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Home My WebLink AboutRBPR-07-2013-17631.TIFTHIS IS NOT A PERMIT Case # R113PR-07-2013-17631 CATAWBA COUNTY HEALTH DEPARTMENT PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES Residential Building Plan Review - Building New AUTH_CONST Contractor JONATHAN TAYLOR, 7243 SIGMON PENINSULA LN, SFIERRILLS FORD NC 28673 0:7045062023 LANTERRACONSTRUC"I'IONcr,GMAIL.COM Owner DANIEL GONZALES, 3516 MCPHERSON ST, WA\HAM NC 28173 2:518-984-1808 NAME TO APPEAR ON PERMIT Daniel Gonzales SITE ADDRESS: 4691 KISER ISLAND RD, TERRELL NC 28683 PIN # 461602563072 NAME of SUBDIVISION: B L KISER Lot # 31 Sccuon/Block _ PROPERTISIZE: Square Deet Acres 0.51 DIRECTIONS: Hwy 150 E/ RIGHT KISER ISLAND RD/ LOT ON RIGHT PRIMARY CONTACT: Contractor SEWER TYPE: GALLONS PER DAY: 480 WATER SUPPLY: DESCRIBE WORK: 1 story w/ attached garage w/ unfinished walkout basement / house will be located out of flood plain 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? No APPLICATION FOR: STRUCTURE TYPE: FACILITY TYPE: Single Family Residence DESCRIPTION OF EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: NUMBER OF EXISTING BEDROOMS: New Structure PRIMARY RESIDENCE OTHER DESCRIPTION: # OF OCCUPANTS: 5 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 63 X 77 # OF NEW BEDROOMS:: 4 Desired system types (Improvement Permit or Authorization to Construct). ACCEPTED: ALTERNATIVE. OTHER INNOVATIVE: Other described: CONVENTIONAL. ANY YES 1 9- rhspph, Awn 07/08/2013 13 16 Page I of 4 C CATAWBACOUNTY CawP RBPR-07-2013-17631 Public Health Department Subdivision B L KISER '��Environmental Health Division PIN# 461602563072 PO Box 389. 100-A Southwest Blvd, Newton, NC 28658 NAME ON PERMIT: DANIEL GONZALES, 3516 MCPI IERSON ST, WAXI IAM NC 28173 Site Address: 4691 KISER ISLAND RD,'I ERRELL NC 28682 Property Size: Square feet Acres 051 Directions: Hwy 150 E/ RIGHT KISER ISLAND RD/ LOT ON RIGHT 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 arules I understand that I am solely responsible for the proper identification a/�d I behng of all property lines and corners and making the sRe acce/ssibl so th >ret si a "tion can be performed Date: '`�/ R) 1 } Signature ofAppllcant or Agent L An Environmental Health Specialist will contact you wi m 2 vvorkin�of application date. If you need further information or assistat 'e please call 828-466-7_291 AKIN MINIMUM SETBACKS FRONT: 30 SIDE: 15 FEENAME Authorization to Construct Fee (New/Expansion) Fee TOTAL FEES REAR: 30 MAX HEIGHT: DATE FEE AMOUNT 07/08/2013 S300.00 $300.00 SYSTEM REDESIGN AND/OR RETRIP WILL INCUR AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) 1 9 - A'PphCanon 07/n3/2013 13 16 Page 2 of 4 1 TI IIS IS NOT A 13ERMIT CATAWBA COUNTY HEALTH DEPARTMENT Application for P.nvtrau»ental SerPage Ivice; �,/ Improvement Permit — Authorization to Constructp/ 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 Address4691 Kiser Island Rd _ Subdivision None Terrell, NC 28682 _ _ _ Lot # 331 Acres 0.49 Section/BlocklPhase Driving Directions to Properi), From 1.77, Weston Hwy iso Lea un Kiser Island Rd Property mi on the nght hand side. i LU CLNAME. TO APPEAR ON PERtMIT^ ty i Owner Applicant Cmrtractor ❑ O Applicant Contact Informafinn — 1 U Name Dan Gonzalez _ W Address 35.16 McPherson St; Waxhaw, NC 28.173 m F� Phone ( Cell Phone 518-984-1808 jOwner Cotitact Inform_a_ti_on Name Z Address Phone , - Cell Phone Contractor Contact Information L&j Name -f�, '�✓1 C(LITI. _ Address 1 _7)'i) 5;r tlow 1 `N!J -J S rrl = Phone Cell Phone zWHO WH4, BE THE PRIMARY CONTACT? ❑ Owner Applicant Wontractol Z DescriptionbfExisting Structures on Site None Q # of Be ooms * 1 Structure Uimensimu _ # of Occupants _ 1C� Basement ❑ Yes ❑ No Basement Fixtures ❑ Yes ❑ No C Planned Putpre Additions or Improvements (Building Permit NOT requested at this time) cc Describe' 4 bed Ranch w/ Walkout Basement Proposed Future Structure Dimensions 63 h x 77 Ft # of gedroolns *t if npplicnble 4 ? Are there eafements or right-of-ways recorded on this property ❑ Yes ❑ No Descrtba 50 foot setback from the Lake Is a public viater supply available on or adjacent to the above property ** ❑ Yes W No Check type available ❑ Community Well ❑ Semi -Public Well ❑ County/City/Township Water Linc Existing water supply in use W Individual Well El Community Well ❑ Semi -Public Well ElCounty/City/Township ater Line Qy t 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'-) Proposed Facility T ype El Prima I Residence M New Residence ❑ Addition w Residence ff of New Bedroom:: *t _ Project Description 4 Bedroom Ranch w/ Walkout Basement Stricture Dimensions 63 ft x 77 h it of Occupants 4 Basement ■❑ Yes ❑ No Hasement Fixtures XYes ❑ Nr? ❑ Accestry Structure(s) Describe _. _ -_-- # of New Bedrooms *t tf applicable Structure Dimensions # of Oe:aipattts Accessory Dwelling ❑ Yes ❑ No Pitnbing ❑Yes ❑ No Describe Plumbing Needed ❑ Mu1N-t amity Residence N Units-- _ HHedrooms per IJnit*t Wal T#Bedrooms *t_ _ Structure Dimensions ❑ Food Service Specify Type ---- h Sseats Fluor Space -Entire Food Service Facility (Sq FU _ # 9mployees per Shifa _ Ji of Shifts Dating Area (Sq. Ft.) _ U Rusin ets Specific "Type of Business _ - _ Retail Floor Space _ +i Of Employees per Shin f: of 5hdts Lf Other Fae' dity Type Specify .. If ghurch # of Seats Kitchen ❑ Yes ❑ No [f Daycare Specify Occupancy Applicafioit for Well Construction/AbandenmentfRepair I Proposed Well Type ❑ Individual Well ❑ Scutt -Public Well ❑ Community well .Abandonment Type ❑ Drilled ❑ Bored ❑ Dug ❑ Unknown Well Repai7 Requested ❑ Yes ❑ No Dcscribe _ I Calculated Design Flow, Commercial f_ . _ _ Additional information may be required to determine'design now from certain facilities. ''his value will be determined during consultation with on- site staff. `Any mann that will be intended tun sleeping at the time ui'constructh, or tar future consideration should be noted as a i bedroom and counted on all applications. The number of bedrooms will be confirmed by rooms identified on house plants as a bedroom at the lime nfhuilding permit issuance. 'Phis pray prevent the need for septic system sitz increase in the future. t1f 5 structure is pI lumbed hilt no bedrooms, calculated design now is required. ** If No, n iett permit must be issued with the Authanzation to Construct. Note: You inust nbtain 7onhtg approval pour to imiuing a home of stiucturc oil this property. Any represcaration by you of house ur su'ticture locution should cunlonn to applicable scillicks W CHANGE WORK ORDER REQUIRING RED@:SIGN AND/OR RETRIP WILL INCURS AN W ADDITIONAL CHARGE (SEE FEE SCHEDULE) understain<Uthat this is a Tonna( appltwtron for Lovironinci nal tier ices and authorize Catawba County Environmental Health employees to go on this property for evaluation purpose„s. I cervfy the above information to be correct and understand (� that at Improvement Permit issued as a result of this in Rrnnanon is valid for 5 years or may be non -expiring under certain U specified co?ditions. improvement Permits and Well Permits are transtercablc. but may be revoked if this information, site plans or imuTded use changes for the proposed facility. An Authorization to Construct issued by this department is valid for (5) five years from the date is>ucd and cR not nsterabllee / Signature i f Owner or Agent Printed N4 e of Owner or Agent Date - I }?/ t -s - - -- Catawba County, North Carolina This map p(oduct was prepared Gain the Catawba County, NC, Pecs pat Infonnation System N Catawba County has etude substantial effort, to ensure (he alcaraC\ of location and labeling infonnanon on rained on (his map Catawba Comity promotes and recommends the independent verification of any Alaidata contained on this map product by the Luer The Couno, of Catawba, its employees, agents and personnel disc UP, and shall not be held Imhlc to, andant age,, and all daage,, loss or habihn, whether direct, indirect or wnseyuential which at or maN arise Gum this map product or the use thereof by any person or entnv Selected Parcel Number: 4616-02-56-3072 1 inch = 40 feet Prepared for: �\V //(I At THIS IS NOTA LEGAL DOCUMENT I 1 � /\ /\ 221.90 4691 (215) 98.38 Date: 7/8/2013 0 0 0 T. 0 0 of 0 0 Timc:,12:30:34 PM V� 4o- CATAWBA COUNTY Case N IMPV-12-1I-23921 Public Health De artmen[SubdivisionEneaonmenlal Heealth DivisionB L KISERPO Box 389, 100-A Southwest Blvd, Newton, NC 28658 Lot 4 g1 PIN4 461602563072 Applicant DAN GONZALEZ Site Address: 4691 KISER ISLAND RD, Terrell, NC Property Size: SF 049 ACRES Directions: NC 150 Ii WY, RIGHT KISER ISLAND RD, PROPERTY ON RIGHT PAST BURLEY DR Improvement Permit Facility: Primary Residence 4 Bedroom House Permit Category: New Septic Bedrooms 4 WATER SUPPLY: Private Well Basement? Yes Basement Plumbing? Yes -------------------------- -------- — ------------ ----------- --------- ------------ --------- INITIAL SYSTEM SPECIFICATIONS -------------------I——---------------- —------------ ----------------------------------------------------------- Permit Valid: Expires In Five Years: _X_ No Expiration Projected Daily Flow 480 9-p,d Proposed Wastewater System: 50% REDUCTION Type: IVA - ANY SYSTEM WITH LPP DISTRIBUTION PUMP REOUIRED ***** OPERATOR RE,OUIRED Permit Conditions: Do not grade, fill, or drive over am' part of the septic area - -----'---------------- — --------------------- ---------------------------------------------'------------ REPAIR SYSTEM SPECIFICATIONS Repair System Required? Required Proposed Wastewater System: 50% REDUCTION Type: IVA -ANY SYSTEM WITII LPP DISTRIBUTION PUMP REOUIRED ***** OPERATOR REOUIRED Landscaping or other site alterations that potentially divert groundwater or surface water toward the septic system, or prevent proper drainage away from the septic system, including the direction of gutter flows or foundation drains, is not approved, and may result in failure to approve the initial system installation, or the suspension/revocation of existing permits The issuance of this permit by the Health Department does not guarantee the issuance of other permits. It is the responsrbdrq of the applicam/propeny owner to insure that all Catawba County Planning/Zoning and Building Inspections requirements are met. This Improvement Permit is subject to revocation if the site plan, plat or the intended use changes, or if site conditions are altered. The Improvement Permit is not affected by a change in ownership of the properly. This permit was issued in compliance with the provisions of the North Carolina 'Laws and Rules for Suwane Treatment and Di.snnsa/Svsrems' (I5A NCAC I8A .1900). Neither Catawba County nor the Environmental Health Specialist warrants that the septic tank system will continue to function satisfactorily for any given period of time. Robbie Phelps 12/27/2011 AUTHORIZED S I ATF. AGENT APPROVAL DATE Permit Expiration Date 12/25/2016 Aro grading or cony(ructton activiti, is allaned in areas desrgnalec(for system and repair without approval ofthe Health Department h�A Cr1TAW13A COUNTY Permit H IMPV- 12-11-23921 �-y G Public Health Department Name Dan Gonzalez < �o� �� Environmental Health Division Address 4691 Kiser Island Rd o P h - PINg 0 Box X89, IOOA Sout west b v , Newton NC _86j8 1842 sM (828)465.8270 Fax (828)465-8276 TDD(828)465-8200 1 _ SITE PLAN _tit i IDD o fI"I G7f t c L Z:5ryf4-L� r jr " r � , 0n t1 )i • L\ tl Of N I v l� 1--1 IV ZS _ • s a, wQ u Scale ' 3 li Al Department of Environment, Health, and Natural Resources Sheet Division of Environmental Health Property ID On-site Wastewater Section Lot # SOIL/SITE EVALUATION File # for ON-SITE WASTEWATER SYSTEM ApplD 13718 Owner Applicant. Address 4691 Kiser Island Rd Date Evaluated 12119!2011 Proposed FacOdy 4 br Design Flow (.1949) 480 Property Size' Location of Site Property Recorded' Water Supply [ I Public (x I Individual [x I Well ( I Spring [ ] Other Evaluation Method [ ] Auger Boring [ x] Pit [ I Cut Type of Was!ewaler [ ] Sewage [ I Industrial Process [ I Mixed P R O SOIL MORPHOLOGY b F ,1941 PROFILE FACTORS I .1940 .1942 L Landscape Honzon 1941 1941 Soil 1943 1956 1944 Profile E Posifionl Depth Structure/ Consistence Wetness/ I Soil Sapro - Restr Class # Slope;/ (IN.) Texture Mineralogy Color Depth (IN.) Class Horiz & LTAR 1 I 0-35 cl,sbk fr,ss,sp 35-48 sicl,sbk fr,ss,sp 48 03 2 0-22 fill I bottom of footing 22-36 cl,sbk I fr,ss,sp 36-48 sicl I fr,ss,sp I 48 0 3 Description I Initial System I Repair System I Other Factors ( 1946). (Available Space ( 1945) s I s Soil Evaluation By. Robbie Phelps System Type(s) 509% 50% I Others Present Site LTAR I 0 3 0 3 Site Classification (A 948) PS Site Evaluation By Others Present Sheet COMMENTS: FILE #. Also see soil notes and case notes attached to case WLS2008-0043' Landscape Position Group Texture .1955 LTAR Structure R -Ridge I S -Sand 1.2 - 0 8 SG -Single Grain SS -Shoulder Slope LS -Loamy Sand M -Massive LS -Linear Slope CR -Crumb FS -Foot Slope II SL -Sandy Loam 0 8 - 0 6 GR -Granular NS -Nose Slope L -Loam SBK-Subangular Blocky HS -Head Slope ABK-Angular Blocky CC -Concave Slope III SI -Silt 0 6 - 0 3 PL -Platy CV -Convex Slope SICL-Silty Clay PR -Prismatic T -Terrace Loam FP -Flood Plain CL -Clay Loam SCL-Sandy Clay Loam IV SC -Sandy Clay 04 -0 1 SIC -Silty Clay C -Clay Consistence Consistence Mineraloav Moist Wet SEXP-Slightly Expansive VFR-Very Friable NS -Non -Sticky EXP -Expansive FR -Friable SS -Slightly Sticky FI -Firm S -Sticky VFI-Very Firm VS -Very Sticky EFI-Extremely Firm NP-Non-Plashc SP -Slightly Plastic P-Plashc VP -Very Plastic Sketch of Soil Evaluation Locations W v CATAWBA COUNTY PERMIT ZONING AUTHORIZATION (R) New Dwelling IIVRPIN# PFRMII' NO: ZONR-07-201:3-039703 P O Box 389 Phone 828-465-83811 t\I'1'LIIi D: 07/08/2013 100A Southwest Blvd FAX82S-a65-9484 ISSUIiD. 07/08/2013 Newton. North Ciroloin 28658 ExI'IRI:S03/27/2014 www camwbecount-vne.gov Ow lief DANIEL GON%ALES. 3516 MCPI-IFRSON SI-, WAN IA\4 NC 28173 CS 18-98,1-1808 ** NO I'I:0I'1.I7SO1''f ACCOIJN'I' ASSIGNI?D ** Contractor IONATI IAN TAYLOR, 72,12 SIGNION PENINSULA LN, SI-IERRILLS FORD NC 38673 C7045062023 LAN'1'L'I:RACONS'I'RUCIION rr Ct\,IAIL.CO\q PIioPElrry IDP 461602563072 CENSUS TRACE 011504 STREE (-ADDRESS: 4691 RISER ISLAND RD, TERRI'LL NC 28682 PROJECI" DESCRIPTION. 1 story w/ attached garage w/ unfinished walkout basement / house will be located out of flood plain 1'1,001)/_ONE^ Yes OWNER'I'YPE: 100 YEAR FLOOD ZONE PLAIN'? LAND O\\'NI?R: FLOOD PLAIN,SFRUCFURP No FRONT- SE II3ACK30.00 SIDE SETBACK: 15 REAR SETBACK: FRONT SETRACK 2: SIDE STRI7FTS F BACK' tYIAS I -IEIGI IT: SETBACK COMMI-INT: REQUIRED SETBACKS FRONT 30 REAR: 30 SIDE 15 I. BCfoIC an inspection can be made by the Budding Inspection ( ) -ICC. the applicant must pull a string to dcsienate the side and scar property lines where the stricture is beufe placed or coosti"ucted. Horne shall be plical on the lot in harmonv with the site -built sU'uctmes, of have the Goof door face the loud Montage. I N V OI C EN: 07-13-293278 PEI? DESCRIPTION DAT(? FFE AMOUNT Residental Zoning Fee 07/08/2013 S25 00 'TOTAL FEES 525.00 30 The annlicant hereby certifies that all infocmalion and :IWIchmenrs to This C@I'theale of Zoning' Conliolialicc arc true and cnrreel. and a cknoMML,es that this permit was isaued on the basis of the infornfntion remrired herein. The applicant Mother ackooleledges that onv con;lruclion. alicrauon or addition tehich differs firm this applirunut shall he suhject to removal or altcuaion sit as to hang Said Structure into confenmance with the specificauonc and St;unlarls of tile Cataleba Comm, Zoning OrdinauLc. Such covcOINC acUntt shall be at the e\pensc of the applicant. -r1,,, ✓ t yLcf(� APPLICANTNA611{(PRINTED) APP1,1(a\N'TSIGNAfl1Rl? ZONIN'(i APPRU\1kD BY *****'ZONING FEES ARE NON-REFUNDABLE ***** CO\II'ANY NAME 07/08/2013 13 12 IbSUFD Wf h It OUE eI! Page I of I