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Home My WebLink AboutEHPR-05-2023-44232.tif w� THIS IS NOTA PERMIT Case# EHPR-05-2023-44232 CAIAWBA COUNTY HEALTH DEPARTMENT PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES / sa Environmental Health Plan Review -Septic Malfunction AUTH CONST- SEPTIC MALFUNCTION Applicant MELLISSA HARRIS,2454 COLEY FISH POND RD,NEWTON NC 28658 C:9106152794 OTIIER:7044838100 MILOSMOM08c YAIIOO.COM Contractor LOOSE. ENDS REPAIR (BRANDON MARTIN),6499 GEORGE HILDEBRAN SCHOOL RD,HICKORY NC 28602 B:8282174138 NAME TO APPEAR ON PERMIT Mellissa Harris SITE ADDRESS: 2454 COLEY FIST I POND RD,NEWTON NC 28658 PIN# 365910458725 NAME of SUBDIVISION: Lot u Section/Block PROPERTY SIZE: Square Feet 33,976.80 Acres 0.78 DIRECTIONS: S NC 16 Hwy left Coley Fish Pond Rd on left past Dale St PRIMARY CONTACT: Contractor SEWER TYPE: Septic Tank GALLONS PER DAY: 240 WATER SUPPLY: Private Well DESCRIBE WORK: replace septic tank 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? Yes Is any of the wastewater going to be generated on the site other than domestic sewage? No Is the site subject to approval by any other public agency? No Are there any easements or right-of-ways on this property? No APPLICATION FOR: Existing Structure STRUCTURE TYPE: PRIMARY RESIDENCE FACILITY TYPE: House OTHER DESCRIPTION: DESCRIPTION OF residence EXISTING STRUCTURES ON SITE(IF ANY) DIM EXISTING STRUCTURE: 36 x 36 NUMBER OF EXISTING BEDROOMS: 2 #OF OCCUPANTS: 2 PROPOSED CONSTRUCTION BASEMENT? No BASEMENT FIXTURES? No PLUMBING REQUIRED? EMPLOYEES PER SHIFT: NUMBER OF SHIFTS: TOTAL EMPLOYEES: SEATING CAPACITY: TOTAL FLOOR SPACE(SO FT): Desired system types(Improvement Permit or Authorization to Construct): ACCEPTED: ALTERNATIVE: CONVENTIONAL: OTHER: INNOVATIVE: ANY: Other described: 05/D2/2023 IG:48 Page I of 6 4.6tr♦e CATAWBACOUN'ITY Casey EH PR-05-2023-44232 f.(.... Public Health Department Subdivision , � Environmental Health Division PIN# 365910458725 PO Box 389,100-A Southwest Blvd,Newton,NC 28658 NAME ON PERMIT: (MELLISSA I IARRIS),2454 COLEY FISI I POND RD,NEWTON NC 28658 (Mellissa Harris) Site Address: 2454 COLEY FISI I POND RD,NEWTON NC 28658 Property Size: Square Feet 33,976.80 Acres 0.78 Directions: S NC 16 Hwy left Coley Fish Pond Rd on left past Dale St Completed applications are valid for a period of 2 years.Improvement Permits ere 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 00 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 Applicant of 5/ r the owner of the property or legal agent of the owner. " Date: /;3 Signatureor Agent% �41 4-401‘w - -, if you need further information or assistance please call 828-465-8270 AREA4 FEENAME DATE FEE AMOUNT Authorization to Construct(Repair)Fee 05/02/2023 $150.00 TOTAL FEES S150.00 FEES ARE NON-REFUNDABLE ONCE A SITE VISIT IS MADE OR WORK ON A PLAN REVIEW HAS COMMENCED SYSTEM REDESIGN AND/OR RETRIP WILL INCUR AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) ch:,pph,ai n ni 05/02/2023 16:48 Page 2 of 6 Catawba county public health Application for Environmental Health Services THIS IS NOT A PERNIIT Application is for: ❑New Construction [Existing Facility ❑Improvement Permit Authorization to Construct ElNew Septic Septic Repair/Malfunction ❑ Septic Relocation El Septic Expansion ❑Existing System Inspection or Reconnection ❑New Well ❑Replacement Well El Well Abandonment ❑Well Repair Proper Address 74151. CCA / P,s 47 'Poo et1Zd 10 e w T ,Il 1)C 2SuSES Acres . Subdivision 'IS. Low 2 45 Driving Directions to Property lrW V .19 .;`,'t4 :y� `f p CDI P Li "IS4l ponr4 �el 44 Describe work eV.) L TAIL �C}Q 1(1 n Applicant Name c\e IAA(,15 Applicant Address 7,4E ti tot gi_a Ft s►.I SoCt Q R) 2 w,k-D,r 1 NC, o6(OS f. Phone CiA0-011g--Ci2-]9 yv .rl� "?O�l-+-i�,3$iUo Email ;k4- n10�Mo8� na . Cam Owner Name �j�,,.l�r � Ahoy e Owner Address Phone Email Contractor Name B canc.},0, - 1'00�2. n el & C. Contractor Address Phone $y$ — .I 1 - 9 I o Email Name to Appear on Permit? 'N Owner ❑Applicant 0 Contractor Who will be the Primary Contact? i5110vvner 0 Applicant Contractor Proposed New Construction-Residential Primary Residence ❑ New Residence ❑ Addition to Residence #of New Bedrooms*f #of Occupants Project Description Structure Dimensions,also specify dimensions of decks&porches (Choose One) El Basement ❑Crawl Space ❑ Slab If Basement,Will There Be Water Using Fixtures In Basement ❑Yes ❑ No Retaining Wall>2' ❑ Yes ❑ No Accessory Dwelling #of New Bedrooms*j #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 ❑Yes 0 No Describe Plumbing Needed (Choose One) ❑Basement ❑Crawl Space El Slab If Basement,Will There Be Water Using Fixtures In Basement ❑Yes ❑ No Retaining Wall>2' El Yes 0 No Multi-Family Residence #of Apartments #Bedrooms per Apartment*t Total#Bedrooms in Structure*1' #of Occupants Structure Dimensions (Choose One) ❑Basement ❑Crawl Space ❑ Slab If Basement,Will There Be Water Using Fixtures In Basement El Yes El No Retaining Wall>2' ❑ Yes 0 No Well Construction/Abandonment/Repair Proposed Well Type ❑ Individual Well El Semi-Public Well ❑Community Well Abandonment Type 0 Drilled ❑ Bored ❑ Dug 0 Unknown Well Repair Requested 0 Yes ❑No Describe Will Certified Well Contractor Install Water Line or Electrical Line from Well Head to Pressure Tank?D 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 t-breik., Structure Dimensions '17(� +-CAL #of Bedrooms * 2- #of Occupants 2_ 0 Basement ❑Yes El No Basement Plumbing ❑ Yes ❑ No f Existing Water Supply !'-'-Individual Well 0 Shared Well-Number of Connections El Community Well ❑ County/City/Township Water Line Is a public water supply available?** ❑ Yes ,No Commercial ❑Proposed New Construction ❑Existing/Change of Use ❑Repair Food Service Specify Type #Seats Dining Area(Sq.Ft.) #Employees per Shift #of Shifts Church #of Seats Daycare❑ Yes ❑No #of Children #of Employees per Shift #of Shifts Commercial Kitchen ❑Yes ❑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 No❑Yes No o ❑Yes f�No Does the site contain any jurisdictional wetlands? Does the site contain any existing wastewater systems? 0 Yes 0 YesXoIs any wastewater going to be generated on the site other than domestic sewage? Is the site subject to approval by any other public agency? 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. 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,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 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. �q,� y/L/73 Signature of Owner or Legal Agent 0al.N1u Wt'-+" , Date Printed Name of Owner or Legal Agent Me[It-5 SG kin'(Y i s Catawba County Environmental Health `' i •97QQ jPV3 CI r-- 6:0)8 i lir 6 •1733 1 •2434 •17 / :000 kg‘(1- dill/ c"...) A>, • fr 753 \7 •17 5 a. +,l •2447 ( > <> fir's .zasx Parcel: 365910458725, 2454 COLEY FISH 1 in=80ft POND RD 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 2023 Catawba County NC 05/02/2023 Parcel Report - Catawba County NC Parcel Information: Owner Information: Parcel ID: 365910458725 Owner: HARRIS MELLISSA Parcel Address: 2454 COLEY FISH POND RD Owner2: City: NEWTON, 28658 Address: 2454 COLEY FISH POND RD LRK(REID): 35125 Address2: Deed Book/Page: 3469/0079 City: NEWTON Subdivision: State/Zip: NC 28658-8202 Lots/Block: / Last Valid Sale: $84,000 on 2018-08-24 School Information: School District: COUNTY Plat Book/Page: Elementary School: BALLS CREEK Legal: Middle School: MILL CREEK Calculated Acreage: .780 Tax Map: 063N 03011H High School: BANDYS Township: NEWTON School Map State Road #: 1803 TaxNalue Information: Tax Rates Zoning Information: City Tax District: All in County Zoning District: COUNTY County Fire District: NEWTON RURAL Zoning1: R-30 Building(s) Value: $120,300 Zoning2: Land Value: $11,300 Zoning3: Assessed Total Value: $131,600 Zoning Overlay: Year Built/Remodeled: 1962/2016 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 828-465-8436 Current Tax Bill Miscellaneous: Firm Panel Date: 2007-09-05 Building Permit Address Search for this parcel. Firm Panel #: 3710365900J If available, Building Permits for this parcel. Septic 2010 Census Block: 2039 links are not permits. 2010 Census Tract: 011402 Septic Final Permits prior to 08/2018, contact Agricultural District: PROXIMITY Environmental Health. Building Details WaterShed: Voter Precinct: P22/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 CAI'AWI3A COUNTY 100A SOUTHWEST BLVD NEWTON,NORTH CAROLINA 28658 RECEIPT -44 PHONE:828.465.8399 (—) Tuesday,May 2,2023 l g 42 sM www.catawbacountync,gov PAY OR: I larris, Mellissa PAYMENTS TRANSACTION NUMBER: TRC-63 I 85758-02-05-2023 PAYMENT DATE: 05/02/2023 PAYMENT TYPE: Credit Card 304732723 INVOICE NUMBER ACCOUNT FEE NAME FEE AMOUNT 05-23-422018 110.5a0200-663000 Authorization to Construct(Repair) S150.00 Fee TOTAL PAYMENTS: S150.00 EHPR-05-2023-44232 CASE TYPE: Environmental Health Plan Review WORK CLASS: Septic Malfunction SITE ADDRESS: 2454 COLEY FISH POND RD,NEWTON NC 28658 Applicant MELLISSA HARRIS,2454 COLEY FISH POND RD,NEWTON NC 28658 C:9I06I52794 MILOSMOM08@YAHOO.COM **NO PEOPLESOFT ACCOUNT ASSIGNED** Contractor LOOSE ENDS REPAIR,6499 GEORGE HILDEBRAN SCHOOL RD,I IICKORY NC 28602 B:8282174138 receipt 05/022023 16:47 Page I of I