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Home My WebLink AboutRBPR-07-2012-15970.TIFTHIS IS NOT A PERMIT Case # RBPR-07-2012-15970 CATAWBA COUNTY HEALTH DEPARTMENT PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES Residential Building Plan Review - Swimming Pool IMPROVEMENT Contractor SAME AS OWNER, , Owner ROBERT HARTSELL, 3442 33RD AVE PL NE, HICKORY NC 28601 H:828-465-8519 NAME TO APPEAR ON PERMIT ROBERT HARTSELL SITE ADDRESS: 3442 33RD AV PL NE, HICKORY NC 28601I N # 372416941168 NAME of SUBDIVISION: La3 Section/Block PROPERTY SIZE: Square Feet 40,946.40 Acres •94 DIRECTIONS: SPRINGS RD/ SULPHUR SPRINGS RD/ LEFT 33RD AVE PLACE NE/ LAST HOUSE ON LEFT / GREEN SIDING 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 SWIMMING POOL 18 X 36 W/ 6FT CONCRETE DECKING AREAAROUND POOL 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: 56 X 46 NUMBER OF EXISTING BEDROOMS: 3 PROPERTY EASEMENTS: NONE # OF OCCUPANTS: 4 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 18 X 36 W/ 6FT DECK AREA (30X48 TOTAL) 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 informatio ass e please call 828-466-7291 �ea 2 MINIMUM SETBACKS FRONT: 30 SIDE: 10 REAR: 10 MAX HEIGHT: FEENAME Improvement Permit (Existing) Fee TOTAL FEES DATE FEE AMOUNT 07/12/2012 $90.00 $90.00 CHANGE WORK ORDER REQUIRING REDESIGN AND/OR RETRIP WILL INCURE AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) F,9 - chapplication 07/12/2012 17:23 Page I of 3 THIS IS NOT A PERMIT Case # RBPR-07-2012-15970 CATAWBA COUNTY HEALTH DEPARTMENT PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES Residential Building Plan Review - Swimming Pool IMPROVEMENT Contractor SAME AS OWNER, , Owner ROBERT HARTSELL, 3442 33RD AVE PL NE, HICKORY NC 28601 H:828-465-8519 NAME TO APPEAR ON PERMIT ROBERT HARTSELL SITE ADDRESS: 3442 33RD AV PL NE, HICKORY NC 28601 NAME of SUBDIVISION: PIN # 372416941168 Lot # Section/Block PROPERTY SIZE: Square Feet 40,946.40 Acres •94 DIRECTIONS: SPRINGS RD/ SULPHUR SPRINGS RD/ LEFT 33RD AVE PLACE NE/ LAST HOUSE ON LEFT / GREEN SIDING 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 SWIMMING POOL 18 X 36 W/ 6FT CONCRETE DECKING AREA AROUND POOL 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: 56 X 46 NUMBER OF EXISTING BEDROOMS: 3 # OF OCCUPANTS: 4 PROPERTY EASEMENTS: NONE PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 18 X 36 W/ 6FT DECK AREA (30X48 TOTAL) 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 y 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 ap 'cation date. If you need further information or assistance please call 828-466-7291 MINIMUM SETBACKS FRONT: 30 SIDE: 10 REAR: 10 MAX HEIGHT: FEENAME Improvement Permit (Existing) Fee TOTAL FEES DATE FEE AMOUNT 07/12/2012 $90.00 $90.00 CHANGE WORK ORDER REQUIRING REDESIGN AND/OR RETRIP WILL INCURE AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) 1i9 - chapplicalion 07/12/2012 13:34 Pagel of 3 �V�A THIS IS NOT A PERMIT CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services Page I r82,M Improvement Permit I Authorization to Construct ❑ Septic Repair ❑ Septic Malfunction ❑ Septic Expansion ❑ New Well Permit ❑ Replacement Well ❑ Well Abandonment ❑ Well Repair ❑ Existing System Inspection (Pre -Approval Required) ❑ Application is for New Construction E:1 Existing Facility Property Add ress-3gTL :5151V(04 41_ Az Subdivision Lot# .3 Acres J Section/Block/Phase Driving Directions to Property S�m1� s Qvf' -Fo r � 5 _ �o�ric� %7 M, 9Y u 0.4 sf�► W NAME TO APPEAR ON PERM IT? Applicant Contact Information Name --Ie0be<t Address Phone Owner Contact Information Name Address Phone Contractor Contact Information Name Address Phone ['Owner ❑ Applicant ❑ Contractor PL L i°JC4,l , JC t000 7 ICell Pone Cell Phone Cell Phone WHO WILL BE THE PRIMARY CONTACT? ❑ Owner [:]Applicant ❑ Contractor Description of Existing Structures on Site s 4.47 # of Bedrooms *t Structure Dimensi ns i�Z k If '6/ # of Occupants � Basement P'Yes ❑ No Basement Fixtures ❑ Yes [ o Planned Future Additions or Improvements (Building Permit NOT requested at this time) Describe Proposed Future Structure Dimensions # of Bedrooms *t if applicable Are there easements or right-of-ways recorded on this property ❑ Yes [P-Pdo Describe Is a public water supply available on or adjacent to the above property ** c[ es ❑ No Check type available ❑ Community Well ❑ Semi -Public Well ❑ County/City/Township Water Line Existing water supply in use ❑ Individual Well ❑ Community Well ❑ Semi -Public Well [✓County/City/Township Water Line ❑ I WOULD LIKE TO SCHEDULE A COMBINED FLAGGING AND SOI L EVALUATION (SEE COMBINED EVALUATION PROCEDUES) �$ THIS IS NOT A PERMIT a CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services Page 2 I s S, Prgposed Facility Type Primary Residence F-1 New Residence F1 Addition to Residence# ofCNw Bedrooms *t Project Description q rcwd Structure Dimensions I S" x -3Co' ccupants Basement ❑ Yes ❑ No Basement Fixtures ❑ Yes ❑ No ❑ Accessory Structure(s) Describe # 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* i 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 # of Employees per Shift # of Shifts ❑ Other Facility Type Specify If Church # of Seats Kitchen ❑ Yes ❑ No Retail Floor Space 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 i 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 LU ADDITIONAL CHARGE (SEE FEE SCHEDULE) LU J I understand that this is a formal application for Environmental Services and authorize Catawba County Environmental CL Health employees to go on this property for evaluation purposes. I certify the above information to be correct and understand Q that an Improvement Permit issued as a result of this information is valid for 5 years or may be non -expiring under certain V specified conditions. Improvement Permits and Well Permits are transferrable, but may be revoked if this information, site W plans or intended use changes for the proposed facility. An A thorization to Construct issued by this department is valid for m ca (5) five years from the date issued and is no ransferable� Signature of Owner or Agent Printed Name of Owner or Agent �G�ar'f -Ha4sieW Date -7 1 to tZ Print Parcel Map Page 1 of I. Real L�3( � it 0H VaJo state - 81.44 45 1+]i].67 19.2�� 33RD AV PL 14E MM= 24; Parcel Summary Printed Map Scale 1 inch = 95ft Parcel ID: 372416941168 Parcel Address: 3442 33RD AV PL NE, HICKORY Owner: HARTSELL ROBERT G JjAddress: 3442 33RD AVE PL NE11 City: HICKORY Owner2: HARTSELL DIA W 11 Address2: 11 State/Zip: NC, 28601-7719 Building(s) Value: $217,100 11 Land Value: $16,300 11 Total Value: $233,400 DISCLAIMER: 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. http://www.gls.catawba.ne.uslwebsite/ParcellprintMap.asp?pinc=3 72416941168&paddr=3... 7/10/2012 N 1 inch = 60 feet 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 contained on this map. Catawba County promotesand 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. Selected Parcel Number: 3724-16-94-1168 Prepared for: 167.76 p't 137 1.1 \242 ! 269 THIS IS NOT A LEGAL DOCUMENT r r Date: 7/12/2012 Time: 1:06:35 PM I CATAWBA COUNTY NC - Parcel Report Information Regarding Selected Parcel(s) Parcel ID: 3724-16-94-1168 Name: HARTSELL ROBERT G Name2: HARTSELL DIA W Address: 3442 33RD AVE PL NE Address2: City: HICKORY State: NC Zip: 28601-7719 Account: 159762438 Calc Acreage: 0.94 Tax Map: LRK: 403310 Deed Book: 3026 Deed Page: 0558 Subdivision Name: Subdivision Block: Lots: 3 Plat Book: 56 Plat Page: 125 Building Number: 3442 Street Name: 33RD AV PL NE Site Zip: 28601 Township: CLINES Fire Code: ST. STEPHENS City Code: COUNTY State Road: 2364 Total Bldgs Value: $217,100 Land Value: $16,300 Total Value: $233,400 Year Built: 2008 Year Remodeled: Last Sale Date: Last Sale Amount: Neighborhood: 58 Watershed: Watershed Split: Voter Precinct: P29 E911 District: COUNTY Zoning: R-20 Zoning2: Zoning3: Zoning Split: N Zoning Overlay: Zoning District: COUNTY Split Zoning Dist: N Split Zoning Dist(1): 0 Split Zoning Dist(2): 0 School District: COUNTY Elementary School: SNOW CREEK Middle School: ARNDT High School: ST STEPHENS School Split: NO P&Z Case Number: Census Tract 2010: 010301 Census Block 2010: 2018 Small Area Plan: ST STEPHENS/OXFORD Agricultural District: Proximity Printed: Thursday, July 12, 2012 01:06 PM A4 r) % Applicant Address: City: State/Zip OPERATION PERMIT' / For Office Use Only \ Catawba County Public Health Department 'CDP File Number a 4 a 0 3 Environmental Health Division WLS2008-00571 P.0 Box 389, 100-A Southwest Blvd S County ID Number: Newton NC 28658 valuated For: NEW Phone: (828)-465-8270 Fax: (828) 465-8276 ROBERT G & DIA W //Property Owner: ROBERT G & DIA'W - ��5 OAH PATH Address: 33f1"LP UR SPRINGS RD CONOVER City: HICKORY NC 28613 State/Zip: NC 28601-770 \ Phone #: / \Phone #: Property Location & Site Information Address/Road #: Subdivision: Phase 3442 33RD AV PL NE HICKORY NC Structure: SINGLE FAMILY # of Bedrooms: 3 # of People: 3 \ "Water Supply: PUBLIC P I Issued by: 1952 - Phelps, Robert "CA issued by: 1952 - Phelps, Robert Design Flow: 3 6 0 Soil Application Rate: 0 a 7 5 \ Nitrification Field No. Drain Lines Total Trench Length: Trench Spacing: Trench Width: Aggregate Depth: Lot: 3 a Directions SPRINGS RD TO SULPHUR SPRINGS RD/ ABOUT 1/2 MILE LFT ON 33RDAVE PL NEI 1ST VACANT LOT ON LFT BESIE NEW CONSTRUCTION***per owner Hickory water line run down street*** `System Classification/Description: TYPE III G. OTHER NON-CONV. TRENCH SYSTEMS "Distribution Type: GRAVITY -SERIAL `Pre -Treatment: / Drain field / 1 0 1 1 Sq. ft. `System Type: INFILTRATOR QUICK 4 STANDARD 5 3 3 7 ft. 9 Olnches O.C. OFeet O.C. 3 Inches Q 2 Feet inches Installer: Kelly Isenhour Certification #: 1099 *EHS: 1952 - Phelps, Robert Minimum Trench Depth: ZZ 4 Inches Minimum Soil Cover: Inches Approval Status Maximum Trench Depth: 3 0 Inches Approved El Disapproved Maximum Soil Cover: Inches Page 1 of 4 \ rADP Fife Number 24203 County ID Number: WLS2008.00571 Septic Tank / / Manufacturer. / Lat. STB: 160 Long: Gallons: 1000 Installer: Kelly Isenhour I Date: Certification #: 1099 'Filter Brand: POLYLOK PL -68 *EHS: 1952 - Phelps, Robert ST Marker: 1,A9 YeS ❑ No Approval Status Reinforced Tank: ❑ Yes ® No ® Approved ❑ Disapproved 1 Piece Tank: ❑ Yes ® NO / / Pump Tank Manufacturer: Installer: PT: Certification #: Gallons: 'EHS: Date: / Approval Status Riser Sealed ❑ Yes ❑ No ❑ Approved ❑ Disapproved Riser Height: ❑ Yes ❑ NO (Min. 6 in.) Reinforced Tank: ❑ Yes ❑ No 1 Piece Tank: ❑ Ye5 ❑ No Supply Line / Pipe Size: 3 inch diameter Installer: Kelly Isenhour Pipe Length: feet Certification #: 1099 "Schedule: 40 "EHS: 1952 - Phelps, Robert Pressure Rated ❑ Yes ® NO Approval Status Approved fittings ❑ Yes ❑ No ® Approved ❑ Disapproved Pump Requirement Pump Type: Installer: _ \ Dosing Volume: - Gal Certification #: Draw Down: Inches 'EHS: `Chain: Approval Status Valves Accessible ❑ Yes ❑ No ❑ Approved ❑ Disapproved Flow Adjustment Valve ❑ Yes ❑ NO Check -valve ❑ Yes ❑ No PVC Unions ❑ Yes ❑ No Vent Hole ❑ Yes ❑ No \ Anti -siphon Hole El Yes ❑ NO / Page 2 of 4 CDP File Number 24203 �EMA 4X Box or Equivalent ❑ Yes Box 12 inches Above Grade ❑ Yes Box Adj. To Pump Tank' ❑ Yes Conduit Sealed ❑ Yes Pump Manually Operable ❑ Yes *Activation Method: L County ID Number: WLS2008-00571 Electric Equipment ❑ No ❑ No ❑ No ❑ No ❑ No Alarm Audible ❑ Yes ❑ No Alarm Visible ❑ Yes ❑ No 1952 - Phelps, Robert *Operation, Permit completed by: Authorized State Agent: Installer: Certification #: *EHS: Approval Status Approved ❑ 'Disapproved j I Date of Issue: 1 0/ 0 1/ x 0 0 9 This system has been installed in compliance with applicable NC General Statutes: Article 11, Chapter 130A, Rules for Sewage Treatment and Disposal, 15A NCAC 18A.1 900 et. Seq., and all conditions of the Improvement Permit and Construction Authorization. This property is served by a TYPE III G. sewage septic System. Rule .1961 requires that a Type TYPE III G. septic system meet the following criteria: Minimum System Review By The Local Health Department: NIA Management Entity: OWNER Minimum System Inspection/Maintenance Frequency By Certified Operator: NIA Reporting Frequency By Certified Operator: NIA Rule .1961 requires that a Type IV and V septic systems designed for a home/business owner must maintain a valid contract with a public management entity with a certified operator or a private certified operator for the life of the septic system. Rule .1961 requires that Type VI septic systems designed for a home/business owner must maintain a valid contract with a public management entity with a certified operator for the life of the septic system. Rule. 1961 (2) (e) requires a contract shall be executed between the system owner and a management entity prior to the issuance of an Operation Permit for a system required to be maintained by a public or private management entity, unless the system owner and certified operator are the same. The contract shall require specific requirements for maintenance and operation, responsibilities of the owner and systems operator, provisions that the contract shall be in effect for as long as the system is in use, and other requirements for the continued proper performance of the system. It shall also be a condition of the Operation .Permit that subsequent owners of the systems execute such a contract. O Hand Drawing 0lmport Drawing **Site Plan/Drawing attached.** Total Time:(HH:MM) 0 _ _ Hours. Minutes Page 3 of 4 CDP File Number: 24203 Drawing Type: Operational Permit Drawing County File Number: WLS2008-00571 Date: 1 0 0 1/ a 0 0 9 Scale: - ---------- ------ - ---- - --- - ----- ---- ------------ . ...... - --------- T __j T t J_ ---- ---- ----------- ..... ...... .......... (D Inch 0 Block 0 N/A .......... . ..... A— .......... . ..... . 0%. 9) -- -- ------ - --- -------d --- ---- --- -_ --- ------ -- + 4 ........ .. it 4iS137 0 .. ........ . . ...... ............ ...... --- -------- Page 4 of 4 Owner Contractor CATAWBA COUNTY PERMIT ZONING AUTHORIZATION (R) New Dwellin I IVR PIN# PERMIT NO: ZONR-07-201:2-029512 1'. 0. Bos 389 Phone: 828-465-8380 APPUED: 07/12/2012 I OOA Southwest Blvd FAX: 828-465-8484 ISSUED: 07/12/2012 Newton, North Carolina 28658 1 XPIRCS: 03/27/2013 mm. catawbacountync.gov ROBERT HARTSELL, 3442 33RD AVE PI -NE, HICKORY NC 28601 1:828-465-8519 **NO PEOPLESOFT ACCOUNT ASSIGNED ** SAME AS OWNER, . PROPERTY ID#: 37241694-1168 STREET ADDRESS: 3442 33RD AV PL NE, HICKORY NC 28601 CENSUS TRACT: 010301 PROJECT DESCRIPTION: PVT INGROUND SWIMMING POOL 18 X 36 W/ 6FT CONCRETE DECKING AREAAROUND POOL FLOOD ZONE? No OWNER TYPE: VALUE: $20,000.00 100 YEAR FLOOD ZONE PLAIN? LAND OWNER: FLOOD PLAIN, STRUCTURE? No REQUIRED SETBACKS FRONT: 30 REAR: 10 SIDE: 10 I. Before an inspection can be made by the Building Inspection Office, the applicant must pull a string to designate the side and rear property lines where the structure is being placed or constructed. 2. Home shall be placed on the lot in harmony with the site -built structures. or have the front door face the road frontage. INVOICE/: 07-12-288241 FEE DESCRIPTION DATE FEE AMOUNT Residential Zoning Fee 07/12/2012 $25.00 TOTAL FEES $25.00 The applicant hereby certifies that all information and attachments to this Certificate of Zoninp- Compiliance are true and correct, and acknowledges that this permit Nvas issued on the basis of the information required herein. The applicant iorther acknowledges that am, construction. alteration or addition which differs from this application shall be subject to removal or alterationeso- to bring said structure into conformance with th specifications and standards o1 th Cat aba .o oning Ordinance. Such crnrectivelaction shape at the - APPI-ICAN-f NAME (PRINTED) n'I'LLICAN-f, S1GNAfURI: ZONING APPROVED BY CO\ -IRAN)' NAN1 ***** ZONING FEES ARE NON-REFUNDABLE ***** 07/12/2012 13:32 ISSUED BY: Pat Queen Ila, -,c I oft