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Home My WebLink AboutRBPR-07-2013-17630.TIFOwner THIS IS NOT A PERMIT Case # RBPR-07-2013-17630 CATAWBA COUNTY HEALTH DEPARTMENT PLAN REVIEW APPLICATION FOR ENVIRONIN4ENTAL SERVICES Residential Building Plan Review - Building New IMPROVEMENT - AUTH CONST - NEW WELL GRIN GETER, 4905 HENLEY RD, MAIDEN NC 28650 1-1:8284288381 0:8282388798 FIOME:8284288381 NAME TO APPEAR ON PERMIT Erin Geter SITE ADDRESS: 4253 FRANCIS LN, MAIDEN NC 28650 PIN # 366703104562 NAME of SUBDIVISION: Loth 14 Section/Block PROPERTY SIZE: Square Peet .Acres 1 32 DIRECTIONS: Hwy 16S/righ ton Buffalo Shoals Rd/right on Davis Rd/1st Street on left/lot will be on the right PRIMARY CONTACT: Owner SEWER TYPE: Septic Tank GALLONS PER DAY: 480 WATER SUPPLY: Private Well DESCRIBE WORK: New 60 x 70 home with 4 bedrooms 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? No 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? APPLICATION FOR: STRUCTURE TYPE: FACILITY TYPE: Single Family Residence DESCRIPTION OF none EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: NUMBER OF EXISTING BEDROOMS: 0 NEW STRUCTURE DIM:: 60 x 70 # OF NEW BEDROOMS:: 4 New Structure PRIMARY RESIDENCE OTHER DESCRIPTION: # OF OCCUPANTS: 3 PROPOSED CONSTRUCTION BASEMENT? No BASEMENT FIXTURES? No PLUMBING REQUIRED? Yes Desired system types (Improvement Permit or Authorization to Construct)' ACCEPTEDALTERNATIVE CONVENTIONAL. OTHER INNOVATIVE: ANY: YES Other described APPLICATION FOR WELL CONSTRUCTION PROPOSED WELL TYPE: Individual Well REPLACE WELL?: NO 19 - ehappl":,1um 07/08/2013 12 00 Paee I of cATA��'RA COUNT Y Case r RBPR-07-20IJ-17630 (A:1D8PJ Public health Department Subdivision Environmental Health Division PINS 366703104562 PO Bos 389. 100-A Southwest Blvd. Newton. NC 28658 NAME ON PERMIT: ERIN GETER. 4905 HENLEY RD, MAIDEN NC 28650 Site Address: 4253 FRANCIS LN, MAIDEN NC 28650 Property Size: Square Peet Acres 1 32 Directions: Hwy 16S/righ ton Buffalo Shoals Rd/right on Davis Rd/l st Street on left/lot will be on the right Improvement Permits issued as a result of this information are valid for 5 years or may be non-expuing 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 Iabeli g of all property lines and corners and making the site accesarb{d so that a co ate 91(e evaluation n can be performed. Date. `% /f?S / � Signature of Applicant or Agent a/712?4 ` !� AA 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 Authorization to Construct Fee (New/Expansion) 07/08/2013 5300.00 Fee Improvement Permit Fee Well Permit & Inspection Fee TOTAL FEES 07/08/2013 S15000 07/08/2013 $30000 $70.00 SYSTEM REDESIGN AND/OR RETRIP WILL INCUR AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) 1 9 - chopplicauon 17/08/2013 12 00 Page 2 of CATAWBA THIS IS NOT A PERMIT couxn' CATAWBA COUNTY HEALTH DEPARTMENT moo, Application for Environmental Services Page 1 Improvement Permit [Authorization to Const ct Septic Repair ❑ Septic Malfunction ❑ Septic Expansion E:1 New Well Permil,� Replacement Well ❑ Well Abandonment ❑ Well Repair ❑ Existing System Inspection (Pre -Approval Required) ❑ Application is for New Construction ❑ Existing Facility E:1Property Address4a53 '_ruri+a 3 l�t.r,a, Subdivision UC0'( FGl✓!t-\S YY�a,c� t h l rvc Q%(t o Lot # Acres Section/Block/Phase Driving Directions to Property O -V J i NAME TO APPEAR ON PERMIT? ❑ Owner [9 -Applicant ❑ Contractor Applicant Contact Information Name E ri(\ C Address LJ4305 Phone ate` y�8 $32P1 Owner Contact Information Name Address Phone Contractor Contact Information Name Address vv a t YAC acdLo� Cell Phone Dz�_ -!N15y Cell Phone Phone Cell Phone WHO WILL BE THE PRIMARY CONTACT? ❑ Owner d2Applicant ❑ Contractor Description of Existing Structures on Site Y-\ (D . e— # of Bedrooms *j Structure Dimensions{ # of Occupants _ Basement ❑ Yes No Basement Fixtures ❑ Yes ^ No 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 �Klo Does the site contain anyjurisdictional wetlands? ❑ Yes 12'xTo Does the site contain any existing wastewater systems? ❑ Yes ®No Is any wastewater going to be generated on the site other than domestic sewa_e? 10 Yes fCo Is the site subject to approval by any other public agency? ❑ Yes D -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 �is/ ❑ County/City/Township Water Line Is a public water supply available? ** ❑ Yes Eo 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 11 Innovative ❑ Other `-CJ Any C A TA 7BA "CHIS IS NOT A PERMIT c orcoti 9 L7 CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services Page 2 Pro used Facility Type Primary Residence [?/New Residence ❑ Addition to Residence # of New Bedrooms * j Project Description re s , c�eyl c e_ CO-�S�ZAc-'i"lb it Structure Dimensions 1,eo X —7Q # of Occupants 3 Basement ❑ Yes 0 No Basement Fixtures ❑ Yes �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 Total # Bedrooms *T ❑ Food Service Specify Type #Bedrooms per Unit* T Structure Dimensions # 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 ❑ Senii-Public Well ❑ Community Fell 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 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. 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. 1 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. Signature of Owner or Agent ,�y( J_ C /&— Date Printed Name of Owner or Agent (, Vjn A 1 inch = 80 feet Catawba County, North Carolina This map product was prepared from the Catawba Counts, NC, (Ieuspanal Infotmatmn Svstem Catawba Coumo has made substantial effum, to ensure the accuires of location and labeling mfomtation contained on thu map Cmaeba County promotes and recommends the independent verification ofanv dura contained on this map product by ihr user Thu Count, of Caia, ba, its employees, agents and personnel disclaim, and shall not be held I ble for anv and all damages, loss or Habil uy, whether dn,"I, indirect or consequential whWi arises or mev arise from this map product or the use thereof by any perwri or entry Selected Parcel Number: 3667-03-10-4562 Prepared for: PI14 t\48-65 6 5629.- 1.32A 4562 405 7 4233 7518' 20 ��>>2 �3 22.12 4 _ O 5 Fo, 1 i-425`9 �✓� S 0 53 7A 150.69 0 00 9 0� 1.07 15 a2%� �0 THIS IS NOT A LEGAL DOCUNIFNT Date: 7/8/21113 /1.010- 72104i 12 6j Time: 11:14:38AM CATAWBA COUNTY NC - Parcel Report Information Regarding Selected Parcel(s) Parcel ID, 3667-03-10-4562 Name , GETER ERIN FELTS Name2 Address 4905 HENLEY RD Address2 City: MAIDEN State NC Zip. 28650-9614 Account Calc Acreage: 1 32 Tax Map. LRK. 200825 Deed Book 3171 Deed Page: 0055 Subdivision Name: Subdivision Block' Lots: 14 Plat Book. 48 Plat Page 65 Building Number 4253 Street Name FRANCIS LN Site Zip' 28650 Township. CALDWELL Fire Dist. BANDYS Crty/Tax: State Road Total Bldgs Value: Land Value' $18,500 Total Value, $18,500 Year Built' Year Remodeled. Last Sale Date: 2/6/2013 Last Sale Amount' $19,500 Neighborhood 113 Watershed. WS-II Protected Area Watershed Split. NO Voter Precinct' P9 E911 District. COUNTY Zoning: R-40 Zoning2' Zoning3 Zoning Split N Zoning Overlay WP-0 Zoning District COUNTY Split Zoning Dist N Split Zoning Dist(l) 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: 011602 Census Block 2010 5032 Small Area Plan BALLS CREEK Agricultural District Printed, Monday, July 08, 2013 11'14 AM IMPROVEMENT- PERMIT " "y" " "" Catawba County Public Health Department CDP File Number 3 1 8 9 4 Environmental Health Division County ID Number: WLS2009-00257 P.O Box 389, 100-A Southwest Blvd Evaluated For NEW Newton NC 28658 PERMIT VALID UNTIL 05/20/2014 Phone: (828)-465-8270 Fax: (828) 465-8276 *NOTE TO INSPECTIONS DIVISION: Building Permits cannot be issued with this Improvement Permit. Applicant: JOHN C RICHARDSON /�Property Owner: DALE FARMS INC Address: 3952 PEACH ST Address: 4193 DAVIS RD City: NEWTON City: MAIDEN State)Zip: NC 28658 State/Zip: NC 28650-912 \ Phone #: Phone #: PfODerty Location & Site Information /'Address/Road #: Subdivision: Phase: 4253 FRANCIS LN MAIDEN NC Structure: SINGLE FAMILY # of Bedrooms: 4 # of People: 'Water Supply: NEW WELL Lot: 14 Directions HWY 16 E/ RT ON BUFFALO SHOALS RD / GO APPROX 3 MILES/ RT ON DAVIS RD/ 1ST ST TO LEFT / LOT WILL BE ON THE RIGHT Svstem Specifications /Initial Svstem / Site Classification: PS Design Flow: 4 8 0 Soil Application Rate: 0 3 -System Classification/Description: TYPE 111 G OTHER NON-CONV. TRENCH SYSTEMS Minimum Trench Depth: Maximum Trench Depth: Septic Tank: 1 -Piece: Pump Required: Pump Tank: / Inches - Inches 1 a 0 0 Gallons OYes QNo OYes 4 N ()May Be Required Gallons 'Proposed System: 25% REDUCTION \ 1 -Piece: OYes QNo Repair System Required•QYes ONo ONO, but has Available Space Repair Svstem h 'Site Classification: PS Minimum Trench Dept . Inches Soil Application Rate: 0 3 Maximum Trench Depth: Inches 'System Classification/Description: Pump Required. (gYes QNo 0 May be Required TYPE IV A ANY SYSTEM WITH LPP DISTRIBUTION Pump Tank: Gallons 'Proposed System: 50% REDUCTION Page 1 of 3 CDP File Number ""c' County ID Number: *Site Modifications ❑ Open Fill Sheet No grading or construction activity is allowed in areas designated for system and repair without approval of Health Department. *Permit Conditions The issuance of this permit by the Health Department in no way guarantees the issuance of other permits. The permit holder is responsible for checking with appropriate governing bodies in meeting their requirements. The Improvement Permit shall be valid for years from date of issue with a site plan (means a drawing not necessarily drawn to Site Plan scale that shows the existing and proposed property lines with dimensions, the location of the facility and appurtenances, the 0 site for the proposed Wastewater system, and the location of water supplies and surface waters) Plat The Improvement Permit shall be valid without expiration with plat (means a property surveyed prepared bya registered land surveyor, drawn to a scale of one inch equals no more than 60 feet, that Includes: the specific location of the proposed facility O and appurtenances, the site forthe proposed Wastewater system, and the location of water supplies and surface waters. Plat also means, for subdivision lots approved by the local planning authority and recorded with the countyreglster of deeds, a copy of the recorded subdivisions plat that is accompanied by a site plan that Is drawn to scale). The Department and Local Health Department may Impose conditions on the issuance and may revoke the permits forfailure of the system to satisfythe conditions, the rules, orthis article. This permit is subject to revocation if the site plan, plat, orintended use changes (NCGS 13DA-335(f)). The person owning or controlling the system shall be responsible forassurfng compliance with the laws, rules, and permit conditions regarding system location, installation, operation, maintenance, monitoring, reporting, and repair (.1939(b)). Applicant/Legal Reps. Signature Required? Oyes ONO Applicant/Legal Reps. Signature %%le_�� — nate: S / Z Z / 09 *Issued By: 2246• Megan McBride Date of Issue: 0 5 / a 0 / a 0 0 9 Authorized State Agent: OValid without Expiration? 0Hand Drawing ®Import Drawing **Site Plan/Drawing attached."* TotalTlme:(HH:MM) 0 0 Hours 0 0 Minutes Page 2 of 3 31 894 WLS2009-00257 CDP File Number: County File Number: Drawing Type: Improvement Permit Date: 0 5 0/ ;2 0 0 9 Click below to Import an image from an external location: � ThIS �evml1i� �5 n�i Intended {vr �('p}iG I�$IGi1R'iloY�ff i notriJP rlodP C.�, 0( 6VE'Y �f A( 4ec?. FrAh(15 Lu''e ,1�c Page 3 of 3 rID 1 IS' —f hl'�L'il li 0 Pool ri „l. ' ARH , • '• •t ��' ,zu pnQrNc"��i�^� pRa l� / r ' / N AP rox Areh FrAh(15 Lu''e ,1�c Page 3 of 3 a NCDENR Division of Environmental Health On -Site Wastewater Section 'Owner DALE FARMS INC Proposed Design Flow (.1949) Property Size 1.39 1940 Horizon Profile# Landscape Depth POS Slope % (IN) t L 0.9 4 % 9.42 GPS Saprolite (in) EHS Megan McBri 1 L I 0-9 4 % 19.45 CPS Saprohte(in) 4 8 0 Location of Site 4253 FRANCIS LN EHS COPIArof loI Megcn McBri, ��II 3 L 10.9 .1941 4 % 9.48 GPS Saprohte(in) Texture Structure Consistence Color Color SL 2 -Mod, sbk fir ss sp I EHS CL Cop'01110 Mager, MaBri, k o� GPS Saprohte (in) a EHS Cop yiohle % S I 'Date: 0 5/ 1 5/ .1 0 0 9 GPS apro ite(in) 1944 Rest �u Horizon 947 Class EHS Cop ¢Pro81e Profile 1 LTAR ,_, Available Space (.1945) PS Other Factors(.1946) PS Site Classification (.1948) Ps Initial LTAR: 0 . 3 Repair LTAR: 0 . 3 Others Present: Comments: All profiles had slight mottling (not redox.) that decreased with depth. This could have possllby come from compaction clue to past farming, Evaluated By: Megcn Mcarida ps ps ps Soil/Site Evaluation *File #: 3 1 8 9 4 For On -Site Wastewater System PIN #: WLS2009-00257 Proposed Facility SINGLE FAMILY 4 8 0 Location of Site 4253 FRANCIS LN Water Supply NEW WELL Evaluation Method Pit SOIL MORPHOLOGY .1941 Other Profile Mineralogy Matrix Mottle Factors Texture Structure Consistence Color Color SL 2 -Mod, sbk fir ss sp I 1942 Wet CL 2-1 sbk fir ss sp I .1943 Depth 4 2 1944 Rest Horrzon 1947 Class ps Prohle 3 0 LTAR . SL 2 -Mod, sbk fir ss sp 1942 Wet CL 2-1 sbk fir as sp 1943 Depth 4 5 W W4 Rest. rrzon .1947 Class Ps Profile 0 3 LTAR — SL 2 -Mod, sbk fir ss sp 1942 Wet CL 2 -Mod- sbk fir $s sp 1943 Depth 4 8 19H44 Rest onzon 1947 Class Ps Profile 0 3 LTAR 1942 Wet 1943 Depth v 1944 Rest Horizon 1947 Class profile LTAR _ 1942 Wet 1943 Depth GPS apro ite(in) 1944 Rest �u Horizon 947 Class EHS Cop ¢Pro81e Profile 1 LTAR ,_, Available Space (.1945) PS Other Factors(.1946) PS Site Classification (.1948) Ps Initial LTAR: 0 . 3 Repair LTAR: 0 . 3 Others Present: Comments: All profiles had slight mottling (not redox.) that decreased with depth. This could have possllby come from compaction clue to past farming, Evaluated By: Megcn Mcarida ps ps ps Attach Image The "Open Drawing Form" button, opens the the drawing form. The "Import" button, attaches the drawing, or other image Into the space below. N4 �oScale Soil QJ ohiy Profile: 1 @ X _ Profile: 2 (2 X _ Profile: 3 X Profile: _ X Profile: _ Q X Profile:__ Q X— Profile: _ (a X _ Profile: _ (z X Profile' X Profile: _ X os -:'� well 0 r -Lo o' �Y0.hU4 I:j� ,), Open Drawing Form Y z Y z Y _.. z Yi— z Y z Y z Y z Y _..` _ Z Y z Y z