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Home My WebLink AboutRBPR-07-2012-16022.TIFTHIS IS NOT A PERMIT Case # RBPR-07-2012-16022 CATAWBA COUNTY HEALTH DEPARTMENT PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES Residential Building Plan Review - Deck/Porch IMPROVEMENT Contractor TIERNEY CUSTOM HOMES, INC., 4720 TRAILS END RD, DENVER NC 28037- B:(704)489-1714 Owner SEAN GRAY, 5996 TAURUS DR, DENVER NC 28037-7658 NAME TO APPEAR ON PERMIT Sean Gray SITE ADDRESS: 5996 TAURUS DR, DENVER NC 28037 PIN # 368616925524 NAME of SUBDIVISION: STONECROFT PH 6 Lot # 88 Section/Block PROPERTY SIZE: Square Feet Acres 0.67 DIRECTIONS: Hwy 16 South / Left on Grassy Creek / Left on Sagitaruios on Coner of Taurus PRIMARY CONTACT: Contractor SEWER TYPE: Septic Tank GALLONS PER DAY: WATER SUPPLY: Private Well Public water is ""NOT" available for this property. DESCRIBE WORK: Adding 15 x 30 covered / Screen unheated Cover over New Slab Patio APPLICATION FOR: Existing Structure STRUCTURE TYPE: PRIMARY RESIDENCE FACILITY TYPE: Single Family Residence OTHER DESCRIPTION: DESCRIPTION OF House EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: 50 x 60 NUMBER OF EXISTING BEDROOMS: 3 PROPERTY EASEMENTS: none NEW STRUCTURE DIM:: 30 x 15 BASEMENT? No # OF OCCUPANTS: 2 PROPOSED CONSTRUCTION BASEMENT FIXTURES? No PLUMBING REQUIRED? No 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 lans or int nded use changes for the proposed facility. A Well Permit and Authorization to Construct issued by this department is valid for (5) fi ye rs fro he date issued and is not transferable. Note: You must obtain "Zoning Approval prior to locating a home or structure on this prop y . ny r esentation by you of house or structure locatiot shoul conform to applicable setbacks. a Date: kj ,/ZU / z 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 DATE FEE AMOUNT Improvement Permit (Existing) Fee 07/23/2012 $90.00 TOTAL FEES $90.00 CHANGE WORK ORDER REQUIRING REDESIGN AND/OR RETRIP WILL INCURE AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) [:1- chappliiaiu n 07/23/2012 13:14 Page 1 of 3 THIS IS NOT A PERMIT CATAWBA COUNTY HEALTH DEPARTMENT �c Application for Environmental Services Page I l8 4.2 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 Subdivision Lot # Acres S tionB o hase Driving Directions to Property `kS ��"T : �l Ca2,redL ® �tc..ES NAME TO APPEAR ON PERMIT? [Owner ❑ Applicant ❑ Contractor Applicant Contact Information / ' Name Address Phone Cell Phone Owner Contact Infar tion Name ,_��ftyj � ` /�ev Address Phone Vy1_ Cell Phone Contractor Contact Inf��majion Name 7_—jewel 61om �#*nP.S , Address,.h_,10 /e_ 5 /_— i JUAM&L A C -�LF03 T" Cell Phone WHO WILL BE THE PRIMARY CONTACT? ❑ Owner ❑ Applicant VContractor Description of Existing Structures on Site # of Bedrooms *f 3 Structure Dimensions 59 J( `P d r # of Occupants a Basement ❑ Yes � No Basement Fixtures El Yes Z No Planned Future Additions or Improvements (Building Permit NOT requested at this time) Describe Proposed Future Structure Dimensions # of Bedrooms * j 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 **Yes ❑ No Check type available ❑ CommunityWell F-1 Semi -Public Well County/City/Township Water Line Existing water supply in use Individual Well ❑ Community Well ❑ Semi -Public Well PYCounty/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 Application for Environmental Services Page 2 1842 �a 5 Proposed Facility Type ❑ Primary Residence ❑ New Residence � ® Addition to Residence # of New Bedrooms Project Description L� { o � �� 1'I' Structure Dimensions Sox i S # of Occupants D Basement ❑ Yes ®No Basement Fixtures ❑ Yes Z No ❑ Accessory Structure(s) Describe # of New Bedrooms *'I 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 *-I'- 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 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. j 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 evaluatio purposes. [certify the above information to be correct and understand that an Improvement Permit issued as a resu thi information is valid for 5 years or may be non -expiring under certain specified conditions. Improvement Perini and 11 Permits are transferrable, but may be revoked if this information, site plans or intended use changes for the pr, cility. An AN"orization to Construct issued by this department is valid for (5) five years from the date issued anot arable Signature of Owner or Agent [/U Printed Na e o Owner or Agent Date � 3 �o 12 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 JA or consequential which arises or may arise from this map product or the use thereof by any person or entity. Selected Parcel Number: 3686-16-92-5524 1 inch = 60 feet Prepared for: ED 6' R40 0*1 00 �a5 � o cs r ' o0 0 774"1 R-40 89 4697 0" r- 00 87 �a5 00 3630o 'o ®TPAo 00 0 88 1 X373 i` 5524 231.38 TAURUS � ' ` 25 � R-40 85 106.59 J� 00 CO X -D R-40 3345 M N G) N � � 78 4372 6323 � Plat 67-90 Plat 58-179 'y &g�nti 76 �. THIS IS NOTA LEGAL DOCUMENT 77 D:4te: 7!23/2012 Time: 1:16:10 PM CATAWBA COUNTY NC - Parcel Report Information Regarding Selected Parcel(s) Parcel ID: 3686-16-92-5524 Name: GRAY SEAN C Name2: GRAY KASSANDRA Address: 5996 TAURUS DR Address2: City: DENVER State: NC Zip: 28037-7658 Account: 198125 Calc Acreage: 0.67 Tax Map: LRK: 802391 Deed Book: 2625 Deed Page: 0864 Subdivision Name: STONECROFT PH 6 Subdivision Block: Lots: 88 Plat Book: 58 Plat Page: 179 Building Number: 5996 Street Name: TAURUS DR Site Zip: 28037 Township: MOUNTAIN CREEK Fire Code: SHERRILLS FORD City Code: COUNTY State Road: Total Bldgs Value: $288,700 Land Value: $27,400 Total Value: $316,100 Year Built: 2004 Year Remodeled: Last Sale Date: 11/30/2004 Last Sale Amount: $272,000 Neighborhood: 129 Watershed: WS-IV Protected Area Watershed Split: NO Voter Precinct: P41 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: BALLS CREEK Middle School: MILL CREEK High School: BANDYS School Split: NO P&Z Case Number: Census Tract 2010: 011504 Census Block 2010: 4051 Small Area Plan: SHERRILLS FORD Agricultural District: Printed: Monday, July 23, 2012 01:16 PM It ATAWISA COUNTY HEALTH DEPARTMENT ` Telephone:.(828) 465-8270 TDD: (828) 465-8200 WLS # Z003 o 13 0'i f Improvement Permit V""AC V" Repair Permit._ Operation Permit. V - System Type Well Permit. Replacement Well 4 Owner/Agent Phone Address '00 ,�,,, '��%�%L Subdivision t v; (I�_ %1L •2$11—) Section/Block/Phase Lot# Lot Size 0, 6 Directions: (� d" [ ,tom J .r I S l7 / L� ,,� Ci •; rr Ln.a��t Lt OA ,Sc ,` fl a'r 11iJ f- -V la t an ra ti rwr ! Lr -f l a fi Dm A1-. —� r Property Address 5 - Facility: Facility: House Mobile Home Business Multi -family Other: Pin Number J' 3a>; b / i q 73 '-fS'9 —p41 VIC Other . Zoning Approval # # Bedrooms # Seats # Employees . Application Rate 0, ZS- GPD Flow Hot Tub or Spa yes/no Special Fixtures Basement yes/pls . 100% Repair Area &/no Basement Plumbing yes( Water Supply: Private Well Public I-' Semi -Public Type of System: Trench i,,"- Bed Pump Pump/Panel Panel LPP Other 2.�• U/!) Septic Tank Size ( 0 U J Pump Tank Size Nitrification Field: Total Square Feet f 0 •)-3 Depth of Stone ' Bed Size Trench Width 3 (, Total Length of All Trenches 34�t 2 Number of Trenches -- Trench Length'/ 1 /! / D //_ Feet on Center Maximum Trench Depth .� � 'l Distance of Nearest Well /v0'` *DO NOT INSTALL SEPTIC WHEN WET* *WELL RECORDE, QUIRED AT COMPLETION* Topo 7 % Slope 1 ig,y t Texture C I, - Structure raj, 1 Clay Min. Soil Wetness 1 �, Soil Depth LI'L 1 Restric. Hoz, at_"x Available space AR/no 1 Overall Class So IJ Comments: I C1 I � � Filter Required Riser required when 1 - frJ� �f��ari f� i,'kc'r tank is more than 6 1 -J {ro nn JvJJt inches deep. I - I Uur r. any to y tl. **NO GUARANTEE OR WARRANTI IS IMPLIED OR GIVEN AS TO THE PERFORMANCE OR LENGTH OF TIM12 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 health Department. Permit Date e S'- If - Oq EHS -,,Owner/Agent, %� Septic Tank Installed By („rv.r%i AM6.7-IJ Date `/- (.y -a4 EHS WZ�.r't� �jn Well Installed By Well Grout Approval Date Well Head Approval Date yDate Sample Collected A Date of Results Results EHS 14* White - Office Yellow - Owner/Agent Pink - Building Inspection Authorization to Construct