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Home My WebLink AboutRBPR-07-2012-15944.TIF$A COG THIS IS NOT A PERMIT Case # RBPR-07-2012-15944 CATAWBA COUNTY HEALTH DEPARTMENT PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES 1842 SM Residential Building Plan Review - Swimming Pool I MI z jAb Re&f'4 IMPROVEMENT Applicant FRED SETTLEMYRE, 2215 ZION CHURCH RD, HICKORY NC 28602 H:8282940981 Owner FRED SETTLEMYRE, 2215 ZION CHURCH RD, HICKORY NC 28602 H:8282940981 NAME TO APPEAR ON PERMIT FRED SETTLEMYRE SITE ADDRESS: 2215 ZION CHURCH RD, HICKORY NC 28602 PIN # 370016842072 NAME of SUBDIVISION: BROOKSTONE Lot # 1 Section/Block PROPERTY SIZE: Square Feet 19,602.00 Acres 0.45 DIRECTIONS: 10 W / RIGHT ON ZION CHURCH RD BEFORE BROOKSTONE ON LEFT PRIMARY CONTACT: Owner SEWER TYPE: Septic Tank GALLONS PER DAY: 360 WATER SUPPLY: Public Water Public water IS available for this property. DESCRIBE WORK: PVT INGROUND POOL 12 X 24 not including pool deck area APPLICATION FOR: New Structure STRUCTURE TYPE: ACCESSORY STRUCTURE FACILITY TYPE: OTHER DESCRIPTION: DESCRIPTION OF single family dwelling EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: 66 x 70 NUMBER OF EXISTING BEDROOMS: 3 # OF OCCUPANTS: 2 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 12 x 24 / not including decking area 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 non -expiring date, but may be revoked if this information, site plans or intended use changes for the proposed facility. A Well Permit and Authorization to Construct issued by this department is valid for (5) five years from the date issued and is not transferable. 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. Date: Signature of Applicant or Agent An Environmental Health Specialist will contact you within 2 working days of application date. If you need further information or assistance please call 828-466-7291 AREA2 MINIMUM SETBACKS FRONT: 30 SIDE: 10 REAR: 10 MAX HEIGHT: FEENAME DATE FEE AMOUNT Improvement Permit Fee 07/05/2012 $150.00 TOTAL FEES $150.00 CHANGE WORK ORDER REQUIRING REDESIGN AND/OR RETRIP WILL INCURE AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) F9 - chapplication 07/06/2012 09:41 Pagel of 3 THIS IS NOT A PERMIT Case # RBPR-07-2012-15944 CATAWBA COtTNTY hIEALTH DEPARTMENT PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES Residential Building Plan Review - Swimming Pool IMPROVEMENT Applicant FRED SETTLEMYRE, 2215 ZION CHURCH RD, HICKORY NC 28602 H:8282940981 Owner FRED SETTLEMYRE, 2215 ZION CHURCH RD, HICKORY NC 28602 H:8282940981 NAME TO APPEAR ON PERMIT FRED SETTLEMYRE SITE ADDRESS: 2215 ZION CHURCH RD, HICKORY NC 28602 PIN # 370016842072 NAME of SUBDIVISION: BROOKSTONE Lot # 1 Section/Block PROPERTY SIZE: Square Feet 19,602.00 Acres 0.45 DIRECTIONS: 10 W / RIGHT ON ZION CHURCH RD BEFORE BROOKSTONE ON LEFT PRIMARY CONTACT: Owner SEWER TYPE: Septic Tank GALLONS PER DAY: 360 WATER SUPPLY: Public Water Public water IS available for this property. DESCRIBE WORK: PVT INGROUND POOL 12 X 24 not including pool deck area APPLICATION FOR: New Structure STRUCTURE TYPE: ** NO STRUCTURE SELECTED ** FACILITY TYPE: Accessory Structure OTHER DESCRIPTION: DESCRIPTION OF single family dwelling EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: 66 x 70 NUMBER OF EXISTING BEDROOMS: 3 # OF OCCUPANTS: 2 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 12 x 24 / not including decking area 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 non -expiring date, but may be revoked if this information, site plans or intended11changes for the proposed facility. A Well Permit and Authorization to Construct issued by this department is valid for (5) five years from the dissued and is not transferable. Note: You must obtain Zoning Approval prior to locating a home or structure on this prope Any representation by you of house or structure location should conform to applicable setbacks. Date: 'I _11? _� Signature of Applicant or agent An Environmental Health Specialist will contact you within 2 working ays of application date. If you need further information or assistance please call 828-466-7291 AREA2 MINIMUM SETBACKS FRONT: 30 SIDE: 10 REAR: 10 MAX HEIGHT: FEENAME Improvement Permit Fee TOTAL FEES DATE FEE AMOUNT 07/05/2012 $150.00 $150.00 CHANGE WORK ORDER REQUIRING REDESIGN AND/OR RETRIP WILL INCURE AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) tA) - :h;lpplicatwn 07/05/2012 13:52 Page I of 3 THIS IS NOT A PERMIT CATAWBA COUNTY,.HEALTH DEPARTMENT c Application for Environmental Services Page 1 18 SM Improvement Permit ❑ Authorization to Construct ❑ Septic Repair ❑ Septic Malfunction ❑ Septic Expansion ❑ New Well Permit ❑ Replacement Well ❑ Well Abandonment ❑ Well Repair ❑ Existing System Inspection (Pre -Approval Required) ❑ Application is for New Construction ❑ Existing Facility , ] Property Address ,,I_ 2/D/!/ G�%�U�%� f� Subdivision„�/J6�! Lot # Acres Section/Block/Phase _ Driving Directions to Property LL(�� 3Zl �Q/,l i/i _ z 1V 1 % 4Ll��„X 4 7-?fZ_ Xw Z,'y� A G/7 �� 46-_7_C%' 22 2/1,O/ NAME TO APPEAR ON PERMIT? Owner ❑ Applicant ❑ Contractor Applicant Contact Information Name Address ��la� 2/D�t/ C�Gii51 X10 Phoneme Cell Phonez Owner Contact Inform tion Name Address Phone Cell Phone Contractor Contact Information Name Address Phone Cell Phone WHO WILL BE THE PRIMARY CONTACT? Owner ❑ Applicant ❑ Contractor Description of Existing Structures on Site a /e- 4�1 Sc # of Bedrooms *t _ Structure Dimensions # of Occupants Basement ❑ Yes 5 No Basement Fixtures ❑ Yes 9 -No Planned Future Additions or Improvements (Building Permit NOT requested at this time) Describe k&4�_ Proposed future Structure Dimensions/2 X Z Y # of Bedrooms *f if applicable Are there easements or right-of-ways recorded on this property X Yes ❑ No Describe Is a public water supply available on or adjacent to the above property ** 0 Yes ❑ 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 P1 County/City/Township Water Line ❑ I WOULD LIKE TO SCHEDULE A COMBINED FLAGGING AND SOIL EVALUATION (SEE COMBINED EVALUATION PROCEDUES) THIS IS NOT A PERMIT CATAWBA COUNTY HEALTH DEPARTMENT -c Application for Environmental Services Page 2 1 2 SM Proposed Facility Type ❑ Primary Residence ❑ New Residence ❑ Addition to Residence # of New Bedrooms *t Project Description Structure Dimensions # of Occupants Basement ❑ Yes ❑ No Basement Fixtures ❑ Yes ❑ No [Accessory Structure(s) Describe VIX ? A � �_r' R r.' woo V�,� A # of New Bedrooms *t if applicable Structure Dimensions # of Occupants Accessory Dwelling ❑ Yes ❑ No Plumbing ❑ Yes ❑ No Describe Plumbing Needed ❑ Multi -Family Residence # Units #Bedrooms per Unit* f Total # Bedrooms *t Structure Dimensions ❑ Food Service Specify Type # Seats Floor Space -Entire Food Service Facility (Sq Ft) # Employees per Shift # of Shifts Dining Area (Sq. Ft.) ❑ Business Specific Type of Business Retail Floor Space # of Employees per Shift # of Shifts ❑ Other Facility Type Specify If Church # 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 Repair Requested ❑ Yes ❑ No Describe Calculated Design Flow, Commercial f Additional information may be required to determine design flow from certain facilities. This value will be determined during consultation with on- site 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. tlf 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 REQUIRING REDESIGN AND/OR RETRIP WILL INCURE AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) I understand that this is a formal application for Environmental Services and authorize Catawba County Environmental Health 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 valid for 5 years or may be non -expiring under certain specified conditions. Improvement Permits and Well Permits re transferrable, but may be revoked if this information, site plans or intended use changes for the proposed facility. An uthorization to Construct issued by this department is valid for (5) five years from the date issued and i of tra ferable Signature of Owner or AgentC '� Printed Name of Owner or Agent Date I inch = 46 feet n Catawba Cout North Carolina 66 '['his map product was prepared from the Catawba Couniv, ,�C, 6cospatial Information SN stein So Catawba Court" has made Substantial efforts to ensure the accuracy of location and labeling inforination contained on this map, Catawba Count} promotes and recommends the independent verification of am data Contained on this map product b% the user. The County or Catawba, its employees, agents and personnel disclaim, and shall not be held liable for any and all damages, loss or liabilit", Miethei direct, indirect or consequential which arises or may arise from this tuall product or the use thereof by any person or enlllt Selected Parcel Number: 3700-16-84-2072 ,1,075 R - a 99 120�'7 17tr ft' 10 98 'I'll 1,17 -GAL DOCTNIF-M- 0 Prepared for: 46 Datc: 715i'011 Time: 11:37:03:10 4+.93A < SW S Al WBA COUNTY HEALTH DEPARTMENT P' Telephone: (828) 465-8270 TD : (828) 465-8200 WI,$ # 4900-5 - UUc? grl ImprovemeAt Permit %,/ACRepair Permit._ Operation Permit. TD Type'(1Lg Well Permit. Replacement Well Owner%Agent Q o 10 r t—C, G� x f —77 Phone o-q---L4 (3r} - O no Address�,�$65 Wh,}-,% K� Llt'ckor.r Nc- 8g60A Subdivision I�r�okstorta Section/Block/Phase Loth 2OQ.t15 Directions: Hwyto L,) (�Qt Z;orn Gt�Jr�k P-0 Lu+ o l,+ Just- 1o,fari. fookCtio'nQ,. / Property Address aa IS Facility: House Mobile Home Business Multi-family Other: Pin Number 31 D O I b 8 ` I a o -1 Other . Zoning Approval # (� # Bedrooms # Seats # Employees . Application Rate�� no GPD Flow 3 60 lyll Hot Tub or Spa yes�S ecial Fixtures Basement ye iQn . 100% Repair Area e Basement Plumbing yes Water Supply: Private Well Public V Semi-Public ###%###*#***********#*#####*####*##########*******###*#####i*##*##########i***R***#*********##*## Type of System: Trench V Bed Pump Pump/Panel Panel LPP Other n�S i o eQ-d j •:j 10 Septic Tank Size 100 Pump Tank Size Nitrification Field: Total Square Feet '10 J Depth of Stone - Bed Size Trench Width 31 Total Length of All Trenches 30 o Number of Trenches Trench Length (0 50 /_/_/_/_ Feet on Center Maximum Trench Depth Distance of Nearest Well O r *DO NOT INSTACI, SEPTIC WHEN WET* *WELL RECORD REQUIRED AT COMPLETION* Topo L,V % Slope ,2 . Texture 5C- IaO , I1 Z a n C,h-jr(' Structure 5 b k Clay Min. I : ( 4h �& K R, R-P Ck , (Jar tS D L +e Soil Wetness 501% $o.p. N Soil Depth 3 6501% h ' r Res[ric. Hoz. at y t I U p ro e\ rr n y We- I Available spaceo 3 6R, Ho Overall Class P U y 8 t X -7c) �' N I p' ro r+1 Pra Pa.r }�/ I rr �S Comments: l l.0 (`fl67u — _ _ _ rp�r I F, UVo_r SY34-¢.M or rf,Pc%r igo90 (Xvo-r} GII su4cc.� wQi-*-r Go' X50' J c� r rJ r7 rq i ns c, w� 1, ro ^� Sy3Ve,rh Filter Required I `� • 6a� Riser required when Us r) r oP o <�o v r tank is more than 6 Ke, 3 Y" }¢,,,n S H � ((o J inches deep. I **NO GUARANTEE OR WARRANTY IS IMPLIED OR GIVEN AS TO THE PERFORMANCE OR LENGTH OF TIME THIS SYSTEM WILL FUNCTION** *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) five 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 approved by a representative of the Catawba County Health Department before any portion of the installation is put into use. The siting of the well by the Health Department staff is to provide protection from known possible sources of contamination. No volume of water is guaranteed at any site by the He4th Department. Permit Date //( EHS Owner/Agent Septic T Installed By La_ _i r r r Date ( 31 0 EHS Q A Well Installed By Well Grout Approval Date Well Head Approval Da j Date Sample Collected Date of Results Results EHS White - Office Yellow - Owner/Agent Pink - Building Inspection Authorization to Construct CATAWBA COUNTY NC - Parcel Report Information Regarding Selected Parcel(s) Parcel ID: 3700-16-84-2072 Name: SETTLEMYRE FRED WILLIAM Name2: SETTLEMYRE ELOISE BRITTAIN Address: 2215 ZION CHURCH RD Address2: City: HICKORY State: NC Zip: 28602-7114 Account: 59195000 Calc Acreage: 0.45 Tax Map: LRK: 602212 Deed Book: 2687 Deed Page: 1787 Subdivision Name: BROOKSTONE Subdivision Block: Lots: 1 Plat Book: 43 Plat Page: 101 Building Number: 2215 Street Name: ZION CHURCH RD Site Zip: 28602 Township: HICKORY Fire Code: MOUNTAIN VIEW City Code: COUNTY State Road: 1008 Total Bldgs Value: $190,300 Land Value: $21,800 Total Value: $212,100 Year Built: 2005 Year Remodeled: Last Sale Date: 8/23/2005 Last Sale Amount: $192,500 Neighborhood: 80 Watershed: WS -III Protected Area Watershed Split: YES Voter Precinct: P23 E911 District: COUNTY Zoning: R-20 Zoning2: Zoning3: Zoning Split: N Zoning Overlay: ED-O,WP-O Zoning District: COUNTY Split Zoning Dist: N Split Zoning Dist(1): 0 Split Zoning Dist(2): 0 School District: COUNTY Elementary School: BLACKBURN Middle School: JACOBS FORK High School: FRED T FOARD School Split: NO P&Z Case Number: Census Tract 2010: 011801 Census Block 2010: 3000 Small Area Plan: MOUNTAIN VIEW Agricultural District: Printed: Friday, July 13, 2012 04:18 PM Applicant Owner THIS IS NOT A PERMIT Case # RBPR-07-2012-15944 CATAWBA COUNTY IJEALTH DEPARTMENT PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES Residential Building Plan Review - Swimming Pool IMPROVEMENT FRED SETTLEMYRE, 2215 ZION CHURCH RD, HICKORY NC 28602 H:8282940981 _ FRED SETTLEMYRE, 2215 ZION CHURCH RD, HICKORY NC 28602 H:8282940981 NAME TO APPEAR ON PERMIT FRED SETTLEMYRE SITE ADDRESS: 2215 ZION CHURCH RD, HICKORY NC 28602 PIN # 370016842072 NAME of SUBDIVISION: BROOKSTONE Lot tt 1 Section/Block PROPERTY SIZE: Square Feet 19,602.00 Acres 0.45 DIRECTIONS: 10 W / RIGHT ON ZION CHURCH RD BEFORE BROOKSTONE ON LEFT PRIMARY CONTACT: Owner SEWER TYPE: Septic Tank GALLONS PER DAY: 360 WATER SUPPLY : Public Water Public water IS available for this property. DESCRIBE WORK: PVT INGROUND POOL 12 X 24 not including pool deck area APPLICATION FOR: New Structure STRUCTURE TYPE: f-IOU�� prj n YrSIUtZVICv *' Ne tJRZ 3ZLEe `* FACILITY TYPE: OTHER DESCRIPTION: CctbSUty S�N%� DESCRIPTION OF single family dwelling I EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: 66 x 70 NUMBER OF EXISTING BEDROOMS: 3 # OF OCCUPANTS: 2 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 12 x 24 / not including decking area 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 non -expiring date, but may be revoked if this information, site plans or intended,, se changes for the proposed facility. A Well Permit and Authorization to Construct issued by this department is valid for (5) five years from the dissued and is not transferable. Note: You must obtain Zoning Approval prior to locating a home or structure on this prope . Any representation by you of house or structure location should conform to applicable setbacks. 'Date: Signature of Applicant or igen An Environmental Health Specialist will contact you within 2 working ays of application date. If you need further information or assistance please call 828-466-7291 AREA2 MINIMUM SETBACKS FRONT: 30 SIDE: 10 REAR: 10 MAX HEIGHT: FEENAME Improvement Permit Fee TOTAL FEES DATE FEE AMOUNT 07/05/2012 $150.00 $150.00 'DER REQUIRING REDESIGN ANDIOR RETRIP WILL INCURE AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) A0512012�13:52 Page I of 3