HomeMy WebLinkAboutRBPR-07-2014-19524.TIFApplicant
Contractor
Owner
THIS IS NOT A PERMIT Case # RBPR-07-2014-19524
CATAWBA COUNTY HEALTH DEPARTMENT 0 `.-10
PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES
Residential Building Plan Review - Manufactured Home _.
T
AUTH CONST -NEW WELL
VOLLIE MANNING, 3152 WATER PLANT RD, MAIDEN NC 28650
H:8284610991 HOME:8284610991
OAKWOOD HOMES #712,1265 HWY 70, NEWTON NC 28658
B:(828)217-1862 C:(828)464 -2662F:828-464-4301
MARVIN LEATHERMAN, 1362 HARRIS AV, NEWTON NC 28658
16
Paid By ELIOBERTO (AL) ALFONSO, 1265 HWY 70 W, NEWTON NC 28658-
0:8282175480
NAME TO APPEAR ON PERMIT
Vollie Manning
SITE ADDRESS: 2283 SIGMON DAIRY RD, NEWTON NC 28658 PIN # 363917203222
NAME of SUBDIVISION: FERNWOOD ACRES SUB PHASE 1 Lot # 6 Section/Block
PROPERTY SIZE: Square Feet Acres 0.59
DIRECTIONS: 10W/ LEFT SIGMON DAIRY RD / LOT ON RIGHT
PRIMARY CONTACT: Contractor SEWER TYPE: Septic Tank
GALLONS PER DAY: 360 WATER SUPPLY: Private Well
DESCRIBE WORK: DW MOBILE HOME 2014/ Must meet appearance criteria, Screen or Remove Towing Tongue, Deck must be
36 sq ft deck on front, Must be masonry underpinned/ Must be parallel to road and must face front of property
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? No
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:
FACILITY TYPE: Mobile Home
DESCRIPTION OF VACANT LOT
EXISTING STRUCTURES
ON SITE (IF ANY)
DIM EXISTING STRUCTURE:
NUMBER OF EXISTING BEDROOMS:
PRIMARY RESIDENCE
OTHER DESCRIPTION:
# OF OCCUPANTS: 2
PROPOSED CONSTRUCTION
NEW STRUCTURE DIM:: 28 X 52
# OF NEW BEDROOMS:: 3
Desired system types (Improvement Permit or Authorization to Construct):
ACCEPTED: ALTERNATIVE:
OTHER: INNOVATIVE:
Other described:
CONVENTIONAL:
ANY: YES
APPLICATION FOR WELL CONSTRUCTION
PROPOSED WELL TYPE: Individual Well REPLACE WELL?: NO
G9 - :harpliolliori 07/16/2014 11:28 Page 1 of4
CATAWBA COUNTY Case # RBPR-07-2014-19524
Public Health DepartmentSubdivision FERNWOOD ACRES SUB PHA
Environmental Health Division PIN#
as 363917203222
PO Box 389, 100-A Southwest Blvd, Newton, NC 28658
1842 sM
NAME ON PERMIT: (VOLLIE MANNING), 3152 WATER PLANT RD, MAIDEN NC 28650
(Vollie Manning)
Site Address: 2283 SIGMON DAIRY RD, NEWTON NC 28658
Property Size: Square Feet Acres 0.59
Directions: 10W/ LEFT SIGMON DAIRY RD / LOT 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 an inr. property lines and corners and making the site access so th t"a complete site evaluation can be performed.
Date: 7 �� l Y Signature of Applicant or Agent
A Environmental Health Specialist will contact you within 2 worl:i days of application date.
If you need further information or assistance please 828-466-7291
AREA1
MINIMUM SETBACKS FRONT: 30 SIDE: 15 REAR: 30 MAX HEIGHT:
FEENAME DATE FEE AMOUNT
Authorization to Construct Fee (New/Expansion) 07/16/2014 $150.00
Fee
Well Permit & Inspection Fee 07/16/2014 $300.00
'TOTAL FEES $450.00
FEES ARE NON-REFUNDABLE
ONCE A SITE VISIT IS MADE OR
WORK ON A PLAN REVIEW HAS COMMENCED
SYSTEM REDESIGN AND/OR RETRIP WILL INCUR AN ADDITIONAL CHARGE
(SEE FEE SCHEDULE)
1-.9 - 0happl1r:11ion 07/16/2014 1 126 Page 2 of 4
A'W7BATHIS IS NOT A PERM1T
CATAWBA COUNTY HEALTH DEPARTMENT
�oro Application for Environmental Services Page 1
Improvement Permit ❑ Authorization to Construct Septic Repair El Septic Malfunction E:1Septic Expansion V New Well Permit [:1 Replacement Well ❑ Well Abandonment ❑
Well Repair ❑ Existing System Inspection (Pre -Approval Required) ❑
Application is for New Construction ❑ Existing Facility ❑
Property Address 7 m 3 S : 7,N.p . ► AV c, Subdivision
f F Lot # Acres
Section/Block/Phase
Driving Directions to Property Fee,> �.-%— ,S !rte �cn low y /0 &J ?'o
NAME TO APPEAR ON PERMIT? [Owner
Applicant Contact Information
Name l% I t: t
I Address
I Phone
[] Applicant ❑ Contractor
Owner Contact Information
Name
Address
Phone
Contractor Contact Information
Name 0/\ (� .� o a _L h4�.�.,� S 7! Z
,,J C zp. G s (-)
Cell Phone !re gq
I Cell Phone
Address 1 t&" y ? o t j '�.J C-
Phone , CjrZ F--_ ` 'if L G 6 2 I Cell Phone 2 77—C— d
WHO WILL BE THE PRIMARY CONTACT? ❑ Owner ❑ Applicant Contractor
Description of Existing Structures on Site
# of Bedrooms *t "7� Structure Dimensions 2P—^ 57Z # of Occupants Z
Basement
Basement
p
TheApplicant hlnotify 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.
0 Yes o Does the site contain any jurisdictional wetlands?
El Yes No Does the site contain any existing wastewater systems?
10 Yes 2,1 No Is any wastewater going to be generated on the site other than domestic sewage?
Yes 13 No Is the site subject to approval by any other public agency?
0 Yes No 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 ❑ No
If applying for an Improvement Perm+it or Auth�o�r�ization to Construct, Please Indicate Desired Sys�te�m++ Type(s_
):
(systems can be ranked in order of your preference)
0 Accepted 13 Alternative Conventional 0 Innovative 11 Other Any
CATAWBA THIS IS NOT A PERMIT
COUNTY CATAWBA COUNTY HEALTH DEPARTMENT
NT
Dmnin Cmntnn
Application for Environmental Services Page 2
Proposed Facility Type
❑ Primary Residence 96 New Residence ❑ Addition to Residence # of New Bedrooms *t 3
Project Description X S Z n,•a.., Y{ I. G-, •' a1 -o—
Structure
oStructure Dimensions Z F S # of Occupants 2—
Basement
Basement ❑ Yes ;?I -No Basement Fixtures Yes No
u 5 ,._..-....:..._,._ ..d,,...:..., ,..: ........ .. :...:.:.r�..._ �..,...,.............-...::.�...�:..__...,=...,a:��.....__,_.,..:�:..-....:.....�..�,.:.�_�.... ,
❑ Accessory Str- cture Describe
# of New Bedrooms *t if applicable Structure Dimensions
# of Occupants Accessory Dwelling ❑ Yes ❑ No
Plumbing ❑ Yes ❑ No Describe Plumbing Needed
Multi-Famil Residence #Units ., :.-.m,....... �.�:, :. #Bedrooms per Unita.
❑.. y P *t
Total # Bedrooms *t Structure Dimensions
Food Service
.::Specify
._:._._._�...,_.....:_.�._..._..y_...:., ..1_. _..,,:.�..._..�.:,... y ...... �......,.,�-.��...�..,_,�....._...,_.. �„�y:.�...:.o. _�._._...�.....r__
Type
# Seats Floor Space -Entire Food Service Facility (Sq Ft)
# Employees per Shift # of Shifts Dining Area (Sq. Ft.)
❑ Business
:.:. S Type of BusinessRetail Floor S .. ,..,m...,....., -,..v...: _ _ ..:,. ,_ .....� �.:..�., ....:...:.:........_ .......,,,,puace ,.m_.�:,-...�.,...,...,
Specific
# of Employees per Shift # of Shifts
❑ Other Facility Type Specify
If Church # of Seats Kitchen ❑ Yes ❑ No If Daycare Specify Occupancy
Application for Well Cper'
onstruction/Abandonment/Re
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 comers and making the site
accessible so that a complete site evaluation can be Perfbrmed. `
Signature of Owner or Agent_ Date 71,1Z
Printed Name of Owner or Agent It% d,^/ s
17-148 2422
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2382
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3222
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THIS IS NOT A LEGAL DOCUMENT ate Saved: 6/11/2014 Time: 10:43:24 AM
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Catawba County, North Carolina e
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: 3639-17-20-3222
1 inch = 50 feet
Prepared for:
17-148 2422
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00
,0 6
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2382
s
3222
0
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0 5
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CATAWBA COUNTY NC - Parcel Report
Information Regarding Selected Parcel(s)
Parcel ID:
3639-17-20-3222
Name: '
LEATHERMAN MARVIN RAY
Name2:
LEATHERMAN MARGARET BRENDA
Address:
1362 HARRIS AVE
Address2:
City:
NEWTON
State:
NC
Zip:
28658-1611
Account:
Calc Acreage:
0.59
Tax Map:
047N 01039
LRK:
30436
Deed Book:
2187
Deed Page:
1376
Subdivision Name:
FERNWOOD ACRES SUB PHASE 1
Subdivision Block:
Lots:
6
Plat Book:
17
Plat Page:
148
Building Number:
2283
Street Name:
SIGMON DAIRY RD
Site Zip:
28658
Township:
NEWTON
Fire Dist:
NEWTON RURAL
City/Tax:
State Road:
2013
Total Bldgs Value:
Land Value:
$10,000
Total Value:
$10,000
Year Built:
Year Remodeled:
Last Sale Date:
Last Sale Amount:
Neighborhood:
113
Watershed:
Watershed Split:
NO
Voter Precinct:
P34
E911 District:
COUNTY
Zoning:
R-20
Zoning2:
Zoning3:
Zoning Split:
N
Zoning Overlay: DWMH-O
Zoning District:
COUNTY
Split Zoning Dist:
N
Split Zoning Dist(1):
0
Split Zoning Dist(2):
0
School District:
COUNTY
Elementary School:
STARTOWN
Middle School:
MAIDEN
High School:
MAIDEN
School Split:
NO
P&Z Case Number: RZ2012-06
Census Tract 2010: 011702
Census Block 2010:
2010
Small Area Plan:
STARTOWN
Agricultural District:
Printed: Wednesday, July 16, 2014 10:43 AM
Ole Lie I I
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s� CATAWBA COUNTY
F Public Health Department
Environmental Health Division
PO Box 389, 100-A Southwest Blvd, Newton, NC 28658
I$ 2 w
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Case # IMPV-06-2014-051325
Subdivision Fernwood Acres sub Phase
PIN# 363917203222
LOT# 6
NAME ON PERMIT: VOLLIE MANNING, 3152 WATER PLANT RD, MAIDEN NC 28650
Site Address: 2283 SIGMON DAIRY RD, NEWTON NC 28658
Property Size: Square Feet 25,700.40 Acres •59
Directions: 70 East. right 321 Business, left on 10 W, left Sigmon Dairy Rd, approx 1 mile on right
Improvement Permit
Facility: Primary Residence
Permit Category: New Septic Bedrooms 3
WATER SUPPLY: Private Well
Basement? No Basement Plumbing? No
INITIAL SYSTEM SPECIFICATIONS
Permit Valid: Expires In Five Years: _X_ No Expiration:
Projected Daily Flow 360 g,p,d
Proposed Wastewater System: 25% REDUCTION
Type: IIIG - OTHER NON -CONY TRENCH SYSTEMS
Permit Conditions: Keep all parts of new septic system and repair area minimum: 50' from any well, 10' from property
lines, 5' from home including decks. Lines to be installed on contour. Do not grade drive or fill over
system or repair area.
............ _..- - ..__.... . _ .. -- - _...... - - - ... .
REPAIR SYSTEM SPECIFICATIONS
Repair System Required? Required
Proposed Wastewater System: 25% REDUCTION
Type: HIG - OTHER NON -CONY TRENCH SYSTEMS
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.
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 Sewaee Treatment and Disuosal Svstems' (I5A 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 06/30/2014
AUTHORIZED STATE AGENT APPROVAL DATE
Permit Expiration Date: 06/24/2019
No grading or construction activity is allowed in areas designated for system and repair without approval of'the /lealth Department.
E9 - chpermit 06/30/2014 09:52 Page I of 3
A
Permit #
G
2
CATAWBA COUNTY
Name
Public Health Department
Address
vdw
Environmental Health Division
PO Box 389, 100A Southwest Blvd, Newton NC 28658
j8 42
(828) 465-8270 Fax (828) 465-8276 TDD (828) 465-8200
PIN#
I
Site Plan Improvement Permit
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Scale
EHPR-6-14-19232
Vollie Manning
2283 Sigmon Dairy Rd Newton
NC
363917203222
Z36'
Department of Environment, Health, and Natural Resources
Division of Environmental Health
On-site Wastewater Section
Owner:
Address:
Proposed Facility:
Location of Site:
Water Supply:
Evaluation Method:
Type of Wastewater:
R� gt!�!
A_
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LL 3-5%
4
3
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IDescription
(Available Space (.1945)
ISystern Type(s)
I Site LTAR
SOIL/SITE EVALUATION
for ON-SITE WASTEWATER SYSTEM
Vollie Mannino
2283 Siqmon Dairy Rd Neton NC
3 br home Design Flow (.1949) 360
well
pits by Shawn Abee
X Sewage Industrial Process
Sheet:
Property ID:
Lot #:
File #:
AppID: EHPR 6-14-19232
Applicant:
Date Evaluated: 6/23/2014
Property Size:
Property Recorded:
]Spring ]Other
Cut
Mixed
V
Vz-
jp,
1;1, * I E) R R H 0 EQ GY
L
G TOR
4 ��PRO S
.49,
956 r-;,194
4�,
9 12
E fs"
#1 9,41,� 0y)�L' y.:Profile*t,*
An
' LK Va r,,, V',,%CIasi_
thV
I :': N1,
f�66tiVVI, iAO "*
'lass
ekture,2�crv-be
0-61, topsoil PS .3
6-24" SCL SS,SP,SEXP,FR 48"
24-48" SIC
same as I
same as 12
Initial System Repair System Other Factors (.1946):
PS PS Soil Evaluation By: Jason Bovd
IIIG IIIG Others Present:
.3 .3 Site Classification (.1948): PS
Site Evaluation By:
Others Present:
. COMMENTS:
Landscape Position Group
Texture
R -Ridge I
S -Sand
SS -Shoulder Slope
LS -Loamy Sand
LS -linear Slope
FS -Foot Slope it
SL -Sandy Loam
NS -Nose Slope
L -Loam
HS -Head Slope
CC -Concave Slope III
SI -Silt
CV -Convex Slope
SICL-Silty Clay
T -Terrace
Loam
FP -Flood Plain
CL -Clay Loam
Consistence
Moist
VFR-Very Friable
FR -Friable
FI -Firm
VFI-Very Firm
EFI-Extremely Firm
SCL-Sandy Clay
Loam
IV SC -Sandy Clay
SIC -Silty Clay
C -Clay
Consistence
Wet
NS -Non -Sticky
SS -Slightly Sticky
S -Sticky
VS -Very Sticky
NP -Non -Plastic
SP -Slightly Plastic
P -Plastic
VP -Very Plastic
.1955 LTAR
1.2-0.8
0.8-0.6
0.6-0.3
0.4-0.1
Mineraloav
SEXP-Slightly Expansive
EXP -Expansive
Sketch of Soil Evaluation Locations
I I
D
Sheet:
FILE #:
Structure
SG -Single Grain
M -Massive
CR -Crumb
GR -Granular
SBK-Subangular Blocky
ABK-Angular Blocky
PL -Platy
PR -Prismatic