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Home My WebLink AboutRBPR-07-2014-19423.TIFTHIS IS NOT A PERMIT Case # RBPR-07-2014-19423 CATAWBA COUNTY HEALTH DEPARTMENT PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES Residential Building Plan Review - Building Addition IMPROVEMENT Applicant MATTHEW STARNS, 4329 BURTON DR, MAIDEN NC 28650 C:8282446807 Contractor MATTHEW STARNS, 4329 BURTON DR, MAIDEN NC 28650 C:8282446807 Owner PATRICK LEDBETTER, PO BOX 321, CLAREMONT NC 28610 C:8283203238 NAME TO APPEAR ON PERMIT Patrick Ledbetter SITE ADDRESS: 4146 LITTLE MOUNTAIN RD, NEWTON NC 28658 PIN # 367801250867 NAME of SUBDIVISION: Lot # Section/Block PROPERTY SIZE: Square Feet Acres 1.32 DIRECTIONS: 16S/ left Buffalo Shoals Rd/ left Little Mtn Rd/ house on right PRIMARY CONTACT: ica SEWER TYPE: Septic Tank GALLONS PER DAY: 240 WATER SUPPLY: Private Well DESCRIBE WORK: addi I o existing dwelling / 16 x 40 workout room 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: STRUCTURE TYPE: New Structure PRIMARY RESIDENCE FACILITY TYPE: Single Family Residence OTHER DESCRIPTION: DESCRIPTION OF single family dwelling EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: 28 x 28 NUMBER OF EXISTING BEDROOMS: 2 # OF OCCUPANTS: 4 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 16 x 40 Desired system types (Improvement Permit or Authorization to Construct): ACCEPTED: ALTERNATIVE: CONVENTIONAL: OTHER: INNOVATIVE: ANY: Other described: E9 - chapplication 07/16/2014 15:19 Page I of 4 Z �84 U sM Applicant Contractor Owner THIS IS NOT A PERMIT Case # RBPR-07-2014-19423 CATAWBA COUNTY HEALTH DEPARTMENTmm PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES Residential Building Plan Review - Building Addition IMPROVEMENT MATTHEW STARNS, 4329 BURTON DR, MAIDEN NC 28650 C:8282446807 MATTHEW STARNS, 4329 BURTON DR, MAIDEN NC 28650 C:8282446807 PATRICK LEDBETTER, PO BOX 321, CLAREMONT NC 28610 C:8283203238 NAME TO APPEAR ON PERMIT Patrick Ledbetter SITE ADDRESS: 4146 LITTLE MOUNTAIN RD, NEWTON NC 28658 PIN # 367801250867 NAME of SUBDIVISION: Lot # Section/Block PROPERTY SIZE: Square Feet Acres 1.32 DIRECTIONS: 16S/ left Buffalo Shoals Rd/ left Little Mtn Rd/ house on right PRIMARY CONTACT: Applicant SEWER TYPE: Septic Tank GALLONS PER DAY: 2400 WATER SUPPLY: Private Well DESCRIBE WORK: addition to existing dwelling / 16 x 40 workout room 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 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: 28 x 28 NUMBER OF EXISTING BEDROOMS: 2 # OF OCCUPANTS: 4 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 16 x 40 Desired system types (Improvement Permit or Authorization to Construct): ACCEPTED: ALTERNATIVE: CONVENTIONAL: OTHER: INNOVATIVE: ANY: Other described: 1=9 - rhgphLation 07/07/2014 16.42 Page I of aii�A CATANVBA COUNTY Case # RBPR-07-2014-19423 T, ! Public Health Department Subdivision Environmental Health Division PIN# 367801250867 PO Box 389, 100-A Southwest Blvd, Newton, NC 28658 184 sm NAME ON PERMIT: ( PATRICK LEDBETTER), PO BOX 321, CLAREMONT NC 28610 ( Patrick Ledbetter) Site Address: 4146 LITTLE MOUNTAIN RD, NEWTON NC 28658 Property Size: Square Feet Acres 1.32 Directions: 16S/ left Buffalo Shoals Rd/ left Little Mtn Rd/ house 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 and rules. I understand that I am solely responsible for the proper identification nd labeling of all property lines and corners and making the site accessible so that a omplete site evaluation can be performed. Date: �� J �r Signature of Applicant or Agent `�]�.� /,J1L / / An Environmental Health Specialist will contact you within 2 working days of'appIication date. If you need further information or assistance please call 828-466-7291 AREA1 MINIMUM SETBACKS FRONT: 80 SIDE: 15 FEENAME Improvement Permit (Existing) Fee TOTAL FEES REAR: 30 MAX HEIGHT: DATE FEE AMOUNT 07/07/2014 $90.00 $90.00 SYSTEM REDESIGN AND/OR RETRIP WILL INCUR AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) 1=9 - ehapplication 07/07/2014 16:42 Page 2 of 4 SBA CATAWBA COUNTY Public Health Department Environmental Health Division PO Box 389, 100-A Southwest Blvd, Newton, NC 28658 I$ 2 sv 0 M Case # 1MPV-12-2013-045801 Subdivision PIN# 367801250867 LOT# NAME ON PERMIT: PATRICK LEDBETTER, PO BOX 321, CLAREMONT NC 28610 Site Address: 4146 LITTLE MOUNTAIN RD, NEWTON NC 28658 Property Size: Square Feet 57,499.20 Acres 1.32 Directions: Drums Crossroads/Buffalo Shoals Rd/left on Little Mountain Rd/2nd house on right not including the house on the corner Improvement Permit INITIAL SYSTEM EXISTING Facility: Primary Residence Permit Category: Other Bedrooms 2 WATER SUPPLY: Basement? No Basement Plumbing? No .. ... .... .... ...._. - - INITIAL SYSTEM SPECIFICATIONS Permit Valid: Expires In Five Years: _X_ No Expiration: Projected Daily Flow 240 g.p.d Proposed Wastewater System: CONVENTIONAL Type: IIA - CONV SYSTEM (SINGLE-FAMILY OR 480 GPD OR LESS) Permit Conditions: Permit issued to allow for replacement of existing above ground pool in same location. Original septic system was repaired under permit #6779. Any future repair of septic system must be minimum: 1 00'from any well, 10' from property lines, 5' from any building foundation. Lines to be installed on contour. Do not grade drive or fill over existing system or repair area. New pool will not require any grading and will be an above ground pool allowing for a 5' setback. If a repair is required in fu ........ _. .....---- _ _.... ---- --- ......... REPAIR SYSTEM SPECIFICATIONS Repair System Required? Required Proposed Wastewater System: LOW PRESSURE PIPE Type: IVA - ANY SYSTEM WITH 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 aooroved, 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 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 Disoosal 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. Jason Boyd 12/19/2013 AUTHORIZED STATE AGENT APPROVAL DATE Permit Expiration Date: 12/19/2018 No grading or construction activity is allowed in areas designated for system and repair without approval of the Health Department. E9 - chpermit 12/19/2013 09:00 Pagel of 3 uti6� Scale Site Plan Improvement Permit (2-5 va ` L. 1+1e- r'^1---1 4a D Permit # L CATAWBA COUNTY Public Health Department Name F Address Environmental Health Division z�2 PO Box 389, 100A Southwest Blvd, Newton NC 28658 18 42 sM (828) 465-8270 Fax (828) 465-8276 TDD (828) 465-8200 PIN# uti6� Scale Site Plan Improvement Permit (2-5 va ` L. 1+1e- r'^1---1 4a D Q L 1r F z�2 T. �C 0 RBPR-12-13-18308 Patrick Ledbetter 4146 Little Mountain Rd Newton NC 367801250867 Y ` glad Lo r l� M' LPP Biu e o t o lY iV oz -+ 6--C'� 1, oQ- f �-s 1SS �a�c 0� AC ree , :r S Y Sty is ne-Q-a'-� THIS IS NOT A PERMIT W01 W CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services Page I Improvement Permit ❑ Authorization to Construct PD 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 Address U LJN!, (Vq RC-� Subdivision Lot # Acres Section/Block/Phase Driving Directions to Property Huy Z ) ;) � S_ 1 too- - in� U V-7 gloklf NAME TO APPEAR ON PERMIT? Owner n Applicant ❑ Contractor Applicant Contact Information Name ( n C1_,b( 54n ✓�n 5 Address (�j� Cj j� I r iL" Dv Phone j3,2 j�- — .42 c f Owner Contact Information Name I Address Phone p Contractor Contact Information Name A( -,L, cq C o2 6, tiz I Cell Phone i1 (1-11 Y� I,, () C n, S- Cell Phone Address L(Gj1-(yr t ��t r.� n Phone �� _ u (d,Qv'� I Cell Phone WHO WILL BE THE PRIMARY CONTACT? ❑ Owner Wpplicant ❑ Contractor Description isting Structures on Site -r of Bedrooms - ms *t , Structure DimeDimensions c >3 # of Occupants n�l Basement ❑ Yes [f No Basement Fixtures Yes No The Applicant s fy the local health department submittal'of submitta ppataon if any of wing ap T pp hall not 1 of this a hc. 1. i W the following ply to the property in question. If the answer to any question is "yes", applicant must attach supporting documentation. 0 Yes i�-No Does the site contain any jurisdictional wetlands? Yes 10 Does the site contain any existing wastewater systems? a Yes "0 Is any wastewater going to be generated on the site other than domestic sewage? Yes ,No Is the site subject to approval by any other public agency? 0 Yes E;,No Are there any easements or right of ways on this property? Describe Existing water supply in use � Individual Well ❑ Community water supply available Semi -Public*❑ Well � No ' mm ❑ County/City/TownshipWater Line Is p 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) ❑ Accepted 0 Alternative 0 Conventional 11 Innovative 0 Other ❑ Any CATAWBA THIS IS NOT A PERMIT COUNTY CATAWBA COUNTY HEALTH DEPARTMENT T Application for Enviromnental Services Page 2 Proposed Facility Type Primary Residence ❑ New Residence Addition to Residence # of New Bedrooms * j Project Description -A o'{n(; -k i ),I Structure Dimensions # of Occupants Basement ❑ Yes O� No Basement Fixtures 0 Yes JqNo ❑ Accessory Structure(s) Describe # of New Bedrooms *t if applicable Structure Dimensions # of Occupants Accessory Dwelling ❑ Yes ❑ No Plumbing ❑ Yes ❑ No Describe Plumbing Needed Mintz -Family Residence # Units #Bedrooms per Unit*� 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/Abaudonment/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 �OADate 7 17 1 Printed Name of Owner or Agent A 1 inch = 60 feet Catawba County, North Carolina This map product was prepared from the Catawba County, NC, Geospatial Information System. 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: 3678-01-25-0867 Prepared for: 1.36A 9 9 5\\\61 1.32A 08X6,7,7'--- tib/ THIS IS NOT A LEGAL DOCUMENT 7 29 3 s 2 2.18A 2753 at 59-131 Date Saved:,6/11/2014166 Time: 4:21:- PM CATAWBA COUNTY NC - Parcel Report Information Regarding Selected Parcel(s) Parcel ID: 3678-01-25-0867 Name: LEDBETTER PATRICK ONEAL Name2: Address: PO BOX 321 Address2: City: CLAREMONT State: NC Zip: 28610-0321 Account: Calc Acreage: 1.32 Tax Map: 002 K 06019A LRK: 1625 Deed Book: 2458 Deed Page: 1692 Subdivision Name: Subdivision Block: Lots: Plat Book: Plat Page: Building Number: 4146 Street Name: LITTLE MOUNTAIN RD Site Zip: 28658 Township: CALDWELL Fire Dist: BANDYS City/Tax: State Road: 1815 Total Bldgs Value: $54,800 Land Value: $15,700 Total Value: $70,500 Year Built: 1955 Year Remodeled: 1978 Last Sale Date: 4/21/2003 Last Sale Amount: $78,000 Neighborhood: 122 Watershed: WS -IV Protected Area Watershed Split: NO Voter Precinct: P1 E911 District: COUNTY Zoning: R-40 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: BALLS CREEK Middle School: MILL CREEK High School: BANDYS School Split: NO P&Z Case Number: Census Tract 2010: 011402 Census Block 2010: 4016 Small Area Plan: BALLS CREEK Agricultural District: Printed: Monday, July 07, 2014 04:21 PM Q. North Carolina Department of Health and Human Services Division of Public Health Pat McCrory Governor Onsite Water Protection Branch April 30, 2014 Patrick O'Neal Ledbetter PO Box 321 Claremont, NC 28610 Re: Approval No. JMB369 Aldona Z. Wos, M.D. Ambassador (Ret.) Secretary DHHS Penelope Slade -Sawyer Division Director Private Well Located Less than 25' from Building Perimeter [Rule 15A NCAC 2C .0 1 07(a)(2)(M)] Property location: 4146 Little Mountain Rd Newton, NC 28658 Dear Mr. Ledbetter: On April 27, 2014 the On-site Water Protection Branch received your request for a variance from the Well Construction standards, Title 15A North Carolina Administrative Code Subchapter 2C .0100. The request for a variance concerns a water supply well on the referenced property that currently serves a single family dwelling and an addition is planned for the home that will be within twenty five feet of the well. Specifically, the variance request grants you permission to use an existing water supply well at a distance closer than the twenty five foot setback to a building perimeter. Achieving the twenty five foot setback would be difficult given the challenges of the property. Based upon information provided by the property owner, it is my finding that based upon current conditions as the site exist today (as well as the current proposal for use of the structure) you meet the conditions necessary for approval of a variance as specified by 15A NCAC .0118 (a) (1) and (2). On that basis and if the following conditions are met, the requested variance is approved: www.ncdhhs.gov • www.publichealth.nc.gov Tel 919-707-5874 • Fax 919-845-3973 Location: 5605 Six Forks Road • Raleigh, NC 27609 Mailing Address: 1642 Mail Service Center • Raleigh, NC 27699-1642 An Equal Opportunity / Affirmative Action Employer AIH North Carolina Public Health Ledbetter April 30, 2014 1) The well shall be sampled for the same parameters of a newly constructed well. If samples indicate contaminants, further repairs/treatment may be required. 3) No potential sources of groundwater contamination shall be stored near the well -head. 4) No termite treatment shall be applied within twenty five feet of the well unless alternative methods are approved by the health department. The granting of this variance is for the well location only. It in no way relieves the owner or agent from other requirements of the North Carolina Well Construction Standards including, but not limited to the requirements in 15A NCAC 2C .0113(b) to repair or to abandon any well which acts as a source or channel for the migration of contamination. This approval does not imply sufficient water quality. Further, the approval does not relieve your responsibility to comply with any other applicable Federal, State, or local laws or regulations. If you have any questions regarding this variance, please contact me at (828) 713-3335. Sincerely, John M. Brooks R.E.H.S, MS