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HomeMy WebLinkAboutEHPR-07-2023-44812.tif KIIII'llab.� THIS IS NOTA PERMIT Case# EHPR-07-2023-44812 d r - CATAWBA COUNTY HEALTH DEPARTMENT U rj' PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES Ig42 SM Environmental Health Plan Review-Septic Malfunction AUTH CONST- SEPTIC MALFUNCTION Applicant BRIE LEWIS,2063 SAMANTHAS WELLS,NEWTON NC 28658 H:8283201063 HOME:8283201063 BRIE.LEWIS@HOTMAIL.COM NAME TO APPEAR ON PERMIT Brie Lewis SITE ADDRESS: 2466 OLD CONOVER STARTOWN RD,NEWTON NC 28658 PIN# 373115733489 NAME of SUBDIVISION: Lot# Section/Block PROPERTY SIZE: Square Feet 442,134.00 Acres 10.15 DIRECTIONS: Hwy 321 left AC Little,left Old Conover Startown Rd,2nd on left PRIMARY CONTACT: Applicant SEWER TYPE: Septic Tank GALLONS PER DAY: 480 WATER SUPPLY: Public Water DESCRIBE WORK: Tank has collapsed, 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: 30 x 60 NUMBER OF EXISTING BEDROOMS: 4 #OF OCCUPANTS: 4 PROPOSED CONSTRUCTION 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: ehapplication 07/03/2023 11:58 Page 1 of 6 ice• CATAWBA COUNTY Case# EHPR-07-2023-44812 Public Health Department Subdivision Environmental Health Division PIN# 373115733489 PO Box 389,100-A Southwest Blvd,Newton,NC 28658 w NAME ON PERMIT: (BRIE LEWIS),2063 SAMANTHAS WELLS,NEWTON NC 28658 (Brie Lewis) Site Address: 2466 OLD CONOVER STARTOWN RD,NEWTON NC 28658 Property Size: Square Feet 442,134.00 Acres 10.15 Directions: Hwy 321 left AC Little,left Old Conover Startown Rd,2nd 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: -7-3-Q3 Signature of Applicant or Agent r 9- 0 If you need further information or assistance please call 828-465-8270 AREA2 sss**ss*****ssssss**sss**ss***s*sss*sssssss*ssssss*s***s***s***s***ss**s*ssssss*sssss****************ss*ssss FEENAME '!DATE FEE AMODNT Authorization to Construct(Repair)Fee 07/03/2023 $150.00 TOTALFEES $15U 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 07/03/2023 11:58 Page 2 of 6 catawba county public health Application for Environmental Health Services THIS IS NOT A PERMIT Ap-plicatioii-is for: - New Construction CI Existing Eacility 0 Improvement Permit 0 Authorization to Construct [New Septic Septic Repair/Malfunction U Septic Relocation E3 Septic Expansion 0 Existing System Inspection or Reconnection 0 New Well Replacement Well ,Well Abandonment 0 Well Repair Propertx Address at46,e. old („r,„v_e_r-sfari-0,0,-, Rot_ IvA-0,1 Acres lU fi Subdivision Lot# DriNing Directions to Property loa 5 I1455 +0Lr r Ie 12 o 0 rt nor-5-t-ct—eirN , Describe work Spp Applicant Name Le t Applicant Address 7et -1 a in 4 AG,5 1.0-f2- S AJ C_ Phone 8 3p.0— 106 Email by,;e Ie 0 Owner Name z a me_ a a pp I;e +— Owner Address Phone Email Contractor Name Contractor Address Phone Email Name to Appear on Permit? U Owner U Applicant U Contractor Who will be the Primary Contact? U Owner 0 Applicant U Contractor Proposed New Construction-Residential Primary Residence U New Residence U Addition to Residence #of New Bedrooms*t #of Occupants Project Description Structure Dimensions,also specify dimensions of decks&porches (Choose One) 0 Basement 11 Crawl Space 0 Slab If Basement,Will There Be Water Using Fixtures In Basement El Yes El No Retaining Wall>2' El Yes 1:1 No Accessory Dwelling #of New Bedrooms*t #of Occupants Structure Dimensions (Choose One) 0 Basement El Crawl Space 0 Slab If Basement,Will There Be Water Using Fixtures In Basement 0 Yes 0 No Retaining Wall>2' El Yes I=1 No Accessory Structure(s)Describe Structure(s)Dimensions Plumbing D Yes ID No Describe Plumbing Needed (Choose One) 0 Basement El Crawl Space 0 Slab if Basement,Will There Be Water Using Fixtures In Basement 0 Yes El No Retaining Wall>2' U Yes 1:1 No Multi-Family Residence #of Apartments #Bedrooms per Apartment*t Total#Bedrooms in Structure*t #of Occupants Structure Dimensions (Choose One) El Basement El Crawl Space 0 Slab if Basement,Will There Be Water Using Fixtures In Basement 0 Yes El No Retaining Wall>2' 0 Yes 0 No Well Construction/Abandonment/Repair Proposed Well Type U Individual Well U Semi-Public Well U Community Well Abandonment Type U Drilled U Bored U Dug U Unknown Well Repair Requested U Yes U No Describe Will Certified Well Contractor Install Water Line or Electrical Line from Well Head to Pressure Tank?U Yes U 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 EThttng Structures on Site Describe (du•% , a s\-Ory IU !`;G)L Structure Dimensions 30 (DO #of Bedrooms* #of Occupants Basement ❑Yes fa No Basement Plumbing ❑Yes No Existing Water Supply: , ❑Individual Well ❑ Shared Well—Number of Connections ❑Community Well [i County/City/Township Water Line Is a public water supply available?** PI 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 M.No Does the site contain any jurisdictional wetlands? ❑Yes 0 No Does the site contain any existing wastewater systems? 0 Yes 3 No Is any wastewater going to be generated on the site other than domestic sewage? 0 Yes 0 No Is the site subject to approval by any other public agency? 0 Yes la 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 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 prop- or legal agent e owner. Signature of Owner or Legal Agent '" ' Date ` - 3'a3 Printed Name of Owner or Legal Agent r j e__ �_� 5 Catawba county Geospatial i' ea0 Estate Search MAKING. LIVING. SETTER. Information Services N 11 20) ao 7qs • e& 40 //\-:\ '9N,gNA 0-4' •21) I'As / � , (17 °+° Pj�A1F„{`or Z \ 1 G ,5) 'X C1/41••• •'0\ \ 1- .99 !° O� 2 ... 1.17A \ 1:" 00 10.15A \ % 1.91A 01lio �, \--"- is �71 \- 1• \ i 5.82A ‘ I-) 1.07A \ 1.00A tr 61.. 1e�.71 9 Sg ' cry 33 00 0 1 in=2001t w-+E S Parcel: 373115733489, 2466 OLD CONOVER STARTOWN RD NEWTON, 28658 Owners: CALDWELL JAIME SHAUNA, LEWIS BRIE ALLYSON Owner Address: 2063 SAMANTHAS WELLS Values - Building(s): $215,100, Land: $80,100, Total: $295,200 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 07/03/2023 7/3/23, 11:44 AM Parcel Report Parcel Report - Catawba County NC Parcel Information: Owner Information: Parcel ID: 373115733489 Owner: CALDWELL JAIME SHAUNA Parcel Address: 2466 OLD CONOVER STARTOWN Owner2: LEWIS BRIE ALLYSON RD Address: 2063 SAMANTHAS WELLS City: NEWTON, 28658 Address2: LRK(REID): 27198 City: NEWTON Deed Book/Page: 2788/1880 State/Zip: NC 28658-9410 Subdivision: School Information: Lots/Block: / School District: NEWTON CONOVER Last Valid Sale: Elementary School: NORTH NEWTON Plat Book/Page: Middle School: NEWTON CONOVER Legal: High School: NEWTON CONOVER Calculated Acreage: 10.150 Tax Map: 033N 01002 School Map Township: NEWTON State Road #: 1149 Tax/Value Information:Tax Rates Zoning Information: City Tax District: NEWTON Zoning District: NEWTON County Fire District:All in City Zoning1: R-20A Building(s)Value: $215,100 Zoning2: Land Value: $80,100 Zoning3: Assessed Total Value: $295,200 Zoning Overlay: Year Built/Remodeled: 1941/ Small Area: 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 #: 3710373100J If available, Building Permits for this parcel. Septic links 2010 Census Block: 1024 are not permits. 2010 Census Tract: 011200 Septic Final Permits prior to 08/2018, contact Agricultural District: Environmental Health. Building Details 7/31)3 k 9çi �j� P tJI( 4./ PJl Voter Precinct: P25/Voting Map J hu-'r1.Ubu�� Parcel Report Data Descriptions �'� � GICeS4a-triis re List all Owners Deed History Report Assessment R4ort p t (Obi necfi 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=3731157334898dype=u 1/1 i CATAWBA COUNTY Case# ��. OP-5-11 18434 „r Public Health Department Subdivision Environmental Health Division "n e " PO Box 389,100-A Southwest Blvd,Newton,NC 28658 Lot# v PIN# 373115733489 Applicant/Owner BRIE LEWIS E.1' - � ipSite Address: 2466 OLD CONOVER STARTOWN RD,Newton,NCElia_ Property Size: SF ACRES Directions: Catawba County Health Department Operation Permit System Type: 111G-OTHER NON-CONY TRENCH SYSTEMS (In accordance with Table Va) Description: 25%REDUCTION W Types V and VI systems expire in 5 years. Owner must contact health department 6 months prior to exiration for permit renewal. System Installation Comments: PERMIT CONDITIONS: 1. All maintenance, monitoring, and performance requirements shall be in accordance with 15A NCAC 18.1900, Rule .1961 2. Operation & Maintenance Specifics: Subsurface system operator required? Yes No_X_ If yes, see attached sheet for additional operation conditions, maintenance and reporting. This system has been installed in compliance with applicable North Carolina General Statutes, Rules for Sewage Treatment and Disposal, and All conditions of the Improvement Permit and Construction Authorization. Leatherman's Septic 05/25/2011 SYSTEM INSTALLER INSTALLATION DATE Susan Bumgarner- #1919 05/30/2011 AUTHORIZED STATE AGENT DATE OF OPERATION PERMIT ISSUANCE Form F 05/31/I 110:48 ' ! t ft-f PR -S - P 1 - /0 b6 � I-I S- 11 - iso q 0P- 5 - II - N 43y ..ye,t. s‘ Lf 0\LC , A • CATAWBA COUNTY �" 100A SOUTHWEST BLVD T\ NEWTON,NORTH CAROLINA 28658 RECEIPT V („�) PHONE:828.465.8399 l� Monday,July 3,2023 1842 5M www.catawbacountync.gov PAYOR: Lewis,Brie PAYMENTS TRANSACTION NUMBER: TRC-67704730-03-07-2023 PAYMENT DATE: 07/03/2023 PAYMENT TYPE: Credit Card 307532031 INVOICE NUMBER ACCOUNT FEE NAME FEE AMOUNT 07-23-425015 110-580200-663000 Authorization to Construct(Repair) $150.00 Fee TOTAL PAYMENTS: $150.00 EHPR-07-2023-44812 CASE TYPE: Environmental Health Plan Review WORK CLASS: Septic Malfunction SITE ADDRESS: 2466 OLD CONOVER STARTOWN RD,NEWTON NC 28658 Applicant BRIE LEWIS,2063 SAMANTHAS WELLS,NEWTON NC 28658 H:8283201063 BRIE.LEWIS@HOTMAIL.COM **NO PEOPLESOFT ACCOUNT ASSIGNED** receipt 07/03/2023 11:57 Page 1 of 1