Loading...
HomeMy WebLinkAboutRBPR-07-2012-15971.TIFTHIS IS NOT A PERMIT Case # RBPR-07-2012-15971 CATAWBA COUNTY HEALTH DEPARTMENT PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES Residential Building Plan Review - Swimming Pool IMPROVEMENT - AUTH CONST - REPAIR Contractor LAKE NORMAN POOL & SPA, 411 S CENTER ST, STATESVILLE NC 28677- 13:(704)878-6699C:(704)902-7650 DMCKINNEY@WATERSFINE .COM Owner CASSANDRA STARNES, 4146 54TH AV NE, HICKORY NC 28601 C:828-441-0224 NAME TO APPEAR ON PERMIT CASSANDRA STARNES SITE ADDRESS: 4146 54TH AV NE, HICKORY NC 28601 PIN # 373511760147 NAME of SUBDIVISION: Lot # Section/Block PROPERTY SIZE: Square Feet 96,703.20 Acres 2.22 DIRECTIONS: SULPHUR SPRINGS RD/ LF 37TH ST DR NW/ BEAR RT 54TH AV NE/ ON RT PRIMARY CONTACT: Contractor SEWER TYPE: Septic Tank GALLONS PER DAY: WATER SUPPLY: Public Water Public water IS available for this property. DESCRIBE WORK: -PVT INGROUND POOL 20 X 40 / size including concrete deck area is 56 x 48 ( **septic being moved for pool area**.) 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: 73 x 61 NUMBER OF EXISTING BEDROOMS: PROPERTY EASEMENTS: none # OF OCCUPANTS: PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 56 x 28 concrete area / pool 20 x 40 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 2 MINIMUM SETBACKS FRONT: 30 SIDE: 15 REAR: 30 MAX HEIGHT: FEENAME DATE FEE AMOUNT Authorization to Construct (Repair) Fee 07/12/2012 $300.00 TOTAL FEES $300.00 CHANGE WORK ORDER REQUIRING REDESIGN AND/OR RETRIP WILL INCURE AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) E9 - ehapplication 07/13/2012 08:50 Pagel of 3 �A p� THIS IS NOT A PERMIT Case # RBPR-07-2012-15971 CATAWBA COUNTY HEALTH DEPARTMENT PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES 1842 sM Residential Building Plan Review - Swimming Pool IMPROVEMENT - AUTH CONST - REPAIR Contractor LAKE NORMAN POOL & SPA, 411 S CENTER ST, STATESVILLE NC 28677- B:(704)878-66990:(704)902-7650 DMCKINNEY@WATERSFINE .COM Owner CASSANDRA STARNES, 4146 54TH AV NE, HICKORY NC 28601 C:828-441-0224 NAME TO APPEAR ON PERMIT CASSANDRA STARNES SITE ADDRESS: 4146 54TH AV NE, HICKORY NC 28601 PIN # 373511760147 NAME of SUBDIVISION: Lot # Section/Block PROPERTY SIZE: Square Feet 96,703.20 Acres 2.22 DIRECTIONS: SULPHUR SPRINGS RD/ LF 37TH ST DR NW/ BEAR RT 54TH AV NE/ ON RT PRIMARY CONTACT: Contractor SEWER TYPE: Septic Tank GALLONS PER DAY: WATER SUPPLY: Public Water Public water IS available for this property. DESCRIBE WORK: PVT INGROUND POOL 20 X 40 /size including concrete deck area is 56 x 48 APPLICATION FOR: New Structure STRUCTURE TYPE: ACCESSORY STRUCTURE FACILITY TYPE: Accessory Structure OTHER DESCRIPTION: DESCRIPTION OF single family dwelling **septic being moved for pool area** EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: 73 x 61 NUMBER OF EXISTING BEDROOMS: # OF OCCUPANTS: PROPERTY EASEMENTS: none PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 56 x 28 concrete area / pool 20 x 40 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 pro Any representation by you ot`house or structure location should conform to applicable setbacks. ,✓% ) Date: 7 / Z r / Z Signature of Applicant or Agent An Environmental Health Specialist will contact you within 2 working days of application d e. If you need further information or assistance please call 828-466-7291 MINIMUM SETBACKS FRONT: 30 SIDE: 15 REAR: 30 MAX HEIGHT: FEENAME DATE FEE AMOUNT Authorization to Construct (Repair) Fee 07/12/2012 5300.00 TOTAL FEES $300.00 CHANGE WORK ORDER REQUIRING REDESIGN AND/OR RETRIP WILL INCURE AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) 1.9 - �happlicatiori 07/12/2012 14:01 Page 1 of 3 A THIS IS NOT A PERMIT ;? CATAWBA COUNTY HEALTH DEPARTMENT Y Application for Environmental Services Page I Ig 2 „a 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 Property Address I X46 '5q' W Driving Directions to Property New Construction ❑ Existing Facility ❑ ,4vG ME Subdivision ze&o/ Lot# Section/Block/Phase NAME TO APPEAR ON PERMIT? ❑ Owner ❑ Applicant ❑ Contractor Applicant Contact Information Name �lc_ A4 Address 4 1 I v C.-,ti-��r `U� • `� f `-fes v; 11 Alc 7( -7 Acres Z . Z Zo Phone -10 -/ - g 7g .- (o 61& I Cell Phone -7 a� Owner Contact Information Name Address I /4(, 54"' ��v�_. !VZE /bicl/V C— Z8&c> Phone Cell Phone B' Zg Contractor Contact Information Name 5+�Jesv,lie Poo/ _,,/�, T. 4. /_�-1�� IVx . iso/ G-�+�' Address y-(1 L ,air 6rf-, �/; /�e , / G Z fi %i Phone '70c/ - t37g_-(o6 9,7 Cell Phone -7p c./ -(�FpZ -7 c> WHO WILL BE THE PRIMARY CONTACT? ❑ Owner © Applicant ❑ Contractor Description of Existing Structures on Siteosa� # of Bedrooms *j" 3 Structure Dimensions # of Occupants Basement ❑ Yes ❑ No Basement Fixtures ❑ Yes ❑ No Planned Future Additions or Improvements (Building Permit NOT requested at this time) Describe Proposed Future Structure Dimensions # of Bedrooms *f 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 ** Rr 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 E"County/City/Township Water Line KI WOULD LIKE TO SCHEDULE A COMBINED FLAGGING AND SOIL EVALUATION (SEE COMBINED EVALUATION PROCEDUES) .a�A THIS IS NOT A PERMIT 2 CATAWBA COUNTY HEALTH DEPARTMENT ®� Application for Environmental Services Page 2 1842 tiu Proposed Facility Type ❑ Primary Residence ❑ New Residence ❑ Addition to Residence # of New Bedrooms *t Project Description Structure Dimensions Basement ❑ Yes ❑ No # of Occupants Basement Fixtures ❑ Yes ❑ No ❑ Accessory Structure(s) Describe A k) �IMk^ % ��� # of New Bedrooms * I if applicable Structure Dimensions 5 Zvi Zo'X Lto # of Occupants Accessory Dwelling ❑ Yes [—]No Plumbing ❑ Yes ❑ No Describe Plumbing Needed ❑ Multi -Family Residence # Units #Bedrooms per Unit* f Total # Bedrooms *f 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. 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) 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. 1 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 Authorization to Construct issued by this department is valid for (5) five years from the date issued and is ferable Signature of Owner or Agent %.G6" Printed Name of Owner or Agent -De le -L Date 7—/Z—/Z Print Parcel Map and Report Page 1 of 3 � �� 0 Search 106.31 Z3r.a V 7.4''1'3 31Ey57 {� x.5.3 0452 'ti 3435 33 319„4 6 727L' 587:X5 zs 7 7.35 291 0345 100.72 .� 145.•421 8 ,f r` 13291 �3'��50 �"� 3 413. 0147 9072 4 23.3 7- ' 329. 4 1\6 0 JZo'�40' P. / mow.:In .95 1 17 A Parcel Summary 11 Printed Map Scale 1 inch = 128ft Parcel ID: 373511760147 JjParcel Address: 4146 54TH AV NE, HICKORY (Owner: STARNES CASSANDRA (`Address: 4146 54TH AVE NE IlCity: HICKORY MICHELLE jOwner2: WHISNANT CARRIE E JjAddress2: IlState/Zip: NC, 28601-7016 lBuilding(s) Value: $341,100 111 -and Value: $158,400 IlTotal Value: $499,500 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 http: //www. gis. catawba.nc.uslwebsite/Parce llprintMapandReport. asp?pinc=3 73 511760147... 7/12/2012 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. Selected Parcel Number: 3735-11-76-0147 1 inch = 60 feet Prepared for: Plat 64.78 �o ,f 2.22A 0147 UPo NN �bAx N1 1.30A 304`0 1� �. 38-27 �7- 8" LP 9Q t Baa�p x bis w , d THIS IS NOT A LEGAL DOCUMEN 1 �. „I y 5`Time: 9.13-20T >u, ti DME-17/13/2012r"@aAM CATAWBA COUNTY NC - Parcel Report Information Regarding Selected Parcel(s) Parcel ID: 3735-11-76-0147 Name: STARNES CASSANDRA MICHELLE Name2: WHISNANT CARRIE E Address: 4146 54TH AVE NE Address2: City: HICKORY State: NC Zip: 28601-7016 Account: 210787 Calc Acreage: 2.22 Tax Map: 0218 01009 LRK: 22203 Deed Book: 2835 Deed Page: 1844 Subdivision Name: Subdivision Block: Lots: 1 Plat Book: 64 Plat Page: 78 Building Number: 4146 Street Name: 54TH AV NE Site Zip: 28601 Township: CLINES Fire Code: ST. STEPHENS City Code: COUNTY State Road: 1652 Total Bldgs Value: $341,100 Land Value: $158,400 Total Value: $499,500 Year Built: 2002 Year Remodeled: Last Sale Date: Last Sale Amount: Neighborhood: 58 Watershed: Watershed Split: Voter Precinct: P33 E911 District: COUNTY Zoning: R-40 Zoning2: Zoning3: Zoning Split: N Zoning Overlay: CRC-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: SNOW CREEK Middle School: ARNDT High School: ST STEPHENS School Split: NO P&Z Case Number: Census Tract 2010: 010301 Census Block 2010: 1000 Small Area Plan: ST STEPHENS/OXFORD Agricultural District: Printed: Friday, July 13, 2012 09:13 AM A CATAWBA COUNTY HEALTH DEPARTMENT /' v Telephorte {828) 465-88270n TDD (828) 465-8200 WLS # 6.3 l `i 1 IP L/ Rpr„Prmt. Opr� Prmt. Sys Type Well Prmt. Replacement Well Well Rpr Print. Owner/Agent (r, -e n -e i v% ,P Phone 7� /y (a Address, . _S (M) /1 (� �+%L Subdivision G S�rrh��t JS'1/•'� n tn': C, rf.A&A SecttoJi/Block/Phase Loth Lot Size _ `7 Directions / Property Address / `/ �Syf� G�t (L6,24 Facility: House V Mobile Home Business Multi-fanuly Other: Pin Number 7;�7 5/ J % b6 A/ 7 Other Zomng Approval # # Bedrooms rj' # Seats # Employees Application Ratef 3 GPD Flow X60 Hot Tub or Spa yes/no Special Fixtures Basement yes/no 100% Repair Area/no Basement Plumbing yes/no�r -�� Water Supply- Private Well Public Semi -Public Type of System. Trench Beds Pum Pump/Panel Panel LPP Other Septic Tank Size /00() Pump Tank Size Nitrification Field: Total Square Feet /'J06 Depth of Stone Bed Size Tre h Width lj z 3 j Total Length of All Trenches 160 Number of Trenches g —� _ Feet on Center Depp-__'% t Distance of Nearest Well — Trench Len tlt.�� -3'�� 7� d � Maximum Trench De *DO NOT INSTALL SEPTIC WHEN WET*% *WZLL RECORD REPVJRED AT COMPLETION* Topo 6—lb % Slope Texture Structure Clay Min. Soil Wetness`! 4(+ " Soil Depth ,3 %7" " Restric Hoz. at i % �(�QJ Available space e /no Overall Class S U Comments �_ e ti _ ` /J • ` IV -6_1\Pc _- i a6 �tot Filter Required Riser required when tank is more than 6 inches deep. `tj�� **NO GUARANTEE OR WARRANTY IS IMPLIED OR GIVEN AS TO THE Pte® R LLT'H OF TIME THIS SYS EM WILL FUNCTION** *Improvement Permit has no expiration date and is transferable, but may be revoked if site plans or intend e s- changes for the proposed facility An Authorization to Construct is valid for (5) five years from date issued and is not transferable. Well rmit 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 De artment before any portion of the installation is put into use. The siting of the well by the Health Department staff is to provide protectio rom known possible sources of contamination. No volume of 1 water is guaranteed t any site by the Health Department. Permit Date A /5— oZ EHS Owner/AgSeptic Tank Installed By /L.f A --L �'`.l . t wd— ° Datey /0.0L, EHS ,,�. eeF-> Well Installed By Well Grout Approval Date Well Head Approval Date Date Sample Collected Date of Results Results EHS White Office Yellow Owner/Aunt - Pink Building Inspection Authorization to Construct