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HomeMy WebLinkAboutRBPR-07-2013-17722.TIFTHIS IS NOT A PERMIT Case # RBPR-07-2013-17722 CATAW13A COUNTY HEALTH DEPARTMENT PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES Residential Building Plan Review - Accessory Structure IMPROVEMENT 713i f,0J-yd Owner RONALD ISOM, 3341 RHONEY FARM RD, VALE NC 28168-8979 C:8282342575 NAME TO APPEAR ON PERMIT Ronald Isom SITE ADDRESS: 3341 RHONEY FARM RD, VALE NC 28168 NAME of SUBDIVISION: Lot # PROPERTY SIZE: Square Feet Acres 3.9 DIRECTIONS: Hwy 127 North to Hwy 10 turn right / righ Rhoney Farm Rd / 1 mile on left PRIMARY CONTACT: O GALLONS PER DAY: 360 DESCRIBE WORK: 30 x etached 1 1/2 story 1408 sf garage with sized for 3 bedroom per owner ) SEWER TYPE WATER SUPPLY PIN # 267803108778 Section/Block Septic Tank Private Well 1/2 bath (sink and toilet only roughed in) ** septic system 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? Yes Property Easements Description: Yes (power Rutherford Electric) APPLICATION FOR: New Structure STRUCTURETYP ACCESSORY STRUCTURE FACILITY TY : Single Family Residence THER DESCRIPTION: DESCRIPTIO — bTf5 EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: 28 x 36 NUMBER OF EXISTING BEDROOMS NEW STRUCTURE DIM:: 30 x 32 BASEMENT? No # OF OCCUPANTS: 2 PROPOSED CONSTRUCTION BASEMENT FIXTURES? No Desired system types (Improvement Permit or Authorization to Construct): ACCEPTED: ALTERNATIVE: OTHER: INNOVATIVE: Other described: PLUMBING REQUIRED? Yes CONVENTIONAL: ANY: YES 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: Signature of Applicant or Agent An 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 AREA2 f:9 - ehapplicotim 07/31/2013 08:48 Page l of 4 S� CATAWBA COUNTY Case # RBPR-07-2013-17722 Public Health Department Subdivision Environmental Health Division � PIN# 267803108778 PO Box 389, 100-A Southwest Blvd, Newton, NC 28658 I8 Z su NAME ON PERMIT: RONALD ISOM, 3341 RHONEY FARM RD, VALE NC 28168-8979 Site Address: 3341 RHONEY FARM RD, VALE NC 28168 Property Size: Square Feet Acres 3'9 Directions: Hwy 127 North to Hwy 10 turn right / righ Rhoney Farm Rd / 1 mile on left MINIMUM SETBACKS FRONT: 80 SIDE: 10 REAR: 5 MAX HEIGHT: FEENAME DATE FEE AMOUNT Improvement Permit (Existing) Fee 07/24/2013 $90.00 TOTAL FEES $90.00 SYSTEM REDESIGN AND/OR RETRIP WILL INCUR AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) 1a1 - ehapplicaliun 07/31/2013 08:48 Pace 2 of4 - tea► Ig42 SM THIS IS NOT A PERMIT Case # RBPR-07-2013-17722 CATAWBA COUNTY HEALTH DEPARTMENT 0 PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES Residential Building Plan Review - Accessory Structure IMPROVEMENT Lil D Owner RONLAD ISOM, 3341 RHONEY FARM RD, VALE NC 28168-8979 C:8282342575 NAME TO APPEAR ON PERMIT Ronlad Isom SITE ADDRESS: 3341 RHONEY FARM RD, VALE NC 28168 PIN # 267803108778 NAME of SUBDIVISION: Lot # Section/Block PROPERTY SIZE: Square Feet Acres 3.9 DIRECTIONS: Hwy 127 North to Hwy 10 turn right / righ Rhoney Farm Rd / 1 mile on left PRIMARY CONTACT: Owner SEWER TYPE: Septic Tank GALLONS PER DAY: 240 WATER SUPPLY: Private Well DESCRIBE WORK: 30 x 32 Detached 1 1/2 story 1408 sf garage with 1/2 bath (sink and toilet only roughed in) septic system sized for 3 bedroom per owner ) 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? Yes Property Easements Description: Yes (power Rutherford Electric) APPLICATION FOR: New Structure STRUCTURE TYPE: ACCESSORY STRUCTURE FACILITY TYPE: Accessory Structure OTHER DESCRIPTION: DESCRIPTION OF House EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: 28 x 36 NUMBER OF EXISTING BEDROOMS: 2 # OF OCCUPANTS: 2 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 30 x 32 BASEMENT? No BASEMENT FIXTURES? No PLUMBING REQUIRED? Yes Desired system types (Improvement Permit or Authorization to Construct): ACCEPTED: ALTERNATIVE: CONVENTIONAL: OTHER: INNOVATIVE: ANY: YES Other described: E9 - ehapplication 07/24/2013 11:32 Page I of 4 CATAWBA COUNTY Case 4 RBPR-07-2013-17722 r Public Health Department p Subdivision al Environmental Health Division PIN# 267$03108778 PO Box 389, 100-A Southwest Blvd, Novton, NC 28658 NAME ON PERMIT: RONLAD 1SOM, 3341 RI IONEY FARM RD, VALE NC 28168-8979 Site Address: 3341 RHONEY FARM RD, VALE NC 28168 Property Size: Square I"cet Acres 3.9 Directions: Hwy 127 North to Hwy 10 turn right / righ Rhoney Farm Rd / 1 mile on left 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 Welt 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 valuation can be performed. Date:_7_Zt/-l3 __ Signature of Applicant or Agent 'e ,�, ' A�QG�.-- An 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 AREA2 MINIMUM SETBACKS FRONT: 80 SIDE: 10 REAR: 5 MAX HEIGHT: FEENAME Improvement Permit (Existing) Fee TOTA L. FE ES DATE FEE AMOUNT 07/24/2013 $90,00 ;$90.00 SYSTEM REDESIGN AND/OR RETRIP WILL INCUR AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) - . }c.; Pl al -on 07!24/2013 1 I :31 Page 2 of 4 'CATA"AnTHIS IS NOT A PERMIT �COUNTY CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services Page I Improvement Permit VAuthorization to Construct[7 Septic Repair F-1 Septic Malfunction 7 Septic Expansion F-1 New Well Permit F] Replacement Well 7 Well Abandonment ❑ Well Repair Ej Existing System Inspection (Pre -Approval Required) F Application is for New Construction El Existing Facility ❑ Property Address 33yd Subdivision Lot # Acres Section[Block/Phase Driving Directions to Property A�0,41A­­ 71-0 //z- i /P 7_044Xc'l. 7A e-, e9 I - NAME TO APPEAR ON PERMIT? [2'Owner DApplicant F-1Contractor Applicant Contact Information Name A0 /, 4 Id-�d'I.,'I e -.7-7 -5 Address Phone Owner Contact Information Name Address Phone Contractor Contact Information Name Address Phone b/W,- �- -' _21 5V& F I Cell Phone 215- 7 -5 - Cell Phone Cell Phone WHO WILL BE THE PRIMARY CONTACT? 7 Owner r'j Applicant F Contractor Description of Existing Structures on Site -s e # of Bedrooms *t -2 Structure Dimensions .21r )r _3 a # of Occupants Basement Q es ❑ No Basement Fixtures ❑ Yes � o ?j1j SqSt<y),j 1 7 d ' The Applicantshall notify the loca.l hc tdepartment upon submittal of this application if any of (lie following apply to the property in question. If the answer to any question is "yes", applicant must attach supporting documentation. 0 Yes ®`No Does the site contain any jurisdictional wetlands? M -Yes 0 No Does the site contain any existing wastewater systems? 0 Yes 9,N0 Is any wastewater going to be generated on the site other than domestic sewage? Vres No Is the site subject to approval by any other public agency? 2'Yes 0 No Are there any easements or right of ways on this property? Describe /lei. 9_indiv'id­L'iaI'We)I El Commu"'itvWe'll, Sem' -P"'fic"W'ell'', Existing water supply in use F County/City/Township Water Line Is a public water supply available?" n Yes P_Ko 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 ff-'Any f C A rT`AWB © I HIS IS NOTA PERMIT 11 1COUNTY 'C�l` CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services Page 2 Proposed Facility Type ❑ Primary Residence ❑ New Residence ❑ Addition to Residence # of New Bedrooms *t Project Description Structure Dimensions # of Occupants 3 Basement ❑ Yes ❑ No Basement Fixtures ❑ Yes ❑ No Accessory Structure(s) Describe�q,2 # of New Bedrooms *t if applicable © Structure Dimensions # of Occupants O Accessory Dwelling Ipwes 2 -No !) Plumbing �es ❑ No Describe Plumbing Needed 11&-,� J,_ ❑ Multi -Family Residence # Units #Bedrooms per Unit*j Total # Bedrooms *t Structure Dimensions j ❑ 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 Daycarc Specify Occupancy Application for Well Construction/Abandonment /Repair Proposed Well Type F]Individual Well ElSemi-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 RETRfP WILL YNCIUR 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 i transferable; Improvement Permits and Well Permits are transferrable. Permits may be revoked if the information on this application, I site plans or intended use changes for the proposed facility. 1 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 «Oth applicable laws and riles. t understand that 1 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 Date Printed Name of Owner or Agent Catawba County, North Carolina This map product was prepared from the Catawba Countv, 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: 2678-03-10-8778 1 inch = 100 feet Prepared for: WSJ r II y Qc I 3.90) 877 I � I .M I o,� YI 1 1 8.00 t ( 100 1 THIS IS NOT A LEGAL DOCUMENT I / / 110 1 it 6 3341 t Date: 7/24/2013 1 40 .CATA'WBA Ge©spatial Information Services Real Estate Search N w+E S Parcel: 267803108778, 3341 RHONEY FARM RD VALE, 28168 Owners: ISOM RONALD MICHAEL, Owner Address: 3341 RHONEY FARM RD Values - Building(s): $138,500, Land: $29,000, Total: $167,500 1 in=100ft This map/report product was prepared from the Catawba County, NC Geospatiai Information Services. Catawba County has made substantial efforts to ensure the accuracy of location and labeling information contained on this map or data on this report. Catawba County promotes and recommends the independent verification of any data contained on this map/report 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/report product or the use thereof by any person or entity. Copyright 2012 Catawba County NC, 07/24/2013 CATAWBA COUNTY NC - Parcel Report Information Regarding Selected Parcel(s) Parcel ID: 2678-03-10-8778 Name: ISOM RONALD MICHAEL Name2: Address: 3341 RHONEY FARM RD Address2: City: VALE State: NC Zip: 28168-8979 Account: Calc Acreage: 3.9 Tax Map: 007 B 04001 LRK: 6765 Deed Book: 2907 Deed Page: 1036 Subdivision Name: Subdivision Block: Lots: Plat Book: Plat Page: Building Number: 3341 Street Name: RHONEY FARM RD Site Zip: 28168 Township: BANDYS Fire Dist: COOKSVILLE City/Tax: State Road: 1002 Total Bldgs Value: $138,500 Land Value: $29,000 Total Value: $167,500 Year Built: 2010 Year Remodeled: Last Sale Date: 4/24/2008 Last Sale Amount: $16,500 Neighborhood: 89 Watershed: WS -III Protected Area Watershed Split: NO Voter Precinct: P2 E911 District: COUNTY Zoning: R-40 Zoning2: Zoning3: Zoning Split: N Zoning Overlay: WP -0 Zoning District: COUNTY Split Zoning Dist: N Split Zoning Dist(1): 0 Split Zoning Dist(2): 0 School District: COUNTY Elementary School: BANOAK Middle School: JACOBS FORK High School: FRED T FOARD School Split: NO P&Z Case Number: Census Tract 2010: 011802 Census Block 2010: 1007 Small Area Plan: PLATEAU Agricultural District: Printed: Wednesday, July 24, 2013 11:15 AM CATAWBA COUNTY Q Public Health Department aEnvironmental Health Division PO Box 389, 100-A Southwest Blvd, Newton, NC 28658 Applicant/Owner R. MICHAEL ISOM Site Address: 3341 PHONEY FARM RD, Vale, NC Property Size: SF ACRES Directions: Case # OP -9-10-10908 Subdivision Lot # PM# 267803108778 Catawba County Health Department Operation Permit System Type: IIIG - OTHER NON -CONY TRENCH SYSTEMS (In accordance with Table Va) Description: 25% REDUCTION Types V and VI systems expire in 5 years. p Owner must contact health department 6 months prior to exiration for permit renewal. System Installation Comments: PERMIT CONDITIONS: 1. All maintenance, monitoring, and performance requirements shall be in accordance with 15A NCAC 18.1900, Rule .1961 2. Operation & Maintenance Specifics: Subsurface system operator required? Yes No_X If yes, see attached sheet for additional operation conditions, maintenance and reporting. This system has been installed in compliance with applicable North Carolina General Statutes, Rules for Sewage Treatment and Disposal, and All conditions of the Improvement Permit and Construction Authorization. tim Hice SYSTEM INSTALLER Susan Bumgarner AUTHORIZED STATE AGENT 09/09/10 14:40 09/03/2010 INSTALLATION DATE 09/09/2010 DATE OF OPERATION PERMIT ISSUANCE Form F uT�i �S-10-9S1o� fk�sc per' Fjw Vt �-�\ vOVA tS4- �$ Case# EHPR-11-09-2683 CATAWBA COUNTY Subdivision 2 Public Health Department L Environmental Health Division Section/Bl/Ph/Lot# PO Box 389, 100A Southwest Blvd, Newton NC 28658 PIN# 1$ Z ut (828) 465-8270 Fax (828) 465-8276 TDD (828) 465-8200 r V `� aL I) -0q3DYq W Applicant/owner Michael Isom Site Addresses Rhoney Farm Rd Vale NC Property Size: 3.9 j Directions: WELL PERMIT Proposed use: Private X Public ❑ Semi -Public ❑ Other " GROUTING DEPTH: MINIMUM 20 FEET n�� S.e SETBACKS: I. BUILDNG FOUNDATIONS 25 FT. 5. UNDERGROUND STORAGE TANKS 100 FT. 2. EXISTING & PROPOSED SEPTIC SYSTEMS MM. 50 FT. 6. STREAMS/BROOKS/CREEKS 50 FT. 3. EXISTING & PROPOSED SEPTIC REPAIR AREA MIN. 50 FT. 7. LAKES/PONDS RESERVOIRS 50 FT 4. SEWAGE PUMP SUPPLY LINE 50 FT. ALL OTHER POSSIBLE SOURCES OF GROUND WATER CONTAMINATION 100 FT. The well driller must verify all separations are adhered to before drilling the well. If the well driller is unable to maintain any of the above separations, contact the Health Department at (828) 465-8270 before drilling the well. SEE IT AN F ERMITTED WELL LOCATION ISSUED Bye PERMIT ISSUANCE DATE 2 —/v ' d i CUSTOMER SIGNATURE DATE . WELL INSPECTION: GROUTED DEPTH: 20' �j cd11(,� G�� ❑ DATE: J• -13f 10 APPROVED CASING: PVC ❑ STEEL ❑ DATE: 1­1�-I0 CASING HEIGHT 12' ABOVE LAND SURFACE ❑ DATE: WELL COMPLETION REPORT RECEIVED ❑ DATE: WELL HEAD APPROVED ❑ DATE: WATER SAMLES TAKEN: BA ❑ IO ❑ N/N ❑ DATE: INITIALS: INITIALS: rA ro,/ INITIALS: 1 f d�iheY To (�o INITIALS: INITIALS: hcar� INITIALS: l WELL DRILLER DATE DRILLED / Well permits are valid for 5 years from the date of issuance and are subject to suspension and/or revocation for non-compliance with appropriate state and local rules and regulations, or if false information was given in order to obtain a permit. Wells shall be constructed in accordance with all state and local regulations and rules. The Well Completion Report must be submitted to the Health Department within 30 days upon completion of a well. AUTHORIZED STATE AGENT CERTIFICATE OF COMPLETION APPROVAL DATE CAN=entsand Setting5\;english\.ocalseningffemporary Internet Files\Content.0utlook\P6CRMTUF\Isom-Well.docx -- < --- - C-, CATAWBA COUNTY Case # AUTH-5-10-7512 Ir Public Health Department Subdivision -i Environmental Health Division 6 � PO Box 389, 100-A Southwest Blvd, Newton, NC 28658 Lot # 1 w PIN4 267803108778 Applicant/Owner R. MICHAEL ISOM Site Address: 3341 RHONEY FARM RD, Vale, NC Property Size: SF 3 9 ACRES Directions: HWY 10 W - TURN RIGHT ONTO PHONEY FARM RD - PROPERTY ON LEFT JUST PAST LYNN MTN. RD Authorization to Construct Permit Authorization to Construct Wastewater Svstem (Reauired for Buildina Permitl * See site plan and number of additional attachments ( ). Proposed Wastewater System: 25% REDUCTION Wastewater Flow 360 g.p.d Type: IIIG - OTHER NON -CONY TRENCH SYSTEMS Soil LTAR: 0.3 g.p.d./ft2 Permit Category: New Septic Type of Facility: House Basement? Yes Basement Plumbing? Yes Bedrooms: 3 Wastewater Svstem Requirements Tank Size: New Tank 1,000 gal Pump Tank gal Grease Trap gal Dosing Volume gal Pump Specs: GPM @ TDH Pressure Head ft Draw Down in Drainfield: Total Area: 900 sq ft Total Length: J00 ft Maximum Trench Depth Aggregate Depth in Trench Width 3 ft Minimum Soil Cover 8 in Minimum Trench Separation 9 ft on center Number of Drain Lines 3 Distribution: Gravity Additional Specifications: 24 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. Proposed Repair System Class: IIIB Proposed System: 25% REDUCTION Distribution Type:: Pressure Manifold Soil LTAR: 0.3 g.p.d.M2 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 Authorization to Construct Permit is subject to revocation if the site plan, plat or the intended use changes, or if site conditions are altered. The Authorization to Construct 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 Sewaee Treatment and Disnosal Svstems' (15A NCAC 18A .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. Megen McBride 05/21/2010 AUTHORIZED STATE AGENT APPROVAL DATE Permit Expiration Date: 05/20/2015 No grading or construction activity is allowed in areas designated for system and repair without approval of the Health Department. 05/21/10 14:45 Acdruh-j dor PR -11 -4°i -2.b7'3 skis4c4't 11't+ 15 fid, - ,ov, 6tmr ,4 cuf5, 5-I. f►ar^ S�Svc-�v 5 a► d eCks or pores, 10 - i, 4r4 r1 f r pef � C i vkr'S, loo -P. for-, VO -I is T 50-P, �rom cree �S. � P sys-�� oL4 aE ( a+j OLV-ca a+� !O\A 6` a 11 A 1 � � e��-rr c►�t ad ' z�S-��►� 3ao f D� 5?u � � 6w �o our, ba not iM5141� 4eh We-�, ` Do Y14 jriv�, raj.e, CL4, OY-fill over sysjch,, or rtfir, �" = Iryn 100' Thin Q4, e�"169 i 5~ ! ~.2Yo