Loading...
HomeMy WebLinkAboutEHPR-10-2023-45863.tif $A THIS IS NOTA PERMIT Case# EHPR-10-2023-45863 0(1 CATAWBA COUNTY HEALTH DEPARTMENT �� PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES 1$�2 sM Environmental Health Plan Review-OSWP IPa2 Permit Fee Applicant BENFIELD OUTDOOR SERVICES&SOLUTIONS,939 BRAWLEY SCHOOL,MOORESVILLE NC 28117 B:7043600376 INFO@YARDSBYBOSS.COM YARDSBYBOSS.COM Owner PATRICK STANKIEWICZ,7530 LIBERTY RD,SOLON OH 44139 C:4406678454 PATRICKcjJSSELECTRIC.COM Paid By ERICA VAUGHAN, 14305 CATO DR,HUNTERSVILLE NC 28078 C:7044676673 ERICA@ERICAVAUGHAN.COM ERICAVAUGHAN.COM NAME TO APPEAR ON PERMIT Patrick Stankiewicz SITE ADDRESS: 7326 RIGHT ANGLE ST,SHERRILLS FORD NC 28673 PIN# 460703231898 NAME of SUBDIVISION: AARON H LAIL Lot!! 13 Section/Block PROPERTY SIZE: Square Feet 24,393.60 Acres 0.56 DIRECTIONS: E NC 150 Hwy,left Little Mountain Rd,right on Right Angle St,on left PRIMARY CONTACT: Applicant SEWER TYPE: Septic Tank GALLONS PER DAY: 480 WATER SUPPLY: Private Well DESCRIBE WORK: a2 IP 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? 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: 8 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 55 x 55 #OF NEW BEDROOMS:: 4 BASEMENT? Yes BASEMENT FIXTURES? Yes 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: YES INNOVATIVE: ANY: Other described: ahapplicanon 10/25/2023 14:47 Page 1 of3 CATAWBA COUNTY Case# c;' EHPR-10-2023-45863 Public Health Department Subdivision AARON H LAIL Environmental Health Division PIN# 460703231898 PO Box 389,100-A Southwest Blvd,Newton,NC 28658 u. NAME ON PERMIT: (PATRICK STANKIEWICZ),7530 LIBERTY RD,SOLON OH 44139 (Patrick Stankiewicz) Site Address: 7326 RIGHT ANGLE ST,SHERRILLS FORD NC 28673 Property Size: Square Feet 24,393.60 Acres 0.56 Directions: E NC 150 Hwy,left Little Mountain Rd,right on Right Angle St,on left Completed applications are valid for a period of 2 years.Improvement Permits are valid:with complete site plan=80 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 AREAS FEENAME DATE FEE AMOUNT IPa2 Permit Fee 10/25/2023 $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) ciipplicau,i 10/25/2023 14:47 Page 2 of3 I ' T , 1 ( ) catawba county public health a1Pomfii periccMFl 86n4e Id 1 Application for Environmental Health Services �h 1 o to ilat 1 I�S Ii IV- THIS IS NOT A PERMIT Application is for: ❑ New Construction ❑Existing Facility RImprovement Permit 0 Authorization to Construct New Septic ❑Septic Reparr/Malfunetion ❑ Septic Relocation ID Septic Expansion Existing System Inspection or Reconnection New Well ❑Replacement Well ❑ Well Abandonment El Well Repair Property Address 7326 Right Angel St, Sherrills Ford NC Acres 0.557 Subdivision Aaron H ,Lail Properties J' Lot# 13 Driving Directions to Property NC 150 r1 Wq, + e f f Li I.2 le AL. 1 t G ig i r 61, },,'ji 4 J ule St rk lett Describe work Applicant Name BENFIELD OUTDOOR SERVICES & SOLUTIONS Applicant Address 93g Rrawley School Rd, Mooresvillq NC Phone 704-360-0376 I Cell Phone Owner Name Patri2k & Alison Stankiewiez o r -- itea Uau�hn 1 D f - �-1i7-('L73 eir Caeerie va tghan.tot Phone J Cell Phone Contractor Name License# Contractor Address Phone Cell Phone Name to Appear on Permit? ❑Owner ❑Applicant ❑Contractor Who will be the Primary Contact? ❑Owner ❑Applicant ❑Contractor Proposed New Construction-Residential Primary Residence [S'New Residence ❑ Addition to Residence #of New Bedrooms*t 4 #of Occupants 8 Project Description New House Structure Dimensions,also specify dimensions of decks&porches 55'x55' Basement ❑Yes ❑ No Basement Plumbing 7Yes ❑ No Accessory Dwelling #of New Bedrooms*t #of Occupants Structure Dimensions Basement El Yes c3 No Basement Plumbing ❑Yes ❑ No Accessory Structure(s)Describe Structure(s)Dimensions Plumbing El Yes (l No Describe Plumbing Needed Multi-Family Residence #of Apartments #Bedrooms per Apartment*t Total#Bedrooms in Structure*t #of Occupants Structure Dimensions Basement El Yes El No Basement Plumbing El Yes El No Well Construction/Abandonment/Repair Proposed Well Type E Individual Well ❑Semi-Public Well El Community Well Abandonment Type 0 Drilled 0 Bored ❑ Dug 0 Unknown Well Repair Requested El Yes ❑No Describe Will Certified Well Contractor Install Water Line or Electrical Line from Well Head to Pressure Tank?❑ Yes 0 No catawbacountync.gov RECEIVED Environmental Health Catawba County Government Center 25 Government Drive I PO Box 389 I Newton NC 28658 1828.465.8270 OCT 2 3 2023 MAKING. LIVING. BETTER. Environmental Health Existing Structures on Site Describe Structure Dimensions #of Bedrooms* #of Occupants Basement ❑Yes ❑ No Basement Plumbing El Yes ❑ No J_ Existing Water Supply J U � �i��p 1AtiC�� ElIndividual Well Shared Well—Number of Connections 7 ❑ Community Well ❑County/City/Township Water Line Is a public water supply available?** ❑ Yes ❑No Commercial D 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 El No #of Children #of Employees per Shift #of Shifts Commercial Kitchen El Yes El 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 6d'No Does the site contain any jurisdictional wetlands? ❑Yes c}'No Does the site contain any existing wastewater systems? ❑Yes ci No Is any wastewater going to be generated on the site other than domestic sewage? ❑Yes No Is the site subject to approval by any other public agency? ❑Yes IZ2f 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 ❑Conventional 0 Innovative 0 Other ❑ 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 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. Signature of Owner or Legal Agent .�LCI.¢�g¢o� leo Date 10-23-23 Printed Name of Owner or Legal Agent Michael Benfield/ 4 •I II Permit#: IMPV-11-2023-207956 ROY COOPER•Governor , ,.. NC DEPARTMENT OF KODY H. KINSLEY•Secretary 41 ' ` HEALTH AND " a= HUMAN SERVICES MARK BENTON •Deputy Secretary for Health '. ,» SUSAN KANSAGRA•Assistant Secretary for Public Health Division of Public Health Submittal Includes: ❑✓ (a2)Improvement Permit ❑(a2)Construction Authorization ❑Fee$ IMPROVEMENT PERMIT FOR G.S. 130A-335(a2) County: Catawba PIN/Lot Identifier: 46077703231898 Issued To: Patrick and Alison Stankiewiez Property Location: 7326 Right Angel St Sherrills Ford NC Subdivision(if applicable) Lot#: 13 Block: Section: 3 LSS Report Provided: Yes❑✓ No❑ If yes,name and license number of LSS: Miranda Stamper, 1258 New❑✓ Expansion ❑ System Relocation ❑ Change of Use ❑ Proposed Structure: 4 bedroom residence Number of bedrooms: 4 Number of Occupants: 8 Other: Design Wastewater Strength:❑✓ domestic ❑high strength ❑industrial process Proposed Design Daily Flow: 480 GPD Proposed LIAR(Initial): 0.35 Proposed LTAR(Repair): 0.35 Proposed Wastewater System Type*: PPBPS Vertical (Initial) PumpRequired: q uired: ❑Yes 0 No ❑May be required Proposed Wastewater System Type*: PPBPS horizontal Pump)air(ReReq uired:q uired: ❑Yes ❑No ✓❑May be required *Please include system classification for proposed wastewater system types in accordance with I5A NCAC 18A.1961 Table V(a) Saprolite System(initial):❑Yes ❑✓ No Saprolite System(repair):❑Yes ❑✓ No Fill System(Initial):❑Yes ❑✓ No If yes,specify:❑New ❑Existing (when adding more than 6 inches of fill to system area provide a fill plan) Fill System(repair):❑Yes ❑✓ No If yes,specify:❑New ❑Existing (when adding more than 6 inches of fill to system area provide a fill plan) Usable Soil Depth(Initial): 48" Usable Soil Depth(Repair): 33" Max.Trench Depth(Initial)*: 33e Max.Trench Depth(Repair)*: 18" *Measured on the downhill side of the trench Artificial Drainage Required: ❑Yes ✓❑No If yes,please specify details: Type of Water Supply:❑Private well ❑Public well Q Shared well ❑Municipal Supply ❑Spring ❑Other: Drainfield location meets requirements of Rule.1945: Yes Q No❑ Drainfield location meets requirements of Rule.1950: Yes❑✓ No❑ Permit valid for:Q Five years[site plan submitted pursuant to GS 130A-334(13a)] El No expiration[plat submitted pursuant to GS 130A-334(7a)) Permit conditions: See design Licensed Soil Scientist Print Name: Miranda Stamper Miranda Stamper Digitally signed by Miranda Stamper Licensed Soil Scientist Signature: p Date:2023.10.23 12:28:09-04'00' Date: The LSS evaluation Is being submitted pursuant to and meets the requirements of G.S.130A-335(a2). *See attached site sketch* NC DEPARTMENT OF HEALTH AND HUMAN SERVICES • DIVISION OF PUBLIC HEALTH LOCATION:5605 Six Forks Road,Building 3,Raleigh,NC 27609 MAILING ApDRESS:1632 Mail Service Center,Raleigh,NC 27699-1632 www.nodhhs.gov • TEL:919-707-5854 • FAX:919-845-3972 AN EQUAL OPPORTUNITY I AFFIRMATIVE ACTION EMPLOYER L ,«r?a • Permit#: IMPV-11-2023 207956 r 7326 Right Angle St This Section for Local Health Department Use Only Initial submittal received: 10/23/2023 by RP Date Initials G.S. 130A-335(a3)states the following: When on applicant for an Improvement Permit submits to a local health department an Improvement Permit application,the permit fee charged by the local health department,the common form developed by the Department and a soil evaluation pursuant to subsection(a2)of this section,the local health department shall, within five business days of receiving the application,conduct a completeness review of the submittal.A determination of completeness means that the Improvement Permit includes all of the required components.If the local health department determines that the Improvement Permit is incomplete,the local health department shall notify the applicant of the components needed to complete the Improvement Permit.The applicant may submit additional information to the local health department to cure the deficiencies in the Improvement Permit.The local health department shall make a final determination as to whether the Improvement Permit is complete within five business days after the local health department receives the additional information from the applicant.If the local health department fails to act within arty period set out in this subsection,the applicant may treat the failure to act as a determination of completeness.The Department shall develop a common form for use as the Improvement Permit. The review for completeness of this Improvement Permit was conducted in accordance with G.S. 130A-335(a3). This Improvement Permit is determined to be: ❑ Incomplete(If box is checked,information in this section is required.) The following items are missing: Copies of this were sent to the LSS and the Applicant on Date State Authorized Agent: Date: ©Complete State Authorized Agent: - ) `ry1N`I V Date: 11/7/2023 This Improvement Permit is issued pursuant to G.S.130A-335(a2)and(a3)using the signed and sealed LSS/LG evaluation(s) attached here. The issuance of this permit by the Health Department in no way guarantees the issuance of other permits.The permit holder is responsible for checking with appropriate governing bodies in meeting their requirements.This permit is subject to revocation if the site plan,plat,or the intended use changes. The Improvement Permit shall not be affected by a change in ownership of the site. This permit is subject to compliance with the provisions of the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit. The Department,the Department's authorized agents,and the local health departments shall be discharged and released from any liabilities,duties,and responsibilities imposed by statute or in common law from any claim arising out of or attributed to evaluations,submittals,or actions from a licensed soil scientist or licensed geologist pursuant to GS 130A-335(a2). Improvement Permit Expiration Date: 11/7/2028 *See attached site sketch* G.S. 130A-335(a2)Common Form 2 V.2023.07 r t LINE SCHEDULE 7326 RIGHT ANGLE ST, SHERRILLS FORD NC. SECTION -, LOT 13 AARON H LAIL PROPERTIES LINE NUMBER COLOR FIELD ELEVATION LENGTH(FT) DESIGN LEND I H (FT) 4-BEDROOM LP PPBPS SYSTEM (VERTICAL) YELLOW 6 14 0 ( ) 2 ORANGE 1.2 26 0 LINES 4A-6A, 7-9 TOTAL 230 LINEAR FT LTAR 0.35 3 RED 2.2 49 0 50% REDUCTION 7' OC 4 GREEN 3.1 69 34 36" MAX TRENCH BOTTOM 5 WHITE 4.7 89 36 6 BLUE 5.8 90 34 4-BEDROOM PANEL BLOCK REPAIR SYSTEM 7 ORANGE 6.9 85 85 LINES 1-3, 4B, 5B, 6B TOTAL 229 LINEAR FT - - LTAR 0.35 8 PINK 8.0 26 26 20"TRENCH BOTTOM (HORIZONTAL) 9 GREEN 9.6 15 15 TOTAL TOTAL FOR GENERAL USE NOT A SURVEY 463 230 PRELIMINARY NOT FOR CONSTRUCTION CONDITIONS: MUST BE INSTALLED BY A LICENSED NOTES: SEPTIC INSTALLER. DRAINFIELD AREA MUST MAINTAIN SOIL NOTES PROVIDED BY MIRANDA STAMPER NATURAL CONTOURS & SLOPE. IMPROPER OR EXCESSIVE GRADING WILL VOID THIS DESIGN AND INFORMATION FOR BUILDER: BOSS IS NOT LIABLE. DO NOT CHANGE NATURAL CONTOURS DURING TREE REMOVAL AND GRADING INITIAL LINE INFORMATION FOR INSTALLER: PRE-CONSTRUCTION MEETING IS REQUIRED REPAIR LINE PRIOR TO DIGGING. MAINTAIN 100' FROM THE COMMUNITY WELL �osort $ p 12515 eO" le 2" Pi•: p1eT R HORTH G1 G �y, lea Fe��emeDL `� io.e 1' 10/23/23 �25.2� ��, 6' 6 9 •rya,W p l rJ n o O W )o:'3`; � ��S. enpe $ 9 0, N N 7 R�a, House Box O Well House 6 �r ® r\I - a $etbao O.557 Acres 5;: � ye R\ � sia TT . e L" Pi. 1.b 41:\V�, 7. 55 • ,olec" PP F}o�t .\ - 5A ® " /1/2" Pipe `� 60 00.SE TRACK FROM WEL L\tbQe, \\©_ _�' ' ./.6. 99 9 /6' dy RWM-wh a t 11 ale 4� B 256 10 W ! I I I 1 Stje 1" Pipe+P 15 SCALE: et\eo.4,-,..4. 1" = 50 ft. LOT 13 BOSS Benfield Outdoor Services&Solutions,LLC 7326 RIGHT ANGLE ST, 939 SravAey School Rd.Mooresville.NC 28117 Ph:704-360-0376 ERICA VAUGHAN SHERRILLS FORD,NC IRrowadscynoss.cem CATAWBA COUNTY ' DATE9/21/23 DRAWN BY:MDB REVIEWED BY:ME DOSS+ Sheel _I of I 939 BRAWLEY SCHOOL RD PROPERTY ID d: MOORESVILLE NC COUNTY: CATAWBA SOILSITE EVALUATION for ON-SITE WASTEWATER SYSTEM (Complete all fields in full) OWNER: Lot# 13 APPLICATION DATE: ADDRESS:7326 RIGHT ANGLE DATE EVALUATED: 8/17/23 _ PROPOSED FACILITY: 4 BEDROOM PROPOSED DESIGN FLOW(.1949): 480 PROPERTY SIZE: LOCATION OF SITE: _ PROPERTY RECORDED: WATER SUPPLY: 0 Private 0 Public 0 Well 0 Spring 0 Other EVALUATION METHOD: 0 Auger Boring 0 Pit 0 Cut TYPE OF WASTEWATER: 0 Sewage 0 Industrial Process 0 Mixed P o SOIL MORPHOLOGY OTHER F (.1941) PROFILE FACTORS I .1940 L F LANDSCAPEHORIZON POSITION/ DEPTH PROFILE .1942 # SLOPE% (IN.) .1941 .1941 SOIL .1943 .1956 .1944 CLASS STRUCTURE/ CONSISTENCE/ WETNESS/ SOIL SAPRO RESTR &LTAR TEXTURE MINERALOGY COLOR DEPTH CLASS HORIZ B1 L 7-8% 0-4 GR SL NS NP FR 48" FEW 0.35 4-26 SBK C S P Fl INCLUS - - 26-32 SBK CL SS NP FR TtONS @26-32" 32-48 MASS L NS NP FR ,SAP@ 32" B2 L 7-8% 0-6 GR SL NS NP FR 48" FEW 0.35 6-42 SBK C S SP Fl - INCLU - 42-48 SBK CL NS NP Fl STION S@42" B3 L 7-8% 0-4 GR SL NS NP FR 48" SAP@ 0.35 4-23 SBK C S P Fl - 33„ - 23-33 SBK CL SS SP FR 33-48 WSBK L NS NP FR B4 L 10% 0-4 GR SCL NS NP FR 48" FEW 0.35 4-22 SBJ C SS SO FU - INCLU - 22-48 WSBJ CK BS BO FU SIONS @39" ` 50I S . ©p.E. toC$FyDESCRIPTION INITIAL.SYSTEM REPAIR SYSTEM OTHER FACTORS(.1946): �q� t' th Available Space(.1945)229 LF 229 LF SITE CLASSIFICATION(.194:1 MI ' _ System Type(s) LP PPBPS LP PPBPS WO ° �' ' EVALUATED BY: MIRANDA sr•'� i• Site LTAR 0.35 0.35 OTHERS)PRESENT: MICHAEL F J .'�la.1, c _-,. , -Ay COMMENTS:TOPOGRAPHYA CONCERN. CORRECT DURING CLEARING. Ch 12584 Qw - OF H G� NORT Updated March 2022 Permit#: y¢�estSrATFo�q\\'o,.. ROY COOPER •Governor ��Ca NC DEPARTMENT OF KODY H. KINSLEY •Secretary HEALTH AND Vol HUMAN SERVICES MARK BENTON • Deputy Secretary for Health SUSAN KANSAGRA•Assistant Secretary for Public Health Division of Public Health Submittal Includes: [✓_I(a2)Improvement Permit Li(a2)Construction Authorization ❑Fee$ IMPROVEMENT PERMIT FOR G.S. 130A-335(a2) County: Catawba PIN/Lot Identifier: 46077703231898 Issued To: Patrick and Alison Stankiewiez Property Location: 7326 Right Angel St Sherrills Ford NC Subdivision(if applicable) Lot#: 13 Block: Section: 3 LSS Report Provided: Yes ✓❑ No❑ If yes,name and license number of LSS: Miranda Stamper, 1258 New❑ Expansion ❑ System Relocation ✓❑ Change of Use 0 Proposed Structure: 4 bedroom residence Number of bedrooms: 4 Number of Occupants: 8 Other: Design Wastewater Strength:❑✓ domestic ❑high strength ❑industrial process Proposed Design Daily Flow: 480 GPD Proposed LTAR(Initial): 0.35 Proposed LTAR(Repair): 0.35 Proposed Wastewater System Type*: PPBPS vertical Pump Required: ❑ ❑No ❑May be required p y yp (Initial) ✓ Yes Proposed Wastewater System Type*: PPBPS horizontal (Repair) Pump Required: ❑✓ Yes ❑No ✓❑May be required *Please include system classification for proposed wastewater system types in accordance with 15A NCAC 18A.1961 Table V(a) Saprolite System(initial):❑Yes ❑✓ No Saprolite System(repair):❑Yes ❑✓ No Fill System(Initial):❑Yes ❑✓ No If yes,specify:❑New El Existing (when adding more than 6 inches of fill to system area provide a fill plan) Fill System(repair):❑Yes ❑✓ No If yes,specify:El New ❑ Existing (when adding more than 6 inches of fill to system area provide a fill plan) Usable Soil Depth(Initial): 48" Usable Soil Depth(Repair): 32" Max.Trench Depth(Initial)t: 36" Max.Trench Depth(Repair)#: 20.E *Measured on the downhill side of the trench Artificial Drainage Required: ❑Yes ✓❑No If yes,please specify details: Type of Water Supply:❑Private well ❑Public well 0 Shared well ❑Municipal Supply 0 Spring ❑Other: Drainfield location meets requirements of Rule.1945: Yes El No El Drainfield location meets requirements of Rule.1950: Yes I:: No❑ Permit valid for:D Five years[site plan submitted pursuant to GS 130A-334(13a)] ❑No expiration[plat submitted pursuant to GS 130A-334(7a)] Permit conditions: See design Licensed Soil Scientist Print Name: Miranda Stamper Miranda Stamper .Digitally signed by Miranda Stamper Licensed Soil Scientist Signature: p Date:2023.10.2312:28:09-04'00' Date: The LSS evaluation is being submitted pursuant to and meets the requirements of G.S.130A-335(a2). *See attached site sketch* RECEIVED NC DEPARTMENT OF HEALTH AND HUMAN SERVICES • DIVISION OF PUBLIC HEALTH LOCATION:5605 Six Forks Road,Building 3,Raleigh,NC 27609 MAILING ADDRESS:1632 Mail Service Center, Raleigh,NC 27699-1632 OCT 2 3 2023 www.ncdhhs.gov • TEL:919-707-5854 • FAX:919-845-3972 AN EQUAL OPPORTUNITY/AFFIRMATIVE ACTION EMPLOYER Environmental Health siiii;066601,01, Permit #: This Section for Local Health Department Use Only rLInitial submittal received: lD -2-3— 2 3 by io Date Initials G.S. 130A-335(a3)states the following: When an applicant for an Improvement Permit submits to a local health department an improvement Permit application,the permit fee charged by the local health department,the common form developed by the Department,and a soil evaluation pursuant to subsection(a2)of this section,the local health department shall, within five business days of receiving the application,conduct a completeness review of the submittal.A determination of completeness means that the Improvement Permit includes all of the required components.If the local health department determines that the Improvement Permit is incomplete,the local health department shall notify the applicant of the components needed to complete the improvement Permit.The applicant may submit additional information to the local health department to cure the deficiencies in the Improvement Permit.The local health department shall moke a final determination as to whether the Improvement Permit is complete within five business days after the local health department receives the additional information from the applicant.If the local health department fails to act within any period set out in this subsection,the applicant may treat the failure to act as o determination of completeness.The Department shall develop a common form for use as the Improvement Permit. The review for completeness of this Improvement Permit was conducted in accordance with G.S. 130A-335(a3). This Improvement Permit is determined to be: complete(If box is checked, information in this section is required.) The following items are missing: 3 Sao pR �afri C/11,kt 0n fr.t iii Gt p.7 — Pei's%ir fps- jrr V.A.w rot P /ac41r`OK Copies of this were sent to the LSS and the Applicant on /47-27-' -3 Date ��_ State Authorized Agent: `/��'fJ "" 0 Date: 1 O-27-Z J ❑Complete State Authorized Agent: Date: This Improvement Permit is issued pursuant to G.S. 130A-335(a2)and(a3)using the signed and sealed LSS/LG evaluation(s) attached here. The issuance of this permit by the Health Department in no way guarantees the issuance of other permits.The permit holder is responsible for checking with appropriate governing bodies in meeting their requirements.This permit is subject to revocation if the site plan,plat,or the intended use changes. The Improvement Permit shall not be affected by a change in ownership of the site. This permit is subject to compliance with the provisions of the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit. The Department,the Department's authorized agents,and the local health departments shall be discharged and released from any liabilities,duties,and responsibilities imposed by statute or in common law from any claim arising out of or attributed to evaluations,submittals,or actions from a licensed soil scientist or licensed geologist pursuant to GS 130A-335(a2). Improvement Permit Expiration Date: *See attached site sketch* G.S. 130A-335(a2)Common Form 2 V.2023.07 LINE SCHEDULE 7326 RIGHT ANGLE ST, SHERRILLS FORD NC. SECTION -, LOT 13 AARON H LAIL PROPERTIES LINE NUMBER COLOR FIELD ELEVATION LENGTH(FT) DESIGN LENS rH (FT) 4-BEDROOM LP PPBPS SYSTEM VERTICAL 1 YELLOW .6 14 0 (VERTICAL) 2 ORANGE 1.2 26 0 LINES 4A-6A, 7-9 TOTAL 230 LINEAR FT LTAR 0.35 3 RED 2.2 49 0 50% REDUCTION 7' OC 4 GREEN 3.1 69 34 36" MAX TRENCH BOTTOM 5 WHITE 4.7 89 36 6 BLUE 5.8 90 34 4-BEDROOM PANEL BLOCK REPAIR SYSTEM 7 ORANGE 6.9 85 85 LINES 1-3, 4B, 5B, 6B TOTAL 229 LINEAR FT LTAR 0.35 6 PINK 8.0 26 26 20"TRENCH BOTTOM (HORIZONTAL) 9 GREEN 9.6 15 15 TOTAL TOTAL FOR GENERAL USE NOT A SURVEY 463 230 PRELIMINARY NOT FOR CONSTRUCTION CONDITIONS: MUST BE INSTALLED BY A LICENSED NOTES: SEPTIC INSTALLER. DRAINFIELD AREA MUST MAINTAIN SOIL NOTES PROVIDED BY MIRANDA STAMPER NATURAL CONTOURS & SLOPE. IMPROPER OR EXCESSIVE GRADING WILL VOID THIS DESIGN AND INFORMATION FOR BUILDER: BOSS IS NOT LIABLE. DO NOT CHANGE NATURAL CONTOURS DURING TREE REMOVAL AND GRADING INITIAL LINE INFORMATION FOR INSTALLER: PRE-CONSTRUCTION MEETING IS REQUIRED REPAIR LINE PRIOR TO DIGGING. MAINTAIN 100' FROM THE COMMUNITY WELL co sort s S OP E_ ^1„ .o.- + yYoeeLiouO �� :af le 2" pi.: pier NORTH GP 1,y.,a FeEasemept r4 cross wp: DrQeera9 ��co J' 10/23/23 25 2z ��� �' o ao a 3 o �3 r�O9 0 0 cs �0, W o .s N Feroe 8 9 o NO coo o 71ePr' w. House Box d Well House P� b k- ` r- r- 0.557 Acres " ��-\1`I ae geti so 51:, . w • �\ 5 gi ♦ r 1 4;\�� 55 d c 1" Pi 3 6 so prof PP 0• \ — .. t'4 piet '. ON.,_ oft --` __A 5A ® • 1 1/2" Pipe $` �'Oos,. Y00'SETBACK FROM WELL\tbQe 1 ,_O---�4` / 99 9)A6'•' RNM �ht h' 0 25 S' B W I I I 1.. 1 ele 256:0 tr F eet 1" Pipe I? SCALE: B0• 1" = 50 ft. R�ty LOT 13 BOSS Benfield Outdoor Services&Solutions,LLC 7326 RIGHT ANGLE ST, 9J9©ravAey School Rd,MooresvIie,NC28117 Ph:704-3600376 ERICA VAUGHAN SHERRILLS FORD,NC Inlo�yartlsbyboss.com CATAWBA COUNTY DATE:9/21/23 DRAWN BY:M BD BY:MB BOSS Sheet .1 of I 939 BRAWLEY SCHOOL RD PROPERTY ID#: MOORESVILLE NC COUNTY: cnTAWBA SOIL/SITE:EVALUATION for ON-SITE WASTEWATER SYSTEM EM (Complete all fields in full) OWNER: Lot# 13 APPLICATION DATE: ADDRESS:7326 RIGHT ANGLE DATE EVALUATED: 8/17/23 PROPOSED FACILITY: 4 BEDROOM PROPOSED DESIGN FLOW(.1949): 480 PROPERTY SIZE: LOCATION OF SITE: _ - PROPERTY RECORDED: WATER SUPPLY: 0 Private 0 Public 0 Well 0 Spring 0 Other EVALUATION METHOD: 0 Auger Boring 0 Pit 0 Cut TYPE OF WASTEWATER: 0 Sewage 0 Industrial Process 0 Mixed r R o SOIL MORPHOLOGY OTHER F (.194I) PROFILE FACTORS I .1940 I. F LANDSCAPE HORIZON POSITION/ DEPTH 4 PROFILE .1942 a SLOPE% (IN.) .1941 .1941 SOIL1943 .1956 .1944 CLASS STRUCTURE/ CONSISTENCE/ WETNESS/ SOIL SAPRO RESTR & LTAR TEXTURE MINERALOGY COLOR DEPTH CLASS HORIZ 0B1 L 7-8% GR SL NS NP FR 48" FEW 0.35 4-26 SBK C S P Fl _ INCLUS 26-32 SBK CL SS NP FR TIONS - @26-32" 32-48 MASS L NS NP FR ,SAP@ 32" B2 L 7-8% 0-6 GR SL NS NP FR 48" FEW 0.35 6-42 SBK C S SP Fl - INCLU - 42-48 SBK CL NS NP Fl STION S@42" B3 L 7-8% 0-4 GR SL NS NP FR 48" SAP@ 0.35 4-23 SBK C S P Fl - 33„ - 23-33 SBK CL SS SP FR 33-48 WSBK L NS NP FR 0B4 L 10% GR SCL NS NP FR 48" FEW 0.35 4-22 SBJ C SS SO FU - INCLU - 22-48 WSBJ CK BS BO FU SIONS @39" a42 oP E- sr. Fti ♦s F1 l Q DESCRIPTION INITIAL SYSTEM REPAIR SYSTEM OTHER FACTORS(.1946): V 1ny 3 0, 'U Available Space(.1945)229 LF 229 LF SITE CLASSIFICATION(.19413� .F :'+�ljf' ' System Type(s) LP PPBPS LP PPBPS ��� ; " EVALUATED BY: MIRANDA ST.'u,• , OR _�4�;,"� Site LTAR. 0.35 0.35 OTHER(S)PRESENT: MICHAEL f 'tt� ?,44i - COMMENTS:TOPOGRAPHYA CONCERN. CORRECT DURING CLEARING. ' 725a� (4° OF ND R CN GQ Updated March 2022 DigiSign Verified -8d7d2c96•d78c-4f51-8bf7-e62b4d172f3e (1 Catawba county public health Authorized Agent Form PROPERTY INFORMATION 460703231898 Lot #13 NC PIN # Subdivision Name Section/Phase/Lot# Street Address of Property: 7326 Right Angle Street, Sherrills Ford, NC 28673 Section I (please print) Complete if the prospective buyer intends to apply for permits. Permits will be issued to the applicant. Erica and Derek Vaughan (Patrick Stankiewicz Alison Stankiewicz give my permission to (Property Owner) (Perspective Buyer/Applicant) to apply for septic and well permits from Catawba County Environmental Health on my above referenced property. Section II (please print) Complete if the applicant (owner or prospective buyer)wants to designate someone (i.e. real estate agent) as their legal representative (Authorized Agent) to apply for permits. Permits will be issued to the applicant. Alison Stankiewicz 'Patrick Stankiewicz give my permission to Benfield Outdoor Services & Solutions (Owner or Applicant) (Authorized Agent) to act as my legal representative in applying for septic and well permits from Catawba County Environmental Health on the above referenced property. Signatures—All parties names printed above must sign this form 7-)abLiek 5ta //in,stankiew-it,0 09/12/2023 Property Owner U Date Perspective Buyer/Applicant Date Authorized Agent Date catawbacountync.gov Environmental Health Catawba County Government Center 25 Government Drive I PO Box 389 I Newton NC 28658 1828.465.8270 MAKING. LIVING. BETTER. DigiSign Verified -8d7d2c96-+d78c-4f51-8bf7-e62b4d172f3e BENFIELD OUTDOOR SERVICES & SOLUTIONS Benfield Outdoor Services & Solutions Phone: (704) 360-0376 939 Brawley School Rd. Mooresville, North Carolina 28117 Info@yardsbyboss.com LLS: Miranda Stamper#1258 Attention: Catawba County Environmental Health Department Address: 3070 11th Avenue Drive Southeast Hickory, NC 28602 Phone: 828-9-695-5800 Recommended Wastewater Disposal System Owner: Erica Vaughan PIN: 460703231898 Address: 7326 Right Angle Street, Sherrills Ford, NC 28673 To whom it may concern, You will find attached a copy of the wastewater disposal system proposed for the owners Erica Vaughan of lot#(s) 13 PIN # 460703231898 on Right Angle Street in Catawba County. Also attached are the sealed soil notes, site plan and design for an onsite wastewater disposal system. The LSS evaluation attached to this application is to be used to issue an Improvement Permit in accordance with G.S. 130A-335(a2) and (a3). Please review the attached proposal and contact me if you have any questions or concerns. The LSS evaluation attached to this application is to be used to produce design and construction features for permitting in accordance with G.S. 130A-335(a2). I understand that the documentation and fees, as required in G.S. 130A-335(a2), (a3), (a5), and (a6), attached to this application are to be used to issue an improvement permit and/or Construction Authorization pursuant to G.S. 130a-335a2), (a3), and (a5). I understand that authorized county and state officials are granted right of entry to the property indicated on this application to conduct necessary inspections to determine compliance with applicable laws and rules. I understand that if the information in the application for an improvement permit and/or construction authorization is Did iSign Verified-8d7d2c96-d78c-4f51-8bf7-e62b4d172f3e falsified, changed, or the site is altered, the improvement permit and construction authorization shall become invalid. Patrick Stankiewicz Alison Stankiewicz Owner: Signature: PatAicf Startiejewie4 Signature: /Piz OIL Staid/that./ The LSS evaluation is being submitted pursuant to and meets the requirements of G.S. 130A- 335(a2). Miranda Stamper, LSS / 9/26/23 Signature: 7�14:4_ad,tG �ta.kirm- Catawba County Environmental Health 27.59 102.1111 A -sryittcA, 9^ h Y a ( �d N9"� 4 ' ".r d hhp rJ •7300 r '8.23 � r Aq 10.08 5 55.00 100.00 25.4 5 qz� 14.86 99.13 31,39 55.55 65 'err. .. 63,5 •7310 ss.7: 44,30 2B7 00 •7318 ■ 324DO -v •7326 256.00 0 9 Al* G{SST /z99) •7352 •7335 Parcel: 460703231898, 7326 RIGHT ANGLE ST 1 in=60ft SHERRILLS FORD, 28673 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 10/24/2023 Parcel Report - Catawba County NC Parcel Information: Owner Information: Parcel ID: 460703231898 Owner: STANKIEWICZ PATRICK R Parcel Address: 7326 RIGHT ANGLE ST Owner2: City: SHERRILLS FORD, 28673 Address: 7530 LIBERTY RD LRK(REID): 13256 Address2: Deed Book/Page: 3682/0659 City: SOLON Subdivision: AARON H LAIL State/Zip: OH 44139-5608 Lots/Block: 13/ School Information: Last Valid Sale: School District: COUNTY Plat Book/Page: Elementary School: SHERRILLS FORD Legal: Middle School: MILL CREEK Calculated Acreage: .560 High School: BANDYS Tax Map: 012AX 02013 School Map Township: MOUNTAIN CREEK State Road #: 1942 Tax/Value Information: Tax Rates Zoning Information: City Tax District: All in County Zoning District: COUNTY County Fire District: SHERRILLS FORD Zoningl: R-30 Building(s) Value: $0 Zoning2: Land Value: $282,200 Zoning3: Assessed Total Value: $282,200 Zoning Overlay: CRC-O,WP-O,FPM-O Year Built/Remodeled: / 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 #: 3710460700J If available, Building Permits for this parcel. Septic 2010 Census Block: 3026 links are not permits. 2010 Census Tract: 011504 Septic Final Permits prior to 08/2018, contact Agricultural District: Environmental Health. Building Details WaterShed: WS-IV Critical Area Voter Precinct: P31/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. SBA �)41;;H CATAWBA COUNTY ��� I00A SOUTHWEST BLVD NEWTON,NORTH CAROLINA 28658RECEIPT U PHONE:828.465.8399 Wednesday,October 25,2023 j\\\8 4'Z sM www.catawbacountync.gov PAYOR: Vaughan,Erica PAYMENTS TRANSACTION NUMBER: TRC-76261053-25-10-2023 PAYMENT DATE: 10/25/2023 PAYMENT TYPE: Credit Card 312370391 INVOICE NUMBER ACCOUNT FEE NAME FEE AMOUNT 10-23-429643 110-580200-663000 IPa2 Permit Fee $150.00 TOTAL PAYMENTS: $150.00 EHPR-10-2023-45863 CASE TYPE: Environmental Health Plan Review WORK CLASS: OSWP SITE ADDRESS: 7326 RIGHT ANGLE ST,SHERRILLS FORD NC 28673 Applicant BENFIELD OUTDOOR SERVICES&SOLUTIONS,939 BRAWLEY SCHOOL,MOORESVILLE NC 28111 B:7043600376 INFO@YARDSBYBOSS.COM Owner PATRICK STANKIEWICZ,7530 LIBERTY RD,SOLON OH 44139 C:4406678454 PATRICK@JSSELECTRIC.COM Paid By ERICA VAUGHAN, 14305 CATO DR,HUNTERSVILLE NC 28078 C:7044676673 ERICA@ERICAVAUGHAN.COM **NO PEOPLESOFTACCOUNTASSIGNED** '""pt 10/25/2023 14:47 Page 1 of 1