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Home My WebLink AboutEHPR-3-11-10051 (2).TIF �� C p� THIS IS NOT A PERMIT Case # EHPR-3-11-10051 � , �' � CATAWBA COUNTY HEALTH DEPARTMENT v ,:��: `�C Plan Review Application for Environmental Services I842 SM1 Environmental Health Plan Review - OSWP EXPANS/ON NAME TO APPE O PE Kenneth Baker s�7E A��tzESS: 9040 FAIR OAK DR, Sherrills Ford, NC Pin#: 462903007688 NAME of SUBDIVISION:NORTHVIEW HARBOUR Lot # 41 Section/Block/Phase PROPERTY SIZE: Square Feet Acres 0.66 DIRECTIONS: HWY 16 S, 150 E, LEFT SHERRILLS FORD RD, R1GHT [SLAND POINTE RD, LEFT NORTHVIEW HARBOUR DR, LEFT FAIR OAKS DR, PASS BLUESTONE CT LOT ON RIGHT APPLICANT OWNER CONTRACTOR T WHELAN HOMES Kenneth Baker T. WHELAN HOMES INC PO BOX 4419 9040 Fair Oak DR PO BOX 4419MOORESVILLE NC 28117 MOORESVILLE NC 281 17 Sherrills Ford NC 28673-7287 704-662-6460 (704)400-8932 480-686-5188 aCCOUrrT: 69z� PRIMARY CONTACT: Applicant APPLICATION FOR: Existing Structure DIM EXISTING STRUCTURE: 70 X 50 EXISTING FACILITY TYPE: House NUMBER OF EXISTING BEDROOMS: 4 SEWER TYPE: Septic Tank NUMBER OF EXISTING OCCUPANTS: 4 EXISTING WATER SUPPLY IN USE: Public Water CALCULATED DESIGN FLOW: Public water IS available for this property. PUBLIC WATER TYPE AVAILABLE: County/City/Township Water DESCRIBE WORK: EXPANSION PERMIT TO BRING SEPTIC SYSTEM UP TO EXISTING 4 BEDROOMS DESCRIPTION OF PRIVATE RESIDENCE EXISTING STRUCTURES ON SITE (IF ANY) PROPOSED FUTURE ADDITIONS NONE OR IMPROVEMENTS: PROPERTY EASEMENTS: NONE PROPOSED CONSTRUCTION I understand that this is a formal application for a well permit, Improvement permit or Authorization to Construct a ground absorption sewage disposal system to serve the above described facility on this property and authorize Catawba County Health Department employees to go on this property for evaluation purposes. I certify the above information to be correct and understand that an Improvement Permit issued as a result of this information is transferable and may be eligible for a norFexpiring date, but may be revoked if this inform i e p s or intended use changes for the proposed facility. A Well Permit and Authorization to Construct issued by this department is val� or ( five years om the dat � ued and is not transferable. Note: You must obtain Zoning Approval prior to locating a home or structure o this pro erly. ny res tati n by you of house or structure location should conform to applicable setbacks. Date: �� — �� Signature of Applicant or Ag � � �� An Environmental Health Specialist will contact you wi't�ih 2 working ays of application date. If you need further infonnation or assistance please call 828-466-7291 AREA1 ***�*****�**************************************�******************�*�*********�:**********************************�*** Minimum Setbacks Front: Side: Rear: Side St: Max Height: 03/25/ I I 16:04 ��A CATAWBA COUNTY Case # EHPR-3-11-10051 y - , Public Health Department " 2 Environmental Health Division - Plan Review Subdivision NORTHVIEW I-IARBOUR j �: `� PO Box 389, 100-A Soudiwest E31vd, Newton, NC 286�8 Lot# q� 18 2 s� PIN# 462903007688 Applicant/Owner T WHELAN HOMES, PO BOX 4419, MOORESVILLE NC 281 17 Site Address: 9040 FAIR OAK DR, Sherrills Ford, NC Property Size: SF 0.66 ACRES Directions: HWY 16 S, 150 E, LEFT SHERRILLS FOE�D RD, R1GHT ISLAND POINTE RD, LEFT NORTHVIEW HARBOUR DR, LEFT FAIR OAKS DR, PASS BLUESTONE CT LOT ON RIGHT FEE NAME DATE AMOUNT BALANCE DUE Authorization to Construct Fee (New/Expansion) Fee 03/25/201 1 $275.00 __ _ _ _ Improvement Permit Fee 03/25/2011 $150.00 TOTAL FEES $425.00 CHANGE WORK ORDER REQUIRING REDESIGN AND/OR RETRIP WILL INCURE AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) 03/25/11 16:04 � `� �� _� THIS IS NOT A PERMIT � CATAWBA COUNTY HEALTH DEPARTMENT �, �,g ; Application for Environmental Services Page 1 1 84 2 �M Improvement Permit ❑ Authorization to Construct ❑ Septic Repair ❑ Septic Malfunction ❑ Septic Expansion ❑ New Well Permit ❑ Replacement Well ❑ Well Abandonment ❑ Well Repair ❑ E�sting System Inspection (Pre-Approval Required) ❑ Application is for New Construction ❑ Existing Facility ❑ Property Address �d `z'(J I'��2 �7;✓�- Subdivision J� V� Lot # Acres Section/Block/Phase Driving Directions to Property W $ o�� y�e �'� � v� d�,,� o S �� 2a . Tf-U,,�.�,J �.,��- , � .,.� s�,..�.r►�,� G Ls �- 2�. 7 �� Q 2 J i,t?iy� c' 2u� � l A'�d� �'•� T�• / l� �� S C�-..-� /�D �� b � -f� �c� ✓� �- �,�► (S�� d�2 - r.yv� L � ,r►'�- o�� r,�rrL,✓ G.�,�� W a NAME TO APPEAR ON PERMIT? Owner ❑ Applicant ❑ Contractor O Applicant Contact Information V Name W Address m {� Phone Cell Phone � Owner Contact Information � Name �Ca,�., f i�4 �L r3 �•� Z Address °} v . �h (Tr1� (72 • Q Phone �p —(p Yl.¢ - S'/ �(� Cell Phone � Contractor Contact Information � Name l, I,J (^ .ti q�,J U,�,{, L. � Address .p . ox ��I �eo�sJ L G a�«7 = Phone Cell Phone v— - 8"93 a � Z WHO WILL BE THE PRIMARY CONTACT? ❑ Owner Applicant ,� Contractor � Description of E�sting Structu es on Site � Q # of Bedrooms * Structure Dimensions O�5� # of Occupants I Basement [�es ❑ No Basement Fixtures es ❑ No � Planned Future Additions or Improvements (Building Permit NOT requested at this time) OC Describe 11� � Proposed Fu�ture Structure Dimensions # of Bedrooms *�' if applicable ? Are there easements or right-of-ways recorded on this property ❑ Yes No Describe - Is a public water supply available on or adjacent to the above property ** es ❑ No Check type available ❑ Community Well ❑ Semi-Public Well County/City/Township Water Line Existing water supply in use ❑ Individual Well ❑ Community Well ❑ Semi-Public Well ❑ County/City/Township Water Line ❑ I WOULD LIKE TO SCHEDULE A COMBINED FLAGGING AND SOIL EVALUATION (SEE COMBINED EVALUATIO PROCEDUES) �� THIS IS NOT A PERMIT � �" CATAWBA COUNTY HEALTH DEPARTMENT < -' " R° ` Application for Environmental Services Page 2 Ia4'� � Proposed Facility Type ❑ Primary Residence ❑ New Residence ❑ Addition to Residence # of New Bedrooms *�' Project Description Structure Dimensions # of Occupants Basement ❑ Yes ❑ No Basement Fixtures ❑ Yes ❑ No ❑ Accessory Structure(s) Describe # of New Bedrooms *�' if applicable Structure Dimensions # of Occupants Accessory Dwelling ❑ Yes ❑ No Plumbing ❑ Yes ❑ No Describe Plumbing Needed ❑ Multi-Family Residence # Units #Bedrooms per Unit*�' Total # Bedrooms *�' Structure Dimensions ❑ Food Service Specify Type # Seats Floor Space -Entire Food Service Facility (Sq Ft) # Employees per Shift # o f S hifts Dining Area (Sq. Ft.) ❑ Business Specific Type of Business Retail Floor Space # o Emplo yees per Shift # of Shifts ❑ Other Facility Type Specify If Ch # of Seats Kitchen ❑ Yes ❑ No If Daycare Specify Occupancy Application for Well Construction/Abandonment/Repair Proposed Well Type ❑ Individual Well ❑ Semi-Public Well ❑ Community Well Abandonment Type ❑ Drilled ❑ Bored ❑ Dug ❑ Unknown Well Repa Requested ❑ Yes ❑ No Describe Calculated Design Flow, Commercial �' Additional information may be required to determine design flow from certain facilities. This value will be determined during consultation with on- s ite staff. *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 house plans as a bedroom at the time of building permit issuance. This may prevent the need for septic system size increase in the future. i If structure is plumbed but no bedrooms, calculated design flow is required. ** If No, a well permit must be issued with the Authorization to Construct. Note: You must obtain Zoning approval prior to locating a home or structure on this property. Any representation by you of house or structure location should conform to applicable setbacks. � CHANGE WORK ORDER REQUIItING REDESIGN AND/OR RETRIP WILL INCURE AN � ADDITIONAL CHARGE (SEE FEE SCHEDULE) a I understand that this is a formal application for Environmental Services and authorize Catawba County Environmental C Health employees to go on this property for evaluation purposes. I certify the above information to be correct and understand C that an Improvement Pernut issued as a re �t is ormation is valid for 5 yeazs or may be non-expiring under certain O V specified conditions. Improvement Pe its d Wel e its are r'rable, but may be revoked if this information, site W plans or intended use changes for the ropos d facili Aut oriza � to Construct issued by this department is valid for m (5) five years from the date issued an is not s e�b � � Signature of Owner or Agent � � Printed Name of Owner or Agent ��^^� L• W�L Date 3 ' a"�� I Catawba County, North Carolina N This map product was prepared jrom d1e CataN�ba Coanty, NC, Geographrc Injormatron Svstem. Camwbn Cm�nty has made strbstnntrul ejforts to ensure [he accaracy of location nnd labeling injormation conlarned on thrs nJap. Cntawba Com7ry pramates nnd recommends the rndependent rerification ojany dala contained on thrs map prod�ic! by [he i�ser. The Coanty ojCalmrba, its employees, agents and personne! disclaim, and sha(1 not be he(d linb(e for any and nll damages, loss or Iinbiliry, whether direct, indirect or conseq��en�ial ivhrch arises or mcry arrseJrom this mnp pr�oduc� or the irse thereo uny person a� en�iry. L2g@nd Selected Parcel Number: 4629-03-00-7688 1 inch = 60 feet Prepared for: ^, � � � ,<" � ' 4r,. „�..�.,,,�� ', � ,t � !� h � ,. �''' �, / t ';��1 � �1 , � '; � � : : �� _ .��, , �. � ,,�` ^ . 0 l ��:. � � :� : �t ,�, 7R \ � �'�, � . , i` �� I V� \ � 1 ` c�� E :�` / iX :� �,. ! p � ; , . \ ��\ ^� . �� ; ?,..� � , �� %� � ��`i ! / \�\ � `�. -. 1 i � •� _� ` \�'� �.�: �" �.9 . �..� 5�::, � ' � '�. , ,,,N_.. � ;� �C � `� � � ��t ; � , ; �. =� � � �� , � �� ' 4 � � �� , ; `. �+ �, �'�� (�"� >'.��-�� ` ' ` � � �� , ; � k ,. �— - - � �,� ` � � � �� a � � � �i , � ` � � `� � °l � � '` � � � �i.: ,::� �: y �� ., . � --� � �4�58� � � �� , ,�.� { � � � �� :�, � ` _.� f� t � .�.� .�:.:: , � � , �.�� ,; j l� . � , Q � 1.3�8 � � �� / .. : . �::::1 � � . � V� � . �� R=30 / �:. .��::::::::: �::: '1��..�: �� 7 � � �� :.��:: � : :::. �::: 1 • �� t� � ��'$ � � �� .�� ..:� � ---� �.. � , �� : , � � � ; ° , �� : �, x � 0 0 � . � � { .� q.2 � � �.: ::: :: �% � s t ,,'� � , ; ::� 7 4 � . � , . .. � s� '� � I. r � � � ::: �, � �-- � �t f � � � (��` �` � �'~��_ � � �, �� °� � � . ` �� : 44 o . � � '� .. . . . .. . .. . ... � � t p�, �,.;. .. . �w �;.. � � �- � � �� ; g� �g � ::: 7 � � � R-30 � � � ��` � �j�:: '� � � �/ 31.42 � � � � � .;::�' 6 � ;��, �� / � 43 _ �- � . , . G� t � � E � � � �,`, 1 i ` C� �/ '� .� � ,� � - ,--�� , , . � � � + 1 (� �/� . A �_• ` -- i v � � 1 .�-.� -� ' � � P ( t� 1 � -! � �1R�-t � � `v THIS IS NOT A LEGAL DOCUMENT �� } ` �O Friday, March 25, 2011 03:44 PM � � 1 � �� CATAWBA COUNTY NC - Parcel Report Information Regarding Selected Parcel(s) Pa rcel I D: 4629-03-00-7688 Name: BAKER KENNETH P Name2: BAKER PAULA H Address: 9040 FAIR OAK DR Address2: City: SHERRILLS FORD State: NC Zip: 28673-7287 Account: 159767347 Calc Acreage: 0.66 Tax Map: LRK: 801541 Deed Book: 3055 Deed Page: 1916 Subdivision Name: NORTHVIEW HARBOUR Subdivision Block: Lots: 41 Plat Book: 49 Plat Page: 64 Building Number: 9040 Street Name: FAIR OAK DR Site Zip: 28673 Township: MOUNTAIN CREEK Fire Code: SHERRILLS FORD City Code: COUNTY State Road: Total Bldgs Value: $407,100 Land Value: $191,400 Total Value: $598,500 Year Built: 2002 Year Remodeled: Last Sale Date: 12/17/2010 Last Sale Amount: $655,000 Neighborhood: 130 Watershed: WS-IV Critical Area Watershed Split: NO Voter Precinct: P31 E911 District: COUNTY Zoning: R-30 Zoning2: Zoning3: Zoning Split: N Zoning Overlay: CRC-O,WP-O,FPM-O Zoning District: COUNTY Split Zoning Dist: N Split Zoning Dist(1): 0 Split Zoning Dist(2): 0 School District: COUNTY Elementary School: SHERRILLS FORD Middle Schooi: MILL CREEK High School: BANDYS School Split: NO P&Z Case Number: LOMA 7-12-2002 Census Tract 2010: 011502 Census Block 2010: 2013 Small Area Plan: SHERRILLS FORD Agricultural District: Printed: Friday, March 25, 2011 03:44 PM a� 6 � ��ATAWBA COUNTY H�ALTH DEPARTMENT I�d Tel � e: (828) �465-8270 TDD: (828) 465-8200 W LS .2 0� /��/ Q�� IP�_AC�_Rpr. Prmt. Opr. Prmt�Sys. Type �� Wetl Prmt. Replacement Well _� ell Rgr. Prmt. Owner/Agent f�i5�/ [.�./p jLDQ E/Ll"',S Phone �a � �d -)�3 �— Address �nS/D F/�/2 Di9-�'�S F��J1/c� SubdivisionNb277Y�cJ��J /�A�2.[i .S�tR�P�t.v.� /Cb2L� /V�, L . ��'� 23 Section/Block/Phase Lot#�L I.ot Sizep, �� d D'uections: _ C i u -' Property Address O / A,�S l/ Facility: House�_ Mobile Home Business M ti-family . Other: Pin Number �6,,7,� O� DO 7�'�8 Other . Zoning Approval # za� a�O /-- O � 2 d:S � Jf Bedrooms�_ 1� Seats # Employees . Application Rate �,'�_ GPD Flow 3b�a Hot Tub or Spa es o Special Fixtures Baseme ye no . 100% Repair Are �e �no• I Basement Plumbmg�(�o Water Supp y: Private Well Pubh'�r-L�- Semi-Public *•**rs***s*sr*.ss ****s***r********•*rr*s*s*•*srrs:***s*****s•*r*s*.****rs*ss**ss�r�**ss******s***s:****s**s***r*ss*******s Type of System: Trench -..- Bed -- Pump —_ Pump/Panel�_ Panel --- LPP Other — Septic Tank Size�_ Pump Tank Size� Nitrification Field: Total Square Feet GQ (� Depth of Stone � Bed Size — Trench Width �� Total Length of All Trenches �D v Number of Trenches y Trench Length �/�/S"a /S�/-- /— Feet on Center�_ Maximum Trench Depth�f! ��y�Distance of Neazest Well �----� �"DO NOT INSTALL 5E WHEN WET* *WELL RECORD REQUIRED AT COMPLETION* r***rt**r*tr�r*r�***�t*s***w• �**+�*******r�ts�s***s******r*r*t***rt*****s**r***�sr*.�i'1y��Y+�Ai�s**r**r**r***s****r*****rs**s*t*** Topo % Slope � �'k F � �.O h �-t>S �,1 � �f � � � Texture � � ^ � 3� � Structure � �os,� / � .. Clay Min. � ., � P� �, �-� j Z c T� t3 � A c Tc 2r�� Soil Wemess " � � ` Soil Depth ° � ; ��, � iN.s T'� ��-T �� Restric. Hoz, at " � + Available space yes/no � � Overall C18ss S PS U � �� -S�/G l/4N� CoNT�Lf02. Comments: � � � f' '7 ��t� st,ie�lA- �- D n-ys �3 C r-� 2r SC� Soic Noi� � ,2. w�4..,�i � SySTE�`` /S /NsTltC.Lt-� ("-02 iS I � f�c�� a.�,Tr ,Nr-��.M�r�ov No M��y�.' � SNd�. � � ra - s -�.�� I � -� �r� f�s �-r� �- 3 3 sr9vv� �u � � 3 � -�-��: � • `' �. I � �, R f'►� � ac c. �� s i,c� c a I � �.�►2 I ` � — 3 J g ' I � ��Z � — I -j4`�4� .I� y f�- L o F 1= - a N Std !l'�. I��'� � � �� / 12.c �4.� I `' 1 Filter Required � Riser required when � y: ��_ 'k`Jl`�� 5�-�- �� -7'�y.� �,,.� �-q/� tank is more than 6 � ^ --- �- �o� inches deep. � - �-d . � �,,.._ � **NO GUARA Y IS IMPL� �E � O HE PBRFORMANCE OR LENGTH OF TIME THIS SYSTEM WILL FUNCTION** f+�++**rrrtww**wr+wrr**r**r*rrwwrwww*+�+s***r��r**r�r*+r+r*+w*rr* *******�**s+****r*rs***r**rwst*r***s**srs*rr**s *Improvement Permit has no expiration date and is transferable, but may be revoked if site plans or intended use changes for the proposed facility. An Authorization to Construct is valid for (5) �ve years from date issued and is not transferable. Well Permit valid for 5 years provided site conditions do not change. Well location, installation, and protection must meet state and local regulations, and must be inspected and approv�ed b� a representative of the Catawba County Health Department before any portion of the installation 4s put into use. � The s'rting of the well by the Health Department staff is to provide protection from known possible sources of contarnination. No volume of water is guaranteed at any site by the Health Department. ' Permit Date IV 0 U, /S � a A D 1 EHS � i Owner/Agent Sepdc Tank lnstalled By �'T`c-v E �b6L.� Date �- /�=01 EHS -,� � Q_ Well Installed By /l/f'/1" Well Grout Approval Date� Well Head Approval Date /✓/,rr Date Sample Collected � �.�--- ��,,, Date of Results i1/'�/� Results EHS �--�- - 7�e� — � White - Office Blue - Building Inspection Operadon Permit Yellow - Owner/A�ent Green - Buitding Inspecuoo Authorization to Coastruct