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HomeMy WebLinkAboutRBPR-12-2022-42975.tif • LS-P. ►)-)0) -iStie'illis RECEIVED 1.11613.-0 I)(0 ANIin igiVA •I)-,vr) - oils STATE a D . ��` tiD, ROY COOPER •Governor t��c ' ' .PTy' NC DEPARTMENT OF KODY H. KINSLEY•Secretary Oa ,.- 1'.. p HEALTH AND L . ,r1 HUMAN SERVICES HELEN WOLSTENHOLME•Interim Deputy a mbmf}.{ea(th ` . u. MARK T. BENTON•Assistant Secretary for Public Health Division of Public Health COMMON FORM FOR LICENSED SOIL SCIENTIST COVID-19 PERMIT OPTION FOR NON-ENGINEERED SYSTEMS See Instructions for Use in Appendix A Except for"Date received",this Section to be completed by the LSS in accordance with S.L.2020-97,Section 3.19 and G.S. 130A-336.2 LHD USE ONLY: Initial submittal of this NOI received: 12,-1 - L by I'p _e Date initials PART 1:Notice of Intent to Construct(NOI)-Please check all that apply ®Single System or ❑ Multiple Systems AND ® New ❑ Expansion ❑Relocation of all or part of the Existing System ❑ Relocation of Repair Area ❑ Repair—LHD Permit Number ❑ Repair—EOP/LSS COVID 19/AOWE Permit Number 1. Facility Owner's name:(Owner, Company Name, Utility,Partnership,Individual,etc.): Bolick Management LLC,c/o Jeff Bolick Mailing address: 1236 Buffalo Shoals Rd City:Catawba State: NC Zip: 28609 Telephone number: 828-312-2809 E-mail Address: bolick.jeff@yahoo.com 2. Licensed Soil Scientist(LSS)name:Caroline J.Edwards LSS License number: 1220 Mailing address: 991 Duncan Road City:Rutherfordton State: NC Zip:28139 Telephone number: 828-289-0122 E-mail Address: cjedwards234@gmail.com 3. Licensed Geologist(LG)(if applicable)name:_NA License Number: Mailing address: City: State: Zip: Telephone number: E-mail Address: 4. Proof of Errors and Omissions or other appropriate liability insurance for the following persons is attached that includes the name of the insurer,name of the insured and the effective dates of coverage: ®LSS ❑ LG 5. Property location(physical address,tax parcel identification number or subdivision lot,block number of the property to be permitted):3708 Bethany Church Rd #376114420528 new Lot 2 County Name: Catawba 6. Type of facility: ® Place of residence No. Bedrooms: 4 No. Occupants:4 ❑ Place of business Basis for flow calculation: ❑ Place of public assembly Basis for flow calculation: NC DEPARTMENT OF HEALTH AND HUMAN SERVICES • DIVISION OF PUBLIC HEALTH LOCATION:5605 Six Forks Road,Raleigh,NC 27609 MAILING ADDRESS:1642 Mail Service Center,Raleigh,NC 27699-1642 www.ncdhhs.gov • TEL:919-707-5874 • FAX:919-845-3972 AN EQUAL OPPORTUNITY/AFFIRMATIVE ACTION EMPLOYER COVID-19 Permit Option Common Form LHD Reference: ` — 2— Zat 2 aCg 7. Factors that would affect the wastewater load: None 8. Type and located of proposed wastewater system: Illg Rear of duplex 9. Design wastewater flow: 480 gpd Design wastewater strength: ®domestic ❑ high strength ❑ industrial process(For Industrial process wastewater,a Professional Engineer licensed in accordance with G.S.89C shall design the on-site wastewater system.) 10. A plat as defined in G.S.130A-334(7a)is attached: ❑Yes ® No A site plan as defined in G.S. 130A-334(13a)is attached: ®Yes ❑ No 11. Location of proposed or existing wells(drinking water,irrigation,geothermal,groundwater monitoring, sampling,etc.)and any potable and non-potable water conveyance lines is indicated on attached plans and complies with 15A NCAC 18A.1950: ®Yes ❑ No This is a saprotite system. ❑Yes ® No 12. Evaluation(s)of soil conditions and site features in accordance with G.S. 130A-335(a1)signed and sealed by a LSS is attached: ®Yes ❑No 13. Evaluation of geologic and hydrogeologic conditions signed and sealed by a LG is attached ❑Yes ® NA 14. Proposed landscape,site,drainage,or soil modifications are attached: ❑Yes ®NA Attestation by LSS pursuant to S.L.2020-97,Section 3.19 and G.S.130A-336.2 1 Caroline J. Edwards hereby attest that the information required to be included with Licensed Soil Scientist(Print Name) this Notice of Intent to Construct is accurate and complete to the best of my knowledge and that the proposed system shall meet applicable federal,State,and local laws,regulations,rules and ordinances,and that the proposed system does not require a Professional Engineer,licensed in accordance with G.S.89C,and in accordance with 15A NCAC 18A.1938 and activities determined to be engineering as determined by the North Carolina Board of Examiners for Engineers and Surveyors. 12kSignature of Licensed Soil Scientis Date Owner self-submittal of NOI: hereby submit this NOI prepared by Print Nome of Owner Print Name of Licensed PE pursuant to G.S.130A-336.1. Signature of Owner Date DHHS/ENS/OSWP—LSS C-19 COMMON FORM Updated April2022 Page 2 of 6 COVID-19 Permit Option Common Form LHD Reference: Lir1&12-20 zZ_ i t) eme, NOTES: LIABILITY: The Department,the Department's authorized agents,or local health departments shall have no liability for wastewater systems designed,constructed,and installed pursuant to an LSS COVID-19 Permit Option(SI.2020- 97,Section 3.19(d)and G.S.130A-336.2(f)] RIGHT OF ENTRY: The submittal of this Notice of Intent to Construct grants right of entry to the Local Health Department and the State to the referenced property. ISSUANCE OF BUILDING PERMIT: Once the LHD deems that the Notice of Intent to Construct is complete via signature in the section below,the owner may apply to the local permitting agency for a permit for electrical, plumbing,heating,air conditioning or other construction,location,or relocation activity under any provision of general or special law pursuant to G.S.130A-338. OHHS/EHS/OSWP—LSS C-19 COMMON FORM Updated April 2022 Page 3 of 6 COVID-19 Permit Option Common Form LHD Reference: i- ; f - 12- 7a22- ( 's ` q This section for Local Health Department use only. PART 2: LHD Completeness Review of the Notice of Intent to Construct "(c) Completeness Review for Notice of Intent to Construct.-The local health department shall determine whether the notice of intent to construct required pursuant to subsection(b)of this section is complete within five business days after receiving the notice of intent to construct.A determination of completeness means that the notice of intent to construct includes all of the required components.If the local health department determines that the notice of intent to construct is incomplete,the local health department shall notify the owner and list the information needed to complete the notice.The owner may then submit additional information to the local health department to cure the deficiencies in the initial notice.The local health department shall make a final determination as to whether the notice of intent to construct is complete within five business days after the department receives the additional information.if the local health department fails to act within any time period set out in this subsection,the owner may treat the failure to act as a determination of completeness. The owner shall be able to apply for the building permit for the project upon the decision of completeness of the notice of intent by the local health department or if the local health department foils to act within the five business day time period" The review for completeness of this Notice of Intent was conducted in accordance with G.S.130A-336.2(c). This NOI is determined to be: ❑ INCOMPLETE(If box is checked,Information in this section is required.) Based upon review of information submitted in Part 1,the following items are missing: Copies of this form listing missing items were sent to the LSS and the Owner on Date via with directions to re-submit missing items using Page 5 of this form. Email,FAX,USPS,hand-delivered Print Name of Authorized Agent of the LHD Signature of Authorized Agent of the LHD Date VOMPLETE(If box is checked,information in this section is required.) Based upon review of information submitted in Part 1 of this form,this NOI is deemed COMPLETE. Copies of this signed form were sent to the LSS and the Owner on 1D via Date Email,FAX,USPS,hand-delivered A copy of this NOI and tracking information was sent to the State on via Date Email,FAX,USPS,hand-delivered (-) 0.14, r /414.1 fi/4iL Print Name of Authorized Agent TT of the LHD Signature of Authorized Agent of the LHD Date OHHS/EHS/OSWP-LSS C-19 COMMON FORM Updated April 2022 Poge 4 of 6 COVID-19 Permit Option Common Form LHD Reference: 40`I � - 2 ( !6'.) Re-submittal of NOI with missing items included This Section Is for use by owner to submit items noted as missing during CND Completeness Review above. Resubmittals must be accompanied by a cover letter from the LSS. LHD USE ONLY: This NOI resubmittal received: by Date Initials Item#from initial NOI Resubmittal description Attestation by LSS pursuant to S.L 2020-97,Section 3.19 I, hereby attest that the information required to be included with Licensed Soil Scientist(Print Name) this Notice of Intent to Construct is accurate and complete to the best of my knowledge and that the proposed system shall meet applicable federal,State,and local laws,regulations,rules,and ordinances. Signature of Licensed Soil Scientist Dote The section below is for Local Health Department use after submittal of items noted as missing above. LHD Follow-up Completeness Review of Notice of intent to Construct This follow-up review for completeness of this Notice and Intent was conducted in accordance with G.S.130A- 336.2(c). This NOI is determined to be: ❑ INCOMPLETE Based upon review of information submitted in the RESUBMITTAL above,this Notice of Intent remains INCOMPETE because the following items from Part 1 of this form remain missing: Copies of this signed form were sent to the LSS and the Owner on via Date Email,FAX,LISPS,Hand-delivered Print name of authorized Agent of the LHD Signature of authorized Agent of the LHD Date ❑ COMPLETE Based upon review of information submitted in the RESUBMITTAL above in addition to information provided in Part 1 of this form,this NOI is deemed complete. Copies of this signed form were sent to the LSS and the Owner on via Date Email,FAX,LISPS,Hand-delivered A complete copy of this form with tracking information was sent to the State: via Date Email,FAX,LISPS,hand-delivered Print name of authorized Agent of the LHD Signature of authorized Agent of the LHD Date DHHS/EHS/OSWP—LSS C-19 COMMON FORM Updated April2022 Page 5 of 6 COVID-19 Permit Option Common Form LHD Reference: / -5)! 1 PART 3: Authorization to Operate(ATO) Except for date received,the Section below is to be completed by the Owner. LHD USE ONLY: Initial submittal of request for ATO received: by Date initials Date of Post-construction Conference: The following items are included in this submittal for an Authorization to Operate under an L55 COVID-19 permit: 1. Signed and sealed copy of the LSS's report that includes the information in G.S.130A-336.2(k) ❑Yes ❑ No 2. Operation and management program ❑Yes ❑ No 3. Fee (as applicable) ❑Yes ❑ No 4. Notarized letter documenting Owner's acceptance of the system from the LSS ❑Yes ❑No 5. On-site Wastewater Contractor name: License number Mailing address: City: State: Zip: Telephone number: E-mail Address: 6, Proof of Errors and Omissions or other appropriate liability insurance for the On-site Wastewater Contractor is attached and includes the name of the insurer,name of the insured,and the effective dates of coverage. ❑Yes ❑ No Attestation by the Owner for Authorization to Operate I, hereby attest that all items indicated above have been provided to the Print name of Owner County LHD and the system shall meet applicable federal,State, and local laws, regulations,rules,and ordinances. Signature of Owner Dote This section for LHD Use Only. LHD Review of required information for the ATO ❑ INCOMPLETE Based upon review of information submitted in the Section above,the following items are missing from the information required for an Authorization to Operate for an LSS COVID-19 permit: Copies of this signed form were sent to the LSS and the Owner on via Date Email,FAX,USPS,Hand-delivered Print name of authorized Agent of the LHD Signature of authorized Agent of the LHD Date ❑ COMPLETE Based upon review of information submitted in the Section above,this Authorization to Operate is hereby Issued in accordance with G.S. 130A-336.2(m). A copy of this complete NOI/ATO with tracking information was sent to the State on via Date Email,FAX,USPS,Hand-delivered Print name of authorized Agent of the LHD Signature of authorized Agent of the LHD Date ISSUANCE OF CERTIFICATE OF OCCUPANCY: Once the LHD determines completeness based upon the ATO submission,the owner may apply to the local permitting agency for permanent electrical service to a residence,place of business or place of public assembly pursuant to G.S.130A-339. DHHS/FHS/OSWP—LSS C-19 COMMON FORM Updated April 2022 Page 6 of 6 ACORO® CERTIFICATE OF LIABILITY INSURANCE DATE(MMfDDlYYYY) 03/06/2022 THI CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Hiscox Inc. PHONE FAX 520 Madison Avenue (r ,Est): (A/C,202-3007 (A/C,No): ADDRESS:,� contact@hiscox.com 32nd Floor New York,New York 10022 INSURERS)AFFORDING COVERAGE _ _ NAIC# INSURER A: Hiscox Insurance Company Inc 10200 INSURED INSURER B: Earthwise Designs INSURER C: 991 Duncan Rd Rutherfordton,NC 28139 INSURER D: INSURER E: INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE INSD 1NVD POLICY NUMBER IDPOLICY EFF POLICY EXP LIMITS (MM/DDlYYYY} (MMD/YYYY) COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ _ CLAIMS-MADE OCCUR DAMAGE TO RENTED PREMISES(Ea occurrence) $ MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY JECT LOC PRODUCTS-COMP/OP AGG $ OTHER I $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS HIRED AUTOS NON-OWNED PROPERTY DAMAGE AUTOS (Per accident) UMBRELLA LIAB I1 OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I RETENTION$ $ WORKERS COMPENSATION I STATUTEPER ERH AND EMPLOYERS'LIABILITY Y/N — ANYPROPRIETORlPARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICERJMEMBEREXCLUDED? N/A - --- (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ If yes.describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ A Professional Liability P100.217.339.8 04/20/2022 04/20/2023 Each Claim:$2,000,000 Aggregate:$2,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule.may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE I S J` ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD et f CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 09/09/2022 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATIONIS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NUTMEG INS AGENCY INCJPHS NAME: ___ 76210781 PHONE (888)925-3137 FAX (A/C,No,Est): (A/C,No): The Hartford Business Service Center 3600 Wiseman Blvd E-MAIL San Antonio,TX 78251 ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# INSURED INSURER A: Hartford Casualty Insurance Company 29424 Caroline Edwards DBA Earthwise Designs INSURER B: 991 DUNCAN RD RUTHERFORDTON NC 28139-7919 INSURER C INSURER D: INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUER POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSR WVD IMM/DO/YYYY) IMM/DD/YYYYI COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE CLAIMS-MADE OCCUR DAMAGE TO RENTED I PREMISES(Ea occurrence) MED EXP(Any one person) PERSONAL&ADV INJURY GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE POLICY PRO- LOC PRODUCTS-COMP/OP AGG JECT OTHER. AUTOMOBILE LIABIUTY COMBINED SINGLE LIMIT (Ea accident) ANY AUTO BODILY INJURY(Per person) —ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) HIRED NON-OWNED PROPERTY DAMAGE AUTOS AUTOS (Per accident) UMBRELLA LIAB OCCUR l EACH OCCURRENCE EXCESS LIAB CLAIMS- AGGREGATE MADE DED RETENTION WORKERS COMPENSATION x PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER ANY YIN E.L.EACH ACCIDENT $500,000 A PROPRIETOR/PARTNER/EXECUTIVE NIA 76 VWBG AA5OP1 07/24/2022 07/24/2023 OFFICER/MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE $500,000 (Mandatory In NH) If yes,describe under E.L DISEASE-POLICY LIMIT $500,000 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) Those usual to the Insured's Operations. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD 7 • Earthwise Designs Soils& Land Evaluation 11/22/2022 Site and Soils Report with System Design On-site Wastewater System for Duplex 480 gallon/day; Two 2-bedroom units New Lot# 2 on Dreamy Lane Proposed new subdivision of 3708 Bethany Church Rd. Catawba Co. Parcel: 376114420528 Prepared for: Bolick Management, LLC This report is submitted under the rule: LSS COVID-19 PERMIT pursuant to S.L.2020-97,Section 3.19 and G.S. 130A-336.2 PART 1: Submittal of Notice of Intent to Construct(NOI) Earthwise Designs has performed a soils and site evaluation of the proposed lot referenced above. Six pits were evaluated to 48"+with favorable results. We have delineated an area Provisionally Suitable for a III g. gravelless trench system with 25%reduction,per NC General Statues 15A NCAC 18A.1900.The drain field area is relatively uniform and free of gullies, rock outcrops and other disturbances. A new well will be dug in the future. This is not a saprolite system. Details are discussed below and in attached documents. Drain field lines on the sketch were drawn conservatively on 10-12' centers to account for minor contour variations.Ample space exists. System Specifications Initial & Repair: 480 gallon/day III g. gravelless trench,Approved Accepted system with 25%reduction. Gravity fed with serial distribution. See site plan. • Soils: Group IV—Silty Clay 0----L1�llt.�^D: 0.3 • Line length required=400' o Four 100' Iines. • Trench width 36" • Trench bottom: 26"on downhill side of trench. • Septic tank: 1500 gallons Locations per Sub-meter GNSS Arrow 100 Receiver,EOS&ArcGIS software Pit 1: 35.689331,-81.141581 2 Pit 2:35.689176,-81.141722 Pit 3:35.689018,-81.141869 Pit 4:35.688910,-81.141748 Pit 5:35.689033,-81.141591 Pit 6:35.689160,-81.141433 Other site-specific requirements and notes: 1. No cut or fill can encroach on the drainfield area,initial or repair. 2. No structures or roads can be placed in initial or repair area. 3. Heavy machinery over the drainfield area must be avoided after installation. 4. The owner must ensure that the field is installed as described above;will be maintained to reduce erosion, shed water,retain a vegetative cover and not be disturbed. 5. Earthwise Designs makes no guarantees regarding installation,maintenance and operations. System design may not be accurate if improper site alterations occur prior to permitting and installation. Thank you and please contact me for further information, if needed. Caroline J. Edwards NC Licensed Soil Scientist#1220 G��y�°SOIL So�Fti� SC Professional Soil Classifier#117 o�� 9 NC Land Application of Bio-Solids#10006173 ' �''y0111,Y'' • ,t f C � G1���j c'i�::�. `��tr�7.•rJ� Attachments: S i zzo Site Plan in two pages ni Soils Descriptions Proposed Subdivision Plat EARTHWISE DESIGNS 991 Duncan Rd Rutherfordton, NC 28139 Ciedwards234 a(7gmail.com 826)289-0122 cell "1 z"i<C Pm)) \ z;-,1 1 P v'g N 1" .„" 1...A7-'..') • d CD C1) AI\ U. 4)44 3 0 dill" O N 2> c N a / ta 01. v at N � �4.4 � .11.1. / \ Q {.. --! ate]` + ~ �� x ��z ewe ems eb a . .,,, „ ,_ OOOOOOOOOOOOOOOOOOOOO iI ' " ' • OOOOOOOO 7LSD ::::::::. .•• .►►a Z 1:--g, 461 ti o` 'A= C Nfr, A. ea EN444, ,..r _ � ,� � .-1 X cd Rr �. X v 41 o d • pp pp�l . E. i OOOOOOO it • 1 Site Plan Lot 2 Dreamy Ln. N • A Inactive well , . . . I P1 ► \ //: 'V ► I . I ► r' '0`. ► ini : •• •. .• •► ► ► i "� � ► • gw r \ ' i 1 I I ' , ,- '� I I I P12 p'!. • /' s ; I A 1 I 1 1 K P9 y 1 /' / 121\ ♦ ; $11 ♦ Soq Pit ' Earthwise Designs `ems) Soils&Land Evaluation Feet i• •x — — Initial IIIg.4 X 100' 0 35 70 l' i 7 .. ;ouster fl i, DKI1t4;:f, r7A,NASA,M A 1.4Nolun.q '�_ .' Repair Mg.4 X 100' u:AS.NiE,t4NMA,Gmdr..r.duyny..wsna..,r3A.e.Wma, NOV ... • Lark Yeesop.M the GIS we.aa..n..ii%,H.i Coonwndq Mop .S� 'nostrum emu of North(Imam oat o�. .ou„+eamr' 2022 `,�— y.,iniI,(q rrkG.y04 ewoTaeme*y ir.hr.barrvmSA I Overall Site Plan Dreamy Ln. New Duplexes l .. N 1 K AAA C I : : \ 1 n, Il . . . ` . Y*' s • 1 1 • • \ \, \ /f/ i Iflp�l li 14 4..1.'r .14 P6 INN /. I' I • ` �1if off " ''' ' 441f• • P4 v1ell P74 .7 - . 421. i if e:S\ 4 ..... . . • t 11 PO• � : �SPt1 • \, Pao • • 4. �F,._irthwise Designs Soli Pit ) Soils 88 Land Evaluation .- — — Initial Drain Feld c`` D �Feet • 130 '` • ..�I:a k D`uit;s,Wilt,NASA,(X:IhR N W,b..�n, 7�7 [� 1'( j'?' r.". r•••• Repair �(7vLS,MS,OF,NW.,GmrWaupwiaen,Ri#fa�cerr.GSA,Grdmd, N O V ' ifr:�, I •i.j,.Incm.gsad the GIS uar nrr mn:ry,Lan Commit,Ilya 2022 4 / :Dobb•umr.gate N North Carolina DOT,O tN�SuanAlayp...FlkcomR lice I IERI;(iudn,Sa ctinl,h,Si[»lt'ihnoFprtr.IrK,Will/NW. II Owaer/Buyer UO//L/C Date Evaluated //-2-2 Z Location of Site bzra7 Ili. l 6/0<nrj 14;'2 Co: 74.✓c Proposed Facility Proposed Design Flow(1949) '7gayday Property Size.%S ac. Well Supply(Private,Pet41k, ,Spring,Other )Evaluation Method(Auger, it, ut) Profile Flag Landscape Horizon depth Textare Soil structure Mineralogy Soil colorSoli color Notea7..TAR Color grade/ (la) consistence moist/wet Matrix Mottles Slope Grade Cloes Type (Redo y(a S6 134d D-b set F sak /mot ss sP s`74 °Ai' Groh P.-r: y-p4 ...1- EA/ l3ft b 3.3 sic a- Al r FR rr MP 45-reel 'VS" L 7�if 4 o-•3 it%7 all D-/L SGG ) VG FR NS Np r7'4-7ff .7 G�e4R ' f.'.f ��� 2- w Oh. /z-P5-+- G z, al F/1 sr rP,z.L a!P �� O.3 5 en !} i O- s c e. 1 F s F,S 6-7 Gl,., o,1 3 W/�w /.3 -7-Y•W' G i — P F:1 S-' 1r i.r1 R 44 D,3 4 i/-f 841 ' 0-2 rcc. I - . • SSA' Ce? ` SS sv 3-2' 6 . PS lf--- w//vtr a�L P-33 S;G •i G SW(' rR Sr /a, 2..r , Y. ' D.3 t`- t l3 , 33 rGL / /'7 J.,s /c (Y.S NY z.r7 r s� t /f S C z S X Fil.. if S!� �Ps� G,,qp XL- a 3 9 - c / ra2 se /Kr ,yr' /1 6 P-3 a / 0/0 scc 2. Yg- o4 F,4 Air of JAY "1t- Groy�-1G Pf.' 9- 6 /3tz /D-37 fiG L Spit F/ sr P 7, ryt v D•3 • !3 C. 77-`t1 ci I r1 79 ,k F1� �7 ? I- i • women STRUCTURE• -- MCERALOOV ,t/ GRADE TYPE MOIST C�AS4: Jilty C/9j. Comm Sand COS Vey Rae Sandy Loam VFSL Scucwndeu 0 annular OR Lame L / J/ii' 7G/ Sand S Loom L Wank 1 Anguiw B AB1X Wry MAIM VPA Y a 7/P Flan Surd F9 Slit Loam SIL Moderate 2 Sabangalar Boy SBK_ Friable FR a-pa r ft(D��do.1( very Pi ea Sand VPS BM SI Strong 2 Platy PL Firm Pt auto Loamy Como Sand- LCOS Sandy Clay Loam SCL Cr Ass Wedge WE'D Vary Firm Vial e,.a4 Loamy Sand, XS Clay LOOM _ CL Very tine VP 1'damada - PR Plxtr,Pirm or l' �. �..t Loamy Pine Sand LFS Silty Clay Loam SICL ne u COL WET z.,�.• . '�yF Lonny Vay n ue Bard LVFS Sandy Clay SC Medium M Non.Stlaky Ts Fcci /.i Camse Sandy Loam COSL Silty Clay SIC Coarse CO Sin le Oran SOR Slightly Sticky SS 1 t= ,,,, d Sandy Loam , SL Clay C Thick(FL) Meador MA Moderately Stinky 8 kn>,, c,}J}' Flno sandy Loam ESL Very Coarse VC Very Stinky • VS Vexy Thick CPU VIC Cloddy CM Noa-Flaaic . it' Extremely Coarse C Slightly Plastic Sy iytodeatoiyPieala P , Very Phatic VP 1A. • �MINOR 8 ISU SUBDIVISION FOR:CK �' + m , �. E I I -------_44P- —Cl _ 1` .11 " • : 1 - . . _ , y; s�' star = I REMAlNWG PARCEL ,+.� f � . MAM =•^-==�."ems j40 =� sm�r...•w si.r. I .E,.O , OM" ` LOT 2 / .. ... mitommalsontimirinimmillehitiown HELL rmanmenummmancommommg w���... ;":. ., .. _ 1 ', LOT1 �, /' y 11 a� c 1 \ • aos�c: ruiawal IA,. �,. , wo AG.*(NET AAEN r... .... i, \ c. , P..- ......00-0- i.t.. MEND / ...moor ter. mart 111Pr .... ............. • . �. metier- Aws .... i3 Catawba County Environmental Health 136 I277Z o 17) 2627 •3428 • 042 08 61 ti 0528 fitt !ys GP �fl ° •3407 ,15) •3405 21�' f 1248 38. • 9297 3.75 A' 2283 •1.79 ,A4° Parcel: 376114420528, 3708 BETHANY 1 in=80ft CHURCH RD CLAREMONT, 28610 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 12/02/2022 1212/22, 10:22 AM Parcel Report • • Parcel Report - Catawba County NC Parcel Information: Owner Information: Parcel ID: 376114420528 Owner: BOLICK MANAGEMENT LLC Parcel Address: 3708 BETHANY CHURCH RD Owner2: City: CLAREMONT, 28610 Address: PO BOX 730 LRK(REID): 38682 Address2: Deed Book/Page: 3147/0001 City: CLAREMONT Subdivision: SETZER ESTATE State/Zip: NC 28610-0730 Lots/Block: C/ School Information: Last Sale: $100,000 on 2012-09-20 School District: COUNTY Plat Book/Page: 3/146 Legal: LOT C PL 3-146 Elementary School: CLAREMONT Calculated Acreage: 3.190 Middle School: RIVER BEND Tax Map: 074N 03004 High School: BUNKER HILL Township: NEWTON School Map State Road #: 1722 TaxNalue Information: Tax Rates(pdf) Zoning Information: City Tax District: All in County Zoning District: COUNTY County Fire District: CLAREMONT RURAL Zoningl: R-20 Building(s) Value: $104,600 Zoning2: Land Value: $40,000 Zoning3: Assessed Total Value: $144,600 Zoning Overlay: WP-O Year Built/Remodeled: 1963/ Small Area: CATAWBA 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 #: 3710376100J If available, Building Permits for this parcel. Septic 2010 Census Block: 2029 links are not permits. 2010 Census Tract: 011401 1 1uY� Septic Final Permits prior to 08/2018, contact Agricultural District: CAL ' \L itirr Environmental Health. ��- �;I Building Details �11 L•�, WaterShed: WS-IV Protected Area 1i 1 Voter Precinct: P22/ Voting Map 'r 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. gis.catawbacountync.gov/nomaplparcel_report.php?key=376114420528&type=u 1/1 CATAWBA COUNTY �' 100A SOUTHWEST BLVD ■ 1NEWTON,NORTH CAROLINA 28658 RECEIPT PHONE:828.465.8399 Thursday, December 8,2022 ]$42 SM www.catawbacountync.gov PAYOR: Bolick Management LLC Bolick Management LLC(Bolick,Jeff) PAYMENTS TRANSACTION NUMBER: TRC-52843780-08-12-2022 PAYMENT DATE: 12/08/2022 PAYMENT TYPE: Credit Card 298417699 INVOICE NUMBER ACCOUNT FEE NAME FEE AMOUNT 12-22-415701 110-580200-663000 LSSP $135.00 TOTAL PAYMENTS: $135.00 RBPR-12-2022-42975 CASE TYPE: Residential Building Plan Review WORK CLASS: Building New SITE ADDRESS: 3708 BETHANY CHURCH RD,CLAREMONT NC 28610 Applicant CAROLINE EDWARDS,991 DUNCAN RD,RUTHERFORDTON NC 28139 B:8282890122 CJEDWARDS234@GMAIL.COM GMAIL.COM Owner BOLICK MANAGEMENT LLC,PO BOX 730,CLAREMONT NC 28610 **NO PEOPLESOFT ACCOUNT ASSIGNED** receipt 12/08/2022 15:16 Page 1 of 1