' b. Trench system ft. oN Redd � SO' i 0v-Q/t- 3. Total Depth of stone - �C GROUNDWATER INTERCEPTOR DRAIN: v Apia �c�C� (IF REQUIRED) WATER SUPPLY: PRIVATE . PUBLIC .O - - - - --- OWNER NOTIFIED TO CHECK ZONING: YTS ( ) NO ( ) ' OWNER AGREES WITH LAYOUT: YES NO ( ) . /710''"'"k 5, OWNER AGREES WITH SPECIAL INSTRUCTIONS: YES IA NO ( ) ,-/„..4---- 4._ OWNER OR CONTRACTOR SIGNATUREX PERMIT FEE $"`/.4-7-ta- PERMIT VOID AFTER 36 MONTHS SEPTIC TANK CONTRACTOR MUST FOLLOW ALL IMPROVEMENT PERMIT ISSUED BY DETAILS OF THIS PERMIT (LAYOUT) SANITARIAN / �7'ay Sl."4-197 HEALTH DEPT. COPY SOIL CLASSIFICATION: SUITABLE ( ) PROVISIONALLY SUITABLE,4 UNSUITABLE ( ) SITE FACTORS: 1. SLOPE (%) S -4Zir U 7. SOIL PERMEABILITY S -1)- U 2. SOIL TEXTURE (12-48 IN.) S ) - U UNDER 60 MIN.. - OVER 60 MIN. � SANDY, 1OAMY, CLAYE� 7 8. OTHER C.)" PS - U 3. SOIL STRUCTURE (12-48 IN.) S5-)- U (SPECIFY) 4. SOIL DEPTH (IN.) c�- PS - U 9. SOIL SERIES: ' 5. RESTRICTIVE HORIZONS (IN.) e%-,PS - U A. CECIL cs, E. HIWASSEE ( ) (IMPERVIOUS STRATA, ROCK) C. MADISON .( ) D. APPLING ( ) 6. SOIL DRAINAGE - GROUNDWATER S - — U E. PACOLET ( ) F. FLOOD PLAIN ( ) (EXTERNAL - INTERNAL) . . G. 2-1 CLAY SOIL H. OTHER-SPECIFY , CATAWBA COUNTY I00A SOUTHWEST BLVD V + NEWTON,NORTH CAROLINA 28658 RECEIPT ED ,a`, PHONE:828.465.8399 Friday,August 5,2022 I8 4'Z 5M www.catawbacountync-gov PAYOR: Lawrence,Lorrie PAYMENTS TRANSACTION NUMBER: TRC-44733092-05-08-2022 PAYMENT DATE: 08/05/2022 PAYMENT TYPE: Credit Card INVOICE NUMBER ACCOUNT FEE NAME FEE AMOUNT 08-22-410102 I10-580200-663000 Authorization to Construct(Repair) S300.00 Fee TOTAL PAYMENTS: $300.00 EHPR-08-2022-4 1877 CASE TYPE: Environmental Health Plan Review WORK CLASS: Septic Malfunction SITE ADDRESS: 7710 MARYS DR,CATAWBA NC 28609 Owner LORRIE LAWRENCE,PO BOX 558,CATAWBA NC 28609 C:8282285759 LORRIELAWRENCE@ BELLSOUI-.NET **NO PEOPLESOFT ACCOUNT ASSIGNED** receipt 08/05/2022 11:23 Page I of I