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Home My WebLink AboutRBPR-07-2013-17693.TIFI 4 SW THIS IS NOT A PERMIT Case # RBPR-07-20 13 )- 1769") CATAWBA COUNTY HEALTH DEPARTMENT PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES Residential Building Plan Review - Building New IMPROVEMENT Contractor SAME AS OWNER,, Owner RICKY CLINE, 1632 6TH ST SE, HICKORY NC 28601 0:8283022959 NAME TO APPEAR ON PERMIT Ricky Cline SITE ADDRESS: 1632 6TH ST SE, HICKORY NC 28602 PIN # 370220905583 NAJ-NIE of SUBDIVISION: Lot # TR A Section/Block PROPERTY SIZE: Square Feet Acres 2.98 DIRECTIONS: 6th St SE PRIMARY CONTACT: Owner SEWER TYPE- Septic Tank GALLONS PER DAY: 360 WATER SUPPLY: Public Water DESCRIBE WORK: 30 x 60 Pole Barn 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: ACCESSORY STRUCTURE FACILITY TYPE: Accessory Structure OTHER DESCRIPTION: DESCRIPTION OF Single family dwelling EXISTING STRUCTURE ON SITE (IF ANY) DIM EXISTING STRUCTURE: 50 x 70 NUMBER OF EXISTING BEDROOMS: 3 #OF OCCUPANTS: 4 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 30 x 60 BASEMENT? No BASEMENT FIXTURES? No PLUMBING REQUIRED? Desired system types (Improvement Permit or Authorization to Construct): ACCEPTED: ALTERNATIVE: CONVENTIONAL: OTHER: INNOVATIVE: ANY: 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 accessible so that a complete site evaluation can be performed. Date: 7 — 3 Signature of Applicant or Agent An Environmental Health Specialist will contact you within 2 working Lys of application date. If you need further information or assistance please call 828-466-7291 AREA2 I 't -."s.!! 07/18.1201-3 14:03 Page I ol'4 CATAWBA COUNTY �q Public Health Department d Environmental Health Division '•`� PO Box 389, 100-A Southwest Blvd, Newton, NC 28658 184 :M NAME ON PERMIT: RICKY CLINE, 1632 6TH ST SE, HICKORY NC 28601 Site Address: 1632 6TH ST SE, HICKORY NC 28602 Property Size: Square Feet Acres 2.98 Directions: 6th St SE MINIMUM SETBACKS FRONT: 30 SIDE: 5 REAR: FEENAME Improvement Permit Fee TOTAL FEES Case # RBPR-07-2013-17693 Subdivision PIN# 370220905583 5 MAX HEIGHT: DATE FEE AMOUNT 07/18/2013 $150.00 $150.00 SYSTEM REDESIGN AND/OR RETRIP WILL INCUR AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) E9 - chapplication 07/18/2013 15:37 Page 2 of 4 •CATAWBA n`I'IHIS IS NOT A PERMIT coCATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services Page I Improvement Permit ❑ Authorization to Construct ❑ Septic Repair ❑ Septic Malfunction ❑ Septic Expansion ❑ New Weil Permit ❑ Replacement ''Veli ❑ Well Abandonment ❑ Well Repair ❑ Existing System Inspection (Pre -Approval Required) ❑ Application is for New Construction ❑ Existing Facility ❑ Property Address >r, Subdivision Lot # Acres Section./Block/Phase Driving Directions to Property NAME TO APPEAR ON PERMIT?Owner ❑ Applicant ❑ Contractor Applicant Contact Information Name Cc. V !Address (, I L. (n t ` $ I � �� Phone 7 7 0 Z �-1 S `t Cell Phone Owner Contact Information Name Address 'Phone Cell Phone Contractor Contact Information Name Address Phone ( Cell Phone pp ❑ Contractor i Description tyon ofBEiTiHE Structures PRIMARY CONTACT? �O�vner � . ❑ Applicant �Cont P g on,,, # of Bedrooms *t 2 Structure Dimensions .5 o 4 7 hof Occupants BasementYes to 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 -n No Does the site contain any jurisdictional wetlands? 0"Yes tiAo Does the site contain any existing wastewater systems? ❑ Yes IjdlNo Is any wastewater going to be generated on the site other than domestic sewage? Rf Yes ❑ No Is the site subject to approval by any other public agency? ❑ Yes ,60 Are there any easements or right of ways on this property? Describe Existin water supply in use ❑ Individual Well ❑ Community Well ❑ Semi -Public Well p supply ? ** s ❑ No County/City/Township Water Line Is a public waters I available. Ye I 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 Altemative 0 Conventional 0 Innovative 171 Other 0 Any ...... - - - - - --------- . ..... 3.70A 6244 r t17 � r � Q r h o � o (507) Q C01 / o � THIS IS NOT A LEGAL DOCUMENT Date: 7/18/2013 Time: 3:40:57 PM 6 + / 906 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. Selected Parcel Number: 3702-20-90-5583 1 inch =100 feet Prepared for: 4.83A 5850 I 248.04 j113.92 M o 207.00 Co ,O 370.30......3A N3 FM3a._ U5543 r0tA-4 iw no5-43 r17185 - oo S (_Plat 46;47 o� 8533 j! 2.98A 171.85 em 5583 TractA A-2 0o - Plat 54-126 Plat 46-47 oq U 0 8433 0 CITY LIMIT 446.88 DISTRICT 171.85 o ...... - - - - - --------- . ..... 3.70A 6244 r t17 � r � Q r h o � o (507) Q C01 / o � THIS IS NOT A LEGAL DOCUMENT Date: 7/18/2013 Time: 3:40:57 PM 6 + / 906 C/T78NBACOUNTY NC'Parcel Report Information Regarding Selected P|(a) Parcel |D: 3702'20'90'5583 NoAne: CARROLLSUK8MER Name2: CLINE RICKY Address: 1G326TH STSE Addneos2: City: HICKORY State: NC Zip 28602-9649 Account: Calc Acreage: 2.08 Tax : 091H 01001C LRK: 90756 Deed Book: 2152 Deed Page: 0520 Subdivision Name: Subdivision Block: Lots: TRA Plat Book: 54 Plat 120 Building Number: 1632 Street Name: 6TH ST SE Site Zip: 28602 Township: HICKORY Fire Dist: City/Tax: HICKORY State Road: 1171 Total Bldgs Value: *218,700 Land Value: s31.700 Total Value: $250.400 Year Built: 200 Year Remodeled: Last Sale Date: Last Sale Amount: Neighborhood: 84 Watershed: Watershed Split: NO Voter Precinct: P4 E911 District: HICKORY Zoning: R'2 Zoning2: Zoning Split: N Zoning Overlay: Zoning District: HICKORY Split Zoning Dist: N Split Zoning Dist(l): 0 Split Zoning Dist(2): 0 School District: HICKORY Elementary School: SOUTHWEST Middle School: GRANDVIEW High School: HICKORY School Split: NO P&Z Case Number: Census Tract 2O1[LO111O2 Census Block 2O1O:1O12 Small Area Han: in r CATAWBA COUNTY HEALTH DEPARTMENT ��11 I, 7 Telephone (828) 465- 70 TDD (828) 465-8200 WLS#QO J'tf Yo� IP ACR�pr. Pr�Opr Prmt, Sys Type Well Prmt. Replacement Well Well Rpr Prmt. Owner ge L �ItY Phone Address JJ-- l-leiitl.i'l 'Am Subdivision�q•H- �) Annc,S Aar" V V /QC r Sectio Bl Phase Lor Lot izeDirections j 6 L,I ( f/`ay*•� r� �/%tlL� �� 1.1 S�' J �- Property Address /b� _ &/ , S/" &�_. __ Facility- House Mobile Home Business Multi -family Other- Pin Number 37,0%/2- - 01W.0— .� �5 Other Zoning Approval # /` eA-orZ y # Bedrooms `-� # Seats # Employees Application Rate %� r GPD Flowi-W Hot Tub or Spa ye no Special Fixtures Baseme yes no 100% Repair Area yes/no Basement Plumbtn�o Water Su Private Well Public Semi -Public Type of System. Trench Bed Pump Pump/Panel Panel LPP Other i� Septic Tank Size 1()00 Pump Tank Size / Nitrification Field: Total Square Feet 17013 Depth of Stone Bed Size Trench Width �(� �� Total Length of All Trenches yerD Number of Trenches Trench Lengthj(Y) /jam/I a) /f Ll_/_ Feet on Center 9 Maximum Trench Depth Zyf Distance of Nearest Well 'lJ *DO NOT INSTALL SEPTIC WHEN WET* *WELL RECORD REQUIRED AT COMPL I N* Topo to Slope Texture Rt �1 Structure- Clay tructureI i� ` Clay Min. /� jd ,p4 i Soil Wetness Soil Depth / Restric Hoz. at Available space o Overall Class Comments \01� - \ � JQJ� A t/V\ t t Filter Required Riser required when tank is more than 6 inches deep. **NO GUARANTEE OR WARIZANTY IS IMPLIED OR GIVEN AS 10 VM PERFORM NCE OR LENGTH OF TIME THIS SYSTEM WILL FUNCTION** ? *Improvement Permit has no expiration date and is transferable, bi-t ma: , be revoked if site plans or intended use changes for the proposed facility An Authorization to Construct is valid for (5) five years fr(.m da.e issued and is not transferable. Well Permit valid for 5 years provided site conditions do not change. Well location, installation, ind 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 a any s" a by the Health Department. Permit Date o / EH ,t k OwnjHethd `� l Septic Tank all B i 1.)�4, }.t„A� Dateiy4 -1/ EHS i/ J Well Installed By Well Grout�pproval Date Wellp ov 1 e ' Date Sample Collected Date Results EHS White - Office Blue - Building Inspection Operation Permit Yellow Owner/Agent - 'Green - Building Inspection Authorization to Construct