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Home My WebLink AboutRBPR-07-2014-19418.TIFIBLkZ SM THIS IS NOT A PERMIT Case # RBPR-07-2014-19418 CATAWBA COUNTY HEALTH DEPARTMENT PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES Residential Building Plan Review - Building Addition IMPROVEMENT Applicant SAME AS OWNER, , Owner LARRY GREENE, 3941 HOLLY SPRINGS DR, NEWTON NC 28658 C:828-465-2939 NAME TO APPEAR ON PERMIT Larry Greene SITE ADDRESS: 3941 HOLLY SPRINGS DR, NEWTON NC 28658 NAME of SUBDIVISION: HOLLY SPRINGS SUB Lot # PROPERTY SIZE: Square Feet Acres 0.9 DIRECTIONS: 16 S Right Buffalo Shoals, Right on Holly Springs 5th house on left PRIMARY CONTACT: Owner SEWER TYPE GALLONS PER DAY: 360 WATER SUPPLY DESCRIBE WORK: 14 x 21 Laundry room Addition to rear of house 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: Existing Structure STRUCTURE TYPE: FACILITY TYPE: Single Family Residence DESCRIPTION OF House EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: 72 x 30 NUMBER OF EXISTING BEDROOMS: 3 NEW STRUCTURE DIM:: 14 x 21 PRIMARY RESIDENCE OTHER DESCRIPTION: PIN # 366702992743 6 Section/Block Septic Tank Private Well # OF OCCUPANTS: 2 PROPOSED CONSTRUCTION BASEMENT? No BASEMENT FIXTURES? No Desired system types (Improvement Permit or Authorization to Construct): ACCEPTED: ALTERNATIVE: OTHER: INNOVATIVE: Other described: M PLUMBING REQUIRED? Yes CONVENTIONAL: ANY: YES E9 - ehapplication 07/07/2014 14:34 Page] of 4 �A CATAWBA COUNTY Case # RBPR-07-2014-19418 Public Health Department Subdivision HOLLY SPRINGS SUB Environmental Health Division PIN# 366702992743 •�� PO Box 389, 100-A Southwest Blvd, Newton, NC 28658 I g 2 u NAME ON PERMIT: ( LARRY GREENE), 3941 HOLLY SPRINGS DR, NEWTON NC 28658 ( Larry Greene) Site Address: 3941 HOLLY SPRINGS DR, NEWTON NC 28658 Property Size: Square Feet Acres 0.9 Directions: 16 S Right Buffalo Shoals, Right on Holly Springs 5th house 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 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 r es. I understand that I am solely responsible for the proper identification lab? } of 11 e oploperty lines and corners and making the site acces blthat a comple a evaluation can be performed. Date: — / Signature of Applicant or Agent 11,A.A _ An Environmental Health Specialist will contact you within 2 workinays of application 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 07/07/2014 $150.00 $150.00 SYSTEM REDESIGN AND/OR RETRIP WILL INCUR AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) E9 - ehapplication 07/07/2014 14:34 Page 2 of 4 THIS IS NOT A PERMIT .� A LATAWA COUNTS' HEALTH DEPARTMENT ENT Application for Environmental Services Page 1 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 ❑ Existing Facility ❑ Property Address 3 9 /a ( 9�,X- Lot m'(17J5 1�/1 Subdivision # Acres / �� Section/Block/Phase Driving Directions to Property 1c, ,SSAae 1S f i�L� � ; �" �6 f% S /9 n K NAME TO APPEAR ON PERMIT? ❑ Owner ❑ Applicant ❑ Contractor Applicant Contact Information Name ), 1#A, K r, Address 3 -1,4 tY/,),? ? , „1s Phone r_ Cell Phone Owner Contact Information Name 5 YIs� v Address Phone Cell Phone Contractor Contact Information Name Address Phone Cell Phone WHO WILL BE THE PRIMARY CONTACT? Z Owner ❑ Applicant ❑ Contractor Description of Existing Structures on Site 14-oXS t # of Bedrooms *t --7 Structure Dimensions r72 X -(D # of Occupants Basement ❑ Yes No 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 uestion. If the answer to any question is "yes", applicant must attach supporting documentation. �a o Does the site contain any jurisdictional wetlands? 1 r0 No Does the site contain any existing wastewater systems? 0 Yes 131fo Is any wastewater going to be generated on the site other than domestic sewage? AffIfes n No Is the site subject to approval by any other public agency? 0 Yes 01 o Are there any easements or right of ways on this property? Describe Existing water supply in use individual Well ❑ Community Well ❑ Semi -Public Well ❑ County/City/Township Water Line Is a public water supply available? ** ❑ Yes E]-Tqo-- If applying for an Improvement Permit or Authorization to Construct, Please Indicate Desired Sy Type(s): stem T e(s): (systems can be ranked in order of your preference) 0 Accepted 0 Alternative ❑ Conventional ❑ Innovative ❑ Other 0 Any CATAWBA THIS IS NOT A PERMIT COUNTY CATAWBA COUNTY HEALTH DEPARTMENT Application for Enviromnental Services Page 2 Proposed Facility Type D ❑ Primary Residence ❑ New Residence m ddition to Residence # of New Bedrooms *t Project Description y A b InCIIZ X R D o GY Structure Dimensions I g X oq l # of Occupants Basement ❑ Yes ®—No Basement Fixtures Yes a 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 Multi -Family 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 AgentDate Printed Name of Owner or Agent t, 14 A A� �a � ti � 1 inch = 50 feet 7 2 0, 3919 12 5 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: 3667-02-99-2743 Prepared for: 5 167.94 THIS IS NOT A LEGAL DOCUMENT Date Saved: 6/11/2014 Ti me:_.L:.5 - 2 PM CATAWBA COUNTY NC - Parcel Report Information Regarding Selected Parcel(s) Parcel ID: 3667-02-99-2743 Name: GREENE LARRY W Name2: Address: 3941 HOLLY SPRINGS DR Address2: City: NEWTON State: NC Zip: 28658-9678 Account: Calc Acreage: 0.9 Tax Map: 005BK 01006 LRK: 5291 Deed Book: 3142 Deed Page: 1884 Subdivision Name: HOLLY SPRINGS SUB Subdivision Block: Lots: 6 Plat Book: 19 Plat Page: 31 Building Number: 3941 Street Name: HOLLY SPRINGS DR Site Zip: 28658 Township: CALDWELL Fire Dist: BANDYS City/Tax: State Road: 2739 Total Bldgs Value: $169,700 Land Value: $16,600 Total Value: $186,300 Year Built: 1988 Year Remodeled: Last Sale Date: 8/1/1988 Last Sale Amount: $8,900 Neighborhood: 125 Watershed: WS -II 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: TUTTLE Middle School: MAIDEN High School: MAIDEN School Split: NO P&Z Case Number: Census Tract 2010: 011601 Census Block 2010: 2000 Small Area Plan: BALLS CREEK Agricultural District: Proximity Printed: Monday, July 07, 2014 01:51 PM l� l� —fo r� { bQcks d de,S�S >�� r.�- CATAWBA COUNTY HEALTH DEPARTMENT PERMIT # 03683 COMPLETION PERMIT OWNER 'O R CONTRACTOR:trs,;,,,,,DATE: / e/ / ADDRESS: PHONE: LOCATION: SUBDIVISION: ti.LOT: SECTION OR BLOCK: LOT SIZE: House Mobia Home Business Other Flow Rate: gpd Bedrooms: Bathrooms 2. Special Fixtures: Other: Basement Yes ( ) No --I—Fixture in basement -Yes No (—)-- ---------------------------------------------------------------------------------------------- Garbage Disposal Unit: Yes ) No L-)-- Water -Supply: Private ( ) Public ( TANK SIZE: /0 f-,;) gallons Distance from septic tank or nearest source of NITRIFICATION FIELD: pollution: A -7 - Number of lines: 1:3 FINAL APPROVAL OF THIS SEPTIC TANK SYSTEM SHALL IN Length and width of lines NO WAY BE TAKEN AS A GUARANTEE THAT THE SYSTEM WILL (a) Bed System FUNCTION SATISFACTORILY FOR ANY GIVEN PERIOD OF (b) Trench System 36" x TIME. or Trench Sys. 30" x DATE INSTALLED: Total Sq. Ft f3 Depth of Stone INSTALLED BY: REMARKS: SANITARIAN: V SITE AND SEPTIC TAKK LAYOUT HEALTH DEPARTMENT COPY -ERM1'J-- NU. PERMIT ,FEE: oo� -Q2-q-t2 PER%IIT VOID AFTER 36 MONTES CATAWBA COUNTY HEALTH DEPARTMENT IMPROVEMENT PERMIT OWNER OR CONTRACTOR:DATE: ADDRESS: 7A PHONE: LOCATION: SUBDIVISION: LOT fly,_ SECTION OR BLOCK: LOT SIZE: Notified to Sbeck 4ftV-Zonidg Yes (__)--No Zoning Approval # 69"s - House ( Mobile Home ( ) Business Other'Flow Rat-e:gpd Bedrooms: 73 Bathrooms: Special Fixtures: Other: Basement - Yes No Fixtures in Basement Yes No ((_)_,Pu-mp Svstem. yc.s( 1 Ivo ----------------- ---------------------------------------- Garbage Disposal Unit Yes No (C--)— Water Supply: Private (k--�--Public TANK SIZE: .160"r) gallons Comments/Special Instructions: NITRIFICATION FIELD: Number of Lines Length and width of Lines System must be installed as shown. Any (a) Bed System changes will be made only with prior Realth (b) Trench System 36" X Department approval. If unforeseen problems or Trench System 30" X arise during installation, contractor must Total .Sa ar -Footagg I 2�RL 9 _Dep t.__Qf to call Health Department. ----------------- ----------------------------- I CERTIFY .THAT I HAVE REVIEWED AND AGREE TO THE PR.QVIST NS ONT13 IS PERMIT. Owner/Agent Sanitarian Final approval of this septic tank system shall in no way be taken as a guarantee that the system will function satisfactorily for any given period of time. SITE AND SEPTIC TANK PLAN lHealth Department Copy Site Factor: I 1 s s�-1vp1 c.atich Rate Slope and Landscape Position CS,'- PS - U Soil Drainage S P-.- U Sandy Clay Soil Depth S - - U III Fine Silt Loam 0.6-0.4 Restrictive Horizon S - vs�- U Loams Clay Loam Available Space S U Silty Clay Other S U (Specify) Sandy Clay Soil Characteristics: S Silty Clay Repair Area Required: �4�- MS, - U Iva Clays 0.4-0.2 Yes Clay *Bed systems are allowed only in soil Group III,