HomeMy WebLinkAboutRBPR-07-2013-17673.TIFTHIS IS NOT A PERMIT Case # RBPR-07-2013-17673
CATAWBA COUNTY HEALTH DEPARTMENT
PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES
Residential Building Plan Review - Deck/Porch
IMPROVEMENT
T
FE -31
Owner RUSSELL SCHWEIGHARDT, 1528 OLD FARM DR, HICKORY NC 28602
H:828-308-3524 HOME: 828-308-3524
NAME TO APPEAR ON PERMIT
Russell Schweighardt
SITE ADDRESS: 1528 OLD FARM DR, HICKORY NC 28602 PIN # 279006384359
NAME of SUBDIVISION: MEADOWBROOK VILLAGE PL 14-12 Lot # 44 Section/Block
PROPERTY SIZE: Square Feet Acres 0.44
DIRECTIONS: 127 S take a left to Old Farm Dr
PRIMARY CONTACT: Owner SEWER TYPE: Septic Tank
GALLONS PER DAY: 360 WATER SUPPLY: Public Water
DESCRIBE WORK: 1 0x1 4 uncovered rear deck
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?
APPLICATION FOR:
New Structure
STRUCTURE TYPE: PRIMARY RESIDENCE
FACILITY TYPE: Accessory Structure OTHER DESCRIPTION:
DESCRIPTION OF Single Family Dwelling
EXISTING STRUCTURES
ON SITE (IF ANY)
DIM EXISTING STRUCTURE: 50x30
NUMBER OF EXISTING BEDROOMS: 3 # OF OCCUPANTS: 2
PROPOSED CONSTRUCTION
NEW STRUCTURE DIM:: 10x14
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 r the
proper identification an label}�!g of all property lines and corners and making the site accessige so that a co . I tete eval tion can be pert r ed.
Date: 71r�'/ /5 Signature of Applicant or Agent
An Environmental Health Specialist will contact you within 2 workinf application date
If you need further information or assistance please call 828-466-7291
AREA2
MINIMUM SETBACKS FRONT: 30 SIDE: 15 REAR: 30 MAX HEIGHT:
i.Q - Oiapplicalion 07/15/2013 16:07 Page I of
CATAWBA THIS IS NOT A PERMIT
couNTI CATAWBA COUNTY HEALTH DEPARTMENT
Application for Environmental Services Page 1
PPS --11U1 2)
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 [:1Existing Facility ❑
Property Address / S 0 fn6, Subdivision
OTC �7_ g z d ;- Lot # Acres
c
Driving Directions to Property /.? 7, a9cP ji
NAME TO APPEAR ON PERMIT? Owner
Applicant Contact Information
_ � Section/Block/PhSe
/ , /,fie. z-
[:1[:1
Applicant ❑ Contractor
Name�/
Address /3 riS / �Jmcec%1 � 6ccpd 0 2,
` Phone I Cell Phone',
Owner Contact Information
Name
Address I
Phone I Cell Phone
Contractor Contact Information
Name
Address
Phone I Cell Phone
WHO WILL BE THE PRIMARY CONTACT? [Owner Applicant ❑ Contractor
Description of Existing Structures on Site—{G�S�,
# of Bedrooms Structure Dimensions ;=, a 3d # of Occupants
Basement [ "Yes ❑ No Basement Fixtures ❑ Yes 910
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.
Ve
E No Does the site contain any jurisdictional wetlands?
SS No Does the site contain any existing wastewater systems?
VYe
s 0'No Is any wastewater going to be generated on the site other than domestic sewage?
s I� N� Is the site subject to approval by any other public agency?
❑ Yes La'N0 Are there any easements or right of ways on this property? Describe
Existing ter supply in use F-1Individual Well ElCommunity Well E:] Semi -Public W 11
County/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)
0 Accepted 0 Alternative 0 Conventional 0 Innovative 0 Other 0 Any
CATAWBA THIS IS NOT A PERMIT
-- CATAWBA COUNTY HEALTH DEPARTMENT
No.w w.o Application for Environmental Services Page 2.
Proposed Facility Type
❑ Primary Residence ❑ New Residence 2/Addition to Resience # of New Bedrooms * j
Project Description 4, fie, t wrlCZVe.rV1_f_01
Structure Dimensions of Occupants
Basement ❑ Yes ❑ No Basement Fixtures ❑ Yes ❑ No
❑ Accessory Structure(s) Describe
# of New Bedrooms *t if applicable Structure Dimensions
# of Occupants Accessory Dwelling ❑ Yes ❑ No
Plumbing ❑ Yes ❑ No Describe Plumbing Needed
F❑
Multi-Familyly Residence #Units #Bedrooms per Unit*t
Total # Bedrooms *t 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 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.
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 corners and making the site
accessible so that a complete site evaluation can be performed.
Signature of Owner or Agent /��AG ��� Date
Printed Name of Owner or Agent
Catawba County, North Carolina
This map product was prepared from the Catawba County, NC, Geospatial Information System.
N Catawba County has made substantial efforts to ensure the accuracy of location and labeling information
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.
1 inch = 40 feet
--c--U (J�lJ (J
Q 1540
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�-� 4469
Selected Parcel Number: 2790-06-38-4359
Prepared for:
.,
3:57:29 PM
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CATAWBA COUNTY NC - Parcel Report
Information Regarding Selected Parcel(s)
Parcel ID:
2790-06-38-4359
Name:
SCHWEIGHARDT RUSSELL
N'ame2:
Address:
1345 SIREBOURN
Address2:
City:
HICKORY
State:
NC
Zip:
28602-8264
Account:
Calc Acreage:
0.44
Tax Map:
163H 03013
LRK:
55333
Deed Book:
3056
Deed Page:
0316
Subdivision Name:
MEADOWBROOK VILLAGE PL 14-12
Subdivision Block:
Lots:
44
Plat Book:
14
Plat Page:
12
Building Number:
1528
Street Name:
OLD FARM DR
Site Zip:
28602
Township:
HICKORY
Fire Dist:
MOUNTAIN VIEW
City/Tax:
State Road:
1258
Total Bldgs Value:
$89,600
Land Value:
$13,700
Total Value:
$103,300
Year Built:
1970
Year Remodeled:
Last Sale Date:
Last Sale Amount:
Neighborhood:
77
Watershed:
WS -III Protected Area
Watershed Split:
NO
Voter Precinct:
P24
E911 District:
COUNTY
Zoning:
R-20
Zoning2:
Zoning3:
Zoning Split:
N
Zoning Overlay: WP -O
Zoning District:
COUNTY
Split Zoning Dist:
N
Split Zoning Dist(1): 0
Split Zoning Dist(2):
0
School District:
COUNTY
Elementary School:
MOUNTAIN VIEW
Middle School:
JACOBS FORK
High School:
FRED T FOARD
School Split:
NO
P&Z Case Number:
Census Tract 2010: 011801
Census Block 2010: 2000
Small Area Plan:
MOUNTAIN VIEW
Agricultural District:
Printed: Monday, July
15, 2013 03:57 PM
sc) " 4p (WC,
�$ CATAWBA COUNTY
Publie Health Department
< --i Environmental Health Division
Q
PO Box.389, 100-A Southwest Blvd, Newton, NC 28658
t8 w
Applicant/Owner RUSSELL SCHWEIGHARDT
Site Address: 1528 OLD FARM DR, Hickory, NC
Property Size: SF 0.439 ACRES
Directions: 127S/ INTO MT VIEW / LEFT OLD FARM RD/ HOUSE ON LEFT
Case # IMPV-2-11-15224
Subdivision MEADOWBROOK VILLAGI
Lot # 44
PIN# 279006384359
E HPR--I-)1-VS7
Improvement Permit
INITIAL SYSTEM EXISTING - IP FOR REPAIR SYSTEM ONLY
Facility: Primary Residence N
Permit Category: Other Bedrooms 3 _~
WATER SUPPLY: Public Water t"w
Basement? Yes Basement Plumbing? No �\
----------------------------------------------------------------------------------------- ----------------------------------------------------------------------------------------
INITIAL SYSTEM SPECIFICATIONS 4
-------------------------------------------------------- -------------------------------------------------------------------------------------------------------------------
Permit Valid: Expires In Five Years: _X_ No Expiration:
Projected Daily Flow 9-p.d
Proposed Wastewater System: CONVENTIONAL
Type: IIB - CONV SYSTEM WITH <750 LINEAR FEET OF LINE
Pump Required?: No
Operator Required?: NO
Permit Conditions: IP for as built for existing septic system for a family room.
---------------------------------------------------------------------------- --------------------------------------------------- ------------------------ --- -- - ------------------- --
REPAIR SYSTEM SPECIFICATIONS
-------------------------------------------------------------- ----------------------------------------------------------------------------------------------------------------
Repair System Required? Required
Proposed Wastewater System: LOW PRESSURE PIPE
Type: VIA - ANY> 3,000 GPD SYSTEM WITH PRETREATMENT
Pump Required?: Yes
Operator Required?: YES
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 aooroved, and may result in failure to approve the
initial system installation, or the suspensionlrevocation of existing permits.
The issuance of this permit by the Health Department does not guarantee the issuance of other permits. It is the responsibility of the
applicant/property 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 property. This permit was issued in compliance with the
provisions of the North Carolina 'Laws and Rules for Sewage Treatment and Disposal Sustems' (15A NCAC 18A .1900). Neither
Catawba County nor the Environmental Health Specialist warrants that the septic tank system will continue to function satisfactorily
Susan Bumga.rner 02/14/2011
AUTHORIZED STATE AGENT APPROVAL DATE
Permit Expiration Date: 02/13/2016
No grading or construction activity is allowed in areas designated for system and repair without approval of the Health Department.
n1/I4/II I1 -I17
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10- CATAWBA-LINCOLN-ALEXANDER DISTRICT HEALTH DEPARTMENT
HICKORY, N. C.—NEWTON, N. C.—LINCOLNTON, N. C.—TAYLORSVILLE, N. C.
Phones 345-3883 464-2011 735-5521 632-3101
PERMIT TO INSTALL SEPTIC TANK
PERMIT NO................................. PERMIT DATE...........-511&1
90...
i r,;
Owner....... %1S?.c;if r>!"..!" :'2'�.....'c.1 ii�� �...Address
.... .......
,+IG . ... �: �.
Tenant.......................................................................:.............. Address.....................................................................................
Installed ..... '.I::� r%'�����' ..... .............Address.................. .
..
Location of Property.....
...: �.l.::L7..:...
.................'•r.. ....fN'.a:�...:.:.•'.�"''.�. �:�w:a......-. �:'..ir....v'�--��.................................
Kind of tank......... :; r..................Size.............442&-4 ............Length of, trench ....
NOTIFY HEALTH DEPARTMENT AT LEAST EIGHT HOURS BEFORE TANK IS TO BE INSPECTED
Final Inspection ....................::.:'.. f r. ti {;j :.......... 19..,r.'(.i. Approved (J-4 Disapproved( )
Remarks: ..... f''e-,:. •....;:..'.......................................................................................................`.................................
Fr^'
First five feet of line fro outlet use should be of cast iron soil pipe.
A
�
..................................................................
Sanitarian.
Sketch of tank and line showing distance
from dwelling and well on subject property
j and on adjoining property.
DEPA$TMENTOFMOMONMENT AND NATURALRESOU&M Shed-Lcf—
AMSION OF ENVIRONME11TAL HEALTH PROPERTY ID #
ON-SITE WASTEWATER S=ON COUNTY: ('aiZW
SOMM EVALUATION
for ON S C�E WASTEWATER SYS'TENt
Ow 4m. Z. kss e l 1 Scin W C r ti Xla i- APPLICATION DATE
ADDRESS: ) , DATE EVALUATED: ,9 -11-11
PROPOSED FAMITY: PROPOSED DESIGN FLOW (,1949): PROPERTY SIZE:
LWATION OF SITE: PROPERTY RECORDED:
WATER SUPPLY: 0 Privatm @4w& 0 Wna�lt- 0 Sm.ns 0 Otbcr
EVALUATION METBOD: 0 Apgar Boring L Tk �Ctst
1OP
I I
I I
2 I �
I I
0
DiDN
Ata�nbk Sp= (1445)
System Ty9s)
Sit Lta
COMMENTS:
D,MULSYSfEM WAIRSYMM4 OTHERFACTORS (.1946�
SITE CLASSIFICATION (.1948):
_ �� w�o� 6y I�t�
EVALUATED BY;
l. -P P OTE=s) PRESENT: