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HomeMy WebLinkAboutEHPR-08-2022-41882.TIF $A �� TIIIS IS NOT A PERMIT Case# EHPR-08-2022-4 1 8 82 CAIAWBA COUNTY HEALTH DEPARTMENT 1,O PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES /842 sM Environmental Health Plan Review- Septic Malfunction AUTH CONST- REPAIR Applicant THE JOAN K.EVERETT COMPANY (T.EDWARDS), 110 N CENTER ST 202,HICKORY NC 28601 B:8288380684 TEDWARDS801 a YAHOO.COM Owner JERRY FRANCIS, 1220 6TH STNW,HICKORY NC 28601 C:8283121546 LOU.FRAN,c CIIARTER.NET NAME TO APPEAR ON PERMIT Jerry Francis SITE ADDRESS: 2741 SPENCER RD NE,CONOVER NC 28613 PIN# 372314335578 NAME of SUBDIVISION: Lot N 1 Section/Block PROPERTY SIZE: Square Feet 26,571 60 Acres 0.61 DIRECTIONS: McDonald Parkway,right onto Spencer Rd,property on the left PRIMARY CONTACT: Applicant SEWER TYPE: Septic Tank GALLONS PER DAY: 360 WATER SUPPLY: Public Water DESCRIBE WORK: Tank only, hole in tank that had been patched with cement 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 farmhouse EXISTING STRUCTURES ON SITE(IF ANY) DIM EXISTING STRUCTURE: 29x41 NUMBER OF EXISTING BEDROOMS: 3 #OF OCCUPANTS: 6 PROPOSED CONSTRUCTION BASEMENT? Yes 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: > o, 08/05/2022 16:12 Page 1 of 3 eLa1 t h..m�s b ,:1y! • CATAWBA COUNTY Case N El IPR 08 2022 41882 t II(...._ Public Health Department Subdivision d Environmental Health Division 1'INII 372314335578 PO Box 389, 100-A Southwest Blvd,Newton,NC 28658 NAME ON PERMIT: (JERRY FRANCIS), 1220 6T11 ST NW,HICKORY NC 28601 (Jerry Francis) Site Address: 2741 SPENCER RD NE,CONOVER NC 28613 Property Size: Square Feet 26,571.60 Acres 0.61 Directions: McDonald Parkway,right onto Spencer Rd,property on the 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 #ititt#•ittt................ ..........*#t###•►#4.44•R4#R•fR•#...........#R#4R4■i•###*#•##Mf..........*#t3#t FEENAME DATE FEE AMOUNT Authorization to Construct(Repair) 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) thalgdivan•n 08/05/2022 16:12 Page 2 of 3 NPR' o ' .2)). (f' , . . Ir. catawba county RECEED public health A U G 5 2022 Application for Environmental Health Services THIS IS NOT A PERMIT Environmental Health Application is for: ❑New Construction ®Existing Facility 0 Improvement Permit Authorization to Construct ONew Septic Septic Repair/Malfunction ❑Septic Relocation ❑ ansi Se tic Ex �Q ���' rry�p p on p ❑Existing System Inspection or Reconnection { on ��/ ❑New Well 0 Replacement Well El Well Abandonment ❑Well Repair _ Property Address pe n t e k Rd• n ti O n G 11 t rr r c. 4 L eta / 3 Acres • to I Subdivision + Lot# Driving Directions to Proper rn Q-Dp34 01. epriewRv - if,s h I- dA se„pile or R. topers y on 1eJe¢ ' Describe work new ft%n t‹. ^ kale_ 1 Al+Ais a +1114 i4k t Q e % P L C1J Lac*L- Applicant Name '7: , dwAr S - rn�or'- �tArk gt iltran ever-t H �nsPAr Applicant Address 110 f- ort Pe 64. ...c(41 o _�a N i C r C Y Phone Ya2g� $ 06d 4 , Email 'e � �/ a Owner Name J e Yr F�fl e'. i s u Owner Address f a46 64.k. S+, n i c Wo r n �'6s . . Phone aa2 • 31Q - I-y6 Email Oc . FrA Contractor Name nG � Ar4 e r. ne A` Contractor Address Phone Email Name to Appear on Permit? 6 Owner ❑Applicant 0 Contractor Who will be the Primary Contact? 0 Owner ®Applicant 0 Contractor Proposed New Construction-Residential Primary Residence ❑ New Residence 0 Addition to Residence #of New Bedrooms*t #of Occupants Project Description Structure Dimensions,also specify dimensions of decks&porches — (Choose One) ❑Basement 0 Crawl Space ❑ Stab If Basement,Will There Be Water Using Fixtures In Basement 0 Yes ❑ No ' Retaining Wall>2' 0 Yes 0 No Accessory Dwelling #of New Bedrooms*1. #of Occupants Structure Dimensions (Choose One) 0 Basement ❑Crawl Space ❑ Slab If Basement,Will There Be Water Using Fixtures In Basement 0 Yes ❑ No Retaining Wall>2' ❑ Yes 0 No Accessory Structure(s)Describe _ Structure(s)Dimensions Plumbing El Yes ❑No Describe Plumbing Needed (Choose One) ❑Basement 0 Crawl Space El Slab If Basement,Will There Be Water Using Fixtures In Basement ❑Yes ❑ No Retaining Wall>2' 0 Yes 0 No Multi-Family Residence #of Apartments #Bedrooms per Apartment*t Total#Bedrooms in Structure Structure Dimensions #of Occupants_— (Choose One) 0 Basement El Crawl Space 0 Slab If Basement,Will There Be Water Using Fixtures In Basement ❑Yes El No Retaining Wall>2' ❑ Yes 0 No Well Construction/Abandonment/Repair • Proposed Well Type 0 Individual Well ❑Semi-Public Well 0 Community Well -- Abandonment Type 0 Drilled ❑ Bored ❑ Dug 0 Unknown Well Repair Requested 0 Yes 0 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 PO. Box 389, Newton, NC 28658 Phone: (828)465-8270 I Fax: (828)465-8276 I EHAdmin@CatawbaCountyNC.gov Existing Structures on Site Describe j j i — R mda e 1Q 6rrh holl,s_C Structure Dimensions 0(.9 k 1- ll #of Bedrooms * 3 #of Occupants 11 S'1;NS AY' SAf. /vir d x Basement 55]Yes 0 No Basement Plumbing ❑Yes ® No e1/Ar Existing Water Supply • ❑Individual Well ❑Shared Well—Number of Connections 0 Community Well III County/City/Township Water Line Is a public water supply available? ** ® Yes 0 No Commercial ❑Proposed New Construction _❑Existitng/.Change of Use ❑Repair • Food Service Specify Type #Seats Dining Area(Sq.Ft.) • #Employees per Shift #of Shifts Church #of Seats Daycare 0 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. ❑Yes 4 No Does the site contain any jurisdictional wetlands? 4 / IA Yes ❑No Does the site contain any existing wastewater systems? bite �'r f� �c�nQ a - Cr1 S ❑Yes le 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 0 Alternative 0 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 WILT,INCUR AN ADDITIONAL CHARGE SEE FEE CHEDTJLE 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. Jo ll�� �aAn s Z �i rfvP�-�'�"'� Signature of Owner or Legal Agent A,ti l Ai"c — (d O r Date "2/ "a) Printed Name of Owner or Legal Agent % ,Cv4 Geospatial catawba county Information Services Real Estate Search l MA1114, IIYIMG. IIIIIP [� yafl Ji '' __.w"wt jrf;►�J�j V r, ... , ,, , y,a8 , ,. . ... . .. ...,. . . .,. . . . ... ... .. :,, . , ., , . ., „.. .. ',',•,.11 • . - rk vT ... -,...... . i i. a • � ,!, N W- E 1in=100ft s Parcel: 372314335578, 2741 SPENCER RD NE CONOVER, 28613 Owners: FRANCIS JERRY, FRANCIS LOUDELLA Owner Address: 1220 6TH ST NW Values - Building(s): $96,200, Land: $14,700, Total: $110,900 This map/report product was prepared from the Catawba County,NC Geospatlal 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 2D21 Catawba County NC 08/04/2022 Catawba County Environmental Health I A104110.4. O. LL°3.E'.if a El Q273 ;. ry 749.46 135,27 41 ji ci in SpF C�ry��N� 14910 Parcel: 372314335578, 2741 SPENCER RD NE 1in=50ft CONOVER, 28613 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: 372314335578 Owner: FRANCIS JERRY Parcel Address: 2741 SPENCER RD NE Owner2: FRANCIS LOUDELLA City: CONOVER, 28613 Address: 1220 6TH ST NW LRK(REID): 54513 Address2: Deed Book/Page: 3587/0383 City: HICKORY Subdivision: State/Zip: NC 28601-2408 Lots/Block: 1/ School Information: Last Sale: $105,000 on 2020-07-27 School District: COUNTY Plat Book/Page: 26/114 Elementary School: ST STEPHENS Legal: LOT 1 PL 26-114 Middle School: ARNDT Calculated Acreage: .610 High School: ST STEPHENS Tax Map: 160H 01010 Township: HICKORY School Map State Road #: 1441 TaxNalue Information: Tax Rates(pdf) Zoning Information: City Tax District: All in County Zoning District: HICKORY County Fire District: ST STEPHENS Zoningl: R-1 Building(s) Value: $96,200 Zoning2: Land Value: $14,700 Zoning3: Assessed Total Value: $110,900 Zoning Overlay: Year Built/Remodeled: 1923/1936 Small Area: Current Tax Bill Split Zoning Districts: / Zoning Agency Phone Numbers Miscellaneous: Firm Panel Date: 2007-09-05 Building Permit Address Search for this parcel. Firm Panel #: 3710372300J If available, Building Permits for this parcel. 2010 Census Block: 1011 Septic links are not permits. 2010 Census Tract: 010304 Septic Final Permits prior to 08/2018, contact Agricultural District: PROXIMITY Environmental Health. Building Details WaterShed: Voter Precinct: P28/Voting Map Parcel Report Data Descriptions List all Owners Deed History Report Assessment Report This map/report product was prepared from the Catawba County,NC Geospatial Information Services.Catawba County has made substantial efforts to ensure the accuracy of location and labeling information contained on this map or data on this report.Catawba County promotes and recommends the independent verification of any data contained on this map/report product by the user.The County of Catawba,its employees,agents,and personnel,disclaim,and shall not be held liable for any and all damages,loss or liability,whether direct,indirect or consequential which arises or may arise from this map/report product or the use thereof by any person or entity. ©2022, Catawba County Government, North Carolina.All rights reserved. 8/5/2022 i'l ,:�$ , • CATAWBA COUNTY f [,1. P' fE1 Case IE Op-09-20 1 4-054 1 54( z- � 2 Public Health Department ��} Subdivision < 4 Environmental Health Division I'' e 7• PINB 372314335578 '" .l® PO Box 389, 100-A Southwest Blvd.Newton, NC 28658 i o 0 LOT 1 ' f; to . NAME ON PERMIT: R & R RENTALS LLC, 6078 LYNCHBURG RD, HICKORY NC 28601 Site Address: 2741 SPENCER RD NE, CONOVER NC 28613 Property Size: Square Feet 26,571.60 Acres .61 Directions: Springs Rd, right Spencer Rd, cross McDonald Pkwy on left just before 27th St Ln NE Catawba County Health Department Operation Permit System Type: IIIG -OTHER NON-CONY TRENCH SYSTEMS (In accordance with Table Va) Description: 25% REDUCTION System Code: IQ4PS System Code Description: Infiltrator Quick 4 Plus Standard Types V and VI systems expire in 5 years. y` Owner must contact health department 6 months prior to a piration for permit renewal. System Installation Comments: The property lines were represented and marked by the property owner. PERMIT CONDITIONS: -F-- 1. All maintenance, monitoring, and performance requirements shall be in accordance with 15A NCAC 18.1900, Rule .1961 2. Operation & Maintenance Specifics: Subsurface system operator required? Yes No_X_ If yes, see attached sheet for additional operation conditions, maintenance and reporting. This system has been installed in compliance with applicable North Carolina General Statutes, Rules for Sewage Treatment and Disposal, and All conditions of the Improvement Permit and Construction Authorization. Kelly Ishenour-#1099 09/23/2014 SYSTEM INSTALLER INSTALLATION DATE Robbie Phelps 09/26/2014 AUTI IORIZED STALE AGENT DATE OF OPERATION PERMIT Form F ISSUANCE clipermit (19/29/2014 08:34 Page I of3 Permit# OP-9-14.05415 C, CATAWBA COUNTY 4 Name R&R Rentals LLC ��g�l ' 2 Public Health Department Address 2741 Spencer Rd NE d '"`"''P' "' Environmental Health Division — �V ,1�;�' PO Box 389, 100A Southwest Blvd,Newton NC 28658 LOS# 1 $t} su (828)4b5 8270 Fax (828)4G5.827G 'I DO{828)4G5-820O OP SIT[+, PLAN , , 74 1A Sle Y2 7 ' iv 4-Di st Ow 1 b°I - 1-me y y� W r+!1 1r sY4LIC.ey nd Scale I. u U P'A C CATAWBA COUNTY ;C�/ G;t 100A SOUTHWEST BLVD NEWTON,NORTH CAROLINA 28658 RECEIPT PHONE:828.465.8399 y Friday,August 5,2022 \L8 4 2 sM www.catawbacountync.gov PAYOR: The Joan K. Everett Company The Joan K.Everett Company(Edwards,T.) PAYMENTS TRANSACTION NUMBER: TRC-44755495-05-08-2022 PAYMENT DATE: 08/05/2022 PAYMENT TYPE Credit Card 293428488 INVOICE NUMBER ACCOUNT FEE NAME FEE AMOUNT 08-22-410126 110-580200-663000 Authorization to Construct(Repair) S150.00 Fee TOTAL PAYMENTS: $150.00 EHPR-08-2022-41882 CASE TYPE: Environmental Health Plan Review WORK CLASS: Septic Malfunction SITE ADDRESS: 2741 SPENCER RD NE,CONOVER NC 28613 Applicant THE JOAN K.EVERETT COMPANY, 110 N CENTER ST 202,HICKORY NC 28601 B:8288380684 TEDWARDS801@YAHOO.COM **NO PEOPLESOFT ACCOUNT ASSIGNED** Owner JERRY FRANCIS, 1220 6TH ST NW,HICKORY NC 28601 C:828312I546 LOU.FRAN@CHARTER.NET receipt 08/05/2022 16:12 Page 1 of 1