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Home My WebLink AboutRBPR-05-2022-40956.TIF catawba county public health AUTHORIZATION OF REFUND Date: 9/2/22 Case #: RBPR-05-2022-40956 Applicant: Richard Underwood Refund Amount: $150.00 Refund Reason: Settling tank will not be installed. App withdrawn Authorizing Signature: /4417 f 4✓ Received By Staff: L.rtata. 1itt jL j Date: (7l 117 L catawbacountync.gov Environmental Health Catawba County Government Center 25 Government Drive I PO Box 389 I Newton NC 28658 1828.465.8270 MAKING. LIVING. BETTER. �y'A • CATAWBA COUNTY t1 0 0 A SOUTHWEST BLVD 1 NEWTON,NORTH CAROLINA 28658 RECEIPT ,7( PHONE:828.465.8399 Friday, September 2, 2022 www.catawbacountync.gov PAYOR: Underwood, Richard Wayne Underwood,Richard Wayne(UNDERWOOD,*RICHARD) PAYMENTS TRANSACTION NUMBER: "1'RC-46461222-02-09-2022 PAYMENT DATE: 09/02/2022 PAYMENT TYPE: DV INVOICE NUMBER ACCOUNT FEE NAME FEE AMOUNT 08-22-410929 110-580200-663000 Authorization to Construct Fee (N (S150.00) ew/Expansion) Fee TOTAL PAYMENTS: ($150.00) RBPR-05-2022-40956 CASE TYPE: Residential Building Plan Review WORK CLASS: Accessory Structure SITE ADDRESS: 5967 WILLOWBOTTOM RD,HICKORY NC 28602 Lien Agent NO LIEN AGENT REQUIRED,, F:000000000 Owner *BRYAN&ASHLEY GRAFFICE,5967 WILLOWBOTTOM RD,HICKORY NC 28602 C:682-216-1959 ABGRAFFICE@GMAIL.COM Contractor UNDERWOOD,RICHARD WAYNE,510 MATHESON RD,TAYLORSVILLE NC 28681- B:8283123536C:828-312-3536 RICH UNDERWOODF:NA RICH2140@GMAIL,COM ACCOUNT:7324 receipt 09/02/2022 11:48 Page 1 of 1 Catawba County, North Carolina - Disbursement Voucher Vendor No. Date: 9/2/2022 Make Payment To: %�CQ6 Voucher No(s) Richard Underwood ` t f Z 4. 109jr ti 42 ATTACHMENT Prepared by: Julia English Description Amount Settling tank will not be installed. Application withdrawn $150.00 Sub-Total Food Tax Sales Tax Total $ 150.00 For Accounting Use Fund Cost Center Object Project Amount Only 110 580200 663000 Total The undersigned hereby certifies that the goods or services specified above have been received or performed. Payment has not been previously authorized and this expenditure is a proper charge to the appropriation indicated. The above charge is certified to you for payment. (SIGNATURE-APPROPRIATE OFFICIAL) • . ;'A�� THIS IS NOT A PERMIT Case# RBPR-05-2022-40956 d CATAWBA COUNTY HEALTH DEPARTMENT 1kt /b E`J PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES f � � hbl � ) y��f� Ig 2 ski Residential Building Plan Review-Accessory Structure !` AUTHCONST Writ (4,41A i' i li:i,.r' j.,(j ja l' Contractor UNDERWOOD,RICHARD WAYNE (*RICHARD UNDERWOOD),510 MATHESON RD, TAYLORSVILLE NC 28681- B:8283123536 C:828-312-3536 RICH UNDERWOOD OTHER:8286327623F:NA RICH2I40aGMAIL.CO M Lien Agent NO LIEN AGENT REQUIRED,, F:000000000 Owner *BRYAN&ASHLEY GRAFFICE,5967 WILLOWBOTTOM RD,HICKORY NC 28602 C:682-216-1959 ABGRAFFICE@GMAIL.COM NAME TO APPEAR ON PERMIT *Bryan & Ashley Graffice SITE ADDRESS: 5967 WILLOWBOTTOM RD,HICKORY NC 28602 PIN# 269905084097 NAME of SUBDIVISION: DEERFIELD SUED Lot#! 54 Section/Block PROPERTY SIZE: Square Feet Acres 1.25 DIRECTIONS: X PRIMARY CONTACT: Contractor SEWER TYPE: Septic Tank GALLONS PER DAY: 360 WATER SUPPLY: Private Well DESCRIBE WORK: 10x16 Accessory structure to pool storage w/half bath covered area.Will install a settling tank only. Grinder pump will connect to current septic system. 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? Yes Are there any easements or right-of-ways on this property? No APPLICATION FOR: New Structure STRUCTURE TYPE: *"NO STRUCTURE SELECTED** FACILITY TYPE: Accessory Structure OTHER DESCRIPTION: DESCRIPTION OF home and pool EXISTING STRUCTURES ON SITE(IF ANY) DIM EXISTING STRUCTURE: 43x44 home, 18x36 pool NUMBER OF EXISTING BEDROOMS: 3 #OF OCCUPANTS: 4 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 10x22 pool house BASEMENT? No BASEMENT FIXTURES? PLUMBING REQUIRED?Yes Desired system types(Improvement Permit or Authorization to Construct): ACCEPTED: ALTERNATIVE: CONVENTIONAL: OTHER: INNOVATIVE: ANY: Other described: ehupplieation 08/23/2022 14:56 Page 1 of3 C � CATAWBA COUNTY Case# RBPR-OS-2022-40956 Public Health Department Subdivision DEERFIELD SUBD , . Environmental Health Division PIN 269905084097 PO Box 389,100-A Southwest Blvd,Newton,NC 28658 w NAME ON PERMIT: (*BRYAN&ASHLEY GRAFFICE),5967 WILLOWBOTTOM RD,HICKORY NC 28602 (*Bryan&Ashley Graffice) Site Address: 5967 WILLOWBOTTOM RD,HICKORY NC 28602 Property Size: Square Feet Acres 1.25 Directions: X 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 AREA1 SETBACKS: 20' Hobbitstrow; must be 5'from home FEENAME PATE FEE AMOUNT Authorization to Construct Fee(New/Expansion) 08/23/2022 $150.00 Fee 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) ehapplication 08/23/2022 14:56 Page 2 of 3 Catawba county public health Application for Environmental Health Services THIS IS NOT A PERMIT Application is for: 1New Construction ❑ Existing Facility ❑Improvement Permit Authorization to Construct 1 ❑New Septic Septic Repair/Malfunction ❑ Septic Relocation ❑ Septic Expansion O Existing System Inspection or Reconnection ❑New Well 0 Replacement Well ❑ Well Abandonment ❑ Well Repair (Property Address .r96 7 Li: 1(0,J izc,41i -t a 0 l-4i c t(O r( D UDC)2— Acres Subdivision _ Lot# Driving Directions to Property j),? 't-a A_ -kit t ti ,R i 4l+ �o }- o ]-,c,E:) 4-,...,/ ,,.....) (2A- A4, ti c�O i e. ..tip, -1-vPto 1 r(4- ti—e...... .,ICa94 Rt. f s-i— ,--/c.� r c_1.r✓ /1/' / . \Describe work 4(1.1,v or L1 / Applicant Name Q;AA A-(Z-n v tri 06Q(,7a-0 C) I Applicant Address /(), M p-1-k e 5 0,AJ Q 0- -LA riPS�-,`/r a-k b 0 t Phone 1 7_ to Email 41�- 3 � �+� Owner Name ( (`, ,�n.� (6(A cc-,. , . Owner Address c b) Li;I 10,..✓ go 4fo,r►., 0 ( -/-1, e lc.)r y t'(16 2 Phone ,. (og Z. - (1.1 (o - 1 y c9 Email Contractor Name ai c-\n met) JN rh-.cao d Contractor Address s----10 pr.,bs,A lfk t 56,,../ 2 p ./-rq‘t ,c I( r ;fibs-/ Phone ed u - ? 12 - g S 1 6 Email R:r V. -1 t t{r _e ( Ai\__, co Name to Appear on Permit? IlDirOwner 0 Applicant ❑Contractor Who will be the Primary Contact? 0 Owner 0 Applicant Eontractor 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) El Basement ❑Crawl Space 0 Slab If Basement,Will There Be Water Using Fixtures In Basement ❑Yes ❑ 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 0 Yes 0 No Retaining Wall>2' 0 Yes ❑ No Accessory Structure(s)Describe FUc.1 Jo c..4$ Structure(s)Dimensions !d l( ZZ Plumbing (Yes 0 No Describe Plumbing Needed5.ix..)k c 4- 4 o .1 r I' *by#1, d a bcr S n K- (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 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 ❑ No Well Construction/Abandonment/Repair Proposed Well Type 0 Individual Well ❑ Semi-Public Well ❑Community Well Abandonment Type ❑ Drilled ❑ Bored 0 Dug 0 Unknown Well Repair Requested 0 Yes ❑No Describe Will Certified Well Contractor Install Water Line or Electrical Line from Well Head to Pressure Tank?0 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 '; �x 1 Describe 110(-)9 jy d 1 Structure Dimensions `t y #of Bedrooms* 3 #of Occupants ?CO l 1"x3t,, Basement I[ ces ❑ No Basement Plumbing Yes ❑ No Existing Water Supply Individual Well ❑ Shared Well—Number of Connections 0 Community Well ❑County/City/Township Water Line Is a public water supply available?** El Yes El No Commercial El Proposed New Construction El Existing/Change of Use El Repair Food Service Specify Type #Seats Dining Area(Sq.Ft.) #Employees per Shift #of Shifts Church #of Seats Daycare El Yes ❑No #of Children #of Employees per Shift #of Shifts Commercial Kitchen ❑Yes El No Residential Kitchen ❑Yes El 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 CIo Does the site contain any jurisdictional wetlands? es llo Does the site contain any existing wastewater systems? Yes Et 0 Is any wastewater going to be generated on the site other than domestic sewage? g.,Yes i Is the site subject to approval by any other public agency? Yes 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) 0 Accepted 0 Alternative 0 Conventional 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 nwnber 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,angering,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 prope or legal agent of the owner. Signature of Owner or Legal Agent 1042//ikAlebW Date — 2.-3 -- 2 Printed Name of Owner or Legal Agent jot -rfi Uhd el-tux-4 r r Catawba County Environmental Health L.- 4-5 182.91 sA 1�-�W�O o" �� p`� • 130.90 `��'� �~ TO 49.85 O 1 x tit co m ur cti il, CO en N 43 •5967 f 31.42 60 80,07 ) t?, yob 'CP... 0` �- wo oa At, it,A...\--..''''') 61 p' o'\ 1 7 49 2.93 •1500 Parcel: 269905084097, 5967 WILLOWBOTTOM lin=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 07/20/2022 CATAWBA COUNTY HEALTH DEPARTMENT NEWTON, NORTH CAROLINA COMPLETION PERMIT FOR SEPTIC TANKS PERM1IT lN° 01881 �,,A //It DATE : L L 4 7 OWNER inag ADDRESS BUI DIN CON SAC OR SUBDIVISIONv LOCATION LOc # LOT SIZE BLOCK OR SECTION HOUSE (e MOBILE HOME ( ) BUSINESS ( ) OTHER ( ) FHA-VA LOAN ( ) SEPTIC TANK: (SIZE (D00 GALS) WATER SUPPLY : NO. BEDROOMS NO NO FIXTURES 7— INDIVIDUAL - X PUBLIC GARBAGE DISPO AL UNIT:YES ( ) NO ) IF WELL, TYPE : BORED DRILLED DUG AUTO WASHING MACHINE : YES ($40 NO ( ) DISTANCE FROM SEPTIC�TANK OR NEAREST- NITRIFICATION FIELD: 08 0 SQ.FT , POLLUTION: # 6 FT. 1) NUMBER OF LINES SEPTIC TANK IN TA LED BY: 2) LENGTH AND �DTTI L NE5 / /Z- K EE a) BED SY TEM (}0 CERTIFICATE OF CO LETION BY: b) TRENCH SYSTEM ( ) � mow$/ 3) DEPTH OF STONE IN LINES (e., REMARKS : ADEQUATE FALL (GRADE) ON: 1) BUILDING (HOUSE) SEWER LINE : YES (yc) NO ( ) 2) NITRIFICATION LINES : DATE INSTALLED: rf O 3 S7 YES (k) NO ( ) SEPTIC TANK LAYOUT 16 l `( Ea � U O x !l, i Gz. Ip0 O r.a C - 6-1E#LTH DEPARTMENT COPY 1. 1 .ti {0° 3 0 PERMIT NO. 0L, 0J PERMIT FEE: flo C k -0 Ili e PERMIT '-VOID AFTER 36 MONTHS CATAWBA COUNTY HEAL DEPAR NT IMPROVEMENT PERMIT OWNER OR CONTRACTOR: 06,1, 0 t mR._. DATE: %II"/7- gL ADDRESS: (A);th b .,,.. a PHONE: 39/�3i/ 16 LOCATION: Jp 7,5 .C,c„, c Ii-e, c7 J) u), b n-c4. t CQ b pD SUBDIVISION: 11„. 1, LOT II ,5W SECTION OR BLOCK: LOT SIZE: 1 a,..„_, Notified to check 1W_ith Zoning Yes (✓)" No ( ) Zoning Approval I Ve,).T House (✓) Mobile Home ( ) Business ( ) Other ( ) Flow Rate: 360 gpd Bedrooms: 3 Bathrooms: (2y2", Special Fixtures: „,0ri, Other: Basement - Yes ( V) No ( ) Fixtures in Basement - Yes ( ) No (:.-1 Pump System Yes( ) No (6-r Garbage Disposal Unit Yes (,"") No ( ) Water Supply: Private ( (...Y Public ( ) TANK SIZE: ),5-OD gallons Comments/Special Instructions: 13.10oa4,,.A,,,,,,,,�:G; NITRIFICATION FIELD: /t._9.t�.Jrn iu.a7" ¢' T�A*-2z Number of Lines +4 Length and width of Lines System must be installed as shown. Any (a) Bed System J� ' x yb { changes will be made only with prior Health (b) Trench System 36" X Department approval. If unforeseen problems or Trench System 30" X arise during installation, contractor must Total Sauare Footage fpn DcRI,._Qf-itQuel call Health Department. I CERTIFY THAT I HAVE REVIEWED AND AGREE TO E PROVISIONS ON THIS PERMIT. I / / /� ay Owner/Agen nitari n c.)(�"n .. Final approval of this septic tank system shall in no way be taken as a guarantee that the syst=40,till function sat sfact• •r any g4ven period of time. . . .4c-P-140.., ,4- 6 iJ "• ,s . 3eTIC TANK PLAN f , „- u r b0o1 1 lao Ate. Leo, a * . "^1 k, lf 'Glee Y �f ��- yiYC�OJ./I f. -JJ.C' r21.cu-C'/� ,+" )L`a!� i OP') "—� x Qi 1 J I J ,40 L y kn , \ . b hIB44(17t4vm„) (Health Department Cop 1 Site Factor: Soii Gr.up Soil Texture Class Application Rate Slope and Landscape Position S - PS - U Soil Drainage S - PS - U Sandy Clay Soil Depth S - PS - U III Fine Silt Loam 0.6-0.4 Restrictive Horizon S - PS - U Loams Clay Loam Available Space S - PS - U Silty Clay Other S - PS - U (Specify) Sandy Clay Soil Characteristics: S - PS`L - U , IVa Clays Silty Clay 0.4-0.2 Repair Area Required: Yes ( Y.) No ( ) Clay *Bed systems are allowed only in soil Grout) III. CAiii• CATAWBA COUNTY 100A SOUTHWEST BLVD aNEWTON,NORTH CAROLINA 28658 RECEIPT ).,5r PHONE:828.465.8399 �1Tuesday,August 23,2022 42 5M www.catawbacountync.gov PAYOR: Underwood, Richard Wayne Underwood,Richard Wayne(UNDERWOOD,*RICHARD) PAYMENTS TRANSACTION NUMBER: TRC-45857348-23-08-2022 PAYMENT DATE: 08/23/2022 PAYMENT TYPE: Cash INVOICE NUMBER ACCOUNT FEE NAME FEE AMOUNT 08-22-410929 110-580200-663000 Authorization to Construct Fee(N $150.00 ew/Expansion)Fee TOTAL PAYMENTS: $150.00 RB PR-05-2022-40956 CASE TYPE: Residential Building Plan Review WORK CLASS: Accessory Structure SITE ADDRESS: 5967 WILLOWBOTTOM RD,HICKORY NC 28602 Lien Agent NO LIEN AGENT REQUIRED,, F:000000000 Owner *BRYAN&ASHLEY GRAFFICE,5967 WILLOWBOTTOM RD,HICKORY NC 28602 C:682-216-I959 ABGRAFFICE a GMAIL.COM Contractor UNDERWOOD,RICHARD WAYNE,510 MATHESON RD,TAYLORSVILLE NC 28681- B:8283I23536C:828-312-3536 RICH UNDERWOODF:NA RICH2140@GMAIL.COM ACCOUNT:7324 receipt 08/23/2022 14:54 Page 1 of 1