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HomeMy WebLinkAboutEHPR-10-2023-45641.tif $A • THIS IS NOTA PERMIT Case# EHPR-10-2023-45641 CATAWBA COUNTY HEALTH DEPARTMENT '1111,(� PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES `8 2 5M Environmental Health Plan Review-OSWP IMPROVEMENT Owner KWABENA APAU-KESE, 1282 AUDUBON DR,GASTONIA NC 28054 C:7049644090 KAYCECE06@GMAIL.COM NAME TO APPEAR ON PERMIT Kwabena Apau-Kese SITE ADDRESS: LOT 1 SE 3RD AVE,HICKORY NC 28602 PIN# 371208877930 NAME of SUBDIVISION: D S GILBERT ESTATE Lot fl 1 Section/Block PROPERTY SIZE: Square Feet 9,104.04 Acres 0.2090 DIRECTIONS: Startown Rd,right onto 21st St Dr SE,at the roundabout take the 1st exit,road name changes to 21st St SE,right onto 3rd Ave SE,property on the right PRIMARY CONTACT: Owner SEWER TYPE: Septic Tank GALLONS PER DAY: 360 WATER SUPPLY: Public Water DESCRIBE WORK: IP for property subdivision. New 3 bedroom, 26x32 home with 6x22 front porch on a slab. 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:: 26x32,6x22 front porch #OF NEW BEDROOMS:: 3 BASEMENT? No BASEMENT FIXTURES? No PLUMBING REQUIRED? EMPLOYEES PER SHIFT: NUMBER OF SHIFTS: TOTAL EMPLOYEES: SEATING CAPACITY: TOTAL FLOOR SPACE(SO FT): Desired system types(Improvement Permit or Authorization to Construct): ACCEPTED: ALTERNATIVE: CONVENTIONAL: OTHER: INNOVATIVE: ANY: YES Other described: chapplicallot] 10/042023 12:31 Page 1 of3 .403: • CATAWBA COUNTY Case g EHPR-10-2023-45641 Public Health Department (. '�" 2 Subdivision D S GILBERT ESTATE d11111 1 Environmental Health Division PIN# 371208877930 PO Box 389,100-A Southwest Blvd,Newton,NC 28658 w NAME ON PERMIT: (KWABENAAPAU-KESE), 1282 AUDUBON DR,GASTONIA NC 28054 (Kwabena Apau-Kese) Site Address: LOT I SE 3RD AVE,HICKORY NC 28602 Property YSize: Square Feet 9,104.04 Acres 0.2090 Directions: Startown Rd,right onto 21st St Dr SE,at the roundabout take the 1st exit,road name changes to 21st St SE,right onto 3rd Ave SE,property on the right 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 AREA1 ************************************************************************************************************ FEENAME, DATE FEE AMOUNT Improvement Permit Fee 10/03/2023 $150.00 TOTAL FEES S 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) ,1„,pplic:rti., 10/04/2023 12:31 Page 2 of 3 6**N catawba county iyi Application for Environmental Health Services THIS IS NOT A PERMIT Application is for: 0 New Construction ❑Existing Facility AImprovement Permit ❑Authorization to Construct New Septic ❑Septic Repair/Malfunction El Septic Relocation ❑Septic Expansion ❑Existing System Inspection or Reconnection ❑New Well El Replacement Well 0 Well Abandonment ❑Well Repair Property Address I tjfi ti C r,�(or io\' • Z15 •SILO AVES ��5 ZZ-'�`4 51 Gr 5t, iGKOe c 2 GZ Acres o•2a`�O . Subdivisit<n I S C=,lI L Lot# Driving Directions to Property 9'v1 �t�-rli-RT vr- DO' ��.c%elc;�.' )r v r v - 1,\. vv, ' 00) t;VE s � 4- it_ t L^ • i S .a ;.„•‘ Describe work 5 . s c- A- e. c c t.tv% v%3 ‹,2S, Applicant Name 12.yr./ E?13 — K•E Applicant Address k ..2,a v c:o `r� G cx S c� N G, Z is 4-• Phone .7 v (, l-{ `D V Email le_ c:.:4 CA tfr 1, �tw '% 1 • t t;�y, Owner Name tL.1h1 4 C3.i` N r'1 la I a is Owner Address 't 2 gig,. vav • C-1,1 N C z Phone j-l- 14'0 `.(D Email c1J ��.( p t • CV,,-, Contractor Name TT'l� , Contractor Address "g Phone I Email •t i. r} Name to Appear on Permit? ►; S wner ❑Applicant ❑Contractor Who will be the Primary Contact? 1I Owner ❑Applicant ❑Contractor Proposed New Construction-Residential Primary Residence WNew Residence ❑ Addition to Residence #of New Bedrooms*fi 3 of Occupants 9 Project Description '. (Arlo it...) [, t vt u,Ls•. �t inn vt i(t .� .+ „Au,L.:, J ✓ _��-d CLv;tii Structure Dimensions,also specify dimensions of decks&porches � i}J' '+t,-k 2,t9 t On (Choose One) 0 Basement 0 Crawl Space 'Slab If Basement,Will There Be Water Using Fixtures In Basement ❑Ycs ❑ No Retaining Wall>2' ❑ Yes Er-No Accessory Dwelling #of New Bedrooms*f' #of Occupants Structure Dimensions (Choose One) 0 Basement ❑Crawl Space ❑ Slab if Basement,Will There Bc Water Using Fixtures In Basement ❑Yes ❑ No Retaining Wall>2' ❑ Yes ❑ No Accessory Structure(s)Describe Structure(s)Dimensions Plumbing ❑Yes El No Describe Plumbing Needed (Choose One) 0 Basement ❑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 1 of Apartments Bedrooms per Apartment*t_ Total II Bedrooms in Structure*fi ii of Occupants \Structure Dimensions (Choose One) ❑Basement 0 Crawl Space ❑ Slab If Basement,Will There Be Water Using Fixtures In Basement ❑Ycs 0 No Retaining Wall>2' ❑ Ycs 0 No Well Construction/Abandonment/Repair '.Proposed Well Type ❑ Individual Well ❑Semi-Public Well ❑Community Well Abandonment Type ❑ Drilled ❑ Bored ❑ Dug ❑ Unknown Well Repair Requested ❑Yes 0 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 Striuctures on Site Describe 1-/ Structure Dimensions #of Bedrooms* #of Occupants___ _ Basement ❑Yes ❑ No Basement Plumbing El 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? ** ell Yes 0 No Commercial El Proposed New Construction ❑ Existing/Change of Use ❑Repair Food Service Specify Type #Seats Dining Area(Sq. Ft.) #Employees per Shift #of Shifts Church #of Seats Daycare❑Yes ❑No #of Children #of Employees per Shift #of Shifts Commercial Kitchen ❑Yes ❑No Residential Kitchen ❑Yes ❑No Daycare#of Children #of Employees per Shift #of Shifts Business/Other Specify Type Structure Dimensions Retail Floor Space #of Employees per Shift #of Shifts Other Information Calculated Design Flow,Commercial t (This value will be determined by EH staff) The Applicant shall notify the local health department upon submittal of this application if any of the following apply to the property in question. If the answer to any question is"yes",applicant must attach supporting documentation. ❑Yes ' ,No Does the site contain any jurisdictional wetlands? 0 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 site subject to approval by any other public agency? 0 Yes jig-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) 0 Accepted 0 Alternative 0 Conventional 0 Innovative 0 Other_ Dir.Any *Any room that will be intended for sleeping at the time of construction or for future consideration should be noted as a bedroom and counted on all applications.The number of bedrooms will be confirmed by rooms identified on floor plans as a bedroom at the time of building permit issuance. This may prevent the need for septic system expansion in the future. t If structure is plumbed but has no bedrooms,calculated design flow will be determined by EH Staff. **If No,a well permit must be issued with the Authorization to Construct. RETRIP TO THE PROPERTY AND/OR SYSTEM REDESIGN WILL INCUR AN ADDITIONAL CHARGE(SEE FEE SCHEDULE) Environmental Health soil/site evaluations require digging,augering,and/or probing into the ground. Property owner/applicant is responsible for marking all underground utilities,including but not limited to:underground power,cable,telephone,gas,water lines,and irrigation systems/sprinkler systems.Catawba County Environmental Health is not responsible for damage to unmarked utilities. Completed applications are valid for a period of 2 years. Improvement Permits are valid: with complete site plan=60 months(5 years); with complete plat=without expiration. An Authorization to Construct will remain valid as long as the Improvement Permit is valid. An Authorization to Construct,issued for septic repair is valid for 60 months(5 years). Permits may be revoked if the information on this application/site plan changes or if the intended use for the proposed facility changes. Permits may be revoked if site conditions are altered such that they effect permit conditions or installation requirements. I have read this application and certify that the information provided herein is true,complete and correct. Authorized county and state officials are granted right of entry to conduct necessary inspections to determine compliance with applicable laws and rules. I understand that I am solely responsible for the proper identification and labeling of all property lines and corners and making the site accessible so that a complete site evaluation can be performed. The undersigned is the owner of the property or legal agent of the owner. 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I % I 1 % I 1 1 I I 2 1 • f , • Parcel Report - Catawba County NC Parcel Information: Owner Information: Parcel ID: 371208877930 Owner: APAU-KESE KWABENA Parcel Address: Owner2: APAU-KESE CECILIA City: HICKORY, 28602 Address: 1282 AUDUBON DR LRK(REID): 47105 Address2: Deed Book/Page: 3730/0886 City: GASTONIA Subdivision: D S GILBERT ESTATE State/Zip: NC 28054-6424 Lots/Block: 1-7/ E Last Valid Sale: $15,000 on 2022-03-14 School Information: School District: COUNTY Plat Book/Page: UNRE/UNRE Elementary School: WEBB A MURRAY Legal: Middle School: ARNDT Calculated Acreage: .560 High School: ST STEPHENS Tax Map: 123H 02019 Township: HICKORY State Road #: TaxNalue Information: Tax Rates Zoning Information: City Tax District: All in County Zoning District: HICKORY County Fire District: HICKORY RURAL Zoningl: R-4 Building(s) Value: $0 Zoning2: Land Value: $11,300 Zoning3: Assessed Total Value: $11,300 Zoning Overlay: Year Built/Remodeled: / 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 #: 3710371200J If available, Building Permits for this parcel. Septic 2010 Census Block: 3007 links are not permits. 2010 Census Tract: 011000 Septic Final Permits prior to 08/2018, contact Agricultural District: Environmental Health. Building Details WaterShed: Voter Precinct: P35 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. s ©2023, Catawba County Government, North Carolina.All rights reserved. ‘851 CATAWBA COUNTY 100A SOUTHWEST BLVD NEWTON,NORTH CAROLINA 28658 RECEIPT " . PHONE:828.465.8399 Wednesday,October 4,2023 Ig 42 sM www.catawbacountync.gov PAYOR: Apau-Kese,Kwabena PAYMENTS TRANSACTION NUMBER: TRC-74653568-04-10-2023 PAYMENT DATE: 10/04/2023 PAYMENT TYPE: Credit Card 311576967 INVOICE NUMBER ACCOUNT FEE NAME FEE AMOUNT 10-23-428881 110-580200-663000 Improvement Permit Fee $150.00 TOTAL PAYMENTS: $150.00 EHPR-10-2023-45641 CASE TYPE: Environmental Health Plan Review WORK CLASS: OSWP SITE ADDRESS: LOT 1 SE 3RD AVE,HICKORY NC 28602 Owner KWABENAAPAU-KESE, 1282 AUDUBON DR,GASTONIANC 28054 C:7049644090 KAYCECE06 a GMAIL.COM **NO PEOPLESOFT ACCOUNT ASSIGNED** receipt 10/04/2023 12:31 Page 1 of 1