HomeMy WebLinkAboutRBPR-07-2012-15959.tifAugust 3, 2012
CATAWBA COUNTY
P O Box 389 - Newton, North Carolina 28658 - (828) 465-8270 - Fax (828) 465-8276 - TDD (828) 465-8200
Public Health — Environmental Health Division
Terry Taylor
3919 Holly Springs Dr
Newton, NC 28658
Re: Application for improvement permit for relocation of existing repair area
Catawba County Case# R113PR-07-2012-15959
Dear Sir:
On 7/31/12, Catawba County Public Health, Environmental Health Division evaluated the above -referenced
property at the site designated on the plat/site plan that accompanied your improvement permit application.
According to your application the site is to serve a proposed relocation of an existing septic system repair
area with a design wastewater flow of 480 gallons per day, in order to facilitate the addition of a proposed
swimming pool. The evaluation was done in accordance with the laws and rules governing wastewater systems
in North Carolina General Statute 130A-333 including related statutes and Title 15A, Subchapter 18A, of the
North Carolina Administrative Code, Rule. 1900, and related rules.
Based on the criteria set out in Title 15A, Subchapter 18A, of the North Carolina Administrative Code, Rules
.1940 through .1948, the evaluation indicated that the site is not suitable for the proposed relocation of your
septic system repair area due to insufficient space (Rule .1945). The remaining available area, once your
proposed swimming pool is constructed, must be of sufficient size to accommodate a complete repair,
including all required setbacks. Our evaluation has concluded that, based on your proposed swimming pool
location and existing site conditions these requirements cannot be met.
The site evaluation included consideration of possible site modifications, and modified, innovative or
alternative systems. Options to provide an off-site repair area or specific site modifications may available to
you. The site may be reclassified if written documentation is provided that meets the requirements of Rule
.1948(d). A copy of this rule is enclosed. You may hire a consultant to assist you if you wish to try to develop
a plan under which your site could be reclassified.
You have a right to an informal review of this decision. You may request an informal review by the soil
scientist or environmental health supervisor at the local health department. You may also request an informal
review by the N.C. Department of Enviromnent and Natural Resources regional soil specialist. A request for
informal review must be made in writing to the local health department.
�ppSH CARO) D
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"Keeping the Spirit Alive Since 1842!"
GREATER
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Page 2
Terry Taylor
August 3, 2012
You also have a right to a formal appeal of this decision. To pursue a formal appeal, you must file a petition for a
contested case hearing with the Office of Administrative Hearings, 6714 Mail Center, Raleigh, N.C. 27699-6714.
To get a copy of a petition form, you may write the Office of Administrative Hearings or call the office at (919)
733-0926 or from the OAH web site at wwxv.oah.State. nc.usIform.htrrt . The petition for a contested case hearing must
be filed in accordance with the provision of North Carolina General Statutes 130A-24 and 150B-23 and all other
applicable provisions of Chapter 150B. N.C. General Statute 130A-335 (g) provides that your hearing would be
held in the county where your property is located.
Please note: If you wish to pursue a formal appeal, you must file the petition form with the Office of
Administrative Hearings WITHIN 30 DAYS OF THE DATE OF THIS LETTER. Meeting the 30 day
deadline is critical to your right to a formal appeal. Beginning a formal appeal within 30 days will not interfere
with any informal review that you might request. Do not wait for the outcome of any informal review if you wish
to file a formal appeal.
If you file a petition for a contested case hearing with the Office of Administrative Hearings, you are required by
law (N.C. General Statute 15013-23) to send a copy of your petition to the North Carolina Department of
Environment and Natural Resources. Send the copy to: Office of General Counsel, N.C. Department of
Environment and Natural Resources, 1601 Mail Service Center, Raleigh, N.C. 27699-1601. Do NOT send the
copy of the petition to your local health department. Sending a copy of your petition to the local health department
will NOT satisfy the legal requirement in N.C. General Statute 150B-23 that you send a copy to the Office of
General Counsel, NCDENR.
You may call or write the Environmental Health Division of Catawba County Public Health if you need any
additional information or assistance.
Sincerely,
Jason Boyd, REHS
Environmental Health Specialist
Enclosure: Copy of Rule .1948
cc: Doug Urland
Mike Cash
.�'DµTH CAR01Z� "Keeping the Spirit Alive Since 1842!"
9
Accredited
Health
— DeparVnenC A G.C.U.
_ . HICKORY
METRO
ash 2008-2012
�'Dd�ment
History Note: Authority G.S. 130A -335(e);
Eff July 1, 1982;
Amended Eff. Janumy 1, 1990.
15A NCAC 18A .1947 DETERMINATION OF OVERALL SITE SUITABILITY
All of the criteria in Rules .1940 through .1946 of this Section shall be determined to be SUITABLE, PROVISIONALLY
SUITABLE, or UNSUITABLE, as indicated. If all criteria are classified the same, that classification will prevail. Where
there is a variation in classification of the several criteria, the most limiting uncorrectable characteristics shall be used to
determine the overall site classification.
History Note: Authority G.S. 130A-335(e),-
Eff
30A-335(e);Eff July 1, 1982;
Amended Eff. January 1, 1990.
15A NCAC 18A.1948 SITE CLASSIFICATION
(a) Sites classified as SUITABLE may be utilized for a ground absorption sewage treatment and disposal system consistent
with these Rules. A suitable classification generally indicates soil and site conditions favorable for the operation of a ground
absorption sewage treatment and disposal system or have slight limitations that are readily overcome by proper design and
installation.
(b) Sites classified as PROVISIONALLY SUITABLE may be utilized for a ground absorption sewage treatment and disposal
system consistent with these Rules but have moderate limitations. Sites classified Provisionally Suitable require some
modifications and careful planning, design, and installation in order for a ground absorption sewage treatment and disposal
system to function satisfactorily.
(c) Sites classified UNSUITABLE have severe limitations for the installation and use of a properly functioning ground
absorption sewage treatment and disposal system. An improvement permit shall not be issued for a site which is classified as
UNSUITABLE. However, where a site is UNSUITABLE, it may be reclassified PROVISIONALLY SUITABLE if a special
investigation indicates that a modified or alternative system can be installed in accordance with Rules .1956 or. 1957 of this
Section.
(d) A site classified as UNSUITABLE may be used for a ground absorption sewage treatment and disposal system
specifically identified in Rules .1955, .1956, or .1957 of this Section or a system approved under Rule .1969 if written
documentation, including engineering, hydrogeologic, geologic or soil studies, indicates to the local health department that the
proposed system can be expected to function satisfactorily. Such sites shall be reclassified as PROVISIONALLY
SUITABLE if the local health department determines that the substantiating data indicate that:
(1) a ground absorption system can be installed so that the effluent will be non-pathogenic, non-infectious,
non-toxic, and non -hazardous;
(2) the effluent will not contaminate groundwater or surface water; and
(3) the effluent will not be exposed on the ground surface or be discharged to surface waters where it could
come in contact with people, animals, or vectors.
The State shall review the substantiating data if requested by the local health department.
History Note: Authority G.S. 130.4-335(e),-
Eff
30.4-335(e);Eff July 1, 1982;
Amended Eff April 1, 1993; January 1, 1990.
15A NCAC 18A.1949 SEWAGE FLOW RATES FOR DESIGN UNITS
(a) In determining the volume of sewage from dwelling units, the flow rate shall be 120 gallons per day per bedroom. The
minimum volume of sewage from each dwelling unit shall be 240 gallons per day and each additional bedroom above two
bedrooms shall increase the volume of sewage by 120 gallons per day. In determining the number of bedrooms in a dwelling
unit, each bedroom and any other room or addition that can reasonably be expected to function as a bedroom shall be
19
•ost I Sr ice
(� omes i ai Only No s ace Cope a e Pro tiled)
For del ve for t on v s t our websi a usps.co
Terry'faylor
Postage
$
Certified Fee
Terry Taylor ---------------------
Return Receipt Fee
3919 Holly Springs Dr
(Endorsement Required)
Newton, NC 28658 --------------------•
Restricted Delivery Fee
(Endorsement Required)
Total Postage & Fees
I
`� a i1 AStmark
� t ere
'-N012-15959
Sent To
-- -
Terry Taylor ---------------------
Street, Apt. No.;
or PoBoxNo.
3919 Holly Springs Dr
Clty Slate,"ziP+a""
Newton, NC 28658 --------------------•
PS o 800 u e 00 e o tr ctw
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CaIiRIfied PflOyo ides: ela4 (esianaslppgE uuoj Sd
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❑ For an additional fee, a Return Receipt may be requested to provide proof of
delivery. To obtain Return Receipt service, please complete and attach a Return
Receipt (PS Form 3811) to the article and add applicable postage to cover the
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required.
o For an additional fee, delivery may be restricted to the addressee or
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X Print your name and address on the reverse dresspn
so that we can return the card to you. B. R eived by (Pjb a e) C. Date of Delivery
E Attach this card to the back of the mailplece,
or on the front if space permits. 19 -�-zY I
1. Article Addressed to: D. Is delivery address nt from item 17 11 Yes
If YES, enter delivery address below: 13 No
Terry Taylor
3919 I -lolly Springs Dr
Newton, NC 28658
3. Service Type
A Certified Mail 13 Express Mail
0 Registered IJ Return Receipt for Merchandise
13 Insured Mail El C.O.D.
4. Restricted Delivery? (Extra Fee) 0 Yes
2. Article Number- 7005 1820 0006 4091 7437
{Transfer from service label)
PS Form 3811, February 2004 Domestic Return Receipt 102595 -o2 -M-1540
UNITED STATES POSTAL SERVICE First -Class Mail
Post
RBPR-07-2012-15959 USPSage & Fees Paid
Permit No. G-94
• Sender: Please print your name, address, and ZIP+4 in this box 0
EIVEur"
fason Boyd, REI IS AUG 0 9 2012-,
Catawba County Environmental Health
PO Box 389 CATAWBA COU"
Newton, NC 28658 ENVIRONMENTAL HEALTH
THIS IS NOT A PERMIT Case # RBPR-07-2012-15959
CATAWBA COUNTY HEALTH DEPARTMENT
PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES
Residential Building Plan Review - Swimming Pool
IMPROVEMENT
Contractor ANTHONY & SYLVAN POOLS NORTH CAROLINA LLC, 8334-A AI2ROWRIDGE B1.,Vll, CHARLOTTE NC
28273-
B:(704)525 -1100C:7047734426
Owner TERRY TAYLOR, 3919 HOLLY SPRINGS DR, NEWTON NC 28658
NAME TO APPEAR ON PERMIT
Terry Taylor
SITE ADDRESS: 3919 HOLLY SPRINGS DR, NEWTON NC 28658 PIN # 366702899789
NANtE of SUBDIVISION: HOLLY SPRINGS SUB
_ LotN 8 Section/Block
PROPERTYSIZE: Square Feet 44,866.80 Acres 1.03 ff [(_',i�{.
DIRECTIONS: BUFFALO SHOALS RD/ RT HOLLY SPRINGS DR/ HOUSE ON RIGHT—
PRIMARY CONTACT: Owner SEWER TYPE: Septic Tank
GALLONS PER DAY: 480 WATER SUPPLY: Private Well
Public water is '*NOT" available for this property.
DESCRIBE WORK: PVT INGROUND POOL 16 X 31
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: 52x35
NUMBER OF EXISTING BEDROOMS: 4 # OF OCCUPANTS: 4
PROPERTY EASEMENTS: NONE
PROPOSED CONSTRUCTION
NEW STRUCTURE DIM:: 16 X 31
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 loc tions outd conform to applicable setbacks. 7�
Date: / t -A Signature of Applicant or Agent
An Environmental Health Specialist will contact you within 2 working days of application a .
If you need further information or assistance please call 828-466-7291
AREA1
MINIMUM SETBACKS FRONT: 30 SIDE: 15 REAR: 30 MAX HEIGHT:
FEENAAFE
Improvement Permit Fee
TOTAL FEES
DATE FEE AMOUNT
07/16/2012 $150.00
$150.00
CHANGE WORK ORDER REQUIRING REDESIGN AND/OR RETRIP WILL INCURE AN ADDITIONAL CHARGE
(SEE FEE SCHEDULE)
BA COQ THIS IS NOT A PERMIT Case # RBPR-07-2012-15959
1`U
i� �„t CATAWBA COUNTY HEALTH DEPARTMENT a � �
PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES
1842 sm. Residential Building Plan Review - Swimming Pool
�kj;a55
�� ►� �� f��.� �' �� Lgy 'k�tf IMPROVEMENT
Contractor ANTHONY & SYLVAN POOLS NORTH CAROLINA LLC, 8334-A ARROWRIDGE BLVD, CHARLOTT
28273-
B:(704)525-1100C:7047734426
Owner TERRY TAYLOR, 3919 HOLLY SPRINGS DR, NEWTON NC 28658
NAME TO APPEAR ON PERMIT
Terry Taylor
SITE ADDRESS: 3919 HOLLY SPRINGS DR, NEWTON NC 28658 PIN # 366702899789
NAME of SUBDIVISION: HOLLY SPRINGS SUB Lot # 8 Section/Block
PROPERTY SIZE: Square Feet 44,866.80 Acres 1.03
DIRECTIONS: BUFFALO SHOALS RD/ RT HOLLY SPRINGS DR/ HOUSE ON RIGHT
PRIMARY CONTACT: Owner SEWER TYPE: Septic Tank
GALLONS PER DAY: 480 WATER SUPPLY: Private Well
Public water is **NOT** available for this property.
DESCRIBE WORK: PVT INGROUND POOL 16 X 31
APPLICATION FOR:
STRUCTURE TYPE:
New Structure
ACCESSORY STRUCTURE
FACILITY TYPE: House OTHER DESCRIPTION:
DESCRIPTION OF SINGLE FAMILY DWELLING
EXISTING STRUCTURES
ON SITE (IF ANY)
DIM EXISTING STRUCTURE: 52x35
NUMBER OF EXISTING BEDROOMS: 4
PROPERTY EASEMENTS: NONE
NEW STRUCTURE DIM:: 16 X 31
# OF OCCUPANTS: 4
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 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
AREA1
MINIMUM SETBACKS FRONT: 30 SIDE: 15 REAR: 30 MAX HEIGHT:
FEENAME
Improvement Permit Fee
TOTAL FEES
DATE FEE AMOUNT
07/16/2012 $150.00
$150.00
CHANGE WORK ORDER REQUIRING REDESIGN AND/OR RETRIP WILL INCURE AN ADDITIONAL CHARGE
(SEE FEE SCHEDULE)
1;9 - chapplicatirni 07/16/2012 16:04 Page I of 3
Julia English
From: Lela Macijewski
Sent: Monday, July 16, 2012 11:43 AM
To: Julia English
Subject: RE: RBPR-07-2012-15959
No, this month's billing will not come thru until 2nd or 3rd of August. Thanks!
Lela M. Macijewski
Accounting Specialist III
Catawba County Finance Dept.
828/465-8277
Email: LMACIJEW@catawbacountvnc.aov
C�
"A
co(i�fti,
tdpoth Cn=olln�a
From: Julia English
Sent: Monday, July 16, 2012 11:34 AM
To: Lela Macijewski
Subject: RBPR-07-2012-15959
Put on Anthony & Sylvan pool billing account on 7/10/12. Found out they gave us the wrong address and the fee should
be $150 not $90. Is it ok to delete the $90 and add the $150? No billing info for this month has come across yet has it?
Julia English
Administrative Assistant II
Environmental Health
Catawba County Public Health
100A Southwest Blvd
Newton NC 28658
828-465-8270
828-465-8276 fax
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contact the sender Immediately by replying to the e-mail and delete the material from any computer
A
1 inch = 50 feet
Catawba County, North Carolina
This map product was prepared from the Catawba Counly, NC, Geographic hiforrnation Svstenr.
Catawba County has made substantial efforts to ensure the accuracy of location and labeling information
corrtalrred on this reap. Catawba County pronates and recommends the independent verification of any
data contained on this tnap product by the user. The Comity of Catawba, its enrpltryees, agents and
personnel disclaim, and .shall not be held liable for arty and all damages, loss or liability, whether direct, indirect
or consequential which arises or may arise frvrn this map product or the use thereof by any person at- entity. Legend
-- ' THIS IS NOT A LEGAL DOCUMENT
Selected Parcel Number: 3667-02-89-9789
Prepared for:
Monday, July 16, 2012 04:00 PM
n r 1
CATAWBA COUNTY NC - Parcel Report
Information Regarding Selected Parcel(s)
Parcel ID:
3667-02-89-9789
Name:
TAYLOR TERRY L
Name2:
TAYLOR LAURA S
Address:
3919 HOLLY SPRINGS DR
Address2:
City:
NEWTON
State:
NC
Zip:
28658-9678
Account:
206178
Calc Acreage:
1.03
Tax Map:
005BK 01008
LRK:
5293
Deed Book:
2769
Deed Page:
1059
Subdivision Name:
HOLLY SPRINGS SUB
Subdivision Block:
Lots:
8
Plat Book:
19
Plat Page:
31
Building Number:
3919
Street Name:
HOLLY SPRINGS DR
Site Zip:
28658
Township:
CALDWELL
Fire Code:
BANDYS
City Code:
COUNTY
State Road:
Total Bldgs Value:
$180,700
Land Value:
$15,900
Total Value:
$196,600
Year Built:
1993
Year Remodeled:
Last Sale Date:
Last Sale Amount:
Neighborhood:
125
Watershed:
WS-II Protected Area
Watershed Split:
NO
Voter Precinct:
P1
E911 District:
COUNTY
Zoning:
R-40
Zoning2:
Zoning3:
Zoning Split:
N
Zoning Overlay: WP-O
Zoning District:
COUNTY
Split Zoning Dist:
N
Split Zoning Dist(1): 0
Split Zoning Dist(2): 0
School District:
COUNTY
Elementary School:
TUTTLE
Middle School:
MAIDEN
High School:
MAIDEN
School Split:
NO
P&Z Case Number:
Census Tract 2010: 011601
Census Block 2010: 2000
Small Area Plan:
BALLS CREEK
Agricultural District:
Proximity
Printed: Monday, July
16, 2012 04:00 PM
05591
i CATAWBA COUWrr S- HEALTH DEPARTMENT
(704) 465-8270
Lot Eva1.LImprlove. Permit X Repair Permit Cert. of Comp. Permit Oper. Permit
Owner/Agent �c+, S��M Phone `Z3
Address 2 i Z y Subdivision h1zv/�,
w ew Taa Section/Block/Phase / " Lotf-Lr
Lot Size Directions: f4w1/ //S (7,0 lklll-
��ei�-•���s f/ � car ,�-*.► �� �
Facility: House_,CL Mobile Home Business Other: Zoning Approval dgs/no #;F930b--)Fs7
Multi -family- Other Tax Map # - / - F'
Bedrooms 3 Seats Employees Application Rate .3 GPD Flow,36 d
Hot Tub or Spa es/M Special Fixtures 100% Repair Area yes/no REPAIR NOTICE:
s/
W
Basement yeBasement Plumbing yes/no REPAIRS MUST BE WITHIN 30 DAYS OR
Water Supply: Private Public DAYS FROM DATE OF PERMIT.
:�*x,►,c***,r*:*x**xx:�e,�m*.,►�r*:*r�:,►,►******�***�r��k**,r�r:**,�,eye*�*�r**,►*.***�►�.**x:,e:x***,�*,r****
Type of System: Trench—� _Bed Pump Pump/Panel Panel LPP Other
Tank Size: Septic Tank 1600 c „ 1 Pump Tank
Nitrification Field: Total Square Feet IZoo Depth of Stone LL Bed Size
Trench Width 3(i Total Length of All Trenches Li0 O Number of Trenches S
Individual Trench /bO Feet on Center Maximum Trench Depth
Distance of Nearest Well Lot Evaluation: ApprovedGgiN/no (Void After 24 months)
��*�**►*sss:ss:st�,e:xwaitstttttr�►t*ate itsrstsrsr*ir*,tttt►�ts*atstr,►w,ruts+titx*sr�+t+►wswieftsat*ttrsk�earar**asar��rxsr*ie
Topo -3 % Slope I Sketch of lot Evaluation Site - System Design - Final
Texture
structureRl�rrl y I IVO � + � c)4-
Clay
)4-Clay Min. / : / I k6 i -e- r3Jl
t4l-c S�S
Soil Wetness ,�s I ,�-�- �' � S �•.
SO
Soil Depth
Restric. Hoz. at
Available space 497nol— , _ L _ _ _ — (a
I /� 6t �dti..rP
Overall Class S WU — — — — — — —
Comments: I S° _ _ _ _ _ i
I / Q
I �
I ti
I a cts�
Septic Tank Contractors
MUST contact the I !�
Sanitarian BEFORE I
changing permit.
**NO GUARANTEE OR WARRANTY IS IMPLIED OR GIVEN THROUGH THE ISSUANCE OF THIS PERMIT**
Permit Date (Improvement Permit vafter 60 months)
Owner/Agent ✓ ±�� U Sanitarian ��! /rI�
Installed Bvv v"aer�!/� -e . Date // 5 SanitariA
(Note any ch in red by sketch on back)
*******IF A PERMIT HAS TO BE REDESIGNED AND/OR RETRIPS MADE TO THE PROPERTY, THERE********
IS AN ADDITIONAL $25 CHARGE.
White -Office Blue -Bldg. Insp. Comp. Yellow-Owner/Agent Green -Bldg. Insp. I.P.
12-0-0 CATAWBA COUNTY HEALTH DEPARTMENT Na 514 2
'= R Telephone (828) 46' 7 TDD (828) 465-8200 ��.
Imp P-rmt. Auth. to Const. Rpr Print.Opr P Sys Type Well Prmt.--P—(Well Rpr Prmt.
Owner/Agent % U- g -10� Phone
Address 3cj PCI 1 Ltv �5 rv- Subdivision PO L'(H (�!)pr MK -60 G,) 34e, O Section/Bl o haseA I Lot�l
�
Lot Size L Directions (p 5 �� 1 �, (� r,.,, �` l6 1 ty � M;V
-7. d46, kow$e. 0,J I p�-�-
C, I') 16 I It f. dor rr r 0-
Facility- House .V, Mobile Home Business Multi -family Other- Tax Map or Pin Number
Other Zoning Approval #
# Bedrooms ,t/ # Seats # Employees Application Rate GPD Flow
Hot Tub or Spa yes/no Special Fixtures Basemerj!:j>/no 100% Repair Area yes/no
Basement Plumbino e Ino Water Supply- Private Well Public Semi -Public
###*####*#####**########*##*##*#####*#*#*#*#**#####*###*##################**#######*###*#############*###########*######*#
Type -of System. Trench
Septic Tank Size
Bed Size
Bed Pump Pump/Panel Panel LPP Other
Pump Tank Size Nitrification Field. Total Square Feet
Trench Width Total Length of: All Trenches
Depth of Stone
Number of Trenches
Trench Length / / / / / Feet on Center Maximum Trench Depth Distance of Nearest Well
*DO NOT INSTALL SEPTIC WHEN WET* *WELL RECORD REQUIRED AT COMPLETION*
Topo % Slope
Texture
Structure
Clay Min.
Soil Wetness
Soil Depth
Restric Hoz at "
Available space yes/no
Overall Class S PS U
Comments
r t
2Z a�
�•/e tr.3 1 / /c..
I
**NO GUARANTEE OR WARRANTY IS IMPLIED OR GIVEN AS TO THE PERFORMANCE OR LENGTH OF TIME TI -IIS 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 pos ' le sources of contamination. No volume of
water is guaranteed at any site by the Health Department.
Permit Date //— GJ _5( EHS a� fiL(/LS
Owner/ t Septic T nstalle y _ Date
EHS 1 Well Installed By , .,� [�J WWIGrou� roval Date// `l3 -IF
Well H d pproval � tem — "�'Date Sample CollectedDate of Results esults EHS/
White Office Blue - Building Inspection Operation Permit Yellow - Owner/Agent Green `Building F' pection fiuthoriz n to Construct
BA COQ THIS IS NOT A PERMIT Case # RBPR-07-2012-15959
� , �CATAWBA COUNTY HEALTH DEPARTMENT
PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES
1842 SM Residential Building Plan Review - Swimming Pool
IMPROVEMENT
Contractor ANTHONY & SYLVAN POOLS NORTH CAROLINA LLC, 8334-A ARROWRIDGE BLVD, CHARLOTT:
28273-
B:(704)525-1 I OOC:7047734426
Owner MARSHALL YANCEY, 3910 HOLLY SPRINGS DR, NEWTON NC 28658
NAME TO APPEAR ON PERMIT
MARSHALL YANCEY
SITE ADDRESS: 3910 HOLLY SPRINGS DR, NEWTON NC 28658 PIN # 366804901118
NAME of SUBDIVISION: Lot # Section/Block
PROPERTY SIZE: Square Feet 50,965.20 Acres 1.17
DIRECTIONS: BUFFALO SHOALS RD/ RT HOLLY SPRINGS DR/ HOUSE ON RIGHT
PRIMARY CONTACT: Owner SEWER TYPE: Septic Tank
GALLONS PER DAY: 480 WATER SUPPLY: Private Well
Public water is **NOT`* available for this property.
DESCRIBE WORK: PVT INGROUND POOL 16 X 31
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: 52x35
NUMBER OF EXISTING BEDROOMS: 4 # OF OCCUPANTS: 4
PROPERTY EASEMENTS: NONE
PROPOSED CONSTRUCTION
NEW STRUCTURE DIM:: 16 X 31
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
Area 1
MINIMUM SETBACKS FRONT: 30 SIDE: 15 REAR: 30 MAX HEIGHT:
FEENAME
Improvement Permit (Existing) Fee
TOTAL FEES
DATE FEE AMOUNT
07/10/2012 $90.00
$90.00
CHANGE WORK ORDER REQUIRING REDESIGN AND/OR RETRIP WILL INCURE AN ADDITIONAL CHARGE
(SEE FEE SCHEDULE)
F9 - ehapplicdtion 07/10/2012 17:02 Pagel of 3
a
1842 SM
THIS IS NOT A PERMIT Case # RBPR-07-2012-15959
CATAWBA COUNTY HEALTH DEPARTMENT
PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES
Residential Building Plan Review - Swimming Pool
IMPROVEMENT
Contractor ANTHONY & SYLVAN POOLS NORTH CAROLINA LLC, 8334-A ARROWRIDGE BLVD, CHARLOTT
28273-
B:(704)525-1 I OO
8273-
B:(704)525-1100 0:7047734426
Owner MARSHALL YANCEY, 3910 HOLLY SPRINGS DR, NEWTON NC 28658
NAME TO APPEAR ON PERMIT
MARSHALL YANCEY
SITE ADDRESS: 3910 HOLLY SPRINGS DR, NEWTON NC 28658 PIN # 366804901118
NAME of SUBDIVISION: Lot 4 Section/Block
PROPERTY SIZE: Square Feet 50,965.20 Acres 1.17
DIRECTIONS: BUFFALO SHOALS RD/ RT HOLLY SPRINGS DR/ HOUSE ON RIGHT
PRIMARY CONTACT: Owner SEWER TYPE: Septic Tank
GALLONS PER DAY: 480 WATER SUPPLY: Private Well
Public water is "'NOT"` available for this property.
DESCRIBE WORK: PVT INGROUND POOL 16 X 31
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:
NUMBER OF EXISTING BEDROOMS: 4 # OF OCCUPANTS: 4
PROPERTY EASEMENTS: NONE
PROPOSED CONSTRUCTION
NEW STRUCTURE DIM:: 16 X 31
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: O / �— Signature of Applicant or AgentCt�'
An Environmental Health Specialist will contact you within 2 working days of application date. pp
If you need further information or assistance please call 828-466-7291
MINIMUM SETBACKS FRONT: 30 SIDE: 15 REAR: 30 MAX HEIGHT:
FEENAME
Improvement Permit (Existing) Fee
TOTAL FEES
DATE FEE AMOUNT
07/10/2012 $90.00
$90.00
CHANGE WORK ORDER REQUIRING REDESIGN AND/OR RETRIP WILL INCURE AN ADDITIONAL CHARGE
(SEE FEE SCHEDULE)
Cc)-.happlirnicm 07/10/2012 14:28 Page I of
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THIMI
S IS NOT A PERT
'i CATAWSA COUNTY HEALTH DEPARTMENT
Application for Environmental Services Page 1
My
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 �� TKA �1�� v, C Subdivision
/C ��?r ► 1�n� 1 k 1 r �� Lot#qn,,-�pCr Acres
echon/Blocic/Phase
DrivingDirectionstoProperty rill Sf1c �1i�50� ��lC l�l� I (4 I f S
v �
NAME TO APPEAR ON •� W
PERMIT? ❑Owner ❑ Applicant ontractor
Applicant Contact Information
Name�r--
1 Address
Phone `? (74-- I ti' I Cell Phone
Owner Contact Information
Name
Address
Phone J Cell Phone
Contractor Contact Information
Named
Address
Phone f Cell Phone
WHO WILL BE THE PRIMARY CONTACT? ❑ Owner [LA`pplicant ontractor
�# ip Bedrooms�*n ... .......,._.'o"n"
....... ....._....._........ .._.....�.... � _�.. _ ..._..._.. -
cn 'on of E g tures on Site � �� �5•p � , J
. t Structure Dimensions `3 # of Occupants
Basement P`Y,es [:) No Basement Fixtures ❑ Yes [t G /
Planned Future Additions or I em is (Building Permit NOT requested at this time)
Describe lr-�'� ,v X -)l 1
Proposed Future`Sructwt Dimensions( '� # of Bedrooms -t if applicable
Are there easements or right-of-ways recorded on this property ❑ Yes Pm.—
Describe
'.Describe
Ls a public water supply agcmmunityWell
le on or adjacent to the above property ** ❑Yes No
Check type available ❑ 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
❑ iWOULD LIKE TO SCHEDULE A COMBINED FLAGGING AND SO [L EVALUATION
(SEE COMBINED EVALUATION PROCEDUES)
THIS IS NOT A PERMIT
CATAWBA COUNTY HEALTH DEPARTMENT
�t Application for Environmental Services Page 2
Xror� Facility TypearyResidence ❑New Residence Add'�to Residence #ofNewBedrooms*t
roject Descriptionvttc >�
Structure Dimensions # of Occupants
Aso Structnre(s Describ Basement Fixtures Yes .:.......
asement Y El
�' # of New Bedrooms *t i......,,._ V
'f applicable Structure Dimensions
# of Occupants Accessory Dwelling ❑ Yes 2'50
Plumbing ❑ Yes [PDescribe Plumbing Needed
0_ 4 ib-Family.Residence # Units -.._.. .#Bedrooms . r U. .
iiTu nit
Total # Bedrooms *f Structure Dimensions
❑ uFood Service"„ Specify Type �....,.. .....:.,...._ _. _.....,.. .......::............ _,.._...,.
# Seats Floor Space -Entire Food Service Facility (Sq Ft)
# Employees per Shift # of Shifts Dining Area (Sq. Ft.)
❑ Suseness Specific Type of Business Retail Floor _.p .
S ace
# of Employees per Shia # of Shifts
Other Facility Type Specify
If Church # of Seats Kitchen ❑ Yes ❑ No If Daycare Specify. Occupancy
Application for Well Construction/Abandonme ... .......
nt/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 t 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 moms 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. tIf
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)
1 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
�.D 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 Authorization to Construct issued by this department is valid for
(5) five years from the date issued and is 60t transferable
I® r
tnSignature of Owner or Agent f�� f
Printed Njarri of Owner or Agent
Date �( )� 1?s-
l
414.74
4
332
391 '�tty 16.92
200)
GS
19
100.00
� 29 131.92
j9 41
374
294
0794 2743 225--
CD
190.00
172.72 358.26
172.65