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Home My WebLink AboutRBPR-07-2013-17738.TIFTHIS IS NOT A PERMIT Case # RBPR-07-2013-17738 CATAWBA COUNTY HEALTH DEPARTMENT oo �� PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES �MMIR- IMPROVEMENT Residential Building Plan Review - Deck/Porch Contact Person - EnvironnJ0fth118MI3 WAN, 364 REED CREEK RD, MOORESVILLE NC 28117 C:7047563519 Contractor NEW WAVE CONSTRUCTION, 144 PINNACLE LN, MOORESVILLE NC 28117 C:704 -622-9_646F:704-664-5135 Owner T REBECCA ROAN, 5062 LEE PT, TERRELL NC 28682 H:980-721-4312 HOME:980-721-4312 NAME TO APPEAR ON PERMIT Rebecca Boan SITE ADDRESS: 5062 LEE PT, TERRELL NC 28682 NAME of SUBDIVISION: KISER SUNSET KEYS 1 Lot # PROPERTY SIZE: Square Feet Acres 0.37 DIRECTIONS: 16 S to 150 E, right on Kiser Island Rd, turn right to Lee Point PRIMARY CONTACT: Contractor SEWER TYPE GALLONS PER DAY: 240 WATER SUPPLY DESCRIBE WORK: 36x37 rear deck no ele 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? No APPLICATION FOR: New Structure 0 E PIN # 461604721223 12 Section/Block Septic Tank Private Well STRUCTURE TYPE: PRIMARY RESIDENCE FACILITY TYPE: Single Family Residence OTHER DESCRIPTION: DESCRIPTION OF single family dwelling EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: 40x40 NUMBER OF EXISTING BEDROOMS: 2 # OF OCCUPANTS: 1 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 36x37 BASEMENT? Yes BASEMENT FIXTURES? PLUMBING REQUIRED? No Desired system types (Improvement Permit or Authorization to Construct): ACCEPTED: ALTERNATIVE: CONVENTIONAL: OTHER: INNOVATIVE: ANY: YES Other described: E9 - chapel cation 07/26/2013 10:24 Page I of 4 .�YA CATAWBA COUNTY Case # RBPR-07-2013-17738 G Public Health Department KISER SUNSET KEYS 1 d � Subdivision Environmental Health Division PIN# 461604721223 1'4 Box 389. 104-A Southwest Blvd, Newton, NC 28658 1g 2 NAME ON PERMIT: REBECCA BOAN, 5062 LEE PT, TERRELL NC 28682 Site Address: 5062 LEE PT, TERRELL NC 28682 Property Size: Square Feet Acres 0.37 Directions: 16 S to 150 E, right on Kiser Island Rd, turn right to Lee Point 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 comg� to site evaluation can be performed. Date: J t / t Signature of Applicant or Agent An Environmental I lealth Specialist will contact you withiti,'2 working days of app.1 ication date) If you need further information or assistance`please call 828-466-7291 AREA1 MINIMUM SETBACKS FRONT: 30 SIDE: 15 FEENAME Improvement Permit Fee TOTAL, FEES REAR: 30 MAX HEIGHT: DATE FEE AMOUNT 07/26/2013 S150.00 $150.00 SYSTEM REDESIGN AND/OR RETRIP WILL INCUR AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) 179 - rhapplwaiion 07/26/2013 10:24 Page 2 of 4 2-12, CAT AWBA THIS IS NOT A PERMIT �� MI'M cou.Tv CATAWBA COUNTY HEALTH DEPARTMENT --' Application for Environmental Services Page 1 Norlh Carol Improvement Permit Ed 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 ❑ Existing Facility E:1 Property Address JO-- : Subdivision Tey -re 11 . AC LAA. Lot # Section/Block/Phase Driving Directions to Property to 1 So C 1vr n r i tiV. �- ori +J J v -V -X Vr-, NAME TO APPEAR ON PERMIT? Owner ❑ Applicant tJ Contractor Applicant Contact Information Acres Name IJ2vl1 tiJav t (oYIC'MJC c G I Address 3k0y �e F d Cr p k YZA PACI 7 Phone -10 \,4 - -7 S�,,rA I Cell Phone ,o.-1 K�.�•�r Island 'r c,' Owner Contact Information Name V2 1DZCCQA 1 -)OI -An Address cj�1 0� 1 o v �- 7—P �-V-e 1 tJ Phone I Cell Phone (61130) --1 a 1- 4 a I a. Contractor Contact Information Name Soc, e, v\A C)v ctiv-\ Address 31<,'.( t/2,ze_d Cf -e 9- 1, yen,( Phone vy-x o0Y 2,5Q �\ �£ J �,_)C. 2 X I I 1 Cell Phone S �, _ j q WHO WILL BE THE PRIMARY CONTACT? ❑ Owner ❑ Applicant contractor Description of Existing Structures on Site }kov S.-_ t;,v1 d # of Bedrooms *t 2 Structure Dimensions Z -{•()X LI<D # of Occupants I Basement ayes ❑ No Basement Fixtures ❑ Yes �No�-u nknpv/ n The Applicant shall notify the local health department upon submittal of this application if any of the following apply to the property ip question. If the answer to any question is "yes", applicant must attach supporting documentation. 0Yes 13No Does the site contain any jurisdictional wetlands? i( Yes ❑ No Does the site contain any existing wastewater systems? ❑ Yes 9f No Is any wastewater going to be generated on the site other than domestic sewage? 3,//es ❑ No Is the site subject to approval by any other public agency? ❑ Yes ❑ No Are there an�,easements or right of ways on this property? Describe Existing water supply in use Q Individual Well ❑ Community Well ❑ Seini-Public Well i FJCounty/City/Township Water Line Is a public water supply available? ** Yes dNo 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 ❑ Conventional 0 Innovative 13 Other 0 Any f CATH�( BA THIS IS NOT A PERMIT COUNTY \y `y �y CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services Proposed Facility Type ❑ Primary Residence ❑ New Residence (( Addition to Residence # of New Bedrooms *t Project Description ig;; 1 ct t,r, CJ ec (: Structure Dimensions 3�, �! �`7 # of Occupants Basement ❑ Yes ❑ 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 U Multi -Family Residence # Units #Bedrooms per Unit* l Total # Bedrooms *t Structure Dimensions U Food Service Speci fy 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 Page 2 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. f 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 corners and making the site accessible so that a complete site evaluation can be performed. Signature of Owner or Agent�� -- Date 0 `7 12- (o 1 g J _ /) Printed Name of Owner or Agf,ie V� / 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: 4616-04-72-1223 1 inch = 40 feet Prepared for: N THIS IS NOT A LEGAL DOCUMENT Date: 7/26/2013 Time 10:07:49 AM 4i CATAWBA COUNTY NC - Parcel Report Information Regarding Selected Parcel(s) Parcel ID: 4616-04-72-1223 Name: BOAN REBECCA L Name2: Address: 5062 LEE PT Address2: City: TERRELL State: NC Zip: 28682-9775 Account: Calc Acreage: 0.37 Tax Map: 01 8F 01072 LRK: 19713 Deed Book: 2639 Deed Page: 1548 Subdivision Name: KISER SUNSET KEYS 1 Subdivision Block: Lots: 12 Plat Book: 13 Plat Page: 17 Building Number: 5062 Street Name: LEE PT Site Zip: 28682 Township: MOUNTAIN CREEK Fire Dist: SHERRILLS FORD City/Tax: State Road: Total Bldgs Value: $169,800 Land Value: $228,300 Total Value: $398,100 Year Built: 1968 Year Remodeled: Last Sale Date: 2/3/2005 Last Sale Amount: $304,000 Neighborhood: 129 Watershed: WS -IV Critical Area Watershed Split: NO Voter Precinct: P41 E911 District: COUNTY Zoning: R-30 Zoning2: Zoning3: Zoning Split: N Zoning Overlay: CRC-O,WP-O,FPM-O Zoning District: COUNTY Split Zoning Dist: N Split Zoning Dist(1): 0 Split Zoning Dist(2): 0 School District: COUNTY Elementary School: SHERRILLS FORD Middle School: MILL CREEK High School: BANDYS School Split: NO P&Z Case Number: LOMA 3-13-2002 Census Tract 2010: 011504 Census Block 2010: 5027 Small Area Plan: SHERRILLS FORD Agricultural District: Printed: Friday, July 26, 2013 10:07 AM j CATAWBA COUNTY HEALTH DEPARTMENT POsKJ Telephone: (828) 465-8270 TDD: (828) 465-8200 WLS # Ip AC Rpr. P >'. Opr. Prmt, Sys. Type Well Prmt. Replacement Well Well Rpr. Prmt. Ower%Agent �, s �(JAv v Phone A-ddress Ajaj0 G.,t/ Subdivision �Ull LG= Section/Block//PP se Lot# Lot Size , '7 Directions: /0 —S(2:2 c`Sa- %R-) _��.,,� .� /91- c. Property Address 5026.2 bee /0114 Facility: House Mobile Home Business Multi-family . Other: Pin Number 4A64G-Oq- 7Z— /Z,Z_� Other . Zoning Approval # # Bedrooms # Seats # Employees . Application Rate GPD Flow Hot Tub or Spa yes/no Special Fixtures Basement yes/no 100% Repair Area yes/no Basement Plumbing yes/no Water Supply: Private Well Public Semi-Public *************************************************************************************************************************** Type of System: Trench ed Pump Pump/Panel Panel LPP Other Septic Tank Size mp Tank ' e Nitrification Field: Total Square Feet _ Depth of Stone Bed Size Trenc tdth Total Le of All Trenc es / N be Trench Length _/_//_/_/ Feet on Center Maximum Trench Depth Distance of Nearest Well *DO NOT INSTALL SEPTIC WHEN WET* *WELL RECORD REQUIRED AT COMPLETION* Topo % Slope Texture Structure 6 Clay Min. 6 Soil Wetness Soil Depth Restric. Hoz. at Available space yes/no I /� Overall Class S PS U� Comments- Filter Required Riser required when f �� tank is more than 6 inches deep. **NO GUARANTEE OR WARRANTY IS IMPLIED OR GIVEN AS TOT DANCE OR LENGTH OF TIME THIS SYSTEM WILL FUNCTION" *Improvement Permit has no expiration date and is transferable, but may be revoked if site plans or intended use changes for the proposed facility. An Authorization to Construct is valid for (5) five years from date issued and is not transferable. Well Permit valid for 5 years provided site conditions do not change. Well location, installation, and protection must meet state and local regulations, and must be inspected and approved by a representative of the Catawba County Health Department before an 91159rtion of the installation is put into use. The siting of the well by the Health Department staff is to provide protection from known ross�qXrces of contamination. No volume of water is guarantee t a ite b the Health Department.L Permit Date'- EHS / caner/Agent,-, ( Septic Tank fristZlea Date EHS Well Installed By Q i—v— 4t-oCon t Approval Date c9 — G/ -3 Well Head Approval Date L/-1,el— Z-1 Date Sample Collected 41—/L/—�/ I Q Date of Results Results ' ' EHS /'A�// White - Office Yellow - Owner/Agent Pink - Building Inspection Auth6 zatct