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HomeMy WebLinkAboutEHPR-12-2022-42918.tif • THIS IS NOTA PERMIT Case# EHPR-1 2-2022-429 1 8 (.. CATAWBA COUNTY HEALTH DEPARTMENT ±� PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES 1: •_ sM Environmental Health Plan Review-Septic Malfunction AUTH CONST- SEPTIC MALFUNCTION Applicant *MAKARIOS HOLDINGS,LLC (JOSUE MENA-FLORES), 174 CORODELL LN,STATESVILLE NC 86459 B:7049908826 C:7049305382 MICHAELLESTERJR«YAHOO.COM NAME TO APPEAR ON PERMIT *Makarios Holdings, LLC (Josue Mena-Flores) SITE ADDRESS: 6472 LITTLE MOUNTAIN RD,SHERRILLS FORD NC 28673 PIN # 369803404111 NAME of SUBDIVISION: Lot# 5 Section/Block PROPERTY SIZE: Square Feet 27,007.20 Acres 0.62 DIRECTIONS: E NC 150 Hwy,left Little Mountain Rd,on right just past Reid Taylor Rd PRIMARY CONTACT: Applicant SEWER TYPE: Septic Tank GALLONS PER DAY: 360 WATER SUPPLY: Private Well DESCRIBE WORK: Septic tank only,cracked 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: 40 x 20 NUMBER OF EXISTING BEDROOMS: 3 #OF OCCUPANTS: PROPOSED CONSTRUCTION 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: YES Other described: ahapplication 12/01/2022 10:22 Page 1 of6 �I • ' CATAWBA COUNTY Case# EHPR-12-2022 42918 f�U Public Health Department Subdivision 4 Environmental Health Division PIN# 369803404111 PO Box 389,100-A Southwest Blvd,Newton,NC 28658 l; • . w NAME ON PERMIT: *MAKARIOS HOLDINGS,LLC (JOSUE MENA-FLORES), 174 CORODELL LN,STATESVILLE NC 86459 *Makarios Holdings, LLC (Josu Site Address: 6472 LITTLE MOUNTAIN RD,SHERRILLS FORD NC 28673 Property Size: Square Feet 27,007.20 Acres 0.62 Directions: E NC 150 Hwy,left Little Mountain Rd,on right just past Reid Taylor 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: /2—0 1—Zd L Z Signature of Applicant or Agent j-e- �--� ikteA- If you need further information or assistance please call 828-465-8270 AREA4 'FE11NAME ,' I DATE ?,FEFg"AMOUNT Authorization to Construct(Repair)Fee 12/01/2022 S150.00 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) chapplication 12/01/2022 10:22 Page 2 of 6 Catawba county public health Application for Environmental Health Services THIS IS NOT A PERMIT Application is for: ❑New Construction ❑Existing Facility ❑ Improvement Permit ❑ uthorization to Construct ❑New Septic Septic Repair/Malfunction ❑ Septic Relocation ❑Septic Expansion ❑ Existing System Inspection or Reconnection ❑ New Well ['Replacement Well ❑ Well Abandonment ❑ Well Repair Property Address \ylOOYtkG\ \ SYte_errt1\S tiC 2 '+ Acres Subdivisi9 Lot Driving Directions to Property ' C zii t. . eideet Describe work Applicant Name 3osuc ?J€ant..-?\ores ( H v/,tIo j Ncx Dt►-s65 Applicant Address 13.l4, CG`(Oc\e u LGrte 20s6. 4.14 Phone ' C1 c(?U -5SriZ _ Email J Owner Name Owner Address Phone Email Contractor Name Contractor Address Phone Email Name to Appear on Permit? ❑Owner ❑Applicant ❑Contractor Who will be the Primary Contact? El Owner El Applicant ❑Contractor Proposed New Construction-Residential Primary Residence El New Residence ❑ Addition to Residence #of New Bedrooms st #of Occupants Project Description Structure Dimensions,also specify dimensions of decks&porches (Choose One) ❑Basement ❑Crawl Space ❑ 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 ❑ Slab If Basement,Will There Be Water Using Fixtures In Basement ❑Yes ❑ No Retaining Wall>2' ❑ Yes ❑ No Accessory Strocture(s)Describe Structure(s)Dimensions Plumbing ❑Yes ❑No Describe Plumbing Needed (Choose One) ❑Basement ❑Crawl Space ❑ Slab If Basement,Will There Be Water Using Fixtures In Basement ❑Yes 0 No Retaining Wall>2' ❑ Yes ❑ No Multi-Family Residence #of Apartments #Bedrooms per Apartment*t Total#Bedrooms in Structure*t #of Occupants Structure Dimensions (Choose One) ❑Basement ❑Crawl Space El Slab If Basement,Will There Be Water Using Fixtures In Basement ❑Yes ❑ No Retaining Wall>2' El Yes ❑ No Well Construction/Abandonment/Repair Proposed Well Type ❑ Individual Well ❑ Semi-Public Well ❑Community Well Abandonment Type ❑ Drilled ❑ Bored El Dug El Unknown Well Repair Requested ❑ Yes ❑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 Sivq Lc f tk ktoUY!#of Bedrooms* 3 Structure Dimensions �-+ (��t #of Occupants Basement ElYes [l No Basement Plumbing ID Yes [ No Ex) ting Water Supply individual Well ❑ Shared Well—Number of Connections ❑ Community Well ❑ County/City/Township Water Line Is a public water supply available?** ❑ Yes ©No Commercial ❑Proposed New Construction ❑Existing/Change of Use ❑Repair Food Service Specify Type #Seats Dining Area(Sq. Ft.) #Employees per Shift #of Shifts ' Church #of Seats Daycare❑ Yes ❑ No #of Children #of Employees per Shift #of Shifts Commercial Kitchen ❑ Yes El 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 uestion. If the answer to any question is"yes",applicant must attach supporting documentation. 0 Yes OD No®Yes 0 No 0 Yes Does the site contain any jurisdictional wetlands? Does the site contain any existing wastewater systems? to No Is any wastewater going to be generated on the site other than domestic sewage? 0 Yes No Is the site subject to approval by any other public agency? 0 Yes 1p 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) 0 Accepted ❑Alternative ❑Conventional 0 Innovative 0 Other q9 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 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. he undersigned is the owner of the property or legal agent of the owner. Signature of Owner or Legal Agent fitlep,OICti Printed Name of Owner or Legal Agent Jose MM c-PIMPS Date (2-0 1 -Z(J c' Catawba County Environmental Health �993k > r?��) lll, PAM 4Y E=I] �7454 100.00 41N 111 (r i SAC - _ _ p ce 110 }„ OW, 42. r 6456 scar 1.4 •6 72 •6480 ••-wttt (100) (63) (183) LITTLE MOUNTAIN RD (30) 8 77.03 1.31 Parcel: 369803404111, 6472 LITTLE MOUNTAIN tin=60ft RD SHERRILLS FORD, 28673 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 12/01/2022 12/1/22,9:47 AM Parcel Report Parcel Report - Catawba County NC Parcel Information: Owner Information: Parcel ID: 369803404111 Owner: MAKARIOS HOLDINGS LLC Parcel Address: 6472 LITTLE MOUNTAIN RD Owner2: City: SHERRILLS FORD, 28673 Address: PO BOX 6411 LRK(REID): 6194 Address2: Deed Book/Page: 3734/1557 City: STATESVILLE Subdivision: State/Zip: NC 28687-6411 Lots/Block: 5 / School Information: Last Sale: School District: COUNTY Plat Book/Page: 39/153 Elementary School: BALLS CREEK Legal: LOT 5 PL 39-153 Middle School: MILL CREEK Calculated Acreage: .620 Tax Map: 006 X 03015D High School: BANDYS Township: MOUNTAIN CREEK School Map State Road #: 1815 TaxNalue Information: Tax Rates(pdf) Zoning Information: City Tax District: All in County Zoning District: COUNTY County Fire District: SHERRILLS FORD Zoningl: R-40 Building(s)Value: $20,700 Zoning2: Land Value: $11,400 Zoning3: Assessed Total Value: $32,100 Zoning Overlay: WP-O Year Built/Remodeled: 1961/ Small Area: SHERRILLS FORD 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 #: If available, Building Permits for this parcel. Septic 2010 Census Block: 3017 links are not permits. 2010 Census Tract: 011501 Septic Final Permits prior to 08/2018, contact Agricultural District: PROXIMITY Environmental Health. Building Details WaterShed: WS-IV Critical Area Voter Precinct: P31/Voting Map N Lk Parcel Report Data Descriptions List all Owners Deed History Report Assess ent 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. gis.catawbacountync.gov/nomap/parcel_report.php?key=369803404111&type=u 0 // -!2- 0 albItiAlla CATAWBA COUNT\ ALTH DEPARTMENT /G Telephone: (828)465-8270 TDD: (828)465-8200 WLS #cOO.2— 0)5, 5--- IP AC Rpr. Prmt. Opr. Prmt. Sys. Type Well Prmt. _Replacement Well Well Rpr. Prmt. Owner/Agent ta//[./, g e/JD Phone 70 , V 7—o132 Address (p1I7 Lj e. m0 is,or"grly /.1)/4- '- ) Subdivision �a1,-A .S/5/eteS F72Zj Section/Block/Phase Lot# Lot Size /, C�,3--,;tr, r< Directions: �6 s t-c - /_ v tD � -- ,t, S' lt7j"' Q l� Q 4:7" Pit ,a) d4.-poN�x n,i'- -' /!-.SS Qe)/_2 7-,,Z re- Ee.L) l ) ,rev y' U �1 Property Address 9 J� '-117LE 011- eO/J) Facility: House x Mobile Home Business Multi-family . Other: Pin Number u 9,5? 03 5'O W// Other . Zoning Approval# NM- "� #Bedrooms .3 #Seats / Employees . Application Rate NM- GPD Flow 4# Hot Tub or Spa ye no pecial Fixtures Basement y nono . 100% Repair Arra yes/no, Basement Plumbing yes Water Supply: Private Well X Public Semi-Public Type of System: Trench Bed Pump Pump/Panel Panel LPP Other Septic T. . Siz- _ ' mp Tank Siz• . ' rificatio u i: - Square au.- I- 1 o i - Bed Si : - otal Length • 1 Trenches - ••I •= if Trenches .....o...411111111110110,- -Trench-Length / I / / Feet on Center Maximum Trench Depth Distance of 1 :. - t Well *DO NOT INSTALL SEPTIC WHFI WET* *WELL RECORD REQUIRED AT COMPLETION* ***************************** ***************************************** ************************************************ Topa % Slope Text re b *..s-e-fr"-0- I=+20 07)01 eLIr✓t. Struc e Ali.. - Soi ..�''r� " Sail � • w I N 5p 6-f- t -,2pr,. ft-IV 4 tri• i fit✓P-1 L STD'"'` Av. la: c,:yeslno 1�A Ovej.to lass S PS U I t.:,} • Comme s: ~ ,� -- -,-f - I X FP43 411 4' Filter Required ' /� • Riser required when I tank is more than 6 s lI 1 inches deep. **NO GUARANTEE •: • . '.'.•N - 1110?e. ► A 8 I . • I •R NCE IR LENGTH OF TIME THIS SYSTEM WILL FUNC ON** 4-/7-Tt /777-"". 20AU) *Improvement Permit has no expiration date and is transferable, but may be revoked if site plans or intended use changes for the proposed facility. An Authorization to Construct is valid for(5) five years from date issued and is not transferable. Well Permit valid for 5 years provided site conditions do not change. Well location, installation, and protection must meet state and local regulations, and must be inspected and approved by a representative of'the Catawba County Health Department before any portion of the installation is put into use. The siting of the well by the Health Department staff is to provide protection from known possible sources of contamination. No volume of • water is guaranteed!tit ny site by the Health Department. Permit Date .;_i_40 EHS �, ,�. _ __ _ Owner/Agent `is Septic Tank Installed By Date EHS tt Well Installed By 8 ei. K WrG..cr Well Grout Approval Date /f) -Q; Well Head Approval Date JJ-/:.1 •o.. Date Sample Collected II- I -O a. Date of Results Results - EHS �- e White-Office Yellow-Owner/Agent. Pink-Building Inspection Authorization to Construct tA, CATAWBA COUNTY 100A SOUTHWEST BLVD t n "3 NEWTON,NORTH CAROLINA 28658 RECEIPT PHONE:828.465.8399 Thursday, December 1,2022 L8 42 SM www.catawbacountync.gov PAYOR: *Makarios Holdings, LLC *Makarios Holdings,LLC(Mena-Flores,Josue) PAYMENTS TRANSACTION NUMBER: TRC-52333 1 57-01-1 2-2022 PAYMENT DATE: 12/01/2022 PAYMENT TYPE: Credit Card 298115207 INVOICE NUMBER ACCOUNT FEE NAME FEE AMOUNT 12-22-415396 110-580200-663000 Authorization to Construct(Repair) $150.00 Fee TOTAL PAYMENTS: $150.00 EH PR-1 2-2022-429 1 8 CASE TYPE: Environmental Health Plan Review WORK CLASS: Septic Malfunction SITE ADDRESS: 6472 LITTLE MOUNTAIN RD,SHERRILLS FORD NC 28673 Applicant *MAKARIOS HOLDINGS,LLC, 174 CORODELL LN,STATESVILLE NC 86459 B:7049908826C:7049305382 MICHAEL.LESTERJR@YAHOO.COM **NO PEOPLESOFT ACCOUNT ASSIGNED** receipt 12/01/2022 10:21 Page 1 of I