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HomeMy WebLinkAboutEHPR-09-2022-42400.TIF .114' • THIS IS NOTA PERMIT Case# EHPR-09-2022-42400 CATAWBA COUNTY HEALTH DEPARTMENT PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES 18 2 SM Environmental Health Plan Review-Septic Malfunction AUTH CONST- SEPTIC MALFUNCTION Applicant TYLER ISENHOUR, 1951 SLEEPY I IOLLOW DR,I IICKORY NC 28601 C:8283128048 NAME TO APPEAR ON PERMIT Tyler Isenhour SITE ADDRESS: 1951 SLEEPY HOLLOW DR,HICKORY NC 28601 PIN # 373309057788 NAME of SUBDIVISION: SLEEPY HOLLOW 1 of# 29-32 Section/13iock B PROPERTY SIZE: Square Feet 23,958.00 Acres 0.55 DIRECTIONS: Springs Rd,right Section House Rd, left Sleepy Hollow Dr,at end on right PRIMARY CONTACT: Applicant SEWER TYPE: Septic Tank GALLONS PER DAY: 360 WATER SUPPLY: Public Water DESCRIBE WORK: Tank only top caving in 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 residence EXISTING STRUCTURES ON SITE(IF ANY) DIM EXISTING STRUCTURE: 58 x 34 NUMBER OF EXISTING BEDROOMS: 3 #OF OCCUPANTS: 5 PROPOSED CONSTRUCTION BASEMENT? Yes BASEMENT FIXTURES? No PLUMBING REQUIRED? EMPLOYEES PER SHIFT: NUMBER OF SHIFTS: TOTAL EMPLOYEES: SEATING CAPACITY: TOTAL FLOOR SPACE(SO FT): Desired system types(Improvement Permit or Authorization to Construct): ACCEPTED: ALTERNATIVE: CONVENTIONAL: OTHER: INNOVATIVE: ANY: Other described: clapplirnnm 09/29/2022 12:53 Page I of6 • CATAWBA COUNTY Case# EHPR-09-2022-42400 Int ma ,2 Public Health Department Subdivision SLEEPY HOLLOW Environmental Health Division PIN# 373309057788 PO Box 389,100-A Southwest Blvd,Newton,NC 28658 g 5W NAME ON PERMIT: (TYLER ISENHOUR), 1951 SLEEPY HOLLOW DR,HICKORY NC 28601 (Tyler Isenhour) Site Address: 1951 SLEEPY HOLLOW DR,HICKORY NC 28601 Property Size: Square Feet 23,958.00 Acres 0.55 Directions: Springs Rd,right Section House Rd,left Sleepy Hollow Dr,at end 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 ##i########it#ii###i####*#**#i############### FEENAME DATE FEE AMOUNT Authorization to Construct(Repair)Fee 09/29/2022 $150.00 TOTAL FEES S150.00 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) ehapplicauun 09/29/2022 12:53 Page 2 of6 catawba county 11,,Rga public health Application for Environmental Health Services THIS IS NOT A PERMIT Application is for: 0 New Construction ❑ Existing Facility improvement Permit 0 Authorization to Construct 0 New Septic ❑ Septic Repair/Malfunction 0 Septic Relocation ❑ Septic Expansion ❑ Existing System inspection or Reconnection 0 New Well 0 Replacement Well ❑ Well Abandonment 0 Well Repair Ng Ske fvv 11pl/o,,✓ br / .ve cl Kdo1 Property Address t�Kot' Acres • 5 Subdivision Lot# Driving Directions to Property Describe work Rcillocc 4anK Applicant Name Vet i?cpl>ipr r Applicant Address p51 Skew Allot,/ Or I cKor, i idol Phone tik.30,. Cell Phone Owner Name SAIML Owner Address Scvne Phone S t Cell Phone Contractor Name AnAiyony 6ec J ,> 9es Gr" d ,se e License# ;7or Contractor Address 5y 5 „<J,od bC trwv10ic' J/ vc jt6i[51 Phone tote- 304-- 01197 Cell Phone Name to Appear on Permit? 0Owner ❑ Applicant ❑Contractor Who will be the Primary Contact? 20)wner 0 Applicant ❑Contractor Proposed New Construction-Residential Primary Residence 0 New Residence ❑ Addition to Residence *of New Bedrooms*t z of Occupant. Project Description Structure Dimensions.also specify dimensions of decks&porches - Basement ❑ Yes 0 No Basement Plumbing 0 Yes 0 No Accessory Dwelling #of New Bedrooms*t #of Occupants Structure Dimensions Basement ❑ Yes ❑No 1asement Plumbing ❑Yes 0 No Accessory Structure(%)Describe Structure(s)Dimensions Plumbing ❑Yes ❑ No Describe Plumbing Needed Multi-Family Residence #of Apartments #13ednxoms per Apartment*t total#Bedrooms in titntcture*1- #of Occupants Structure Dimensions Basement ❑ Yes ❑ No Basement Plumbing ❑ Yes ❑ No Well Construction/Abandonment/Repair Proposed Well type ❑ Individual Well 0 Semi-Public Well ❑Community Well Abandonment lope 0 Drilled ❑ Bored 0 Dug ❑ f Tnknown Well Repair Requested ❑Yes 0 No Describe Will Certified Well Contractor Install Water Line or Electrical Line from Well Ilead to Pressure lank?0 Yes ❑ No catawbacountync.gov Environmental Health ..oiiwhe Caw/ 1:7,ov troltflt i..,;!C'I 55 2855E 1 L'aa 465 8,, Existing Structures� "" on Site ,�1) tt��,���� Describe 3 134 5, 11.ai&k t . W/�/1 l $QIcA1 Structure Dimensions of Bedrooms * 3 #of Occupants Basement Yes ❑ No Basement Plumbing ❑ Ycs No Existing Water Supply ❑ Individual Well ❑ Shared Well—Number of Connections D Community Well EKounty:Citv/Township Water Line Is a public water supply available?** ❑ Ycs 0 No Commercial ❑ Proposed New Construction ❑ Existing/Change of Use ❑ Repair Food Service Specify Type #Seats Dining Area(Sq. FL) #Employees per Shift #of Shifts Church #of Seats Daycare❑ Yes ❑ No #of Children #of Employees per Shift u of Shifts Commercial Kitchen 0 Yes ❑ No Residential Kitchen 0 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 tile answer to any question is"yes".applicant must attach supporting documentation. ❑ Yes 10'No Does the site contain any jurisdictional wetlands? Qkcs ❑jslo Docs the site contain any existing wastewater systems'? ❑ Ycs O No is any wastewater going to be generated on the site other than domestic sewage? ❑ Yes Is the site subject to approval by any other public agency'? 0 Ycs o Arc there any casements 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 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. 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) 'Completed applications arc 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 Coustnrct 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 arc 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 lega agent of to owner. Signature of Owner or Legal Agent Date /23/61061a Printed Name of Owner or Legal Agent 7ler iiM.{ Geospatial catawba county information Services Real Estate Search \ Z ttt, % s� + ;z, G\` /JO jqd ). `mod P f•P- N w— e 1 in=80ft s Parcel: 373309057788, 1951 SLEEPY HOLLOW DR HICKORY, 28601 Owners: ISENHOUR TYLER L, Owner Address: 1951 SLEEPY HOLLOW DR Values - Building(s): $114,600, Land: $13,500, Total: $128,100 This map/report product was prepared from the Catawba County,NC Geospalial 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 04/14/2022 Catawba County Environmental Health 1►5 115 a8 00 •1951 $(� l Y •1961 1 25 00 104' 0'05 1.1962 Parcel: 373309057788, 1951 SLEEPY HOLLOW 1 in=50ft DR HICKORY, 28601 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 09/27/2022 Parcel Report - Catawba County NC Parcel Information: Owner Information: Parcel ID: 373309057788 Owner: ISENHOUR TYLER L Parcel Address: 1951 SLEEPY HOLLOW DR Owner2: City: HICKORY, 28601 Address: 1951 SLEEPY HOLLOW DR LRK(REID): 63623 Address2: Deed Book/Page: 3270/1256 City: HICKORY Subdivision: SLEEPY HOLLOW State/Zip: NC 28601-7771 Lots/Block: 29-32/ B School Information: Last Sale: $114,000 on 2014-12-19 Plat Book/Page: 13/109 School District: COUNTY Legal: LOTS 29-32 BLOCK B PLAT 13-109 Elementary School: SNOW CREEK Calculated Acreage: .550 Middle School: ARNDT Tax Map: 2116 02001 High School: ST STEPHENS Township: CLINES School Map State Road #: 1679 TaxNalue Information: Tax Rates(pdf) Zoning Information: City Tax District: All in County Zoning District: COUNTY County Fire District: ST STEPHENS Zoning1: R-20 Building(s)Value: $114,600 Zoning2: Land Value: $13,500 Zoning3: Assessed Total Value: $128,100 Zoning Overlay: Year Built/Remodeled: 1972/ Small Area: ST STEPHENS/OXFORD Current Tax Bill Split Zoning Districts: / Zoning Agency Phone Numbers Miscellaneous: Firm Panel Date: 2007-09-05 Building Permit Address Search for this parcel. Firm Panel #: 3710373300J If available, Building Permits for this parcel. Septic 2010 Census Block: 2102 links are not permits. 2010 Census Tract: 010202 Septic Final Permits prior to 08/2018, contact Agricultural District: Environmental Health. Building Details WaterShed: Voter Precinct: P33/Voting Map Parcel Report Data Descriptions List all Owners Deed History Report Assessment Report This map/report product was prepared from the Catawba County,NC Geospatial Information Services.Catawba County has made substantial efforts to ensure the accuracy of location and labeling information contained on this map or data on this report.Catawba County promotes and recommends the independent verification of any data contained on this map/report product by the user.The County of Catawba,its employees,agents,and personnel,disclaim,and shall not be held liable for any and all damages,loss or liability, whether direct,indirect or consequential which arises or may arise from this map/report product or the use thereof by any person or entity. ©2022, Catawba County Government, North Carolina.All rights reserved. .1 O 0. N. '� N o o% > a a -- o ; in .. N i� Li) ... . 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J o VI o VI v � ► en - z a p J u a ILu in / ti - Z ci Z a \ .� vi' o Z s ° 1 Q s° Z W x- i in 1 •� \ 4 t` N w o U tj 11 W �r •,?w �,� C Z i1 Q7.7 a rQ El 0car.` Ea _. . - Q a 1 ) '` ? k1 - 0 `" 15 w N 0 d t -� 0 0 ? 4-+ Q.) 0 ) 0 C V) O O O wr aU C p • 0. 0 I- -- rl • • asi • �$A • CATAWBA COUNTY 100A SOUTHWEST BLVD ` NEWTON,NORTH CAROLINA 28658 RECEIPT ® 714 PHONE: 828.465.8399 Thursday,September 29,2022 18 4 Z SM www.catawbacountync.gov PAYOR: Isenhour,Tyler PAYMENTS TRANSACTION NUMBER: TRC-48141181-29-09-2022 PAYMENT DATE: 09/29/2022 PAYMENT TYPE: Credit Card 295665280 INVOICE NUMBER ACCOUNT FEE NAME FEE AMOUNT 09-22-412898 110-580200-663000 Authorization to Construct(Repair) $150.00 Fee TOTAL PAYMENTS: $150.00 EH PR-09-2022-42400 CASE TYPE: Environmental Health Plan Review WORK CLASS: Septic Malfunction SITE ADDRESS: 1951 SLEEPY HOLLOW DR,HICKORY NC 28601 Applicant TYLER ISENHOUR, 1951 SLEEPY HOLLOW DR,HICKORY NC 28601 C:8283128048 **NO PEOPLESOFT ACCOUNT ASSIGNED** receipt 09/29/2022 12:52 Page 1 of 1