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Home My WebLink AboutEHPR-08-2022-41951.tif • TutS is NOT A PERMIT Case# EHPR-08-2022-4 1 95 1 t CATAWBA COUNTY HEALTI-I DEPARTMENT PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES Ig sM Environmental Health Plan Review- Septic Malfunction AUTH CONST- SEPTIC MALFUNCTION Applicant STUART RADCLIFFE,8775 FIICKORY NUT TRAIL.CONCORD NC 28027 C:7046348735 STUART.R@SUSTAINABLECONIRACTORS.COM Owner CLRRT (CHARLES RADCLIFF TRUST),9911 ROSE COMMONS DR STE E222,HUNTERSVILLE NC 28078 11:9804394997 HOME:9804394997 NAME TO APPEAR ON PERMIT Stuart Radcliffe SITE ADDRESS: 2964 OLD SHELBY RD,HICKORY NC 28602 PIN# 278103306276 NAME of SUBDIVISION: Lot# 3_ Section/Block PROPERTY SIZE: Square Feet 65,340.00 Acres _ 1.5 DIRECTIONS: Corner of Old Shelby Rd and Mountain Grove Rd PRIMARY CONTACT: Applicant SEWER TYPE: Septic Tank GALLONS PER DAY: 480 WATER SUPPLY: Public Water DESCRIBE WORK: Collapsed tank 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? APPLICATION FOR: Existing Structure STRUCTURE TYPE: MULTI-FAMILY RESIDENCE FACILITY TYPE: Multiple Family Residence OTHER DESCRIPTION: DESCRIPTION OF multi family residence EXISTING STRUCTURES ON SITE(IF ANY) DIM EXISTING STRUCTURE: 63 x 37 NUMBER OF EXISTING BEDROOMS: 4 #OF OCCUPANTS: 6 PROPOSED CONSTRUCTION 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: Other described: 08/12/2022 14:46 Page I of6 CATAWBA COUNTYe. 2(t.ii . Case# Public Health Department Subdivision EHPR-08-2022-0 1951 Environmental Health Division PIN# 278103306276 PO Box 389, 100-A Southwest Blvd,Newton,NC 28658 ‘ir.:21, w NAME ON PERMIT: (STUART RADCLIFFE),8775 HICKORY NUT TRAIL,CONCORD NC 28027 (Stuart Radcliffe) Site Address: 2964 OLD SHELBY RD,HICKORY NC 28602 Property Size: Square Feet 65,340.00 Acres 1.5 Directions: Corner of Old Shelby Rd and Mountain Grove Rd 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 FEENAME DATE FEE AMOUNT Authorization to Construct(Repair) Fee 08/12/2022 $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) ehapplicathni 08/12/2022 14:46 Page 2 of6 catawba county Application for Environmental Health Services f( C, THIS IS NOT A PERMIT ( (✓1 Application is for: ❑New Construction 0 Existing Facility Improvement Permit ❑Authorization to Construct VA. Septic Iineptic Repair/Malfunction 0 Septic Relocation 0 Septic Expansion I ,+sting System Inspection or Reconnection « Well ❑ Replacement Well ❑Well Abandonment ❑Well Repair 11.111 Address..._ . "T ‘1, t'rJ jc't.S a. ti r.-• j5 Subdivision (,Jon a Lot# •r Directions to Property 3 't• 1•-• D IC,Sf=tiff otts/.•l45. a/ S /4.44,wr:,r 15..vt. . r rho work let a C.c./�« S<cr� l ► V.Sr tl. .C�_+---"'�.._.. tplrlicant Name / J 4—� — —...../..,I I't i i.ant Address (C. L,.fie S /G.A.r• /C 1 c c 0.4 . ego 513 q 9177 Email 5 7, dt ' 1-..1....6 At +is tier Name $*.,.i 7 L,/1 (Tr.4 . Address 7 N.•r- 1..-C • I Email + 'intractor Name is I / , ass. t r 4nr:x for Address 1 Email in Appear on Permit? ❑Owner 0 Applicant ❑Contractor vi hp silt be the Primary Contact? 0 Owner 0 Applicant 0 Contractor t'ratrrrsed New Construction-Residential _. r,marl Residence ❑ New Residence ❑ Addition to Residence A of New bedrooms't * ' y of Occupants '" C s- LL _.. 't••t Description t /!S't� r� rletrr�S._�� Ic •r+ Tr ;rc Dimensions.also specify imensions of decks porches _ MO ❑Basement ❑Crass!Space 0 Slab If Basement. Will there lie Water Using Fistures In Basement 0 Yes 0 No. -pug Wall)'2' 0 Yes 0 No •rrry Dwelling r+of New Bedrooms•t _ M of Occupants Structure Dimensions ono 0 Basement ❑crawl Space 0 Slab It Itxsernem.will there Be Water Using fixtures In Basement ❑Yes ❑ No +-• ..,Erg Wall>2' ❑ Yes 0 No r•r awry Strecture(s)Describe Slrw:turels)Dimensions i harg ❑Yes ❑No Describe Plumbing Needed _. One) 0 rt;rseniertt ❑crawl spare ❑ Slab If Basement,Will there He Water Using r islures In fusement 0 Ye,, ❑ No t.r•rung Wall>2' ❑ Yes 0 Nn r „+, I amity Residence N of Apartments/ _ ._NBedrooms per Apartmcnt't 2 T-f Total At Bedrooms in Structure•t tn k of Occupants rr c nt a t)imensions 4SA. 0 0 1 444•. Hari ®Basement 0 C'ras l Space 0 Slab IFBasement.Will There Be Water lasing l istures In Basement Yes ❑ No ing Wall:.2' 0 Yes 0 No tt Ell C omstraction/Abandonment/Repair :d Well type 0 Individual Well 0 Semi-Public Well 0 Community Well l.>ument Type 0 Drilled 0 Bored ❑ Dug 0 Unknown + r'epair Requested 0 Yes ❑No Describe pitied Well Contractor Install Water Line or Electrical line from Well Heald to Pressure Tank?0 Yes ❑No Environmental Health Catawba County Government Center, 25 Government Drive I PO. Box 389,Newton,NC 28658 Phone: (8281 4 65-82 70 I Fax:(828)465-8276 I EHAdmin@CatawbaCountyNC.gov _ — - I a.tiug Structures on Site N. .2 _-. _-_ Structure Dimensions G 3 x 2 x L) „I .+„druoms ' t.. h of Occupants 4 _. ,�•rent ]Yes ❑ Ni, Basement Plumbing (, J Yes 0 No • I sisliag Water Supply I"tltvidual Well ❑Shared Well - Number of Connections Li Community Well J County/City-Township Water I me .1 ,relic water supply available?•• Yes 0 No ( ummatercial 0 Proposed New Construction ❑Existing/Change or Use pil Repair ,,.+.i Service Specify l pe I N Seats Dining Area(Sq.Ft.) U Employees per Shift__ 0 of Shifts itII1 col N of Seats _ Daycare❑Yes ❑No 0 of Children rr of Employees per Shift a of Shifts Commercial Kitchen 0 Yes ❑No Residential Kitchen 0 Yes 0 No . He a of Children 4of Employees per Shift =of Shifts _ i c,,...ieeteDther Specify Type Structure Dimensions Retail Floor Space A,w,_,,,_,.p..__,..w 0 of Employees per Shift 0 of Shifts._._.__.._... ._ I+Ihi•r Information • .ii..,t.,ted Design Flow.Commercial t (This value will be determined by EH stall) _I 3rplicanl shall notify the local health department upon submittal of this application if any of the following apply to the property in m.i. If the answer to any question is"yes".applicant must attach supporting documentation. i : i ) 0 No Does the site contain any jurisdictional wetlands? s 0 No Does the site contain any existing wastewater systems? 0 No Is any wastewater going to be generated on the site other than domestic sewage? . 1.. 0 No Is the site subject to approval by any other public agency? > 0 No Are there any easements or right of ways on this property? Describe It:oinking for an Improvement Permit or Authorization in Construct,Please Indicate Desired System Type(s): �— ins can be ranked in order of your preference) e..,epted 0 Alternative 0 Conventional 0 Innovative 0 Other_ _ 0 Any i.om that will be intended for sleeping at the time of construction or for future consideration should be noted as a bedroom and counted applications.The number of bedrooms will be confirmed by rooms identified on floor plans as a bedroom at the time of building permit .• ,hr. This may prevent the need for septic system expansion in the future, 'ructure is plumbed but has no bedrooms.cakulatcd design flow will be determined by EH Start ••.+.a well permit must be issued with the Authorization to Construct. „I I KIP TO THE PROPERTY AND/OR SYSTEM REI)EsIGN «ILL INCUR AN-5DDITIONAL CHARGE(SEE FEE SCREW. l.F:l :mental Health soil/site evaluations require digging,augering.and'ur probing into the ground.Property owner/applicant is responsible 1'Xing all underground utilities,including but not limited to:underground power,cable,telephone,gas.water lines.and irrigation ,a, i„ Sprinkkt systems.Catawba County Environmental ironmental I iealth is not responsible for damage to unmarked utilities. ;kit:xi applications are valid for a period oft years.Improvement Permits are valid:with complete site plan 60 months(5 years i: .-t,...anpkte plat-without expiration. An Authorization to Construct will remain valid as long as the Improvement Permit is solid. to ,al,.»-iration to Construct.issued for septic repair is valid for 60 months(5 years). Permits may be revoked if the information on this t.f ..riiontsite plan changes or if the intended use for the proposed facility changes. Permits may be revoked if site conditions are altered such effect permit conditions or installation requirements. read this application and certify that the information provided herein is true.complete and correct. Authorized county and slate ;;, .mis are granted right of entry to conduct necessary inspections to determine compliance with applicable laws and rules. I ,.i.r.tand that I am solely responsible for the proper identification and labeling of all property lines and corners and making the site .. ;hue so that a complete site evaluation can be performed. ,, ,nidersigned is the owner of the property or legal agent of the owner. • ...ire of t)surer or Legal Agent AV L"' f I P^S fr Date c 1l L 2 .:Name of Owner or Legal Agent ct �-'7 1L.1,!if i 't'r...y?K— countyGeospatiai 5r.atawba .,.5 ,i,., Information Services Real Estate Search 60 \ tts: .15 \/ (24) � ,.saA Q , 1 ti ------------ r ---vi. 120.00 .... --\\'S t rI O ii J 61 i, a 120.00 L........ 'C'" (i01 1.50A 0 (1$'11 13 t. i~+ f 1 Q I'd \ i.-ii 7 ( I ...r., 1 CO _.-----\\ \ .... . ..., \______---------- ,---- 5.5) -:.-....."\ 95 co N 1 Oi�G J ,J" 1 in=80ft ti Parcel: 278103306276, 2964 OLD SHELBY RD HICKORY, 28602 Owners: CLRRT IRREVOCABLE TRUST, ROSEMAN MELINDA TRUSTEE Owner Address: 9911 ROSE COMMONS DR STE E222 Values - Building(s): $162,900, Land: S15,200. Total: $178,100 'his mapireport product was prepared from the Catawba County.NC Gcwspafrat Information Services Catawba County has made substantial otters ri;ensure the accuracy of location and labeling rnlormalion 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 or rsonnal.cksdam,and shalt not be held table for any and an damages loss or liability whether direct indirect or consequential which arises or may a•se from this maprrepon product or the use thereof by any person or entity Copyright 2021 Catawba County NC 08112l2022 Catawba County Environmental Health •2936 dli $1 1$ $ m! `79 •2941 60 2 �4, (157) (24) '60 ct- cP 4.10 •2964 `.P ,0 N 120 00 G �.,•, �1 •2968 J cTg2 Tr 1 18 k. 'el) •2978 S •2974.2976 G 120.00 •2972 ■ 1Z91 g (181f 2 0 O 2 -* Via, p ell cgG653 4 •29 2 �. ''''',10 2 0 tr9 200 00 1 93' co o i :4-pK ,a N.....N............N.. )) •6650 rB�J y Cr- r � -' `a •125) 6627----- f'r" C \ Q Parcel: 278103306276, 2964 OLD SHELBY RD 1in=80ft 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 08/12/2022 Parcel Report - Catawba County NC Parcel Information: Owner Information: Parcel ID: 278103306276 Owner: CLRRT IRREVOCABLE TRUST Parcel Address: 2964 OLD SHELBY RD Owner2: ROSEMAN MELINDA TRUSTEE City: HICKORY, 28602 Address: 9911 ROSE COMMONS DR STE E222 LRK(REID): 48778 Address2: Deed Book/Page: 3439/0908 City: HUNTERSVILLE Subdivision: State/Zip: NC 28078-0323 Lots/Block: 3/ Last Sale: $125,000 on 1984-05-01 School Information: Plat Book/Page: 83/105 School District: COUNTY Elementary School: MOUNTAIN VIEW Legal: LOT 3 PLAT 83-105 Middle School: JACOBS FORK Calculated Acreage: 1.500 Tax Map: 135H 01001 D High School: FRED T FOARD Township: HICKORY School Map State Road #: 1124 Tax/Value Information: Tax Rates(pdf) Zoning Information: City Tax District: All in County Zoning District: COUNTY County Fire District: MOUNTAIN VIEW Zoning1: R-20 Building(s) Value: $162,900 Zoning2: Land Value: $15,200 Zoning3: Assessed Total Value: $178,100 Zoning Overlay: Year Built/Remodeled: 1970/ 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 #: 3710278100J If available, Building Permits for this parcel. Septic 2010 Census Block: 1010 links are not permits. 2010 Census Tract: 011801 Septic Final Permits prior to 08/2018, contact Agricultural District: Environmental Health. Building Details WaterShed: 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. Keshia Parris l From: Stuart Radcliffe <stuart.r@sustainablecontractors.com> Sent: Friday, August 12, 2022 10:57 AM To: EH Administrative Assistants Subject: Permit to repair collapsed tank 2964 old shelby Attachments: septic application tank repair.pdf; septic application tank repair 1.pdf; septic application tank repair 2.pdf This is an external email. Please be cautious before clicking any links or attachments. if you have questions about this email, please send them to suspiciousemairckatawbacountvne.gov This is for tank replacement only, A delivery truck ran over the tank and it collapsed Robbie has been out there but we need it fixed asap. I have a contractor coming Thursday to replace tank can you put a rush on the permit. We have it covered with plywood but its most likely attracting flies mosquitos. Am the trustee of the Charles I. Radcliffe Revocable trust. Sincerely, Stuart Radcliffe 704 634 8735 8611 Concord Mills Blvd. Ste 427 Concord NC, 28027 stuart.rPsustainablecontractors.com S 3 Sustainable Contractors dir C Building for Tomorrow, Today. g'A CATAWBA COUNTY F7141 100A SOUTHWEST BIND NEWTON,NORTH CAROLINA 28658 RECEIPT ,.` PHONE:828.465.8399 Friday,August 12,2022 1 c4 4�. sM www.catawbacountync.gav PAYOR: Radcliffe,Stuart PAYMENTS TRANSACTION NUMBER: TRC-4 5 1 78506-1 2-08-2022 PAYMENT DATE: 08/12/2022 PAYMENT TYPE: Credit Card 293710069 INVOICE NUMBER ACCOUNT FEE NAME FEE AMOUNT 08-22-410520 110-580200-663000 Authorization to Construct(Repair) S150.00 Fee TOTAL PAYMENTS; $150.00 EH PR-08-2022-4 1951 CASE TYPE: Environmental Health Plan Review WORK CLASS: Septic Malfunction SITE ADDRESS: 2964 OLD SHELBY RD,HICKORY NC 28602 Applicant STUART RADCLIFFE,8775 HICKORY NUT TRAIL,CONCORD NC 28027 C:7046348735 STUART.R@SUSTAINABLECONTRACTORS.COM **NO PEOPLESOFT ACCOUNT ASSIGNED** Owner CLRRT,9911 ROSE COMMONS DR STE E222,HUNTERSVILLE NC 28078 H:9804394997 receipt Oa/12t2022 I4;45 Page I of I