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HomeMy WebLinkAboutEHPR-06-2023-44487.tif A iy .�$ �� THIS IS NOT A PERMIT Case# EHPR-06-2023-44487 CAI'AWI3A COUNTY IIEAL FI I DEPARTMENT v� � lik cPLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES J 42 SM Environmental Health flan Review- OSWP IMPROVEMENT Applicant MADISON HOME BUILDERS (RYAN PRUETI'),301 10T11 STNW F-105, NC 28613- 11:8284648870 C:8282440968 HOME:8284648870 OTHER:(282)464-8870 RYAN r MADISONHOMEI3UI LDERS.COM Owner JUSTIN TOMSIC,3326 SEDGEFIELD RD,STALESVILLE,NC 28625 C:7249860348 NAME TO APPEAR ON PERMIT Justin Tomsic SITE ADDRESS: 6412 LONG ISLAND RD,CAI'AWI3A NC 28609 PIN# 369901397262 NAME of SUBDIVISION: Lot 1f 1 Section/Block PROPERTY SIZE: Square Feet 78,408.00 Acres 1.80 DIRECTIONS: Sherrills Ford Rd, Long Island Rd, 1/4 mile on left PRIMARY CONTACT: Applicant SEWER TYPE: Septic Tank GALLONS PER DAY: 360 WATER SUPPLY: Private Well DESCRIBE WORK: IP only for property subdivision public water line does not appear to be available per City of Hickory 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:: 51 x 50 #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: YES ALTERNATIVE: CONVENTIONAL: OTHER: INNOVATIVE: ANY: Other described: 06/01/2023 14:48 Page I of3 CATAWBA COUNTY Case# EHPR-06-2023-44487 Public Health Department'i" 2 Subdivision Q ,g® 4, Environmental Health Division PIN# 369901397262 PO Box 389,100-A Southwest Blvd,Newton,NC 28658 1 .2 w NAME ON PERMIT: (JUSTIN TOMSIC),3326 SEDGEFIELD RD,STATESVILLE NC 28625 (Justin Tomsic) Site Address: 6412 LONG ISLAND RD,CATAWBA NC 28609 Property Size: Square Feet 78,408.00 Acres 1.80 Directions: Sherrills Ford Rd,Long Island Rd,1/4 mile 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 AREA4 FEENAME DATE FEE AMOUNT Improvement Permit Fee 06/01/2023 S150.00 TOTAL FEES $150.00 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) ehapplic::dnm 06/01/2023 14:48 Page 2 of3 T GI catawba county f/�/17 public health 7 n Application for Environmental Health Services 1 On III Aria S.0 THI IS NOT A PERMIT ___--_- lication is for:H New Construction In Existing Facility Improvement Permit Authorization to Construct ew Septic ❑Septic Repair/Malfunction ❑Septic Relocation ❑Septic Expansion i 0 Existing System Inspection or Reconnection 0 New Well 0 Replacement Well _ p ❑Well Abandonment ❑Well Repair _ Propertyj aar.. GNjj -7,S Jc&r?cL .ea_, L°fi✓ftc�,Jha, Ale, 4yee 0 -- — —,�y Acres,I c��/ Subdivision LJ t� L /� _Lot# ear/ 1-[!1 2 Driving Directions to Propett l-N6 6 rD fX 17 I�� DY,cr el d �Cli+, Je oil cc,'" ke�.// iren tL e he l J� n 9\r�nr,Aj. SC_7_ s2� r;�/ �r� /. . 'o -r. .t'rt / Sf► cL/c, Describe work ! c n L ervl '7,5 C act mod/ e•stem en i-e — jVe Lc.%.<i Cit tLe e f her,+F Applicant Name/f f d_45en 1irtYY)eiiikjel r5 Applicant Address 30/-/OM 'SI,Waif Ste. F- e / r-e ne e/el." e Qv,/.3 Phone g,28.-(.(fy-ff�70 Cell Phone Owner Name �J.c:sf-i n 4 l et kyIp� 7ev'Y1Si C S�1Y1 i mc.e0 7 Attu. itri. Owner Address , 7-.(e 5eciqe..A.-6(r_ Kd t Cf eS tl r tie A/C., aktorZ Phone ?2`-I- & - _3tp3 I Cell Phone Contractor Name fl1 cii-' fiev'lebg c&ers tie_ License# O/// Contractor Address '/- ae-f-) I,j /e S. n�Yf�l/� al.in,/.3 Phone RrqSS-Lk.(4-- r]�r. Cell Phone Name to Appear on Permit' L7Owner 0 Applicant El Contractor Who will be the Primary Contact? ❑Owner pplicant 0 Contractor Proposed New Construction-Residential Primary Residence fVNew Residence ❑ Addition to Residence #of New Bedrooms st 3 #of Occupants 'y" Project Description /VG�.4, 51-i tic__ f �,�� Structure Dimensions,also specify dimensions of decks rches -.Z/1 fb(Cfl I"bt,. , (,x l v q Basement 0 Yes ErNo Basement Plumbing ❑ es No r2t Accessory Dwelling #of New Bedrooms•t #of Occupants _ Structure Dimensions Basement 0 Yes 0 No Basement Plumbing 0 Yes ❑ No Accessory Structure(s)Describe Structures)Dimensions Plumbing 0 Yes 0 No Describe Plumbing Needed Multi-Family Residence #of Apartments #Bedrooms per Apartment't Total#Bedrooms in Structure•t #of Occupants Structure Dimensions Basement 0 Yes 0 No Basement Plumbing 0 Yes 0 No - Wen Co.n.tr..wbw/Abrnduansc.VRcpp1r ` Proposed Well Type 0 Individual Well 0 Semi-Public Well 0 Community Well Abandonment Type 0 Drilled 0 Bored ❑ Dug ❑ Unknown Well Repair Requested 0 Ycs ❑No Describe Will Certified Well Contractor Install Water Line or Electrical Line from Well Head to Pressure Tank?0 Yes 0 No catawbacountync.gov Environmental Health (atcwbo lountr lioveinment Center 25 Government Drive I PO Box 389 I Newton NC 28658 1828.465 8210 MAKING. LIVING. BETTER. Existing Structures on Site Describe _. Structure Dimensions #of Bedrooms• #of Occupants • --- Basement ❑Yes ❑ No Basement Plumbing ❑Yes ❑ No Existing Water Supply 0 Individual Well ❑Shared Well—Nt ber of Connections ❑Community Well ❑County'City,Township Water Line Is a public water supply available?** '' Yes la No e ( Ct 4)L* i(V. t r/ • Commercial ❑Proposed New Construction Existing/Change of Use 0 Repair Food Service Specify Type #Scats Dining Area(Sq.Ft.) #Employees per Shift #of Shifts Church #of Scats Daycare❑Yes ❑No #of Children #of Employees per Shift #of Shifts Commercial Kitchen ❑Yes ❑No Residential Kitchen ❑Yes 0 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 tlus application if any of the following apply to the property in question. If answer to any question is"yes",applicant must attach supporting documentation. ❑Yes l , Does the site contain any jurisdictional wetlands? ❑Yes F7'!Vp Does the site contain any existing wastewater systems? ❑Ycs o Is any wastewater going to be generated on the site other than domestic sewage'? Pl es 0 Is the site subject to approval by any other public agency'? 0 Yes 0"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): (sy_stems can be ranked in order of your preference) B 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) 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 scptic 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 arc 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 orJ legal agent of a owner. ell Signature of Owner or Legal Agent ( l(/ ( QA41Date q/iq 1. 6: 3 Printed Name of Owner or Legal Agent 17)10 k\e I€' 10 nog i 'e t1 l . , . . 4 II ? i .I0 i i I ., , r : t , i- O It 'i it fui r il :I i iri ' pi t I) i i / lir i f' i i '' hilthill ii .-i•l rili: V ti :2 2 I iiiiii:i f% 1 ' i• *ti• Iti 1 ! . !pi ( l'1.100ii it it( i •51 - At',.*P .-,0.1 --3t4 "ilk 1 :•.! I it 1: . ,, , •2.1 : e 1 I- ;3 ,,fi :;I .4 ! NI 1....lt.L.. ,.. ,• I //' •. 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I,.7,:',* ,•••`.'„,.i.i A Julia English From: Katherine Smith Sent: Thursday, June 1, 2023 8:54 AM To: Julia English Subject: RE: 6400 Long Island Rd Need address for 2 new lots please The new addresses will be: Lot 1 - 6412 Long Island Rd Lot 2 - 6420 Long Island Rd Thank you, Katherine Smith Catawba County Government Center 25 Government Drive, Newton, NC 28658 Office 828.465.8147 catawba county MAKING. LIVING. BETTER. CONFIDENTIALITY STATEMENT: This electronic communication is from CATAWBA COUNTY and is confidential,privileged and intended only for the use of the recipient named above.If you are not the intended recipient or the employee or agent responsible for delivering this information to the intended recipient,unauthorized disclosure,copying,distribution or use of the contents of this transmission is strictly prohibited.If you have received this message in error,please notify the sender immediately at the following email ksmith@_catawbacountync.gov From:Julia English <JENGLISH@catawbacountync.gov> Sent:Thursday,June 1, 2023 8:17 AM To: Katherine Smith <KSmith@CatawbaCountyNC.gov> Subject: 6400 Long Island Rd Need address for 2 new lots please See plat attached Julia English Administrative Assistant II PO Box 389 125 Government Drive, Newton, NC 28658 (828) 465-8270 office (828) 465-8276 fax https://www.catawbacountync.gov/county-services/environmental-health/ We want to hear from you. Please take a minute to take our customer service survey. English 1 Catawba County Environmental Health 01 519.5 8 NN , 10 C) N. * {k. 1 �,, •6334 \ •6400 • w ai COP. l � P. fP, 1 pO 0 • BJ t11 cV V` 1` m 0 �, z .71 i N Z rn 61 •1472 Parcel: 369901397262, 6400 LONG ISLAND RD 1in=200ft CATAWBA, 28609 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 06/01/2023 • Parcel Report - Catawba County NC Parcel Information: Owner Information: Parcel ID: 369901397262 Owner: MALL MICHELE CARRICO Parcel Address: 6400 LONG ISLAND RD Owner2: MALL JAMES WILLIAM City: CATAWBA, 28609 Address: 6400 LONG ISLAND RD LRK(REID): 20061 Address2: Deed Book/Page: 3567/0046 City: CATAWBA Subdivision: State/Zip: NC 28609-8233 Lots/Block: / Last Valid Sale: $660,000 on 2020-04-21 School Information: School District: COUNTY Plat Book/Page: Elementary School: CATAWBA Legal: Middle School: MILL CREEK Calculated Acreage: 23.510 Tax Map: 019 Y 02034 High School: BANDYS Township: CATAWBA School Map State Road #: 1833 TaxNalue Information: Tax Rates Zoning Information: City Tax District: All in County Zoning District: COUNTY County Fire District: BANDYS Zoningl: R-20 Building(s) Value: $517,300 Zoning2: Land Value: $369,700 Zoning3: Assessed Total Value: $887,000 Zoning Overlay: WP-O Year Built/Remodeled: 1994/ Small Area: SHERRILLS FORD 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 #: 3710368800J If available, Building Permits for this parcel. Septic 2010 Census Block: 2013 links are not permits. 2010 Census Tract: 011501 Septic Final Permits prior to 08/2018, contact Agricultural District: Environmental Health. Building Details WaterShed: WS-IV Protected Area Voter Precinct: P21/ 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. ©2023, Catawba County Government, North Carolina.All rights reserved. �" A CATAWBA COUNTY t a•�' 100A SOUTHWEST BLVD "44 -3 NEWTON,NORTH CAROLINA 28658 RECEIPT V () fr v PHONE:828.465.8399 ��►� Thursday,June 1,2023 I842 sM www.catawbacountync.gov PAYOR: 7bmsic,Justin PAYMENTS TRANSACTION NUMBER TRC-65365736-01-06-2023 PAYMENT DATE: 06/01/2023 PAYMENT TYPE: Credit Card 306204901 INVOICE NUMBER ACCOUNT FEE NAME FEE AMOUNT 06-23-423449 110-sso2o0-66300n Improvement Permit Fee $150.00 TOTAL PAY M EN TS: $150.00 —EHPR-06-2023-44487 CASE TYPE: Environmental Health Plan Review WORK CLASS: OSWP SITE ADDRESS: 6412 LONG ISLAND RD,CATAWBA NC 28609 Applicant MADISON HOME BUILDERS,301 10TH STNW F-105, NC 28613- H:8284648870C:8282440968 RYAN@MADISONHOMEBUILDERS.COM Owner JUSTIN TOMSIC,3326 SEDGEFIELD RD,STATESVILLE NC 28625 C:7249860348 **NO PEOPLESOFT ACCOUNT ASSIGNED** receipt 06/01/2023 14:38 Page I of I