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Home My WebLink AboutEHPR-02-2023-43406.TIF BA �G THIS IS NOTA PERMIT Case# EI-IPR-02-2023-43406 a CATAWBA COUNTY HEALTH DEPARTMENT 1111 PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES \g 2 sM Environmen ealth Plan view-OSWP EXS SYSTEM 31r31)3 Reoi Sep Owner ABDIEL FLORES MONDRAGON,2331 24TI I ST NE,HICKORY NC 28601 C:82829I8465 ARIELFM419 0,GMAIL.COM NAME TO APPEAR ON PERMIT Abdiel Flores Mondragon SITE ADDRESS: 3689 THOMPSON ST,NEWTON NC 28658 PIN # 371118312445 NAME of SUBDIVISION: Lot I 1 Section/Block ----------- PROPERTY SIZE: Square Feet 59,110.92 Acres 1.357 DIRECTIONS: Startown Rd,left onto Sandy Ford Rd, right onto Robinson Rd,left onto Thompson St,property on the left PRIMARY CONTACT: Owner SEWER TYPE: Septic Tank GALLO Y: 360 WATER SUPPLY: Private Well S RIBE WORK: 3/13/23 Revise to existing system inspection will use septic system on property.Will use existing well. IP only. Home has been demoed. Building new home. 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: 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: 4 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 48.6 x32 home,8x6 front porch, 16x5 back porch #OF NEW BEDROOMS:: 3 BASEMENT? Yes BASEMENT FIXTURES? Yes 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: .,6:,;�4i:::n•n 03/13/2023 08:57 Page 1 of3 fig: a CATAWBA COUNTY Case it EIIPR-02-2023-43406 Public Health Department Subdivision F, '�"� -L In E*D a Environmental Health Division PIN1! 371118312445 PO Box 389, 100-A Southwest Blvd,Newton,NC 28658 $. v, NAME ON PERMIT: (ABDIEL FLORES MONDRAGON),2331 24TH ST NE,HICKORY NC 28601 (Abdiel Flores Mondragon) Site Address: 3689 THOMPSON ST,NEWTON NC 28658 Property Size: Square Feet 59,110.92 Acres 1.357 Directions: Startown Rd,left onto Sandy Ford Rd,right onto Robinson Rd,left onto Thompson St, property on the left 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: Li/ 1 j_)2._ Signature of Applicant or Agent � t If you need further information or assistance please call 828-465-8270 AREA1 FEENAME DATE FEE AMOUNT Improvement Permit Fee 02/14/2023 $150.00 Existing Tank Check Fee 03/13/2023 $80.00 TOTAL FEES S230.00 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) cl,vhliL:ni,,,, 03/13/2023 08:57 Page 2 of3 catawba county public health AUTHORIZATION OF REFUND Date: 4/17/2023 Case #: EHPR-02-2023-43406 Applicant: Abdiel Flores Mondragon Refund Amount: 670 Refund Reason: Refund to existing system inspection. Using septic system on site. !l /� Authorizing Signature: / w / Received By Staff: r /1/ u Date: 71dqJ3 catawbacountync.gov Environmental Health Cotuwbc County Government Center 25 Government Drive PO Box 389 I Newton NC 28658 1828.465.8270 MAKING. LIVING. BETTED. Catawba County, North Carolina - Disbursement Voucher Vendor No. Date: 4/17/2023 Make Payment To: wQQG Voucher No(s) Abdiel Flores Mondragon `,I t I Z 1862 Aztec Ct 1109 E7,1 jPA Newton, NC 28658 viV j8 42 ATTACHMENT Prepared by: Julia English Description Amount EHPR-02-2023-43406 refund to existing system inspection. Using septic system on site. $70.00 Sub-Total Food Tax Sales Tax Total $ 70.00 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 • CATAWBA COUNTY 100A SOUTI IWEST BLVD ` NEWTON,NORTH CAROLINA 28658 RECEIPT 1 0 PHONE: 828.465.8399 Monday,April 17,2023 1842 SM www.catawbacountync.gov PAYOR: Mondragon,Abdiel Flores PAYMENTS TRANSACTION NUMBER: TRC-62089986-1 7-04-2023 PAYMENT DATE: 04/17/2023 PAYMENT TYPE: DV INVOICE NUMBER ACCOUNT FEE NAME FEE AMOUNT 02-23-418331 110-580200-663000 Improvement Permit Fee ($70.00) TOTAL PAYMENTS: ($70.00) EHPR-02-2023-43406 CASE'I'YPE: Environmental Health Plan Review WORK CLASS: OSWP SITE ADDRESS: 3689 TI IOMPSON ST,NEWTON NC 28658 Owner ABDIEL FLORES MONDRAGON,2331 24TI I ST NE,I IICKORY NC 28601 C:8282918465 ARI ELFM419(ii)GMAI L.COM **NO PEOPLESOFT ACCOUNT ASSIGNED** receipt 04/17/2023 15:35 Page I of I catawba county public health Application for Environmental Health Services THIS IS NOT A PERMIT Application is for: ❑New Construction ❑Existing Facility 0 Improvement Permit ❑Authorization to Construct w Septic ❑Septic Repair/Malfunction ❑ Septic Relocation ❑Septic Expansion xisting System Inspection or Reconnection ❑New Well ❑Replacement Well ❑ Well Abandonment IK-sell Repair fwt , rfild j)k ;� �r Property Address 3 fo$ ' n,v'os D ,�I S l / �c.ur-Or..� N L. 7if('I/ r.4N0 00t1 Acres I,5 5-1 Subdivision Lot# Driving Directions to Property Describe work Applicant Name 4501 L �.�f o 4e) ril/1 o i‘j or2A-66,.1 Applicant Address ' �� 2 4 z4-GG C T ftJe.(,cito/J Phone - Li3 ;' 9 J-8 it& r Email G rs'e/ 4'i 4`/9 0C�4Y'U/'/ !(7 vt^ Owner Name A(_'eb/G 1` r'"tova) /14o, r�7i_ 4611 ✓ Owner Address Phone _ Email Contractor Name Contractor Address Phone Email Name to Appear on Permit? ❑Owner ❑Applicant El Contractor Who will be the Primary Contact? 213wner El Applicant ❑Contractor Proposed New Construction-Residential Primary Residence knI New Residence ❑ Addition to Residence #of New Bedrooms*1* 3 #of Occupants 3 Project Description t 5 Ll`b il g•(p X 3.Z x r PoNc4+ RI)( S I &cU_ Poi c L Structure Dimensions,also specify dimensions of decks&porches ��// (Choose One) [�'fasement ID Crawl Space ❑ Slab If Basement,Will There Be Water Using Fixtures In Basement 1d"Yes ❑ No Retaining Wall>2' 0 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 0 Yes ❑ No Retaining Wall>2' ❑ Yes ❑ No Accessory Structure(s)Describe Structure(s)Dimensions Plumbing El Yes ❑No Describe Plumbing Needed (Choose One) 0 Basement ❑Crawl Space ❑ Slab If Basement,Will There Be Water Using Fixtures In Basement El Yes ❑ No Retaining Wall>2' 0 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' ❑ Yes El No Well Construction/Abandonment/Repair Proposed Well Type El Individual Well ❑ Semi-Public Well ❑Community Well Abandonment Type ❑ Drilled ❑ Bored ❑ Dug ❑ 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 Structure Dimensions #of Bedrooms* #of Occupants Basement El Yes ❑ No Basement Plumbing El Yes El No Inng Water Supply dividual Well ❑ Shared Well—Number of Connections ❑Community Well El 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 El Yes El No #of Children #of Employees per Shift #of Shifts Commercial Kitchen El 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 question. If he answer to any question is"yes",applicant must attach supporting documentation. ❑Yes rap()' Does the site contain any jurisdictional wetlands? re-Yes OrNo Does the site contain any existing wastewater systems? ❑Yes Ig/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? ❑Yes n o 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 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. j 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 effectpermit 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. / Signature of Owner or Legal Agent Date J-/Z41/ 2 Printed Name of Owner or Legal Agent 4Gv,>-€ (_ Julia English From: Michelle Lail Sent: Friday, February 24, 2023 1:29 PM To: Julia English Subject: RE: 3689 Thompson St Julia, The property was originally 1.89 (including R/W) for the portion below the road. Sometime in 1974 (Note in file says'75- prev pt 131-1-5F) 1.86Ac was added (north side of the road & including R/W).There has property split from it (north side of the road) in 1974, 1978 & 1999. I would say 1974 would be when it was added but I don't have an exact date. Sorry to be so vague. TGIF, Michelle From:Julia English Sent: Friday, February 24, 2023 1:16 PM To: Michelle Lail<MichelleLail@CatawbaCountyNC.gov> Subject: 3689 Thompson St Could you check and see when this lot was created as it is today. Was the small piece across the street always a part of this lot?Or did it get added later? Julia English Administrative Assistant II PO Box 389 125 Government Drive, Newton, NC 28658 (828) 465-8270 office (828) 465-8276 fax https://www.catawbacountvnc.gov/county-services/environmental-health/ We want to hear from you. Please take a minute to take our customer service survey. English Queremos escuchar de usted. Tomese un minuto para realizar nuestra encuesta de servicio al cliente. Espanol Catawba county MAKING. LIVING. BETTER. 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