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HomeMy WebLinkAboutRBPR-04-2023-43987.TIF $A ��� THIS IS NOT A PERMIT Case# RBPR-04-2023-43987 I , I y CATAWBA COUNTY HEALTH DEPARTMENT PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES 18 2 SM Residential Building Plan Review-Deck/Porch EXS SYSTEM Applicant JENNIFER CHAVEZ-CHAVERO,2246 DELLINGER DR,NEWTON NC 28658 Owner JENNIFER CHAVEZ-CHAVERO,2246 DELLINGER DR,NEWTON NC 28658 NAME TO APPEAR ON PERMIT JENNIFER CHAVEZ- CHAVERO SITE ADDRESS: 2246 DELLINGER DR,NEWTON NC 28658 PIN# 364920800505 NAME of SUBDIVISION: BROOKRIDGE Lot# Section/Block PROPERTY SIZE: Square Feet Acres 0.39 DIRECTIONS: St Jmes Church RD Left Jenkins Printing on corner of Dellinger Dr PRIMARY CONTACT: Owner SEWER TYPE: Septic Tank GALLONS PER DAY: 360 WATER SUPPLY: Public Water DESCRIBE WORK: 10x10 rear deck& 16x10 front decks &small shed 10x16 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? Yes Are there any easements or right-of-ways on this property? No APPLICATION FOR: Existing Structure STRUCTURE TYPE: PRIMARY RESIDENCE FACILITY TYPE: Single Family Residence OTHER DESCRIPTION: DESCRIPTION OF Double wide MH EXISTING STRUCTURES ON SITE(IF ANY) DIM EXISTING STRUCTURE: 46x36 NUMBER OF EXISTING BEDROOMS: 3 #OF OCCUPANTS: 4 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 10x10; 16x10 decks&10x16 shed Desired system types(Improvement Permit or Authorization to Construct): ACCEPTED: ALTERNATIVE: CONVENTIONAL: OTHER: INNOVATIVE: ANY: Other described: ,hnppliemon 04/06/2023 14:24 Page I or3 n CATAWBA COUNTY Case# RBPR 04 2023-43987 I Public Health Department Subdivision BROOKRIDGE Environmental Health Division PIN# 364920800505 PO Box 389,100-A Southwest Blvd,Newton,NC 28658 cM NAME ON PERMIT: (JENNIFER CHAVEZ-CHAVERO),2246 DELLINGER DR,NEWTON NC 28658 (JENNIFER CHAVEZ-CHAVEF Site Address: 2246 DELLINGER DR,NEWTON NC 28658 Property Size: Square Feet Acres 0.39 Directions: St Jmes Church RD Left Jenkins Printing on corner of Dellinger Dr 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: 01-GO . 3 Signature of Applicant or Agent 1 {g If you need further information or assistan e please 1 828-465-8270 AREA3 FEENAME DATE FEE AMOUNT Existing Tank Check Fee 04/06/2023 $80.00 TOTAL FEES S80.00 FEES ARE NON—REFUNDABLE ONCE A SITE VISIT IS MADE OR WORK ON A PLAN REVIEW HAS COMMENCED SYSTEM REDESIGN AND/OR RETRIP WILL INCUR AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) ehappiication 04/06/2023 14:24 Page 2 of 3 a catawba county public health Application for Environmental Health Services THIS IS NOT A PERMIT Application is for: D New Construction ❑ Existing Facility ❑ Improvement Permit ❑Authorization to Construct ❑New Septic ❑ Septic Repair/Malfunction ❑ Septic Relocation ❑ Septic Expansion Existing System Inspection or Reconnection New Well ❑ Replacement Well ❑ Well Abandonment ❑ Well Repair ,Property Address 224 ko . V1 -c Dr I Acres •Scl b Subdivision v..a.,. Lot# Driving Directions to Pro erty Pit-te C h I? 11111011111 t'l* , • ' C 1 (AI)(,a 1( yeti,:,5er•Dr Describe work r Applicant Name J Cnn%-Fer Chavez Applicant Address 2231 -E .1enree+n fir-. Phone SZ$ 291 5314Plp Email Owner Name " 3+ennife r CVlowe Z Owner Address Phone Email Contractor Name ` Contractor Address Phone Email Name to Appear on Permit? Owner ❑Applicant [2] Contractor Who will be the Primary Contact? .Owner ❑Applicant ❑ Contractor Proposed New Construction-Residential 1 Primary Residence ❑ New Residence rig Addition to Residence #of New Bedrooms*t #of Occupants Project Description �1eE,e. Structure Dimensions,also specify dimensions of decks&porches i0. x i 0' ram( 11,0 lO I (p(1'r d e:Y1 (Choose One) El Basement 14 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 0 Yes ❑ No Retaining Wall>2' ❑ Yes ❑ No Accessory Structure(s)Describe Small Shed to X I(D d— Structure(s)Dimensions Plumbing 0 Yes Ilia No Describe Plumbing Needed (Choose One) 0 Basement ❑Crawl Space 0 Slab If Basement,Will There Be Water Using Fixtures In Basement 0 Yes ❑ No Retaining Wall>2' ❑ Yes 0 No Multi-Family Residence #of Apartments #Bedrooms per Apartment*f Total#Bedrooms in Structure*f #of Occupants Structure Dimensions (Choose One) ❑Basement 0 Crawl Space ❑ Slab If Basement,Will There Be Water Using Fixtures In Basement ❑ Yes ❑ No Retaining Wall>2' ❑ 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 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 M o i::0; 1 e *IDO L. Structure Dimensions 18,1_3(jo % #of Bedrooms* 3 #of Occupants O Basement ❑Yes g No Basement Plumbing ❑ Yes 74 No ' Existing Water Supply ❑ Individual Well ❑ Shared Well—Number of Connections El Community Well [;County/City/Township Water Line Is a public water supply available?** ❑ Yes ❑No Commercial El 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 ❑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 the answer to any question is"yes",applicant must attach supporting documentation. ❑Yes g No Does the site contain any jurisdictional wetlands? )gYes '[No Does the site contain any existing wastewater systems? Yes la'No Is any wastewater going to be generated on the site other than domestic sewage? )(Yes ja'No Is the site subject to approval by any other public agency? ❑Yes ,LINo 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 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. 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,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 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. \ . .C�,nA ��Signature of Owner or Legal Agent;�/� U_ -fA)Iti& Date D� - nip .0a� Printed Name of Owner or Legal Agent 3 e nrWWfe l' CX\ON C2,- C,1(10i\I e 1'0 Catawba County Environmental Health L• 1 0 0; 0 •225 0 I~ to o ce 25 0 26 Z —J cu CO 149.94 150.0C _-________L .1ENKINS p"TING DR .0 155.00 I 155,s a , t / i if 0 '` �e, , Oe.... L. •L3f I0 H ' " ' cli X ti .. 0/ o 6 4 .22 9 i 1 55.00 z.,. Ill 59 0 O 0 .,_ .2258 0 0 15 . 155.00 I 0 155.59 0 r- A rzt , Parcel: 364920800505, 2246 DELLINGER DR 1 in=50ft NEWTON. 28658 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 1 1/22/2022 4/6/23,2:01 PM Parcel Report Parcel Report - Catawba County NC Parcel Information: Owner Information: Parcel ID: 364920800505 Owner: CHAVEZ-CHAVERO JENNIFER Parcel Address: 2246 DELLINGER DR Owner2: City: NEWTON, 28658 Address: 2246 DELLINGER DR LRK(REID): 901877 Address2: Deed Book/Page: 3769/1423 City: NEWTON Subdivision: BROOKRIDGE State/Zip: NC 28658-7449 Lots/Block: 7/ Last Valid Sale: $27,000 on 2003-10-07 School Information: School District: COUNTY Plat Book/Page: 46/85 Elementary School: TUTTLE Legal: LOT 7 PLAT 46-85 Middle School: MAIDEN Calculated Acreage: .390 High School: MAIDEN Tax Map: Township: NEWTON School Map State Road #: 2137 TaxNalue Information: Tax Rates Zoning Information: City Tax District:All in County Zoning District: COUNTY County Fire District: NEWTON RURAL Zoning1: R-40 Building(s)Value: $136,300 Zoning2: Land Value: $10,400 Zoning3: Assessed Total Value: $146,700 Zoning Overlay: Year Built/Remodeled: 2000/ Small Area: BALLS CREEK 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: 2007-09-05 Building Permit Address Search for this parcel. Firm Panel #: 3710364900J If available, Building Permits for this parcel. Septic links 2010 Census Block: 1012 are not permits. 2010 Census Tract: 011601 Septic Final Permits prior to 08/2018, contact Agricultural District: PROXIMITY Environmental Health. b05t- Building Details , 5 `ns-t WWaterShed:Voter Precinct: P32/Voting Map 36R" 3It)3 Pd 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. ©2023,Catawba County Government, North Carolina.All rights reserved. gis.catawbacountync.gov/nomap/parcel_report.php?key=364920800505&type=u 1/1 • . •,.. CATAWBA COUNTY HEALTH DEPARTMENT . No 7 8 t 0 Telephone: (828)465 8270�FDD: (828)46W00 0d Imp. Print. Au4. to• onst. }� spy mu.. r. Print. J` Sys. Type O-- Well P t. Well Rpr. Putt._ Owner/Agent nil K W/llG�j{ raf' W Phone � —C Address /Z!7 f(ray., e��� Subdivision Fa' kr,+ • 41C Sc ' Bl k/P •se Lot/J_7 Lot.Si.ie Directions: — 44 c K( 'i • j7 Facility: House U Mobile Home V. Business Multi-family Other: Tax Map or Pin Number _(p yq.20 DO D.OS Other . Zoning Approval 0 .p DI 0.533 0 Bedrooms j 0 Seats • 0 Employees . Application Rate GPD Flow 34Q Hot Tub or Spa ye /n ial Fixtures Basement yes/no . 100% Repair Are s no . Basement Plumbing y /no Water Supply: ' •.te Well Public )( Semi-Public__ ******************** ***************************************$*********************************# * ******************** Type of System: Trench X Bed Pump Pump/Panel Panel LPP Other (a• I dUc oaN._._ a Septic Tank Size 1 60 D Pump Tank Size Nitrification Field: Total Square Feet 1 U?) Depth of Stone NM i l Bed Size Trench Width 3(Q tt Total Length-of All Trenches 3 OD umber'of Trenches q Trench Length 70 //UU/'I(j %t/O/ . I • Feet on Center Maximum Trench Dep 10 Distance of Nearest Well *DO NOT INSTALL SEPTIC WHEN WET* *WELL 'I CORD REQUIRED AT COMPLETION' Topo 5 _ / % Slope . Texture I. t el i Structure •,5. / / CIay Min. • Soil Wetness n Soil Depth ~ lJ Restric. Hoz. at t p �p potR- • Available spac o • • Overall Class q`Q � ��. + r . Comments:JJ �• v = •� - 1� 4' qy : 3creN ``'` :____9) 1 1 �b �,, y l; r ® I ` V. 0 ,, • 0 « • .. ..... �.., Ako4krici.sgw,l. ,, . 1 1, j54 t�o' - V4' D?ll( {R . be.., , Filter Required' Riser required when • tank is more than 6 inches deep. **NO GUARANTEE OR WARRANTY IS IMPLIED OR GI EN AS TO THE PERFORMANCE OR LENGTH OF TIME THIS SYSTEM WILL FUNCTION** *Improvement Permit has no expiration date and is transferable, but may be revoked if site plans or intended use changes for the:proposyd facility. An Authorization to Construct is valid for (5) five years from date issued and is not transferable. Well Permit valid fort5:y`ears', provided site conditions do not change. Well location, installation,and protection must meet state and local regulations,and must`b'e;:--- 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))a��,,}y���slgk the Health Department. A� Permit Date `T' L(J'pUy EHS /�-� �G a h Owner Septic Tank Ins lee y I J I�t� Date_ CZ -ze JW *1 Well Installed By Well Grout Approval Date 1 I Well Head val a • Date Sample Collected Date of Results Results EHS ' White-Office Blue-Building Inspection Operation Permit Yellow-Owner/Agent /Agent Green-Building Inspection Authorization to Construct