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HomeMy WebLinkAboutRBPR-07-2023-44842.tif A $ •G THIS IS NOT A PERMIT Case# RBPR-07-2023-44842 Q , CATAWBA COUNTY HEALTH DEPARTMENT 0 PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES 1841 su Residential Building Plan Review- Building New �bb IMPROVEMENT AUTH_CONST -�JI6 ))3 l�NISect Applicant *JEFFREY WEEKS,6065 LITTLE MOUNTAIN RD,SHERRILLS FORD NC 28673 C:7048834485 JEFFWEEKS1971@GMAIL.COM Contractor *JW ROOFING&CONSTRUCTION INC (JEFFREY WEEKS),6065 LITTLE MOUNTAIN RD, SHERRILLS FORD NC 28673 C:7048834485 JEFF.JWCONSTRUCTION(aGMAIL.COM Owner GARY CARPENTER,PO BOX 561,CLAREMONT NC 28610-0561 NAME TO APPEAR ON PERMIT *JW Roofing & Construction Inc (Jeffrey Weeks) SITE ADDRESS: 3964 HOKE ST,CLAREMONT NC 28610 PIN# 376004936294 NAME of SUBDIVISION: WOODLAND OAKS Lot 4 36 Section/Block PROPERTY SIZE: Square Feet Acres 0.74 DIRECTIONS: Balls Creek RD Turn onto Hoke ST,lot is down the road near end on theright PRIMARY CONTACT: Contractor SEWER TYPE: Septic Tank GALLONS PER DAY: 360 CATER SUPPLY Community Well ESCRIBE WORK. 7/18/2023 Revised to 28x 50, 8x12 front and 12 x16 rear decks see new site plan, still 3 bedroom Previous description: New 1 story 3 bedroom Single Family Dwelling; no garage 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? Yes Are there any easements or right-of-ways on this property? No APPLICATION FOR: New Structure STRUCTURE TYPE: PRIMARY RESIDENCE DESCRIPTION OF vacant lot EXISTING STRUCTURES ON SITE(IF ANY) DIM EXISTING STRUCTURE: NUMBER OF EXISTING BEDROOMS: #OF OCCUPANTS: 6 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 50x26;front porch 10x12&10x12 rear deck #OF NEW BEDROOMS:: 3 BASEMENT? No BASEMENT FIXTURES? No PLUMBING REQUIRED? Desired system types(Improvement Permit or Authorization to Construct): ACCEPTED: YES ALTERNATIVE: CONVENTIONAL: OTHER: INNOVATIVE: ANY: Other described: cli:ipp11.:10“n 07/18/2023 11:27 Page I of3 4.6,je CATAWBA COUNTY Case k RU PR-07-2023-44842 Public Health Department /., `f' 2 Subdivision WOODLAND OAKS d - `1 Environmental Health Division PIN# 376004936294 PO Box 389,100-A Southwest Blvd,Newton,NC 28658 NAME ON PERMIT: *JW ROOFING&CONSTRUCTION INC (JEFFREY WEEKS),6065 LITTLE MOUNTAIN RD,SHERRILLS FORD NC 28673 *JW Roofing&Construction Inc Site Address: 3964 HOKE ST,CLAREMONT NC 28610 Property Size: Square Feet Acres 0.74 Directions: Balls Creek RD Turn onto Hoke ST,lot is down the road near end on theright 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 Signature of Applicant or Agent /( If you need further information or assis c pl s c II 8 - )5-8270 AREA3 FEENAME DATE FEE AMOUNT Authorization to Construct Fee(New/Expansion) 07/07/2023 $150.00 Fee Improvement Permit Fee 07/18/2023 $150.00 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) ehapplicauun 07/18/2023 11:27 Page 2 of 3 ..„„93995 ''' °le- . \ 1C ‘ \ • \ q ` 397!i `jam \` ,..�,„.....,... ' 7. \ \ ,,„..,-.7.:...„,„,„,,,,,....' .,•^ ../."\\....)17\_„, \ \ 444'f. \ IN Ar ; �r,F 1 ' f+ • ` i...+ L. '"J F . 1 f 1 .. \ 3980 \ m. . __ _ _._-• , t.,0•111., \"1. \ 1_,..,,,, e' c-Ct Ali.' . "e\k4. I -4,--1 \ tYC .' '''' 1, .,. 3958 Ss \ t` ....--------: \ .., -.:*-----.11\\ 3952 \ ..___ • __,...."-- i fil,4,1 ...........-'.396.3 , • \ T.----'-.-- ,..• (. s fy�'In YG i Y yam... . 11� _.. —~— -. —~^—�_.— SI La l.•I,...ftPa.10.1AG tra;A.:.1ta.:::a C Laub/Oa It. lax iG Selected Parcels Y l ` , A .olio:k 4••ol m So..C.a.,=A.m,•r 1 � na�n ...e..r ..er.'n.a.n. .,n.n.trnn-,al �. t I.F11r m.1 Wel,nninvro.o,fta elo•rotft.!: ��y W.r.:,Cuuq;.a•oas t Y,:w m-,at!.:a l.J.w ...,t N PIN:37f0(/A3ii?9 ...l:nr.•,=........-..1111“..... r.n.eNI...s IM::zn4 M:]en.M..n,.,-l.....•• 7A12023 LRK:22702 •7';1:.!thln ve f,nl.-;y hx trek V aq { t� as tl-.ralgi otaa,..:.iv Wier t..s:x CARPENTER GARY 4ti /. w ..l...-::.nntu,.cf./r.c•war..ma,sir t..11 'V I'a-. P.A.:.rr..a..•,...at,.,-,fa..,.,..r,, 1 inch- 1(10AC feet CARPENTER SUSAN `,,\ 134 3.9u"4 HOKE S T `' Only CLl'�REMONT2tleIO C � � j i �J For Informational Purposes ..d r� MNr l I*wba rnunty Tr- .....,..........---. SBA co CATAWBA COUNTY 100A sour]IWEST BLVD a lli a NEWTON,NOR'!ii CAROLINA 28658 RECEIPT FBI• •P.i,,'.,t '�;'01► PHONE:828A65.8399 V Tuesday,July 18, 2023 �$42 srn ww•w.catawbacountync,gov PAYOR: *JW Roofing&Construction Inc *JW Roofing&Construction Inc(Weeks,Jeffrey) PAYMENTS TRANSACTION NUMBER: TRC-68814797-18-07-2023 PAYMENT DATE: 07/18/2023 PAYMENT TYPE: Credit Card 308168277 INVOICE NUMBER ACCOUNT FEE NAME FEE AMOUNT 07-23-425571 110-580200-663000 Improvement Permit Fee $150.00 TOTAL PAYMENTS: $150.00 RBPR-07-2023-44842 CASE TYPE: Residential Building Plan Review WORK CLASS: Building New SITE ADDRESS: 3964 IIOKE ST,CLAREMONT NC 28610 Applicant *JEFFREY WEEKS,6065 LITTLE MOUNTAIN RD,SHERRILLS FORD NC 28673 C:7048834485 JEFFWEEKSI971 rrGMAIL.COM Owner (iARY CARPENTER,PO BOX 561,CLAREMONT NC 28610-0561 Contractor *JW ROOFING&CONSTRUCTION INC,6065 LITTLE MOUNTAIN RD.SHERRILLS FORD NC 28673 C:7048834485 JEFF.JWCONSTRUCITON@GMAIL.COM **NO PEOPLESOFT ACCOUNT ASSIGNED** receipt 07/18/2023 11:31 Page 1 of I A ‘ • THIS IS NOT A PERMIT Case# RBPR-07-2023-44842 �` 444M0CATAWBA COUNTY HEALTH DEPARTMENT PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES Ig .2 su Residential Building Plan Review-Building New AUTH CONST Applicant *JEFFREY WEEKS,6065 LITTLE MOUNTAIN RD,SHERRILLS FORD NC 28673 C:7048834485 JEFFWEEKS1971@GMAIL.COM Contractor *JW ROOFING&CONSTRUCTION INC (JEFFREY WEEKS),6065 LITTLE MOUNTAIN RD, SHERRILLS FORD NC 28673 C:7048834485 JEFF.JWCONSTRUCTION@GMAIL.COM Owner GARY CARPENTER,PO BOX 561,CLAREMONT NC 28610-0561 NAME TO APPEAR ON PERMIT *JW Roofing & Construction Inc (Jeffrey Weeks) SITE ADDRESS: 3964 HOKE ST,CLAREMONT NC 28610 PIN# 376004936294 NAME of SUBDIVISION: WOODLAND OAKS Lot# 36 Section/Block PROPERTY SIZE: Square Feet Acres 0.74 DIRECTIONS: Balls Creek RD Turn onto Hoke ST,lot is down the road near end on theright PRIMARY CONTACT: Contractor SEWER TYPE: Septic Tank GALLONS PER DAY: 360 WATER SUPPLY: Public Water DESCRIBE WORK: New 1 story 3 bedroom Single Family Dwelling; no garage 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? Yes Are there any easements or right-of-ways on this property? No APPLICATION FOR: New Structure STRUCTURE TYPE: PRIMARY RESIDENCE DESCRIPTION OF vacant lot EXISTING STRUCTURES ON SITE(IF ANY) DIM EXISTING STRUCTURE: NUMBER OF EXISTING BEDROOMS: #OF OCCUPANTS: 6 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 50x26;front porch 10x12&10x12 rear deck #OF NEW BEDROOMS:: 3 BASEMENT? No BASEMENT FIXTURES? No PLUMBING REQUIRED? Desired system types(Improvement Permit or Authorization to Construct): ACCEPTED: YES ALTERNATIVE: CONVENTIONAL: OTHER: INNOVATIVE: ANY: Other described: ehappl ication 07/07/2023 12:28 Page 1 of 3 = \ CATAWBA COUNTY Case# RBPR-07-2023-44842 (...... I., tin 2 Public Health Department Subdivision WOODLAND OAKS „/ •Environmental Health Division PIN# 376004936294 PO Box 389,100-A Southwest Blvd,Newton,NC 28658 8 a, NAME ON PERMIT: *JW ROOFING&CONSTRUCTION INC (JEFFREY WEEKS),6065 LITTLE MOUNTAIN RD,SHERRILLS FORD NC 28673 *JW Roofing&Construction Inc Site Address: 3964 HOKE ST,CLAREMONT NC 28610 Property Size: Square Feet Acres 0.74 Directions: Balls Creek RD Turn onto Hoke ST,lot is down the road near end on theright 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 h 42- Signature of Applicant or Agent /-).-� / If you need further information or assis c pl a call 828-465-8270 AREA3 FEENAME 1 _ n3 DATE rE AMOUNT Authorization to Construct Fee(New/Expansion) 07/07/2023 $150.00 Fee f ,TOTAL FEES z 3 *$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) ehapplication 07/07/2023 12:28 Page 2 of 3 �* CATAWBA COUNTY Case# RBPR-07-2023-44842 aloH ..A w� x Public Health Department Subdivision WOODLAND OAKS `m Environmental Health Division PIN# 376004936294 PO Box 389,100-A Southwest Blvd,Newton,NC 28658 ski NAME ON PERMIT: *JW ROOFING&CONSTRUCTION INC (JEFFREY WEEKS),6065 LITTLE MOUNTAIN RD,SHERRILLS FORD NC 28673 *JW Roofing&Construction Inc Site Address: 3964 HOKE ST,CLAREMONT NC 28610 Property Size: Square Feet Acres 0.74 Directions: Balls Creek RD Turn onto Hoke ST,lot is down the road near end on theright Catawba County Environmental Health Application,Evaluation,and.Permitting Procedures For Septic Systems and Well Construction A. Applications 2. Prior to the lot evaluation,you must notify the 1. Complete applications must be submitted for Environmental Health Specialist assigned to your case, Improvement.Permit(IP),Authorization to Construct(AC), that all required preparations are complete. The or Well Permit as applicable for proposed use.The owner Environmental Health Specialist will visit the lot to flag or his authorized agent must sign all applications: areas where"soil test"holes or pits are to be dug for the 2. The current fee for each permit must be paid at the time soil evaluation. Test holes or pits shall be dug in the the application is submitted: Applications will not be following manner accepted until all fees are paid. a. Holes or pits must be located as nearr as possible to 3. Complete applications must be accompanied by a plat the previously placed flags. prepared by a surveyor on a scale of no less than 1"=60', b. Holes or pits must be a minimum.of 40 inches deep. or a site plan prepared by the applicant. A separate plat 4 feet lone,and 2 feet wide with sloped or stepped or site plan must be submitted for each lot application. access in,and out.For safety reasons;at no time Plats or site plans must show all proposed property lines, should the pit be deeper than 44 inches. lot corners,home locations,all roads,bodies of water c. After holes or pits are dug,the applicant will notify (creeks,streams,lakes,ponds),existing wells within 200', the Environmental Health Specialist and an evaluation all lot dimensions,easements,and right of ways. date(s)will be scheduled. "Post holes"are not 4. Applications will be considered on a first-come;:first-serve acceptable for a soil evaluation basis and will be activated only when complete d. Exceptions to item 2.c.,will be granted if a backhoe applications are received. Incomplete applications will pit evaluation has been previously scheduled with the not be activated. Environmental Health Specialist evaluating your lot. B. Evaluations 3.: The soil site evaluation will be conducted by evaluating 1. All lots must be properly prepared for evaluation in the each previously dug hole or pit in the manner prescribed following manner by current state rules. A soil profile from each will be a. All lots must be fully accessible. Access roads must be described on a soil evaluation form for each lot at least"roughed in." Overgrown or very thickly application submitted. The soil evaluation form will wooded lots must be adequately cleared prior to include,but not be limited to,the followings evaluation to allow for proper access. a. : Soil profile description to include soil depth and b. All lot corners must be true corners(iron pins,axles, characteristics etc.)and must be marked and readily indentified in, b. Topographical features the field. All lot sidelines are to be flagged or strung c. Usable soil areas and locations the entire length and width of the lot.Exceptions to d. Possible system type(s) flagging lot sidelines may be made if all corners can be e. Problems and/or unsuitable characteristics seen from any part of the lot. f. Determination of suitability for system and repair c. Proposed"cut out"lots must be marked as indicated areas on site plan or plat for IP only and will be required to 4. Well construction applications will be evaluated based be surveyed and recorded at the Register of Deeds on required location criteria as established by state well before an AC will be issued. regulations.. d. All home sites and accessory structures(garages,out D. Notification buildings,pools,etc)as indicated on the plat must be The Environmental Health Specialist,upon completion of staked or flagged on the lot at the time of permits for approved lots,etc.,shall notify the owner or evaluation. applicant(as indicated on the application)when permit(s)are completed: Denial letter(s)explaining reasons for the denial _. Improperly prepared lots will not be evaluated and and addressing the appeal process will be issued in a timely _. will be placed in an inactive status. Applications will manner when lots are not approved for system installation% be reactivated when all required preparations are complete. These procedures will be required for all applications subject to approval under the current.North Carolina.Laws and Rules Note:Additional fees and delays may be incurred by for Sewage Treatment and Disposal Systems(1SA NCAC 18A the applicant if the lot has not been properly ,1900)and North Carolina Well Construction Standards(15A prepared for evaluation or if Items are not flagged NCAC 2C.0100) on site,indicated on the site plan,or subsequently changed. ehapplication 07/07/2023 12:28 Page 3 of 3 4 cata.•U �ba county public health 26cz-- al-ab a3_.1-4 gLca Application for Environmental Health Services THIS IS OT A PERIVIIT . Application is for: ,PKNew Construction ❑Existing,Facility El Improvement Permit ❑/Authorization to Construct ew Septic ❑ Septic Repair/Malfunction ❑ Septic Relocation ❑ Septic Expansion ❑Existing System Inspection or Reconnection ❑New Well ❑Replacement Well ❑Well Abandonment ❑Well Repair Property Address 39(9� 1Ke ` C\r�.(e. o 4 Acres Subdivision Lot Driving Directions to Property -)(', Us C er K -\- sr ()* \OKe si- bk. :5 rt-)or, -{'he (beck Scar --1•c_ ter` C Describe work , �.ed Applicant Name e ,r,_ 1!V 4.-e 3 Applicant Address&0/9 S Leh(.e„ {Fill, 12,E. S j rr, 11 S C-o re (j -C F I, 7 3 Phone 76 y_ Fs.?_ 1 c j F S- Email Owner Name S ar,.,e Owner Address Phone Email _ Contractor Name Sam, _ Contractor Address Phone Email _ ` Name to Appear on Permit? 0 Owner ❑Applicant 2-"C; tractor Who will be the Primary Contact? El Owner ❑Applicant 2tontractor • p ProposedNew Construction-Residential Primary Residence New Residence ❑ Addition to esidence #of New Bedrooms*1. 3 #of Occupants 6, Project Description Jj��f� 4/it,t 1 f 4p y1I- - _ r , Structure Dimensions,also spetfrfy dimensions of debks&porches 50 (p -p - 1,0)( 12 1 . , l o )C N.-Li (Choose One) ❑Basement ,'Crawl Space ❑ Slab If Basement,Will There Be Water Using Fixtures In Basement El Yes ❑ No l Retaining Wall>2' ❑ Yes Er5i \ Accessory Dwelling #of New Bedrooms mj' #of Occupants Structure Dimensions (Choose One) ❑Basement El Crawl Space ❑ Slab If Basement,Will There Be Water Using Fixtures In Basement ❑Yes ❑ No Retaining Wall>2' ❑ Yes ❑ No Accessory Structure(s)Describe Structure(s)Dimensions Plumbing ❑Yes ❑No Describe Plumbing Needed (Choose One) ❑Basement ❑ Crawl Space ❑ Slab If Basement,Will There Be Water Using Fixtures In Basement ❑Yes ❑ No Retaining Wall>2' ❑ Yes ❑ No Multi-Family Residence #of Apartments #Bedrooms per Apartment*t Total#Bedrooms in Structure'' #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 Consti uc#ion/Abandonment/Repair . Proposed Well Type , ❑ Individual Well ❑ Semi-Public Well ❑ Community Well Abandonment Type ❑ Drilled ❑ Bored ❑ Dug El 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 Structure Dimensions ' #of Bedrooms: #of Occupants , • Basement ❑Yes ❑ No Basement Plumbing ❑Yes ❑ No. • Existing Water Supply . ❑Individual Well 0 Shared Well—Number of Connections ❑ Community Well ❑ County/City/Township Water Line Is a public water supply available?**- Yes 2156 (,►9 G4-q Commercpel ❑Pr�olioseil New Construction 0 Exsting/Change of Use ❑Repair. . . . Food Service Specify Type #Seats Dining Area(Sq.Ft.) #Employees per Shift #of Shifts Church #of Seats Daycare 0 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 1211STO Does the site contain any jurisdictional wetlands? ❑Yes 0'lo Does the site contain any existing wastewater systems? ❑Yes calcr5 Is any wastewater going to be generated on the site other than domestic'sewage? Er es 0 No Is the site subject to approval by any other public agency? . ❑Yes ErTio 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) cepted , 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. j 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 INCIJR 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/sprinlder systems. Catawba County Environmental Health is not responsible for damage to munarked 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 off the owner. Signature of Owner or Legal Agent w•-E=e/( — Date 7 7 12_ 3 Printed Name of Owner or Legal Age —( 2-e-t-S ' Catawba County Environmental Health e"f , AP°.45 <3 o • y N. a 3980 .39 v , ��� - 9,82 '1') ''Y\ 1 1 ® d a 0 3958 1 k.00 .,,3 r)... cry ' '` 76 .90 68,48 S 134.62 .506222 Parcel: 376004936294, 3964 HOKE ST 1 in=60ft CLAREMONT, 28610 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 07/07/2023 ll• 1 i IX) sl 3: � zti8' v8 � �e F'''v 1 1 lulN t 8 `Q.� ' Ct 3 1il1 j"` '4a `i :Vd N ,k, t a arr. v _ B � a 44:11 3 Clilit.r 1 '4 = g O ' .i C lI: 1 .- • C P r. . J % 4 i '1 I l� ?P I .GI'j`b S• @ •:'3 . �y`�N ` . a f„ �Q� �., .Y 8 C a` "A ' a 4Q...�..... • J..., I 1� �Q i. • I : rt I y 1qtc(: ; ; - 0i I :6a.o'\ • V t.1;.1 "I i!lif4 1144J41 lizlill_ AC , 5 Vl v via i. e a,k4,,, ° pCe' d 0 v • • 0 ,a % QI V ryOerb \ gyp �O ti e - !• G : 4I � s.P � � � U r HI 6: 5 Y / }oa 1-41• _ 0 stv'o'.'" m -. 2-.=. 9 2 1 0- \f %. ;fig a ' t 'a 'a \�N IS ���A. x 'ice 3 ' eolo,P ‘,. .r,,01 Bona ° F Oo-'—lr°°° 1, .' \ c a 60,1a° °'.• � _ Z 9. ,Z ' t N ° A t • 1/4 0 . l. /a, to // N^ i','al `� je6V.d 1 e•g e y C a pn°I n f a o r E 1 ° b' ti °Q' B2 g o alo tE ° e ••••-- ,-.....- .....0 - „ ,....--, , ••• , e ',,,, .9z.° rith t Pit sf) I rs„ , , ✓ y; .�nn gyp j� •9_- • °��4 v,.. , 0.,,_36, ......_ , . ��i,,_ ,.., t o ° °�'CA e:„........_ . . N 1 Q • K ', --i%6G`yai.b c ILA °e0 N° �. ° - // 04.06 ° `yoo" o 33E lEgVirt., pi uti ac 8 Q o i CCII 3 %% °69 . ,.v_ ao .8 3' ,.'`eE.�` 1AIW'1vi II t,/.•, 0 c r'' o 'Q ei�'v / 1 a'o ., O y a € " l� b t t `4 .a' 6g'O 1 tkplyit$ o$4� !L N.-3- A ii ;. . .- *i s1 ,. ,2,-- ..- \ o a it, ki‘i• i•N c't• • A i --- >.._\ ie2 qy /a 4 or �C • Z `�o I°� .0 • w°, • Parcel Report - Catawba County NC Parcel Information: Owner Information: Parcel ID: 376004936294 Owner: CARPENTER GARY W Parcel Address: 3964 HOKE ST Owner2: CARPENTER SUSAN City: CLAREMONT, 28610 Address: PO BOX 561 LRK(REID): 22702 Address2: Deed Book/Page: 3655/0064 City: CLAREMONT Subdivision: WOODLAND OAKS State/Zip: NC 28610-0561 Lots/Block: 36/ Last Valid Sale: School Information: School District: COUNTY Plat Book/Page: 20/65 Elementary School: BALLS CREEK Legal: LOT 36 BLOCK H PLAT 20-65 Middle School: MILL CREEK Calculated Acreage: .740 High School: BANDYS Tax Map: 022BY 09036 School Map Township: CATAWBA State Road #: Tax/Value Information: Tax Rates Zoning Information: City Tax District:All in County Zoning District: COUNTY County Fire District: BANDYS Zoning1: R-20 Building(s)Value: $0 Zoning2: Land Value: $21,400 Zoning3: Assessed Total Value: $21,400 Zoning Overlay: WP-O Year Built/Remodeled: / 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 #: 3710376000J If available, Building Permits for this parcel. Septic 2010 Census Block: 3004 links are not permits. 2010 Census Tract: 011402 Septic Final Permits prior to 08/2018, contact Agricultural District: Environmental Health. Building Details WaterShed: WS-IV Protected Area o Voter Precinct: P1/Voting Map 1 50'O 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. 41 ik CATAWBA COUNTY Case# 1MPV-10-2022-182712 '�(-cc.I" Public Health Department Subdivision WOODLAND OAKS s Environmental Health Division PIN# 376004936294 i'O Box 389,25 Government Drive,Newton,NC 28658 LOT# 36 try iv Site Address: 3964 HOKE ST,CLAREMONT NC 28610 Name on Permit TIM BERGHOFF Property Size: Acres 0.74 Directions: From Balls Creek Rd turn onto Hoke Street,lot is down the road near the end on the right Improvement Permit AN AUTHORIZATION TO CONSTRUCT MUST BE ISSUED PRIOR TO BUILDING PERMITS THIS PERMIT IS NOT FOR SEPTIC INSTALLATION Permit Category: New Septic Wastewater Flow 360 g.p.d type of Facility: Primary Residence-SFD Basement? No Basement Plumbing? No Bedrooms: 3 Water Supply: Private Well Maximum Occupants: 6 INITIAL SYSTEM SPECIFICATIONS Proposed Wastewater System: 50%REDUCTION HORIZONTAL System Classification: 1116-SYSTEM W/SINGLE EFFLUENT PUMP Pump Required REPAIR SYSTEM SPECIFICATIONS Repair System Required? Required Proposed Wastewater System: 50%REDUCTION VERTICAL System Classification: IVA-ANY SYSTEM WITH LPP DISTRIBUTION Pump Required ***** Operator Required Permit Conditions: *DO NOT CUT OR FILL OVER ANY PART OF SEPTIC SYSTEM *DESIGNED FOR CRAWL SPACE FOUNDATION *WILL REQUIRE FILL TO BE BROUGHT IN FOR ADDITIONAL COVER OVER THE SEPTIC DRAIN FIELD. Landscaping or other site alterations that potentially divert groundwater or surface water toward the septic system, or prevent proper drainage away from the septic system, including the direction of gutter flows or foundation drains,is not approved,and may result In failure to approve the initial system installation,or the suspension/revocation of existing permits. The issuance of this permit by the Health Department does not guarantee the issuance of other permits. It is the responsibility of the applicant /property owner to insure that all Catawba County Planning/Zoning and Building Inspections requirements are met. This Improvement Permit is subject to revocation if the site plan,plat or the intended use changes.or if site conditions are altered. The Improvement Permit is not affected by a change in ownership of the property. This permit was issued in compliance with the provisions of the North Carolina'Laws and Rules fop Sewage T amen!and Lispoca/,;5ysrenrs' (I5A NCAC I SA.1900). Neither Catawba County nor the Environmental Health Specialist warrants that the septic tank system will continue to function satisfactorily for any given period of time. Any permit issued for a conventional system may be used for an accepted system without Environmental Health authorization or permit modification.Please notify Environmental Health of this change prior to system installation. E14r"s 10/21/2022 Authorized State Agent Permit issuance Date 10/21/2027 Permit Expiration Date No grading or construction activity is allowed in areas designated for system and repair without approval of the Health Department. chprnnit 10/262022 09:39 -• .......... Catawba County Environmental Health E 14 Pg -OS 04Q2 • *-.# itii& a* :" I filP Vow IC) a 470 0° .".# a 71 a 4, g•L N7- if • 43 49,' Qi\t' ct€, .4. et'o\ ** 0.82 k: • t4 6 lib Li 4 *3964 Ai Aloft. • b 0 % t 4 ‘01* ''' .. .., ,... 5, ... * •••,- 6' ...4.4 . 1:1 *nu , x,r1 (#4k Isti;% 1 150.1‘00 t SCPNI ... t , ..ts • ti v• i 0 276.90 Parcel;376004936294,3964 HOKE ST 1 in=40ft CLAREIvIONT.28610 tits mgatepiwiptettgavas Pronated dam The Clain**CstitZtt NC1 Saaral ittionnallon Services,Catanaa County has melte substantial efforts te ersuil the OCCi OMI ot Walton and Melina inionotilon ' an tsft or dais on lias Men Calawbe Count/ortorales ataladabatdeat vatatatatat et aill data=dam,tat Kt IllajdrePart tabdad by the Mit The County et Ceteete.is emploinee,egert‘ridtkre°11Wft"" baatardats dadatak sad VW riat be kid/able tor any and at ciarneges.loss or Saba*weedier direct indeed or consequential vmelt tulLend or may olio bon Ns • 'wn viaduct ot Ma use*swot by any person Of entity. Catridant 2021 Cotes:to County tiC 10117,2022 ANNUM WASTINAmSECTION COUNTY: V SOIIMTE EVALUATION fa• r ON-SI` 'EWAST ATEt SYSTEM �: ;,r i. CATI NV DATE •ID'2 g t flON°F av C1 mortar/ co rr. Ina WPM lama Mal Awes Ds� Other suumicUPS Ofw : a r . 'c 2 t, i f£ F�S'44F '! r fp 7 3 ,ir,r ,31 f.-4,- n. r -"0 i 1 - '?Se €"-M£r3" rift 4 S 7 -,4=, ' j".fix--F-:-x Ii I F 3:iss 414.i $1.. `€,' s.14.-4 �i L W .t€ F it F= ""g 4 r1�^4"s ; "- �-. ..-11 i ' r7'I . y�j, s.. -,z., i _1.,:,,L £ ,q s£�',..i{' i ti s.' s - 2 r s.'3 £'_ Y s ,-tr��'f n a a 1� p 1T '' t el" .�;i4'i'..-'s •zg € :p e 7 , � �� n-1,h g Ili ,.'-:. c, � `� 2 t �r' .�s ��s{ x ..`:r£ s s.� ���t..,LL�SSr�`- �£� z�.'z'.g. F .�,..-„.� .£ 'i s s r -C.4 �.Zpf ll ..,�.teiia-4-. , s iEdi. CF y,�,f ,ali' "a t4 Alt 4' a �t is ,-E 4 € . s.-E --.,,.. - °saiy n, , S htj r ill Y li ids 1 - ' 7 c s:^°;rt fittg..Z' .J li s- � � � ', p � att�Erg.7,-4,, t £ E11 q & ,• 7 i m ....Iv e! - uY t 7:':Z, es #'ri s ie9e i °E - ,? s u.4 ` 1 ' ln ' .. -x-. � 2 . . -'�'�:z"s 1»u:t-��.s,,,, ... »L aes -,,—,,* � tl �� 14. „£ x ,r�b i/0 . t ii k . - . . o- / y‘ G- , a -- lot Joy $L s1P sj - . 6 igS0 LiktS . �` f ,rid 1 ilk 1j ;'-t ci44, s". 6 .�'' i. .10444./ 1,........ ' R / E . . f DISCIVIVIW 417114 OTNE FACTORS(U4 � / SITE CLASSIFICATION(..t8 Mob*Slaw ONO • Roos Xl9g Sag Qg. E auxrED BY: , o cS)PRESENT: . .. 10L.T4a .,, a0 } 4 Catawba County Environmental Health sti • / . : cls 40) . ONO AO ,ef , • /111111 T � 7 "*"e* •307.9"*"7151.....,/#70."0"...01°4' • ' r ..41.0/ 3P 1 110001111101.70:00?"0".0.070,0; 7....".","..„.„.".....,"*" Parcel:376004936294,3964 HAKE ST 1lnw40ft CLAREMONT.28610 Ttta mottepot woduct see mewed ttom ine Cefa+rbe Corn.NC 8 S Catawba County has made substantial Owls(Q*Mee fee wwAl of Iowan and Weanan Rned WO%en 1 mod.Catrw Y Ore tnitsoandent won deny dens eo ad on tip nvilinvoet product byOw user.7fie County of Cstawba,its ,and palsotwel.dasista,and shall lee le hob bete es say sal sda age',toga or 4,whetter eat,Witold«asselestigal WWI else,er may wise ken the most iportproducttoea use thwoot by any potion se teddy. Codwidta 2021 Catawba County WC 10117/2022 eL CATAWBA COUNTY Case# c '' tMPV-10-2022-182712 IliSt Public Health Department Subdivision WOODLAND OAKS Y�' Environmental Health Division PIN# 376004936294 PO Box 389,25 Government Drive,Newton,NC 28658 LOT# 36 ir Site Address: 3964 HOKE ST,CLAREMONT NC 28610 Name on Permit TIM BERGHOFF Property Size: Acres 0.74 Directions: From Balls Creek Rd turn onto Hoke Street,lot is down the road near the end on the right Improvement Permit AN AUTHORIZATION TO CONSTRUCT MUST BE ISSUED PRIOR TO BUILDING PERMITS THIS PERMIT IS NOT FOR SEPTIC INSTALLATION Permit Category: New Septic Wastewater Flow 360 g.p.d Type of Facility: Primary Residence-SFD Basement? No Basement Plumbing? No Bedrooms: 3 Water Supply: Private Well Maximum Occupants: 6 INITIAL SYSTEM SPECIFICATIONS Proposed Wastewater System: 50%REDUCTION HORIZONTAL System Classification: IIIB-SYSTEM W/SINGLE EFFLUENT PUMP Pump Required REPAIR SYSTEM SPECIFICATIONS Repair System Required? Required Proposed Wastewater System: 50%REDUCTION VERTICAL System Classification: IVA-ANY SYSTEM WITH LPP DISTRIBUTION Pump Required ***** Operator Required Permit Conditions: *DO NOT CUT OR FILL OVER ANY PART OF SEPTIC SYSTEM 'DESIGNED FOR CRAWL SPACE FOUNDATION 'WILL REQUIRE FILL TO BE BROUGHT IN FOR ADDITIONAL COVER OVER THE SEPTIC DRAIN FIELD. Landscaping or other site alterations that potentially divert groundwater or surface water toward the septic system, or prevent proper drainage away from the septic system, including the direction of gutter flows or foundation drains,is not approved,and may result in failure to approve the initial system installation,or the suspension/revocation of existing permits. The issuance of this permit by the Health Department does not guarantee the issuance of other permits. It is the responsibility of the applicant ipropeny owner to insure that all Catawba County Planning/Zoning and Building Inspections requirements are met. This Improvement Permit is subject to revocation if the site plan,plat or the intended use changes.or if site conditions are altered. The Improvement Permit is not affected by a change in ownership of the property. This permit was issued in compliance with the provisions of the North Carolina'Laws and Rules for Sewage Treatment and Disp o,ra( ,yslemt'(15A NCAC IRA.1900). Neither Catawba County nor the Environmental Health Specialist warrants that the septic tank system will continue to function satisfactorily for any given period of time. Any permit issued for a conventional system may be used for an accepted system without Environmental Health authorization or permit modification.Please notify Environmental Health of this change prior to system installation. *Devi rows 10/21/2022 Authorized Slate Agent Permit Issuance Date 10/21/2027 Permit Expiration t)ate No grading or construction activity is allowed in areas designated for s):stem curd repair► ithout approval of the Health Department. ���P�•mni 10/26/2022 09:39 t'to t.OPDIV1S AND%%TIMM.SESOURCES Sad / NS=VtASTEYAtmmSScnc1 tOt9+i'tY: /r `.w SOIL SITE EVALUATION off. , fol ilerfor, 'for t ltil :"I'TEW' TER SYSTEM �,sa, ,g APPLICATION DATE 0.. DATE VALUAThlk as'if' t eposspitkaur , D moms=TEStagtpWW'ON* 'O • PROPERTYS�W e7I14L TACJI?IilN.OF Mt Cf. PROPERTY RECORDED: ViAT, t S RR 11dvate UDMyron. 0a OtherE► c() a, OFWAS : 0 0 > 4- _ ''4}' ))E't S( I"' # 3 IV4 r---L"s i'is j{� ir'l♦ 14; .1 ,'4 "s�' ^3 - es.}rIs^�tp�t'-J:.,{ s Ff. i$�r.yam,.-}' i. p i " £ i. f 1 i " '3 7 Y^ 5 i i itd� r^ R£i- ..- r ,t z' .' 3t t ; i i is --fS,w�3 i kt.f rn c q^-- -..-1 i{Y. �n .j rs - r' ,� t`� 3'�'•�t st � # t;., t � #� I� - �s £ �9 iz#sl-x i , ' , - ;f -�;' { '#' i '-2, ""i.,„, f -� -. 7 4 1 .4.«f -- Es .:ilr2 s i -i=�s #.f a ` s:#t'k.,-.skt"--,tr s g fay �tw`,..a...%., . Y'#*. >.. f _ 8 �" t , }, ; _ {it 'I Sf t E .14 's - 11 :E 1`f"�`-'j Y 5# .r' £it 3i r -h ,fira,i i;,-1,-"£: i,,. dp , .,.. s.Er. ¢u �...z`z tt' tsix >s1 +,st..KK- f'- ,''�.. r '°a`-#1 Er "s'f r r kT "3#� � Y . . I p , '�* ate. �6 fd s6 S'4Pt .%S r . /5 t ' �I-.01 ��.. i .qg 2 AG..y8 u�r sea- .�''� : 1 ok3 . . 4 ,, n tu. OPOR/ O FACTORS(1944 �+; ^ �W SITE CLASSERCA?TON(.t94S) S. ' EVALUMED BY: C MKS) : IiiLTY4 k l -� r t.. cosisorts: f:' , li ^sue r Catawba County Environmental Health O'. • A . • 0 . 7 . ., . .. .. .. . ... le. . / • . . .... , ,,, w, ..b• 9.82 f. • , . .. . 401111.1,, ..:. .. . ..• ,39.4 .. • 4, . .,.. . .tee • •...• V • I� f , r V :.,,,/ Pam:376904936294.3964 HOKE ST 1 in=40ft CLAREMONT,28610 . I Tti+maptisportproduct was papered taw thoCsawbs C ,NC Sees.CatawbaC Ass made w Wets to sasura Oa&assa r sttaes t and I on can t�mesYhmap etrd la ea mart.Catawba Gouty promotes and oscararacods stst un sldl ta�snet eelsr�dasVas productbyteemanila,Countya!Csasen,dsaraplayess, art} odor WO tAt ciaVs,rsaat shad Win Ned e �sadtrda ,less ar t. a t. et r w slues Crtvay t by say pow cr sadly. Copyddta 1 Catawba Comfy NC 101171T0fl • Catawba County Environmental HealthE s i)g -oil .. 04,22 • )0,.....0' !Ilk,,,p. .00,000.- ,,- .... ei , 71 il)P tio. 10 -(20 . - 4 01 a ,O IP o • Crit eee (s10t4-1. 4 ''''...".°1°.°. \\iit.4 to, 11. iii‘ IP' " ' "3 VI ►ass /;tf ctc, 1100 tsv cc� i o* vp 27690 Parcel:378004936294.3964 HOKE ST ,N 1 in=40 t CLAREMONT.28610 tlis onsateport product woe pre steed host the Cotasete ,NC Crw� Catawba has nuts allots Mete a+r erode ctbasageata►d Oon an rip ordda aF tt teperll G C�pia it►e at d�eoerde � aodwd t+y gu tn�t'�Co�grd Catawba,itss+�, artd end shell be Mid tor eny and dsmsgss,toss ortr ►,whet dead,ink a aides or may also ham Ode , t p or the use hereof by any+'swoon for . CW00112021 Catawba County NC 101t7rmza I Catawba County Environmental Health 2 r 9 Ike, SS 0 ... f'S s 3980 CP 9..82 '?.. ,A lb 1• D LO .3964 b9 PZ r \,,,,,Z.-:/- O- •3958 150.00 sr y , 1-04 Y10 278.90 68.48 81.85 .c cao 134.62 506 22 Parcel: 376004936294, 3964 HOKE ST 1 in=60ft CLAREMONT, 28610 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 07/07/2023