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HomeMy WebLinkAboutRBPR-07-2012-15956.tifContractor THIS IS NOT A PERMIT Case # RBPR-07-2012-15956 CATAWBA COUNTY HEALTH DEPARTMENT PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES Residential Building Plan Review - Swimming Pool �ovtlo� IMPROVEMENT SHELTON POOL & SPA, INC., 2424 MYRA LN, LINCOLNTON NC 28092 B:704 -201-1030F:704-748-1282 SHELTONPOOLANDSPA@GMAIL .COM Owner BRYAN FARR, 2651 POLO LN, MAIDEN NC 28650-8737 H:828-273-2872 NAME TO APPEAR ON PERMIT Bryan Farr SITE ADDRESS: 2651 POLO LN, MAgw4 PIN # 362703435936 NAME of SUBDIVISION: The Paddocks PH 1 Lot # 4 Section/Block PROPERTY SIZE: Square Feet 27,442.80 Acres 0.63 DIRECTIONS: Startown Rd / Right Blackburn Bridge Rd / Right Paddock Dr / Left Polo / house on left PRIMARY CONTACT: ontractor SEWER TYPE: Septic Tank GALLONS PER DAY: 360 WATER SUPPLY: Private Well Public water is ""NOT'" available for this property. DESCRIBE WORK: In -ground Swimming pool 20 x 40 with concrete patio = total size 67 x 38 APPLICATION FOR: New Structure STRUCTURE TYPE: ACCESSORY STRUCTURE FACILITY TYPE: House OTHER DESCRIPTION: DESCRIPTION OF Single Family Dwelling EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: 30 x 75 NUMBER OF EXISTING BEDROOMS: 3 # OF OCCUPANTS: 4 PROPERTY EASEMENTS: none PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 67 x 38 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 inform ati on-or-assi nce please call 828-466-7291 Area 2 MINIMUM SETBACKS FRONT: 30 SIDE: 10 REAR: 10 MAX HEIGHT: FEENAME Improvement Permit Fee TOTAL FEES DATE FEE AMOUNT 07/10/2012 $150.00 $150.00 CHANGE WORK ORDER REQUIRING REDESIGN AND/OR RETRIP WILL INCURE AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) F9 - ehapplication 07/10/2012 16:40 Page 1 of 3 �A Cp THIS IS NOT A PERMIT Case # RBPR-07-2012-15956 G CATAWBA COUNTY HEALTH DEPARTMENT adp . PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES Residential Building Plan Review - Swimming Pool IMPROVEMENT Contractor SHELTON POOL & SPA, INC., 2424 MYRA LN, LINCOLNTON NC 28092 B:704 -201-1030F:704-748-1282 SHELTONPOOLANDSPA@GMAIL.COM Owner BRYAN FARR, 2651 POLO LN, MAIDEN NC 28650-8737 H:828-273-2872 NAME TO APPEAR ON PERMIT Bryan Farr SITE ADDRESS: 2651 POLO LN, MAIDEN NC 28650 PIN # 362703435936 NANIE of SUBDIVISION: Lot # Section/Block PROPERTY SIZE: Square Feet 0.00 Acres DIRECTIONS: Startown Rd / Right Blackburn Bridge Rd / Right Paddock Dr / Left Polo / house on left PRIMARY CONTACT: Contractor SEWER TYPE: Septic Tank GALLONS PER DAY: WATER SUPPLY: Private Well Public water is "'NOT"" available for this property. DESCRIBE WORK: In -ground Swimming pool 20 x 40 with concrete patio = total size 67 x 38 APPLICATION FOR: New Structure STRUCTURE TYPE: ACCESSORY STRUCTURE FACILITY TYPE: Accessory Structure OTHER DESCRIPTION: DESCRIPTION OF Single Family Dwelling EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: 30 x 75 NUMBER OF EXISTING BEDROOMS: 3 # OF OCCUPANTS: 4 PROPERTY EASEMENTS: none PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 67 x 38 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 on ouse or structure locatt\ionn should conform to applicable setbacks. Dat d1 7--/ 6 —% Z Signature of Applicant or Agent An Environmental Health Specialist will contact you within 2 woz ng days of application. If you need further information or assistance please call 828-466-7291 MINIMUM SETBACKS FRONT: 30 SIDE: 10 REAR: 10 MAX HEIGHT: FEENAM E Improvement Permit Fee TOTAL FEES DATE FEE AMOUNT 07/10/2012 $150.00 $150.00 .CHANGE WORK ORDER REQUIRING REDESIGN AND/OR RETRIP WILL INCURE AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) 1:O - charplicatUon 07/10/2012 10:19 Pagel of 3 0 LAJW a U W m E► V) Z W H Z Z 0 cc 0 Z °A THIS IS NOT A PERMIT CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services Page 1 1842 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 �C� / �� L_R. )e Subdivision Lot # Acres Section/Block/Phase Driving Directions to ProA4LC/ ert_5 j/_ Ar %0sf✓!J A� T� RT © L&-�7' 4,J P0> 19 NAME TO APPEAR ON PERMIT? [1] Owner Applicant Contact Information r Name Address Phone Owner Contact Information Name -; Fi4 /', Address _26C—/ P19L_0 L_A A) �> Phone k2 — 73 _7Z Contractor Contact Information J Name S.�c'�7�C�' �Cr� A , SAA Address Y1)1 M tY eh �-A Phone ?v 6l — i -a / -- &? o ❑ Applicant ❑ Contractor Cell Phone A4 ,d e -,) Cell Phone Cell Phone WHO WILL BE THE PRIMARY CONTACT? []Owner ❑ Applicant 'Contractor Description of Existing Structures on Site ---Hou .4- !:�A 41LAic I dc- # of Bedrooms * j Structure Dimensions 3D X 7 # of Occupants Basement ❑ Yes 19' No Basement Fixtures ❑ Yes '�4 No Planned Future Additions or Improvements (Building Permit NOT requested at this time) Describe Proposed Future Structure Dimensions # of Bedrooms *)- if applicable Are there easements or right-of-ways recorded on this property ❑ Yes WNo Describe Is a public water supply available on or adjacent to the above property ** ❑ Yes 2 No Check type available ❑ Community Well ❑ Semi -Public Well ❑ County/City/Township Water Line Existing water supply in use 0I 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 EVALUATION PROCEDUES) 0 LLJW ca C 0 Q W m H .�� THIS IS NOT A PERMIT 9g CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services Page 2 184 1 w Proposed Facility Type ❑ Primary Residence ❑ New Residence ❑ Addition to Residence # of New Bedrooms * j Project Description Structure Dimensions Basement ❑ Yes ❑ No # of Occupants Basement FiXtur'es ❑ Yes ❑ No ❑ Accessory Structure(s) Describe ��✓C:�� ca✓ ���)/ I;CJl7�% �i� ilC� # of New Bedrooms *t if applicable Structure Dimensions Accessory Dwelling ❑ Yes -KNo Describe Plumbing Needed # of Occupants Plumbing ❑ Yes N+No ❑ Multi -Family Residence # Units Total # Bedrooms *f ❑ Food Service Specify Type #Bedrooms per Unit* j Structure Dimensions # 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 j 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. 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 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 are transferrable, but may be revoked if this information, site plans or intended use changes for the proposed facility. An Authoriqtiop jo Construct issued by this department is valid for (5) five years from the date issued and is not transferable Signature of Owner or Agent /4'�� - Printed Name of Owner or Agent llkp� �s , s/` ry �e A.) Date -7—Y') -- /,,), Catawba County, North Carolina This map product was prepared from the Catawba County, NC, Geospatial Information System. Catawba County has made substantial efforts to ensure the accuracy of location and labeling information N - contained on this map Catawba County promotes and recommends the independent verification of any data contained on this map 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 product or the use thereof by any person or entity. 1 inch = 40 feet 5 4054 0 Selected Parcel Number: 3627-03-43-5936 Prepared for: al][640-111i JMON :?F=A THIS IS NOT A LEGAL DOCUMENT * 0':� kj 10 1�p 3 6839 �/ Date:7/10/2012 Time: 10:08:07 AM CATAWBA COUNTY NC - Parcel Report Information Regarding Selected Parcel(s) Parcel ID: 3627-03-43-5936 Name: FARR BRYAN KEVIN Name2: Address:. 2651 POLO LN Address2: City: MAIDEN State: NC Zip: 28650-8737 Account: 159769125 Calc Acreage: 0.63 Tax Map: LRK: 700578 Deed Book: 3064 Deed Page: 0542 Subdivision Name: THE PADDOCKS PH 1 Subdivision Block: Lots: 4 Plat Book: 49 Plat Page: 149 Building Number: 2651 Street Name: POLO LN Site Zip: 28650 Township: JACOBS FORK Fire Code: MAIDEN RURAL City Code: COUNTY State Road: Total Bldgs Value: $197,100 Land Value: $29,800 Total Value: $226,900 Year Built: 2000 Year Remodeled: Last Sale Date: 2/10/2011 Last Sale Amount: $192,000 Neighborhood: 113 Watershed: Watershed Split: Voter Precinct: P34 E911 District: COUNTY Zoning: R-40 Zoning2: Zoning3: Zoning Split: N Zoning Overlay: ED -O Zoning District: COUNTY Split Zoning Dist: N Split Zoning Dist(1): 0 Split Zoning Dist(2): 0 School District: COUNTY Elementary School: MAIDEN Middle School: MAIDEN High School: MAIDEN School Split: NO P&Z Case Number: Census Tract 2010: 011702 Census Block 2010: 1030 Small Area Plan: STARTOWN Agricultural District: Proximity Printed: Tuesday, July 10, 2012 10:08 AM jo_� - -11 Ic 1 1-,), --��-a•i. CATAWBA COUNT 'HEALTH DEPARTMENT Na �~ g 035 Telephone: (828) 465-827: (828) 465- 0 Imp. Prmt. uth. to C pr. Prmt. Opr. Prmt. Sys. Type Well Prmt. Well R r. Prmt. Owner/Agent y. _ PhoneAl ` - �f Z8S Address `Z(�yS (W- urk, &-) `, r-:,4 Subdivision S Ma(Jh d ection/Bl kI ase Lot11 Lot re tions: (� - 4 SfArbip r '-Pg- gk+dt�u � Facility: House Mobile Home Business Multi-fau ly . Other: Tax Map or Pin NumberS�O�,� ^Q 5` >q Other „� Zoning Approval # 7-60 t4l`1/41 # Bedrooms 7 # Seats # Employees . Application Rate j 55 GPD Flow 5(QO Hot Tub or Spa ye no !at Fixtures Basement y 100% Repair Are es o Basement Plumbin no /noWater Supply: Private Weil Public Semi -Public. Type of System: Trench Bed Pump Pump/Panel Panel LPP Other �ue L_ Septic Tank Size la'3 Pump Tank Size Nitrification Field: Total Square Feet X749 Depth of Stone Bed Size Trench Width �0 tl Total Length of All Trenches Number of Trenches I Trench Lengths 10 h5165/_/ Feet on Center � Maximum Trench Depth Zk it Distance of Nearest Well 50 � *DO NOT INSTALL SEPTIC WHEN WET* WELL RECORIREQUIRED AT COMPLETION* Topo d �lope0 �15.k L KS lz� ( L2 Texture ! _ t/ ) r nnJ Structure � � I� frre1lC63 �^ t `�tV�►•'�-_ � S'p' � Pr� � �� �L� Clay Min. ' So' it Wetness — C6v1 6'r 64e Soil Depth q6 T"f 1 I Z �• \ l W "- Restric. Hoz. at S �T � Available space o f Cut v I C Overall Class ( Comments. (_ 3 8�`• qd Filter Required �u+ Riser required when tank is more than 6 inches deep. **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 a n site b the Health Department. Permit Date• EHS OM, t Septic T Install B & Date E Well Installed By N W- W Well Crout Approval Date Well uya pprova a —7,6 Date Sample Collected Date 01 Results Results V-11-- n....,o.i n:.o,.• l: ... n _ %,;Iriinn in—rtinn Awh—i—finn to r'nmmirt