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Home My WebLink AboutRBPR-07-2013-17614.TIFTHIS IS NOT A PERMIT Case # RBPR-07-2013-17614 CATAWBA COUNTY HEALTH DEPARTMENT PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES Residential Building Plan Review - Swimming Pool IMPROVEMENT Applicant DIANNA HAYNES, 1895 KINGS GRANT CT, NEWTON NC 28658 H:8282446564 H0N4E:8282446564 Owner DIXON CONSTRUCTION INC, 1706 BRENTWOOD DR, NEWTON NC 28658-3611 NAME TO APPEAR ON PERMIT Dianna Haynes SITE ADDRESS: 1895 KINGS GRANT DR, NEWTON NC 28658 PIN # 363813047952 NAME of SUBDIVISION: KINGS GRANT PH 3 Lot N 26 Section/Block PROPERTY SIZE: Square Feet 15,681.60 Acres 036 DIRECTIONS: Startown Rd, past Elem School, and Startown Fire Dept, left Into Kings Grant, go straight until you come to curve, turn right, house Is on the right PRIMARY CONTACT: Applicant SEWERTYPE: Septic Tank GALLONS PER DAY: 360 WATER SUPPLY : Public Water DESCRIBE WORK: 20x48 above ground pool SITE INFORMATION Do any of the following apply to the property for which this application is applied? If the answer to any of the questions below is "YES', then supporting documentation Is required Does this site contain any jurisdictional wetlands? No Does this site contain any existing wastewater systems? Yes Is any of the wastewater going to be generated on the site other than domestic sewage? No Is the site subject to approval by any other public agency? Yes Are there any easements or right-of-ways on this property? No 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: 30x60 NUMBER OF EXISTING BEDROOMS: 3 # OF OCCUPANTS: 1 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 20x48 Desired system types (Improvement Permit or Authorization to Construct) ACCEPTED ALTERNATIVE CONVENTIONAL: OTHER: INNOVATIVE: ANY. YES Other described Improvement Permits issued as a result of this information are valid for 5 years or may be non -expiring under certain specified conditions An Authorization to Construct issued by this department is valid for (5) five years from the date issued and is not transferable, Improvement Permits and Well Permits are transferrable Permits may be revoked if the information on this application, site plans or intended use changes for the proposed facility I have read this application and certify that the information provided herein is true, complete and correct Authorized county and state officials are granted right of entry to conduct necessary inspections to determine compliance with applicable laws and rules I understand that I am solely responsible for the proper identification and labeling of all property lines and corners and making the site accesible so that a complete site a aluation can be performed. Date: ` )00 Signature of Applicant or Agent _r),t,!?�y'Vra— R Al An Environmental Flealth Specialist gill contact you within 2 working days of apphcatin, ate. If you need further information or assistance please call 828-466-7291 AREA1 MINIMUM SETBACKS FROM` SIDE: REAR: MAX HEIGHT: 19 - charrD, 11on 07/02/2013 16 47 Pagc I of 4 C eTe`� ]R e THIS 1S NOT A PERMIT COUNT) 1� LL , CATAWBA COUNTY HEALTH DEPARTMENT Z7oail�,,„�a. Application for Environmental Services a -e I UD 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 E:1 Existing Facility ❑ Property Address^/ %.S L r X� : �� . Subdivision Lot # Acres Section/Block/Phase i Driving Directions to Property 71+,.4 �.� — /� _ �' , p,y,� p �r�r�.l "t-- —1 X,.C_ z � 0 NAME TO APPEAR ON PERMIT? OTNVner plicant ❑ Contractor Applicant Contact Information Name��. �— Address / g Phone Owner Contact Infor}m�ation Name _A, -,I ,-. Address f) U Phone Contractor Contact Information Name Address Phone Cell Phone Cell Phone a y 2 7 y S (D C/ Cell Phone WHO WILL BE THE PRIMARY CONTACT? ❑ Owner ?D' p licant ❑ Contractor De cription of Existing Structures on Site �4n Li �—�— # of Bedrooms *j l Structure Dimensions ��(�` Kl # of Occupants Basement ❑ Yes [Zor Basement Fixtures ❑ Yes L J The Applicant shall notify the local health department upon submittal of this application if any of the following apply to the property in question. If the answer to any question is "yes", applicant must attach supporting documentation. ❑ Yes ❑ No Does the site contain any jurisdictional wetlands? "% Yes ❑ No Does the site contain any existing wastewater systems? ❑ Yes ❑ No Is any, wastewater going to be generated on the site other than domestic sewage? 'd Yes ❑ No Is the site subject to approval by any, other public agency? ❑ Yes ❑ No Are there any easements or right of ways on this property? Describe Existing water supply in use ❑ Individual Well ❑ Community Well ❑ Semi -Public Well �unty/City/Township Water Line Is a public water supply available? ** ❑ Yes ❑ No If applying for an Improvement Permit or Authorization to Construct, Please Indicate Desired System Type(s): (systems can be ranked in order of your preference) ❑ Accepted ❑ Alternative ❑ Conventional ❑ Innovative ❑ Other 0 Anv /a rff�A A THIS IS NOT A PERI7IT cLttt�1\,.1tL. ! ®lam CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services Page 2 Proposed Facility Type ❑ Primary Residence ❑ New Residence ❑ Addition to Residence # of New Bedrooms * j Project Description Structure Dimensions # of Occupants Basement ❑ Yes ❑ No Basement Fixtures ❑ Yes ❑ No Accessory Structure(s) Describe VC) C-) # of New Bedrooms *'I if applicable Structure Dimensions _ I . �� ; c e--5- 9 GS# of Occupants Accessory Dwelling ❑ Yes ❑ No s Plumbing ❑ Yes ❑ No Describe Plumbing Needed ❑ Multi -Family Residence # Units #Bedrooms per Unit* j 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 Tvpe ❑ Individual Well F-1Semi-PublicWell ❑ Community Well Abandonment Type ❑ Drilled ❑ Bored ❑ Dug ❑ Unknown Well Repair Requested [—]Yes ❑ No Describe Calculated Design Flow; Commercial -r 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. T 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. SYSTEM REDESIGN AND/OR RETRIP WILL INCUR AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) Improvement Permits issued as a result of this information are valid for 5 years or may be non -expiring under certain specified conditions. An Authorization to Construct issued by this department is valid for (5) five years from the date issued and is not transferable; Improvement Permits and Well Permits are transferrable. Permits may be revoked if the information on this application, site plans or intended use changes for the proposed facility. I have read this application and certify that the information provided herein is true, complete and correct. Authorized county and state officials are granted right of entry to conduct necessary inspections to determine compliance with applicable laws and rules. I understand that I am solely responsible for the proper identification and labeling of all property lines and comers and making the site accessible so that a complete site evaluation can be performed. j Signature of Owner or Agent / / 1,/1 N Vl —� /VEL i Date 4I. 1" Printed Name of Owner or Agent N 1 inch = 40 feet )3.90 Catawba County, North Carolina This tttah hlotlticl as lite pit ed tions the C.Itatsb, Coca II, NC, Ucospattal Info no at hili msbarn _ Cataoba County]I is made ,ibsflmnal efflnr, it erasure the accwace ..I loeamm:md labeling Iufonnation contained oo this nt,yr Catawba County pmmolcs and tcconmsuds the independent aenticutlon ofany dura colntaned,m this trap product he 0a: user The County of C',aawbs, its employees, uEcntb and pcisonnel daclamt, and shall not be held hable I, ar, mid all damages, loss or habtLn, whcth¢r direct, Indirect or consequential tchmh arises or mar arise from this map product or the use thereof br am pc15on of entuy Selected Parcel Number: 3638-13-04-7952 Prepared for: - CP70\03 1905 O00 /25 0 ' 26 27 POO 1887 \ T11 IS IS NOTA LEGAL DOC UDI ENT \ /ate: 7/2/2013 Tirne: 4:33:46 PD1 Plai is 18771 CATAWBA COUNTY NC - Parcel Report Information Regarding Selected Parcel(s) Parcel ID 3638-13-04-7952 Name DIXON CONSTRUCTION INC Name2 Address: 1706 BRENTWOOD DR Address2. City: NEWTON State: INC Zip 28658-3611 Account Calc Acreage 036 Tax Map. LRK: 902428 Deed Book: 3113 Deed Page: 1700 Subdivision Name: KINGS GRANT PH 3 Subdivision Block: Lots: 26 Plat Book: 48 Plat Page. 196 Building Number 1895 Street Name KINGS GRANT DR Site Zip: 28658 Township. NEWTON Fire Dist NEWTON RURAL City/Tax. State Road: Total Bldgs Value: $89,700 Land Value: $13,300 Total Value $103,000 Year Built: 2001 Year Remodeled: Last Sale Date. Last Sale Amount. Neighborhood. 113 Watershed Watershed Split: Voter Precinct P34 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 STARTOWN Middle School MAIDEN High School MAIDEN School Split: NO P&Z Case Number: RZ2012-05 Census Tract 2010. 011702 Census Block 2010: 2028 Small Area Plan. STARTOWN Agricultural District Printed Tuesday, July 02, 2013 04 33 PM &5U. `' DyjovL 5rol ?ocl r CATAWBA COLI'°iYflEALTH DEPARTMENT IN� 892i X r Tcicpho tc: tY2,, 46 V 1'DD (828) 465-8200 IP � AC `� Rpr�{m[. Opr res[. Sys.'Iypc-_WcllPnm.___-__Replacement II e hr Prmt. Yhon =V 7' Or ner; Agent —7,9i`t'" � v Subdivision Address 2Un J�i AI Lt L ''!!+ '�s: Seciiontl3la:kiPhas( � Lot#��r-�� 1VAhTM ._. Lot Size ,�-y Directions: t- `,-''�I4('_ �" -"}- -- (O') u�y�� _ _ _Property Address J Facility: House Mobilc Home__, Business_ Multi-taonly__ Other: Pin Number _ '� Other Zunmb Approval g %ITN 7(% CJ Tari 2-S q Bedrooms s Seats N. limployces Application Rate 5 GPD Flow ^ _6 __ Hot Tub r.- Spa ye tato `. 'rat Fixtures..--^ _ (?ase ::e:u ye ; no '_00`, Repair Area vcsr u Basement Plumbing y .bo IV:dcr Supply: Private Well Public Semi -Public_ Baseni rft lumbi r#tYr #VR(kir rtiw♦ikx+w+fi#kk+#+tst#%*w#+kik#tiiw+#t#%###k#444r##43##t+k3334frf♦##+* ZS Type of System: 'I'tench� Bed_ _ E'tnnp_ _ Purnp!I'anel___-_ Panel LPP____ Other 0 Septic Tank Size j(1QQ Pump Tank Size Nilrilicatiou Field: Total Square Feet 1-)O Depth of Stone_AJ IA 1�11. 1, '2,&451 Number of Trenches �J Bed Size Trench Width Total I.enn*th of Ail Trenches it Trench Length SC} I% t�0 i !— _ 1 -- 'teen on Crn;er_ �tasimum 'french Depth .._ Distance of Nearest Well *DO NOT INS'T'ALL SEPTIC Will,sN WET* *WELL RECORD REQUIRED AT COMPL TION# fVW4V Vii#}t#f#*+Vii##rWWi rr3W tt+Witt#++#rtRfw+%ii%r#skiwirfir##rt WWW#4Wk+#3VtWrt W#tf#trtiV V#W##V tWf###r###+#W#fii#f#tr###r## Topo //4 lope Tex este . eat _ Structure Clay Min. Soil Wetness Soil Depth_ " Restric. Hoz. atm""' ' Available space ro Overall Class }�j}C Continents: L.j ( N✓t � i i5S Say 1;01 —)Of 2' O/ Gd U4 C,� I yo f Filter Required t Riser required when f tank is more than 6 (/ : 13 inches deep. i **NO GUAR.AN'I'I E OR WARRANTY IS IMPLIED OR GIVEV AS TO `l HE PLRPORMr ,'CE OR LENGTH OF'1'IME THIS SYSTEM WILL FUNCTION** :tWVVrWf#fi##kiMV#i++wk#4+*#+++k+thrth+k%fWr#+f Maar##ti4it#*atit+trtf44V+tf#V Vrtrt++rt##Vr3W+M+r4+##########f VrtWt##ttk V#rtV%fV *Improvement Permit has no expiration dale and is transferable, bill 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 ch:mge. Well location, installation, and protection must meet state and local regulations, and must be inspected and approved by a represenmlivc of the Catawba Ccnmty Health Department before any portion of the installation is put into use. The siting of the welt by the Health Department stall' is to provide protection from knovv9 passible sources of contamination. No volume of water is guaran cd at any site by c Health Department. Permit Date k lj _/ / EH!i `• f>�t�'\ , Owner/A c (�>^.�---- Septic Tank Ir .a' Br y,� ,..,,., _ Date�D EHS Well Installed By Well Grout Approval Date Vde!i ea �prot•al Date ✓ i)ace Sample Cef:ectal Date of Results Results EHS l hu" - Oiiicc Blue - Bue6eig lrsrL' uon Operation fccnii yellm.o -