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HomeMy WebLinkAboutEHPR-03-2023-43685.tif 1111.111111111 catawba county public health 6/7/2023 Jeff Richards 2388 Hounds Way Hickory, NC 28601 Re: Application For Improvement Permit For 1285 Misty Ln Hickory, NC 28601 Health Department File Number EHPR-03-2023-43685 Dear Sir: The Catawba County Health Department, Environmental Health Division on 5/17/2023,evaluated the above referenced property at the site designated on the plat/site plan that accompanied your Improvement Permit application. According to your application the site is to serve a 3 bedroom home with a design wastewater flow of 360 gallons per day.The evaluation was done in accordance with the laws and rules governing wastewater systems in North Carolina General Statute 130A-333 including related statutes and Title 15A, Subchapter 18A,of the North Carolina Administrative Code, Rule.1900 and related rules. Based on the criteria set out in Title 15A,Subchapter 18A, of the North Carolina Administrative Code, Rule.1940 through .1948,the evaluation indicated that the site is UNSUITABLE for a sanitary system of sewage treatment and disposal. Therefore,we must deny your request for an Improvement Permit. A copy of the site evaluation is enclosed. The site is unsuitable based on the following: X Unsuitable soil topography and/or landscape position (Rule.1940) Unsuitable soil characteristics(structure or clay mineralogy)(Rule .1941) Unsuitable soil wetness condition (Rule.1942) X Unsuitable soil depth (Rule.1943) Presence of restrictive horizon (Rule.1944) X Insufficient space for septic system and repair area (Rule .1945) Unsuitable for meeting required setbacks(Rule.1950) Other(Rule .1946) These severe soil or site limitations could cause premature system failure, leading to the discharge of untreated sewage on the ground surface, into surface waters, directly to ground water or inside your structure. The site evaluation included consideration of possible site modifications, as well as use of modified, innovative, or alternative systems. However,the Health Department has determined that none of the above options will overcome the severe conditions on this site. A possible option might be a system designed to dispose of sewage to another area of suitable soil or off-site to additional property. catawbacountync.gov Environmental Health Cetcwbc County Government Center 25 Government Drive I PO Box 389 I Newton N( 28658 1828.465.8270 MAKING. LIVING. BETTER. Page 2 For the reasons set out above,the property is currently classified UNSUITABLE, and no improvement permit shall be issued for this site in accordance with Rule.1948(c). Note that a site classified as UNSUITABLE may be classified as PROVISIONALLY SUITABLE if written documentation is provided that meets the requirements of Rule.1948(d). A copy of this rule is enclosed. You may hire a consultant to assist you if you wish to try to develop a plan under which your site could be reclassified as PROVISIONALLY SUITABLE. You hove a right to an informal review of this decision. You may request an informal review by the soil scientist or environmental health supervisor at the local health department. You may also request an informal review by the North Carolina Department of Health and Human Services regional soil scientist. A request for informal review must be made in writing to the local health department. You also have a right to a formal appeal of this decision. To pursue a formal appeal,you must file a petition for a contested case hearing with the Office of Administrative Hearings, 1711 New Hope Church Rd, Raleigh, NC 27609. To get a copy of a petition form,you may write the Office of Administrative Hearings or call the office at 984-236- 1850 or download it from the OAH web site at http://www.oah.nc.gov. The petition for a contested case hearing must be filed in accordance with the provision of North Carolina General Statutes 130A-24 and 150E-23 and all other applicable provisions of Chapter 150B. N.C. General Statute 130A-335(g) provides that your hearing would be held in the county where your property is located. Please note: If you wish to pursue a formal appeal,you must file the petition form with the Office of Administrative Hearings WITHIN 30 DAYS OF THE DATE OF THIS LETTER. The date of this letter is 6/7/2023. Meeting the 30 day deadline is critical to your formal appeal. If you file a petition for a contested case hearing with the Office of Administrative Hearings,you are required by law(N.C.General Statute 150E-23)to serve a copy of your petition on the Office of General Counsel, N.C. Department of Health and Human Services, 2001 Mail Service Center, Raleigh, N.C. 27699-2001. Do not serve the petition on your local health department. Sending a copy of your petition to the local health department will not satisfy the legal requirement in N.C.General Statute 150B-23 that you send a copy to the Office of General Counsel, N. C. Department of Health and Human Services. You may call or write the local health department if you need any additional information or assistance. Sincerely, an Evans, Environmental Health Specialist Enclosures: Site evaluation Rule .1940, .1943, .1945, .1948 Catawba County Environmental Health E#pgO3 0Q3 p936 6 M15Tt't-N 137.04 .1275 28791 -6& 5 — 1.18 I 1 r.1285/ s� s I kA / () ,a / .a' 1- V.s c-("� • � v\ / Li ""- t� 1 ° \ / \ $ r; N Pr°pO5e8 So Floma so' > A o ► 45 • 60' A a V 234.99 \ . Parcel: 373515743336, 1285 MISTY LN 1in=40ft HICKORY, 28601 ® —Sot 1 P T LaqVloAS This map/report product was prepared from the Catawba County,NC Geospallal 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,disclakn,and shall not be held liable for any end 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 Copyright nor enti a Ca wba County NC 05/31(2023 DEPARTMENT OF I IEALTI I AND I IUMAN SERVICI S Shoe/ 11 of,t DIVISION OF PUBLIC I IFA1.111,IiNVIRONMI:NFAI.1111A1,1 11 SliCl'ION PROPERTY ID 1: (3Sv ONSITE WATTR PROTECTION BRANCI I COUNTY:( SOIL/SITE EVALUATION far ON-SITE WASTEWATER SYSTEM f (Complete all fields in full)OWER: ,c clE _ APPLICATION DATEP1 43 ADDRESS: 0')3 }]SAS DATE EVALUATED: L PROPOSED FACILITY: S ff,C,C'PIjQPQSED DESIGN FLOW(.1949): 3&7 PROPERTY SIZE: /,0 LOCATION OF SITE: /ar )S !4/ oe PPROPERTY RECORDED: -- WATER SUPPLY: /Private 0 Public /Well 'IJ Spring 0 Other EVALUATION METHOD: ❑Auger Boring Pit 0 Cut TYPE OF WASTEWATER: 'Sewage 0 Industrial Process 0 Mixed I. R SOIL MORPHOLOGY OTHER 0 F (.1941) PROFILE FACTORS • 1 .1940 L LANDSCAPE HORIZON 1 E I POSITION/ DEPTH1942 PROFILE I SLOPE%. (IN.) .1941 .1941 SOIL .1943 .1956 .1944 CLASS STRUCTURE/ CONSISTENCE/ WETNESS! SOIL SAPRO RESTR &LTAR TEXTURE MINERALOGY COLOR DEPTII CLASS IIORIT. L V js--da 5,64 1_- FP— Illa 1 �a -�/2 f �i��� �f Z rs cR �6 S'og Roc., as zZ,z6 P- z3ze,,z2 r 4 o k 5 P--L /- - AU. V a 8 -20 esa Gc- �-' OPV 2 (( c 20-2( I is 0 CI_ 24?g, , 1 cz ,,z-y7 r Zg,30/-0 `Y4 n- 20 5r G1- (��- A vie. I 3C. Za-sy r,,, ek c,� Y1/4 11/2 nA 'S \l ib IVR 0-?? ' g r Ct eoc AII,Viq/ GR a7-q(/ , SO % PA r'4 AA 4 1,1 r2,3z cct DESCRIPTION INITIAL SYSTEM REPAIR SYSTEM OTHER FACTORS(.1946):1_,0/ipbr: /o Available Space(.1945) AJO )1() SITE CLASSIFICATION(.1948): I 1 EVALUATED BY: , C (A//1 S SystemTypc(s) OTHER(S)PRESENT: Site LTAR COMMENTS: Updated February 2014 SOIL/SITE EVALUATION sheet 2-of Z (Contlnurrion Slicer-Complete all field In full) DEPARTMENT OF HEALTH AND HUMAN SERVICES PROPERTY ID II: DIVISION OF PUBLIC HEALTH DATE OF EVALUATION: ENVIRONMENTAL HEALTH SECTION Z!�' f�l�/ rl �� _ COUNTY- r ON-SITE WATER PROTECTION BRANCH r • • . R SOIL MORPHOLOGY OTHER 0 F (.19J1) PROFILE FACTORS 1 .1940 LANDSCAPE .1942 E lIOR17. POSITION/ ON 1941 .1941 SOIL 1943 .1956 .1944 PROFILE x SLOPE•/. DEPTH STRUCTURE! CONSISTENCE/ WETNESS/ SOIL SA PRO RESTR CLASS (IN.) TEXTURE :INERALOGY COLOR DEPTH CLASS IIORIZ &LTr1R j3 ©-6? s6/c L�� J8-�a �sbk c�. f qg ( / PS %.(0 t3 COMMENTS: Updated February 2014 Catawba County Environmental Health \ \ 'N''''''''::N.ss'''<'....:.:H --. IAZ I) 0 bI� � V, \137.0 / 7 / ^iO o1135ro ( m o1 v \\\\\\ 1\" ‘:i.\\. \ \ Ilsttr rD 10 80� m s S .b :28: 5 r. o rn ► / \ \ ro m o 7,1 \ co 1 \co\ r °f Io 4 .a K • , 9 6 � , \ a�9S e ... \ 2 ,�1 \N / 972 0960 1 .pjs 974�� 9s Qv\ s c ~�— 976 N\j,. \..\\\\ \ ma96 a\9 978 978 9,? 9�o ,�� to \\\. o 6 co i�980980� 9,6 SO )o..c .� '•0---"4"------ .ss.---. .;/I -..9,e,N4N:761'%)\04L9 15"1\Zp , - \‘\.\„ .\i'dNrv. �p 9; 9 _98s\0� � � `aa \96E .9 o \ 45 '9B8 a ,,\ ae Z2b " ,s90 \\\\ ,, er Z7 \ \ \m � k \ \ \ Parcel: 373515743336, 1285 MISTY LN �l� LocCtl'kV) ' 1 in=40ft HICKORY, 28601 -> 1 LIGIOV X>3 VIS >a Gsf® C8' X>�1 1 ` 0�° X X—)3—,a9SIO 90 This map/report product was prepared from the Catawba County,NC Geospatlel 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 arty data contained on this map/report product by the user.The County of Catawba,Its employees,agents,end 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 2023 Catawba County NC 05/31/2023 1SA NCAC ISA.1940 TOPOC;RAPIIV AND LANDSCAPE POSITION (a) Uniform slopes under 15 percent shall be considered SUITABLE with respect to topography. (b) Uniform slopes between 15 percent and 30 percent shall be considered PROVISIONALLY SUITABLE with respect to topography. (c) Slopes greater than 30 percent shall be considered UNSUITABLE as to topography. Slopes grcatcr than 30 percent may be reclassified as PROVISIONALLY SUITABLE after an investigation indicates that a modified system may be installed in accordance with Rule .1956 of this Section: however. slopes greater than 65 percent shall not be reclassified as PROVISIONALLY SUITABLE. (d) Complex slope patterns and slopes dissected by gullies and ravines shall be considered UNSUITABLE with respect to topography. (c) Depressions shall be considered UNSUITABLE with respect to landscape position except when the site complies essentially with the requirements of this Section and is specifically approved by the local health department. (f) The surface area on or around a ground absorption sewage treatment and disposal system shall be landscaped to provide adequate drainage if directed by the local health department. The interception of perched or lateral ground-water movement shall be provided where necessary to prevent soil saturation on or around the ground absorption sewage treatment and disposal system. (g) A designated wetland shall be considered UNSUITABLE with respect to landscape position,unless the proposed use is specifically approved in writing by the U.S. Army Corps of Engineers or the North Carolina Division of Coastal Management. Histon•Note: Authority G.S. 130A-3351e1: EfT July 1, 1982: Amended Eff January 1. 1990. 15A NCA( INA .1943 SOIL l)EPTI1 (a) Soil depths to saprolitc,rock.or parent material greater than 48 inches shall be considered SUITABLE as to soil depth. Soil depths to saprolite, rock.or parent material between 36 inches and 48 inches shall he considered PROVISIONALLY SUITABLE as to soil depth. Soil depths to saprolite. rock, or parent material less than 36 inches shall he classified UNSUITABLE as to soil depth. (b) Where the site is UNSUITABLE with respect to depth. it may be reclassified PROVISIONALLY SUITABLE after a special investigation indicates that a modified or alternative system can he installed in accordance with Rule.1956 or Rule ,1957 of this Section. Ilistan•Note: .4ttthortty G.S. I311.I.33510: Elf July 1. 1982: Amended Eff. August 1. 1988. Q 15A NCA(' 18A.1945 AVAILABLE SPACE (a) Sites shall have sufficient available space to permit the installation and proper functioning of ground absorption sewage treatment and disposal systems,based upon the square footage of nitrification field required for the long-term acceptance rate determined in accordance with these Rules. (b) Sites shall have sufficient available space for a repair area separate from the area determined in Paragraph(a)of this Rulc. The repair area shall be based upon the area of the nitrification field required to accommodate thc installation of a replacement system as specified in Rule.1955..1956.or.1957 of this Section. Prior to issuance of the initial Improvement Permit for a site,the local health department shall designate on the permit the original system layout,thc repair area,and the type of replacement system. (e) The repair area requirement of Paragraph(b)of this Rule shall not apply to a lot or tract of land: (I) which is specifically described in a document on file with the local health department on July I. 1982.or which is specifically described in a recorded deed or a recorded plat on January I, 1983;and (2) which is of insufficient size to satisfy the repair area requirement of Paragraph (b) of this Rule, as determined by the local health department:and (3) on which a ground absorption sewage treatment and disposal system with a design daily flow of. (A) no more than 48()gallons is to be installed;or (B) more than 480 gallons is to be installed if application for an improvement pennit which meets the reouirements of Rule.1937(c)of this Subchapter is received by the local health department on or before April I. 1983. (d) Although a lot or tract of land is exempted under Paragraph(c)from the repair area requirement of Paragraph(b),the maximum feasible area,as determined by the local health department.shall be allocated for a repair area. liistar.t•.Vow: Author7ry G.S. 130A-335/c1 and(1): Eff July 1. 1982: Amended Eff February 1. 1992:July 1. 1983:January 1. 1983. I5A NCAC 18A.1948 SITE CLASSIFICATION (a) Sites classified as SUITABLE may be utilized for a ground absorption sewage treatment and disposal system consistent with these Rules. A suitable classification generally indicates soil and site conditions favorable for the operation of a ground absorption sewage treatment and disposal system or have slight limitations that arc readily overcome by proper design and installation. (b) Sites classified as PROVISIONALLY SUITABLE may be utilized for a ground absorption sewage treatment and disposal systcm consistent with these Rules but have moderate limitations. Sites classified Provisionally Suitable require some modifications and careful planning.design.and installation in order for a ground absorption sewage treatment and disposal system to function satisfactorily. (c) Sites classified UNSUITABLE have severe limitations for the installation and use of a properly functioning ground absorption sewage treatment and disposal system. An improvement permit shall not be issued for a site which is classified as UNSUITABLE. However.where a site is UNSUITABLE,it may be reclassified PROVISIONALLY SUITABLE if a special investigation indicates that a modified or alternative system can be installed in accordance with Rules.1956 or.1957 of this Section. (d) A site classified as UNSUITABLE may be used for a ground absorption sewage treatment and disposal system specifically identified in Rules .1955, .1956. or.1957 of this Section or a system approved under Rule.1969 if written documentation,including engineering.hydmgcologic,geologic or soil studies,indicates to the local health department that the proposed system can be expected to function satisfactorily. Such sites shall be reclassified as PROVISIONALLY SUITABLE if the local health department determines that the substantiating data indicate that: (1) a ground absorption system can be installed so that the effluent will be non-pathogenic.non-infectious, non-toxic,and non-hazardous: (2) the effluent will not contaminate groundwater or surface water;and (3) the effluent will not be exposed on the ground surface or be discharged to surface waters where it could come in contact with people,animals,or vectors. The State shall review the substantiating data if requested by the local health department. Ilistort Note: Authority G.S. 130.4-335(ei: Eff.July 1. 1982: Amended 1if.April 1. 1993;January 1, 199a. U.S. Postal ServiceTM CERTIFIED MAIL® RECEIPT 0- Domestic Mail Only Q' For delivery information,visit our website at www.usps.com`-'. `0 . Richards Env Health DE ci Certified Mail Fee - - rU Extra Services&Fees(check box,add tee as appropda 4 ❑Return Receipt(hardcopy) $ /'r r-1cli ❑Return Receipt(electronic) $ OSl).1' ❑Cenified Mail Restricted Davey $ Q 0 Adult Signature Required $ g \ ❑Adult Signature Restricted Delivery$_ rr p Postage \tQ - t ►n $ D N Q' Total Postage and Fees s EHPR-03-2023-43685 ,a Sent To Jeff Richards ru o .1teetandAP2r,�88rW tiles Way r,- guy,-era;2iH kory,NCZ860I PS Form 3800,April 2015 PSN 7530.02-000-9047 See Reverse for Instructions Certified Mail service provides the following benefits: •A receipt(this portion of the Certified Mall label). for an electronic return receipt,see a retail •A unique identifier for your mailpiece. associate for assistance.To receive a duplicate •Electronic verification of delivery or attempted return receipt for no additional fee,present this delivery. LISPS®-postmarked Certified Mail receipt to the •A record of delivery(including the recipient's retail associate. signature)that Is retained by the Postal Service— -Restricted delivery service,which provides for a specified period. delivery to the addressee specified by name,or toauthorized agent. Important Reminders: [�j q �_ I np's ervice,which requires the •You may purchase Certifiednast 21 years of age(not First-Class Mail®,First-Class Package Service®, available at retail). or Priority Mail service. -Adult signature restricted delivery service,which •Certified Mail service is not available for reguu s he signee to be at least 21 years of age International mall. t I nl 0 ar}des delivery to the addressee specified • Insurance coverage Is not available ase hyn or to the addressee's authorized agent with Certified Mail service.However,the purchase (not available at retail). of Certified Mail service does not change the •To ensure that your Certified Mail receipt is insurance coverage automatically included with accepted as legal proof of mailing,it should bear a certain Priority Mail items. �, u would like a postmark on •For an additional fee,and wlt ,�'p,.onmen� receipt,please present your endorsement on the mailpiece,you may request Certified Mali item at a Post Office-for the following services: postmarking.If you don't need a postmark on this -Return receipt service,which provides a record Certified Mail receipt,detach the barcoded portion of delivery(including the recipient's signature). of this label,affix it to the mailpiece,apply You can request a hardcopy return receipt or an appropriate postage,and deposit the mailpiece. electronic version.For a hardcopy return receipt, complete PS Form 3811,Domestic Return Receipt;attach PS Form 3811 to your mailpiece; IMPORTANT.Save this receipt for your records. PS Form 38OO,April 2015(Reverse)PSN 7530-02.000-9047 , SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY • Complete items 1,2,and 3. A. Sig ture • Print your name and address on the reverse /6l/ ✓�� ❑Agent so that we can return the card to you. ' 0 Addressee • Attach this card to the back of the mailpiece, B. ceived by(Printe.I`.me) C. Date of Delivery or on the-front if space permits. 1. Article Addressed to: D. Is delivery address different from item 1? 0 Yes Jeff Rickards If YES,enter delivery address below: 0 No 2388 Hounds Way Hickory, NC 28601 3. Service Type 0 Priority Mail Express® 11111111111111111111111111 III II'I I II II I III ❑Adult Signature 0 Registered Mall Restricted ❑Adult Signature Restricted Delivery ❑Registered Mall )IXCertified Mall® Delivery Mail Restricted Delivery 0 Signature Confirmation 9590 9402 7759 2152 4093 17 ❑Collect on Delivery 0 Signature Confirmation 2. Artir:la Number(Transfer from service label) 0 Collect on Delivery Restricted Delivery Restricted Delivery '7 Mall 7021 0950 0001 2506 6989 lnsur ed 1 red Mail Restricted Delivery (over$500) PS Form 3811,July 2020 PSN 7530-02-000-9053 Domestic Return Receipt USPLi S TRAC'c.EF9K -'Rt NC 7 First-Class Mail Postage&Fees Paid USPS Permit No.G-10 9590 9402 7759 2152 4093 17 United States • Sender: Please print your name,address,and ZIP±4,;in this box* Posts �C+C E l v E DHPR-03-2023-43685 ���[ Dean Evans, REHS Catawba County Public Health JUN 1 2 2023 Environmental Health PO Box 389 Newton, NC 28658 Environmental Health se—cis I it 1II'IIIIfI 1111111111d/1/III 21111111,1„�'J111'IIl11111till (-1?'A •G THIS IS NOT A PERMIT Case# EHPR-03-2023-43685 O -1 CATAWBA COUNTY HEALTHDEPARTMENT PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES 842 sM Environmental Health Plan Review-OSWP IMPROVEMENT Applicant JEFF RICHARDS,2388 HOUNDS WAY,HICKORY NC 28601 C:7046405280 STIZAL@CIIARTER.NET Paid By STEPHANIE RICHARDS,2388 HOUNDS WAY,HICKORY NC 28601 C:7046405280 STIZAL a CHARTER.NET NAME TO APPEAR ON PERMIT Jeff Richards SITE ADDRESS: 1285 MISTY LN,I IICKORY NC 28601 PIN# 373515743336 NAME of SUBDIVISION: WHISTLE PEACE Lot# 6 Section/Block _ _ PROPERTY SIZE: Square Feet 45,302.40 Acres 1.04 DIRECTIONS: Sulpher Springs Rd NE left onto Lynchburg Rd,left onto Reitzel Dr,left Misty Ln,property on left PRIMARY CONTACT: Applicant SEWER TYPE: Septic Tank GALLONS PER DAY: 360 WATER SUPPLY: Private Well DESCRIBE WORK: IP only 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? No 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:: 60 x 69 #OF NEW BEDROOMS:: 3 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: Other described: eliapplir;awn 03/13/2023 14:05 Page 1 or3 �_ CATAWBA COUNTY Case# E11PR-03-2023-43685 • Public Health Department Subdivision WHISTLE PEACE Q �.i '-1 Environmental Health Division PIN# 373515743336 in PO Box 389, 100-A Southwest Blvd,Newton,NC 28658 /8. _ w NAME ON PERMIT: (JEFF RICHARDS),2388 HOUNDS WAY,HICKORY NC 28601 (Jeff Richards) Site Address: 1285 MISTY LN,I IICKORY NC 28601 Property Size: Square Feet 45,302.40 Acres 1.04 Directions: Sulpher Springs Rd NE left onto Lynchburg Rd,left onto Reitzel Dr,left Misty Ln,property on 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: Signature of Applicant or Agent If you need further information or assistance please call 828-465-8270 AREA3 FEENAME DATE FEE AMOUNT Improvement Permit Fee 03/13/2023 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) ci.vpin:a ai 03/13/2023 14:05 Page 2of3 catawba county Nap- 3/e11)7) nuNic 'nerilth Application for Environmental Health Services too THIS IS NOT A PgRM1T , Application is for: ' New Construction []Existing.Facility improvement Permit Authorization to Construct 17. ew Septic 0 Septic Repair/Malfunction ❑Septic Relocation ❑Septic Expansion ❑Existing System Inspection or Reconnection ❑New Well ❑Replacement Well ❑Well Abandonment ❑Well Repair Property Address lot$S M l,5 C-r?G — — --- Acres I,C)4 Subdivision (�l�l�l i t Lot# (p Driving Directions to Proper lrLY��� ( J , T 1V Er-hw'h airkd L�iiCIel tdk on. 'O ear Dui , Describe work pt2,YG +Qs}-- Applicant Name „Tap RidriswaS Applicant Address assg ui- S {*iC OrU_ A,C a �ti '" Phone (qt' L4Q- �Sa - JE'maai`l11—sf ,J �1 C�hcw,y, ,I*' Owner Name (Ck G (n L.V c( `Tr k C" Owner Address 4- ( s F'&L ) JQ,:(i-s -r Q z,v,k042- Phone r Email Contractor Name Contractor Address Phone I Email Name to Appear on Permit? ❑Owner Applicant ❑Contractor Who will be the Primary Contact? 0 Owner Applicant ❑Contractor Proposed New Construction-Residential Primary Residence 114 New Residence �A lion to Residcnc NG of New Bedrooms*t '3 II of Occupants - Project Description St yr � . �rvLa� Structure Dimensions,also specify dimen',ibns of decks&porchc`s 100/ X (pA' (Choose One) ❑Basement ,®Crawl Space 0 Slab If Basement,Will There Be Water Using Fixtures In Basement ❑Yes ❑ No Retaining Wall>2' 0 Yes 1E1 No Accessory Dwelling #of New Bedrooms*t #of Occupants Structure Dimensions (Choose One) 0 Basement 0 Crawl Space ❑ Slab If Basement,Will There Be Water Using Fixtures In Basement 0 Yes ❑ No Retaining Wall>2' ❑ Yes 0 No Accessory Structure(s)Describe Structure(s)Dimensions Plumbing ❑Yes ❑No Describe Plumbing Needed (Choose One) ❑Basement ❑Crawl Space ❑ Slab if Basement,Will There He Water Using Fixtures In Basement ❑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 0 Slab If Basement,Will There Be Water Using Fixtures In Basement 0 Yes 0 No Retaining Wall>2' 0 Yes 0 No Well Construction/Abandonment/Repair Proposed Well Type ❑ 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 1-lead 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 0 Yes ❑ No Basement Plumbing ❑Yes ❑ No Existing Water Supply 0 Individual Well 0 Shared Well—Number of Connections ❑Community Well ❑County/City/Township Water Line is a public water supply available?** LI Yes ❑No Commercial ❑Proposed New Construction 0 Existing/Change of Use ❑Repair Food Service Specify Type #Seats Dining Area(Sq.Ft.) #Employees per Shift #of Shifts Church it of Seats Daycare❑Yes 0 No #of Children if of Employees per Shift #of Shifts Commercial Kitchen 0 Yes ❑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 Shill #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 No Does the site contain any jurisdictional wetlands? ❑Yes No Does the site contain any existing wastewater systems? r'Yes No Is any wastewater going to be generated on the site other than domestic sewage? 'es No Is the site subject to approval by any other public agency? "tr'Yes 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) ❑Accepted 0 Alternative 0 Conventional 0 Innovative 0 Other tiff 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 Eli 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,augcring,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 he 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. Signature of Owner or Legal Agents / Date_ 1 pq.[013 Printed Name of Owner or Legal Agent'- y /�. 7S . GI?Aii% 1 8, c �a i , Geospatial Real Estate Search „,,,:„ . Information Services `ACE 4 -.ir ^'`b 1.08A 225.8 21.35 ��% 'f 37.04 ,. ,, 28.58 58.25 51' 8 ., \ 1 WHISTLE PEACE " 5 1.64A to cp 1.04A i �;N N JJ 1 f p. J Nan& toR 140/ 1 /1,, Q 45 _._„,234.99 —_ _._-----= 213.95 ir w- e 1 in=80ft s Parcel:373516745348, 1295 MISTY LN HICKORY, 28601 Owners: CHAR DAVID C LIVING TRUST, Owner Address: 425 WOODSIDE AVE Values - Building(s): $0, Land: $31,800, Total: $31,800 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 01/26/2023 Catawba County Environmental Health •1296 205.76 21.35 MISTY IN 137.04 •1275 28.66\ (1;8_58 58.25 51.18 •1285 5 cP c� tJ 5348 o N 3336 6 45 234.99 953.45 Parcel: 373515743336, 1285 MISTY LN 1in=60ft 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 2023 Catawba County NC 03/13/2023 Parcel Report - Catawba County NC Parcel Information: Owner Information: Parcel ID: 373515743336 Owner: CHAR DAVID C LIVING TRUST Parcel Address: 1285 MISTY LN Owner2: City: HICKORY, 28601 Address: 425 WOODSIDE AVE LRK(REID): 402687 Address2: Deed Book/Page: 2976/1308 City: JEFFERSON Subdivision: WHISTLE PEACE State/Zip: OH 44047-1255 Lots/Block: 6/ School Information: Last Valid Sale: Plat Book/Page: 48/168 School District: COUNTY Legal: LOT 6 WHISTLE PEACE PL 48-168 Elementary School: SNOW CREEK Middle School: ARNDT Calculated Acreage: 1.040 High School: ST STEPHENS Tax Map: Township: CLINES School Map State Road #: Tax/Value Information: Tax Rates Zoning Information: City Tax District: All in County Zoning District: COUNTY County Fire District: ST STEPHENS Zoningl: R-40 Building(s) Value: $0 Zoning2: Land Value: $27,000 Zoning3: Assessed Total Value: $27,000 Zoning Overlay: CRC-0 Year Built/Remodeled: / Small Area: ST STEPHENS/OXFORD Tax Revaluation 2023: Info, COMPER Split Zoning Districts: / Online Appeals Zoning Agency Phone Numbers Valid Sales (COMPER) for this parcel Contact Tax Dept. at 828-282-2009 Current Tax Bill Miscellaneous: Firm Panel Date: 2007-12-18 Building Permit Address Search for this parcel. Firm Panel #: 3710373500K If available, Building Permits for this parcel. Septic 2010 Census Block: 1032 links are not permits. 2010 Census Tract: 010201 Septic Final Permits prior to 08/2018, contact Agricultural District: PROXIMITY 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. CATAWBA COUNTY 100A SOUTHWEST BLVD ■ NEWTO :109N,NORTH CAR 828.465.8399 A 28658 RECEIPT V ��� Monday, March 13, 2023 1$4/sM www.catawbacountync.gov PAYOR: Richards,Stephanie PAYMENTS TRANSACTION NUMBER: TRC-59557808-13-03-2023 PAYMENT DATE: 03/13/2023 PAYMENT TYPE: Credit Card 302318777 INVOICE NUMBER ACCOUNT FEE NAME FEE AMOUNT 03-23-419635 110-580200-663000 Improvement Permit Fee $150.00 TOTAL PAYMENTS: $150.00 EHPR-03-2023-43685 CASE TYPE: Environmental Health Plan Review WORK CLASS: OSWP SITE ADDRESS: 1285 MISTY LN,HICKORY NC 28601 Applicant JEFF RICHARDS,2388 HOUNDS WAY,HICKORY NC 28601 C:7046405280 STIZAL@CHARTER.NET Paid By STEPHANIE RICHARDS,2388 HOUNDS WAY,HICKORY NC 28601 C:7046405280 STIZAL@CHARTER.NET **NO PEOPLESOFT ACCOUNT ASSIGNED** receipt 03/13/2023 14:02 Page I of I