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THIS IS NOT A PERMIT Case# EHPR-06-2023-44578 CATAWBA COUNTY HEALTH DEPARTMENT PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES I$ sM Environmental Health Plan Review-Septic Malfunction AUTH CONST- REPAIR KeAi d Applicant RAY PUNCH,3121 LUTZ BLVD,NEWTON NC 28658 C:8283100545 Contractor LEATHERMAN SEPTIC TANK SVC INC (HARVEY LEATIERMAN),8420 REEPSVILLE RD RD, LINCOLTON NC 28092 H:8282444409B:7044622194 C:8284612985 HOME:8282444409F:7044622636 Owner FAIRBROOK FRANKLIN LLC,3049 LUTZ BLVD,NEWTON NC 28658 NAME TO APPEAR ON PERMIT Fairbrook Franklin LLC SITE ADDRESS: 1983 AARON DR,NEWTON NC 28658 PIN# 371116927564 NAME of SUBDIVISION: FAIRBROOK Lot# 21 Section/Block A PROPERTY SIZE: Square Feet 41,382.00 Acres 0.95 DIRECTIONS: Startown Rd,left onto Robinwood Rd,right onto Lutz Blvd,left onto Aaron Dr PRIMARY CONTACT: Applicant SEWER TYPE: Septic Tank caw I(INS PFe,QAY; 240 WATER SUPPLY:)Private Well DESCRIBE WORK, Shared well used by duplex(1983& 1981 Aaron Dr)and 3049 Lutz Blvd. PREVIOUS DESCRIPTION:Septic not draining.After septic is pumped it fills back up. Duplex is connect to well located at 3049 Lutz Blvd. Each side of the Duplex has it's own septic. 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: MULTI-FAMILY RESIDENCE FACILITY TYPE: Multiple Family Residence OTHER DESCRIPTION: DESCRIPTION OF Duplex EXISTING STRUCTURES ON SITE(IF ANY) DIM EXISTING STRUCTURE: 55x35 NUMBER OF EXISTING BEDROOMS: 0 #OF OCCUPANTS: 2 PROPOSED CONSTRUCTION #OF MULTI-FAMILY UNITS: 2 BEDROOMS PER UNIT: 2 NEW MULTI-FAMILY BEDROOMS: 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: YES OTHER: INNOVATIVE: ANY: Other described: ehapplication 10/03/2023 011:31 Page I of 3 THIS IS NOTA PERMIT Case# EI-IPR-06-2023-44578 131 I" a CATAWBA COUNTY HEALTH DEPARTMENT Iln 0 PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES I842 SM Environmental Ilealth Plan Review-Septic Malfunction AUTH CONST- REPAIR .e J,)1A3 Rbblc i'2'' f ten tY — y Applicant RAY PUNCH,3121 LUTZ BLVD,NEWTON NC 28658 C:8283I00545 Contractor LEATILERMAN SEPTIC TANK SVC INC (I IARVEY LEATHERMAN),8420 REEPSVILLE RD RD, LINCOLTON NC 28092 H:8282444409B:7044622194 C:8284612985 HOME:8282444409F:7044622636 Owner FAIRBROOK FRANKLIN LLC.3049 LUTZ BLVD,NEWTON NC 28658 NAME TO APPEAR ON PERMIT Fairbrook Franklin LLC SITE ADDRESS: 1983 AARON DR,NEWTON NC 28658 PIN# 371116927564 NAME of SUBDIVISION: _ FAIRBROOK 1 of ti 21 Section/Block A PROPERTY SIZE: Square Feet 41,382.00 Acres 0.95 DIRECTIONS: Startown Rd, left onto Robinwood Rd,right onto Lutz Blvd,left onto Aaron Dr PRIMARY CONTACT: Applicant SEWER TYPE: Septic Tank GALLONS PER DAY: 240 WATER SUPPLY: Community Well Cr-DESCRIBE WORK j Septic not draining. After septic is pumped it fills back up. Duplex is connect to well located at 3049 Lutz Blvd. • Each side of the Duplex has it's own septic. 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: MULTI-FAMILY RESIDENCE FACILITY TYPE: Multiple Family Residence OTHER DESCRIPTION: DESCRIPTION OF Duplex EXISTING STRUCTURES ON SITE(IF ANY) DIM EXISTING STRUCTURE: 55x35 NUMBER OF EXISTING BEDROOMS: 0 #OF OCCUPANTS: 2 PROPOSED CONSTRUCTION #OF MULTI-FAMILY UNITS: 2 BEDROOMS PER UNIT: 2 NEW MULTI-FAMILY BEDROOMS: 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: YES OTHER: INNOVATIVE: ANY: Other described: 06/12/2023 13:04 ..: gA G THIS IS NOTA PERMIT Case# EIIPR-06-2023-44578 .= U CATAWBA COUNTY I fEALTH DEPARTMENT U �C PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES \841 SM Environmental Health Plan Review- Septic Malfunction AUTH CONST- REPAIR Applicant RAY PUNCH,3121 LUTZ BLVD,NEWTON NC 28658 W C:8283100545 Contractor LEATHERMAN SEPTIC TANK SVC INC (HARVEY LEATHERMAN),8420 REEPSVILLE RD RD, LINCOLTON NC 28092 H:8282444409B:7044622194 C:8284612985 HOME:8282444409F:7044622636 Owner FAIRBROOK FRANKLIN LLC,3049 LUTZ BLVD,NEWTON NC 28658 NAME TO APPEAR ON PERMIT Fairbrook_ Franklin LLC ��__�__�_________ ����� SITE ADDRESS: 1983 AARON DR.NEWTON NC 28658 w w _ _ W PIN# 371116927564 M --- SITE NAME of SUBDIVISION: FAIRBROOK I of# 21 Section/Block A PROPERTY SIZE: Square Feet 41,382.00 Acres__ 0.95 DIRECTIONS: Startown Rd,left onto Robinwood Rd,right onto Lutz Blvd,left onto Aaron Dr PRIMARY CONTACT: Applicant SEWER TYPE: Septic Tank GALLONS PER DAY: 240 WATER SUPPLY: Community Well DESCRIBE WORK: Septic not draining. After septic is pumped it fills back up. Duplex is connect to well located at 3049 Aaron Dr. Each side of the Duplex has its own septic. 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: MULTI-FAMILY RESIDENCE FACILITY TYPE: Multiple Family Residence OTHER DESCRIPTION: DESCRIPTION OF Duplex EXISTING STRUCTURES ON SITE(IF ANY) DIM EXISTING STRUCTURE: 55x35 NUMBER OF EXISTING BEDROOMS__. 0 w..__w.. _ _-..W _W.w..�.. _w..-:,. #OF OCCUPANTS: 2 �...�.... �..�.. �...-.-. PROPOSED CONSTRUCTION w w w #OF MULTI-FAMILY UNITS: 2 BEDROOMS PER UNIT: 2 NEW MULTI-FAMILY BEDROOMS: 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: YES OTHER: INNOVATIVE: ANY: Other described: ehapplication 06/09/2023 09:24 Page I of 3 „. CATAWBA COUNTY Case f:HPR 06-2023-44578 t,EL,, Public Health Department Subdivision FAIRBROOK j Environmental Health Division rPIN# 371116927564 .,..... PO Box 389,100-A Southwest Blvd,Newton,NC 28658 /8.2 SM NAME ON PERMIT: FAIRBROOK FRANKLIN LLC (),3049 LU'I'Z BLVD,NEWTON NC 28658 Fairbrook Franklin LLC ( ) Site Address: 1983 AARON DR,NEWTON NC 28658 Property Size: Square Feet 41,382.00 Acres 0.95 Directions: Startown Rd,left onto Robinwood Rd,right onto Lutz Blvd,left onto Aaron 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. 7 Date: �� Signature of Applicant or Agent , ---9 ( ---- If you need further information or assistance plea call 828-465-8270 AREA1 FEENAMF DATE FEN;AMOUNT Authorization to Construct(Repair) Fee 06/09/2023 $300.00 TOTAL FEES $300.00 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) ehapplication 06/09/2023 09:24 Page 2 of 3 Catawba county public health Application for Environmental Health Services THIS IS NOT A PERMIT Application is for: ❑New Construction ['Existing Facility Q Improvement Permit El Authorization to Construct I ` ❑New Septic Septic Repair/Malfunction ❑ Septic Relocation ❑ Septic Expansion ❑Existing System Inspec on or Reconnection ❑New Well ❑Replacement Well ❑ Well Abandonment ❑WRepair (Property Ac ress (7 g 7 �-0�� Acres Subdivision ot# Driving Directions to Property "C'I.tme) b y1 �Ai 2.- 6113 4 Or/ /garri o9 ,Describe work kY\ LAB `'t N1 Applicant Name 04i (to oeiN Applicant Address 3 l 2t � �10 f0,51 Or) �/(,/L Z S� Phone a? fl- 5 Email j g:: = } O A i /() L G 95- �� ail Phone ,, Contractor Name J� �(k O4 � , 1 �L�F c e Contractor Address Phone Email Name to Appear on Permit? f Owner ❑Applicant 0 Contractor Who will be the Primary Contact? 0 Owner [Applicant 0 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) ❑Basement 0 Crawl Space ❑ Slab If Basement,Will There Be Water Using Fixtures In Basement ❑Yes 0 No Retaining Wall>2' ❑ Yes ❑ No Accessory Dwelling #of New Bedrooms*j #of Occupants Structure Dimensions (Choose One) ❑Basement 0 Crawl Space 0 Slab If Basement,Will There Be Water Using Fixtures In Basement ❑Yes ❑ No Retaining Wall>2' ❑ Yes ❑ No Accessory Strueture(s)Describe Structure(s)Dimensions Plumbing ❑Yes ❑No Describe Plumbing Needed (Choose One) ❑Basement 0 Crawl Space ❑ Slab If Basement,Will There Be Water Using Fixtures In Basement ❑Yes ❑ No Retaining Wall>2' 0 Yes 0 No Multi-Family Residence #of Apartments #Bedrooms per Apartment*j'__ Total#Bedrooms in Structure*j' #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 ❑ No Well Construction/Abandonment/Repair Proposed Well Type ❑ Individual Well ❑ Semi-Public Well 0 Community Well Abandonment Type ❑ Drilled 0 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 l Existing Structures of Site Describe Jlf Ji. (3f)ATfl4eii Structure D mensions `� )#of Bedrooms* f Occupants 2 ` Basement ❑Yes 1T_X No Basement Plumbing ❑ Yes [ No ( Existing Water Supply ❑Individual Well IX Shared Well—Number of Connections3 ❑ Community Well ❑ County/City/Township Water Line Is a public water supply available? ** ❑ Yes ❑No 3O Q t Q� Commercial ❑Proposed New Construction ElExisting/Ch(aztge of Usev❑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 j (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? ❑Yes No Is any wastewater going to be generated on the site other than domestic sewage? 0 Yes No Is the siteubject to approval by any other public agency? 0 Yes No Are there any easements or right of ways on this property? Describe If applyin 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 III 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. i 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,angering,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. I The undersigned is the owner of the proper r legal nt o he owner. Signature of Owner or Legal Agent il Date �i Printed Name of Owner or Legal Agent 1 4'U" ' 1 Catawba County Environmental Health 89.65 1.40 0 sto \❑ Aa 0 )p A,t,~ 7,70 6',' '+oi cry 0 '' . 03 00 75.00 Os .. ,.s. 85.7 6.5:16 • • • 'srN .1983 °? •1981' • c • • CN '' .!. 275.00 167.46 219.20 200.00 * l---rc Parcel: 371116927564, 1983 AARON DR 1 in=60ft 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 06/09/2023 r 1 — ii .fii ! ¢3 ! I , .1� 11... - LGJ 4 > • liew C 'C p > a ; '6 rc V El _ ° � 0o a - \, . a ;r o m :r? C •• _� Y Q s J 6: jt� * 93 Q U a u i E f�' o f F LL 2 c� -� vi u) f 3 e ,tom c y t Ili h.I., .ft Itt i l 3 \• ' •vJd L I 3 f 5 oa 0Ir0i1l41W1l16raruualtnili; _ # r 'W. .\it : 0 i i '.. 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J n s S )1,012 Parcel Report - Catawba County NC Parcel Information: Owner Information: Parcel ID: 371116927564 Owner: FAIRBROOK FRANKLIN LLC Parcel Address: 1983 AARON DR Owner2: City: NEWTON, 28658 Address: 3049 LUTZ BLVD LRK(REID): 16428 Address2: Deed Book/Page: 3136/1183 City: NEWTON Subdivision: FAIRBROOK State/Zip: NC 28658-8343 Lots/Block: 21/A School Information: Last Valid Sale: School District: COUNTY Plat Book/Page: 12/117 Elementary School: BLACKBURN Legal: LOT 21 PL 12-117 Middle School: JACOBS FORK Calculated Acreage: .950 High School: FRED T FOARD Tax Map: 015H 01002A School Map Township: HICKORY State Road #: TaxNalue Information: Tax Rates Zoning Information: City Tax District: All in County Zoning District: COUNTY County Fire District: HICKORY RURAL Zoningl: R-20 Building(s) Value: $159,200 Zoning2: Land Value: $12,800 Zoning3: Assessed Total Value: $172,000 Zoning Overlay: Year Built/Remodeled: 1975/ Small Area: MOUNTAIN VIEW 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 #: 3710371100J If available, Building Permits for this parcel. Septic 2010 Census Block: 3023 links are not permits. 2010 Census Tract: 011102 Septic Final Permits prior to 08/2018, contact Agricultural District: Environmental Health. Building Details WaterShed: Voter Precinct: P35/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. g'A C CATAWBA COUNTY I00A SOUTHWEST BLVD �'� •• _� NEWTON,NORTH CAROLINA 28658 RECEIPT 9y, PHONE:828.465.8399 U Friday,June 9, 2023 g 4 2 SM www.catawbacountync.gov PAYOR: PUNCH,RAY PAYMENTS _.. ..�.._-- TRANSACTION NUMBER: TRC-65923997-09-06-2023 PAYMENT DATE: 06/09/2023 PAYMENT TYPE: Cash INVOICE NUMBER ACCOUNT FEE NAME FEE AMOUNT 06-23-423806 II 0-580200-663000 Authorization to Construct(Repair) $300.00 Fee TOTAL PAYMENTS: $300.00 EHPR-06-2023-44578 CASE TYPE: Environmental Health Plan Review WORK CLASS: Septic Malfunction SITE ADDRESS: 1983 AARON DR,NEWTON NC 28658 Applicant RAY PUNCH,3121 LUTZ BLVD,NEWTON NC 28658 C:8283100545 **NO PEOPLESOFT ACCOUNT ASSIGNED** Owner FAIRBROOK FRANKLIN LLC,3049 LUTZ BLVD,NEWTON NC 28658 Contractor LEATHERMAN SEPTIC TANK SVC INC,8420 REEPSVILLE RD RD,LINCOLTON NC 28092 11:8282444409B:7044622194C:8284612985F:7044622636 receipt 06/09/2023 09:23 Page I of I �.. c • Q Q 4 V-) '-'7 z (.1.) 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