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HomeMy WebLinkAboutEHPR-08-2022-42093.tif THIS IS NOTA PERMIT Case# EHPR-08-2022-42093 CATAWBA COUNTY HEALTH DEPARTMENT U� PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES /8 2 sM Environmental Health Plan Review-OSWP IMPROVEMENT Applicant SENG LEE, 1900 ORO DAM BLVD E SUITE 12,ROOM 112,ORAVILLE CA 95966 C:5307641534 NAME TO APPEAR ON PERMIT Seng Lee SITE ADDRESS: 3430 14TH AVE SW,HICKORY NC 28602 PIN# 279213030958 NAME of SUBDIVISION: JOHN P HUFFMAN Lot k 27 Section/Block PROPERTY SIZE: Square Feet 25,264.80 Acres 0.58 DIRECTIONS: 1st Av SW left 33rd St SW right 14th Av SW property on right PRIMARY CONTACT: Applicant SEWER TYPE: Septic Tank GALLONS PER DAY: 360 WATER SUPPLY: Private Well DESCRIBE WORK: IP only Application shows retaining wall not shown on site plan 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: 2 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 25 x 52 #OF NEW BEDROOMS:: 3 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: 08/26/2022 16:43 Page 1 of3 �Q • CATAWBA COUNTY Case# EHPR-08-2022-42093 Q iik Public Health Department F, j" � Subdivision JOHN P HUFFMAN d "j Environmental Health Division �\U PO Box 389,100-A Southwest Blvd,Newton,NC 28658 PIN# 279213030958 111g2 u. NAME ON PERMIT: (SENG LEE), 1900 ORO DAM BLVD E SUITE 12,ROOM 112,ORAVILLE CA 95966 ( Seng Lee) Site Address: 3430 14TH AVE SW,HICKORY NC 28602 Property Size: Square Feet 25,264.80 Acres 0.58 Directions: 1st Av SW left 33rd St SW right 14th Av SW property on 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: Signature of Applicant or Agent If you need further information or assistance please call 828-465-8270 AREA2 FEENAME DATE FEE AMOUNT Improvement Permit Fee 08/26/2022 $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) 08/26/2022 16:43 Page 2 of 3 r 1 Catawba county tool3 RECEIVED Application for Environmental Health Services THIS IS NOT A PERMIT Application is for: gNew Construction El ExistingFacility A UG 8 2022 ❑Improvement Permit ❑Authorization to Construct 'RVew Septic ❑Septic Repair/Malfunction ❑ Septic Relocation El Septic Expansion ❑Existing System Inspection or Reconnection Environmental Health El New Well El Replacement Well El Well Abandonment El Well Repair Property Address • -Acres ( jL A(te, Subdivision Lot# Driving Directions to Property Describe work r?t-tom Applicant Name Applicant Address tei ODI OjeD eV Vc f:k 12.. K-ccn-1 ItZ� QYIkj Ale i CA Ct�(PLe Phone rj'� -7( — 15 3- Email 6uXto .c1 �"� ' u�j.,gT, C Owner Name ,,LL Owner Address �;)rvk�,v ) 4.4 �� v�Gb &-cr 1-f'Cr 1J C- D_XCo b Z Phone Email Contractor Name Contractor Address Phone Email Name to Appear on Permit? ❑Owner MApplicant ❑Contractor Who will be the Primary Contact? ❑Owner Applicant 0 Contractor Proposed New Construction-Residential Primary Residence g New Residence El Addition to Residence #of New Bedrooms*t 3 #of Occupants a Project Description Structure Dimensions,also specify dimensions of decks&porches 2.aC7 J c7 5)(5t (Choose One) ❑Basement Crawl Space ❑ Slab If Basement,Will Tie Be Water Using Fixtures In Basement ❑Yes ig No Retaining Wall>2' 'Yes ❑ No Accessory Dwelling #of New Bedrooms*t #of Occupants Structure Dimensions (Choose One) ❑Basement 1 r.Crawl Space ❑ Slab If Basement,Will There Be Water Using Fixtures In Basement ❑Yes ❑ No Retaining Wall>2' Yes ❑ No Accessory Structure(s)Describe Structure(s)Dimensions Plumbing ❑'Yes 0 No Describe Plumbing Needed (Choose One) ❑Basement ❑Crawl Space ❑ Slab f Basement,Will There Be Water Using Fixtures In Basement ❑Yes ❑ No Retaining Wall>2' ❑ Yes ❑ No Multi-Family Residence #of Apartments #Bedrooms per rtment*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' ❑ Yes ❑ No Well Construction/Abandonment/Repair Proposed Well Type ❑ Individual Well ❑ Semi-Public ell ❑Community Well Abandonment Type El Drilled El Bored ❑ Dug ❑ Unknown Well Repair Requested El Yes ❑No Describe Will Certified Well Contractor Install Water Line or Electrical the 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 Y Existing Structures on Site Describe / tive J Structure Dimensions #of Bedrooms* /#of Occupants Basement ❑Yes ❑ No/ Basement Plumbing ❑ Yes ❑ No Existing Water Supply ❑Individual Well ❑Shared Well—Numbe of Connections ❑Community Well ❑County/City/Township Water Line Is a public water supply available? ** ❑ Y ❑No Commercial ❑ Proposed New Constructionxisting/Change of Use ❑Repair Food Service Specify Type #Seats Dining Area q.Ft.) #Employees per Shift #of Shifts Church #of Seats Daycare ❑Ye ❑No #of Children #of Employees per Shift #of Shifts Commercial Kitchen ❑Yes ❑N Residential Kitchen ❑Yes ❑No Daycare#of Children #of Employe per Shift #of Shifts Business/Other Specify Type Structure Dimensions Retail Floor Space #pi Employe s per Shift #of Shifts Other Information Calculated Design Flow,Commercial 1* (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. IIfje answer to any question is"yes",applicant must attach supporting documentation. ❑Yes 0 No Does the site contain any jurisdictional wetlands? ❑Yes ,tJ"No Does the site contain any existing wastewater systems? ❑ Yes la'No Is any wastewater going to be generated on the site other than domestic sewage? ❑Yes J'No Is the site subject to approval by any other public agency? ❑Yes c,2'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 grConventional 0 Innovative 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.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. 1. 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 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. --Tf' Signature of Owner or Legal Agent 464 Date__q4K____?..-- Printed Name of Owner or Legal Agent • lc 4 Cr&I d" .55 lq t 4 AM 41s ft(- f hk," � y 1 y4.11/1, Stu pet( i(a`Ihe J ' 1 011 tri N " 0 CO Ni O W O W 0 (0 ( 1 00 .; ‘\NNN:\ Vc(" 14% r'r 1 r' RECEIVED A U G 2 5 2022 r• 8- r = -1- ".-'c'... ; Environmental Health I '6 min A -- i 1 ct hr o IF s M r , ,,,,. w __ 0,. g M 4C10 CD i 1. V 9--) ___. . tgl �� 2' E l k .. El ' • N0)„ . il I I ,_ 1 T,— ■ r,...._. ill .1:. t L-- i III g I. A 6 a g I _ Parcel Report - Catawba County NC Parcel Information: Owner Information: Parcel ID: 279213042029 Owner: LOPEZ OMAR Parcel Address: Owner2: LOPEZ BERENICE City: HICKORY, 28602 Address: 409 EASTWAY LN SW LRK(REID): 59858 Address2: Deed Book/Page: 3698/0159 City: CONOVER Subdivision: JOHN P HUFFMAN State/Zip: NC 28613-9264 Lots/Block: 29/ Last Sale: School Information: School District: HICKORY Plat Book/Page: 10/12 Elementary School: LONGVIEW/SOUTHWEST Legal: LOT 29 PL 10-12 Middle School: GRANDVIEW Calculated Acreage: .440 High School: HICKORY Tax Map: 179H 03050 Township: HICKORY State Road #: TaxNalue Information: Tax Rates(pdf) Zoning Information: City Tax District: All in County Zoning District: HICKORY County Fire District: LONG VIEW RURAL Zoning1: R-1 Building(s) Value: $0 Zoning2: Land Value: $2,600 Zoning3: Assessed Total Value: $2,600 Zoning Overlay: Year Built/Remodeled: / 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 #: 3710279200J If available, Building Permits for this parcel. Septic 2010 Census Block: 1117 links are not permits. 2010 Census Tract: 011101 Septic Final Permits prior to 08/2018, contact Agricultural District: Environmental Health. Building Details l 1 ztt(z 7- no ceiwei "4- WaterShed: (ivet,%tpeg, �r11 5 (� r14/`� Voter Precinct: P19 p .t t ``ll;reet / Teritivt- Parcel Report Data Descriptions of Lets', eu._) 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. _C CATAWBA COUNTY g �}+ 100A SOUTHWEST BLVD ` H NEWTON,NORTH CAROLINA 28658 RECEIPT _ ,7 PHONE:828.465.8399 Friday,August 26,2022 18 4 2 5M www.catawbacountync.gov PAYOR: Lee,Seng PAYMENTS TRANSACTION NUMBER: TRC-4605 1 59 1-26-08-2022 PAYMENT DATE: 08/26/2022 PAYMENT TYPE: Money Order 0018900434 INVOICE NUMBER ACCOUNT FEE NAME FEE AMOUNT 08-22-411203 110-580200-663000 Improvement Permit Fee $150.00 TOTAL PAYMENTS: $150.00 EHPR-08-2022-42093 CASE TYPE: Environmental Health Plan Review WORK CLASS: OSWP SITE ADDRESS: , Applicant SENG LEE, 1900 ORO DAM BLVD E SUITE 12,ROOM 112,ORAVILLE CA 95966 **NO PEOPLESOFT ACCOUNT ASSIGNED** receipt 08/26/2022 16:34 Page 1 of 1