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HomeMy WebLinkAboutRBPR-07-2014-19561.TIFTHIS IS NOT A PERMIT Case # RBPR-07-2014-19561 CATAWBA COUNTY HEALTH DEPARTMENT ` �❑' PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES Residential Building Plan Review - Building New • T AUTH CONST -NEW WELL Owner RANDY HOWARD, PO BOX 1116, DENVER NC 28037 Paid By LAKE NORMAN MASONRY (RANDY HOWARD), PO BOX 1116, DENVER NC 28037 13:7044891460 NAME TO APPEAR ON PERMIT RANDY HOWARD SITE ADDRESS: 4979 SALLYBROOK LN, DENVER NC 28037 PIN # 460603227656 NAME of SUBDIVISION: Lot # Section/Block PROPERTY SIZE: Square Feet Acres 27.85 DIRECTIONS: Hwy 16S to Denver, left on Campround/left on Burris/Rt on Bankhead, Rt on Salybrook/Drive on right before RR Tracks PRIMARY CONTACT: Owner SEWER TYPE: Septic Tank GALLONS PER DAY: 480 WATER SUPPLY: Private Well DESCRIBE WORK: New single family dwelling w/4 bedrooms, 30 x 30 Detached garage and approx 25 x 45 In -ground pool 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: Single Family Residence DESCRIPTION OF None EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: ACCESSORY STRUCTURE OTHER DESCRIPTION: NUMBER OF EXISTING BEDROOMS: # OF OCCUPANTS PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 65 x 65, 30 x 30, 25 x 45 # OF NEW BEDROOMS:: 4 BASEMENT? No BASEMENT FIXTURES? No 4 PLUMBING REQUIRED? Yes Desired system types (Improvement Permit or Authorization to Construct): ACCEPTED: ALTERNATIVE: CONVENTIONAL: OTHER: INNOVATIVE: ANY: YES Other described: APPLICATION FOR WELL CONSTRUCTION PROPOSED WELL TYPE: Individual Well REPLACE WELL?: NO I:1)-chapplicalion 07/21/2014 17:20 Page 1 of `a$A CATAWBA COUNTY Case # RBPR-07-2014-19561 Public Health Department Subdivision Environmental Health Division PIN# 460603227656 PO Box 389, 100-A Southwest Blvd, Newton, NC 28658 1842 SM NAME ON PERMIT: ( RANDY HOWARD), PO BOX 1116, DENVER NC 28037 ( RANDY HOWARD) Site Address: 4979 SALLYBROOK LN, DENVER NC 28037 Property Size: Square Feet Acres 27'85 Directions: Hwy 16S to Denver, left on Campround/left on Burris/Rt on Bankhead, Rt on Salybrook/Drive on right before RR Tracks 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 acce so that a cpmplete site evaluation can be performed. Date: 7— 2/— /`f 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 AREA1 MINIMUM SETBACKS FRONT: 30 SIDE: 15 REAR: 30 MAX HEIGHT: FEENAME Authorization to Construct Fee (New/Expansion) Fee Re -Trip or Redesign Fee Well Permit & Inspection Fee TOTAL FEES, DATE FEE AMOUNT 07/21/2014 $300.00 07/21/2014 $70.00 07/21/2014 $300.00 $670.00 . FEES ARE NON-REFUNDABLE ONCE A SITE VISIT IS MADE OR WORD ON A PLAN REVIEW HAS COMMENCED SYSTEM REDESIGN AND/OR RETRIP WILL INCUR AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) I:Q - ,happlicau>n 07/21/2014 17:20 Page 2 of 4 ,CATA JAMA THIS IS NOT A PERMIT _GLINTY CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services Page 1 Improvement Permit ❑ Authorization to Con ruct Septic Repair [:1 Septic Malfunction F1Septic Expansion El New Well PermV?Replacement Well ❑ Well Abandonment ❑ Well Repair ❑ Existing System Inspection (Pre -Approval Required) ❑ Application is for New Construction ❑ Existing Facility ❑ Property Address Lf I-) w S Q 1� h mG L I N, Subdivision P"vz-r MC 2g0 3`7 Lot # Acres ;Z -1 Section/Block/Phase Driving Directions to Property HW y I (o S N Dz n +ec.r ) L -c-4+ o o cc, mjoi ^ 4 n -4 L , e f l- 12r ��, Batikht��l, 1ZS' S�,llybrc��lc '2r� %& Oh Rr �z-��c J� P, TNu�`S NAME TO APPEAR ON PERMIT? R Owner ❑ Applicant ❑ Contractor Applicant Contact Information Name j�ancl, A- ►�aws,rc/ Address �, b, a a x III (0 �kn vtr N(_ Z $? c 3 7 Phone -),) c4 - S'o�. _may s I Cell Phone 7 o 44, -�;-a b - 3 9 y 5 Owner Contact Information Name 51='t M< t4,S /413 t v le-- Address Phone I Cell Phone Contractor Contact Information Name Address Phone I Cell Phone WHO WILL BE THE PRIMARY CONTACT? ©'Cfwner ❑ Applicant ❑ Contractor tur s on Site # of Bedrooms Structure Dimensions # of Occupants Basement ❑ Yes ❑ No Basement Fixtures 0 Yes No The Applicant shall notify the local health department upon submittal of this application if l p pp ' any of the following apply to the propein question. If the answer to any question is "yes", applicant must attach supporting documentation. Yes Does the site contain any jurisdictional wetlands? * Yes Does the site contain any existing wastewater systems? * Yes (ft __ Is any wastewater going to be generated on the site other than domestic sewage? _ NN Is the site subject to approval by any other public agency? n 9 Ye 0 No Are there any easements or right of ways on this property? Describe R, �� ao��%crS / S,�Ic Ex 0gCounty/City/Townshipr ply in use -7 u ❑ Indimve.. _.�.. ls.a o public water supply available? + i .. Well - _. .. p idual Well ❑ Community Well � Semi -Public Well Water L' pub pp y e? ** ❑ Yes B/No If applying for an—l" mprovement Permit or Authorization to Construe Please Indicate Desired S. -y -stem Type(s) (systems can be ranked in order of your preference) 0 Accepted 0 Alternative 13 Conventional 11 Innovative 0 Other q/Any CATAWBA THIS IS NOT A PERMIT COUNTY CATAWBA COUNTY HEALTH DEPARTMENT NT Application for Enviromnental Services Page 2 Proposed Facility Type ❑ Primary Residence EI-IN"ew Residence ❑ Addition to Residence # of New Bedrooms * j �- Project Description `NCS ��y�dt cry G Structure Dimensions i95 toS # of Occupants - Basement ❑ Yes 0'No Basement Fixtures 0 Yes o Accessory Stur Describe x3e ofBedrooms *tif applicable StructureDimensions .?b x 3o. �,......�� ..- "-�..� # of Occupants O - Accessory Dwelling ❑ Yes 19 �0 Plumbing ❑ Yes OrNo Describe Plumbing Needed x't5' Pot: I &,ecL PW -J2z Apro F l6 X 2(' ❑ Multi -Family Residence # Units #Bedrooms per Unit* j - Total # Bedrooms *t Structure Dimensions U 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 WeII Construction/Abandonment/ R.,epa...._..-...�._. �. .._,.,.... n• 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. 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. 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 performed. Signature of Owner or Agent 4 P " Date 7— Z) Printed Name of Owner or Agent Pgv\c'�J f� ))' vV\t ;trd Catawba wba Cunt. . 11�TT®rth Car®. . ,....... ......... County, line This map product was prepared from the Catawba County, NC, Geospatial Information System. j.� 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: 4606-03-22-7656 -1 inch = 100 feet Prepared for: �V 1.09A c9 2f 6 1 ' 48 -9 t 891 14.9 1 136.2 � Ate 2 0.- '243,' 13.5 - 1 rr J 00_ 24 / /`%` 1 THIS ... L . NOT A LEGAL D . UMENT..... ... .. .... .. .. _ .... _ ....._ . . , CATAWBA COUNTY NC - Parcel Report Information Regarding Selected Parcel(s) Parcel ID: 4606-03-22-7656 Name:• HOWARD RANDY Name2: HOWARD KATIE N Address: PO BOX 1116 Address2: City: DENVER State: NC Zip: 28037-1116 Account: Calc Acreage: 27.85 Tax Map: LRK: 802569 Deed Book: 3234 Deed Page: 1298 Subdivision Name: Subdivision Block: Lots: Plat Book: 73 Plat Page: 110 Building Number: 4979 Street Name: SALLYBROOK LN Site Zip: 28037 Township: MOUNTAIN CREEK Fire Dist: SHERRILLS FORD City/Tax: State Road: Total Bldgs Value: Land Value: $140,700 Total Value: $140,700 Year Built: Year Remodeled: Last Sale Date: 3/27/2014 Last Sale Amount: $205,000 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 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: Census Tract 2010: 011504 Census Block 2010: 4017 Small Area Plan: SHERRILLS FORD Agricultural District: Printed: Monday, July 21, 2014 04:29 PM �aA CATAWBA COUNTY Public Health Department Q .n. Environmental Health Division PO Box 389, 100-A Southwest Blvd, Newton, NC 28658 Ig 2 N El a Case # IMPV-03-2014-048082 Subdivision PIN# 460603227656 LOT# NAME ON PERMIT: RANDY & KATIE HOWARD, PO BOX 1116, DENVER NC 28039 Site Address: SALLYBROOK LN, DENVER NC 28037 Property Size: Square Feet 0.00 Acres Directions: HWY 16 TO CAMPGROUND RD, TURN LEFT ON CATAWBA BURRIS, RIGHT ON BANKHEAD RD, RIGHT ON SALLYBROOK, PROPERTY BESIDE RR TRACKS Improvement Permit Facility: Primary Residence - Primary Dwelling 480 gpd Detached garage with apartment ; Permit Category: New Septic Bedrooms 4 WATER SUPPLY: Private Well Basement? No Basement Plumbing? No INITIAL- SYSTEM .SPECIFICATIONS Permit Valid: Expires In Five Years: _X_ No Expiration: Projected Daily Flow 720 g.p.d Proposed Wastewater System: 25% REDUCTION Type: IIIG - OTHER NON -CONY TRENCH SYSTEMS Permit Conditions: Keep all parts of septic system and repair area minimum: 100' from any well, 10' from property lines, 5' from building foundations. Lines to be installed on contour. Do not grade drive or fill over system or repair area. Minimum 1500 gallon tank required. REPAIR SYSTEM SPECIFICATIONS Repair System Required? Required Proposed Wastewater System: 25% REDUCTION Type: IIIG - 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 Disposal 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 03/24/2014 AUTHORIZED STA1'E AGENT APPROVAL DATE Permit Expiration Date: 03/20/2019 No grading or construction activity is allowed in areas designated for system and repair without approval of the Health Department. E9 - ehpermii 03/24/2014 17:24 Page I of 3 Site Plan Improvement Permit 64 S ( je r6Q T-4 1Jv, T, A s75r Sor 12�f— ���4 Sv ZSR `buy bo i r Scale � P !o r a -,C `7rO 0 1 tl�,sro,�� `I CATAWBA COUNTY Permit # EHPR-3-14-18645 G� Public Health Department Name Randy and Katie Howard Environmental Health Division Address Sallybrook Lane Denver NC PO Box 389, 100A Southwest Blvd, Newton NC 28658 PIN# 460603227656 1$ �i sM (828) 465-8270 Fax (828) 465-8276 TDD (828) 465-8200 Site Plan Improvement Permit 64 S ( je r6Q T-4 1Jv, T, A s75r Sor 12�f— ���4 Sv ZSR `buy bo i r Scale � P !o r a -,C `7rO 0 1 tl�,sro,�� `I Department of Environment, Health, and Natural Resources Division of Environmental Health On-site Wastewater Section SOILISITE EVALUATION for ON-SITE WASTEWATER SYSTEM Owner: Randv and Katie Howard Address: Sallvbrook Lane Denver NC Proposed Facility: 4 BR Home +2 BR qE Design Flow (.1949) 720 Location of Site: Water Supply: well Evaluation Method: pits by Randy Howard Type of Wastewater: X Sewage [ J Industrial Process P R 0 b 48" PS .3 SOIL MORPHOLOGY F 48" PS .3 .1942 SS SP SEXP FR .1941 i .1940 Profile Wetness/ Soil Sapro Restr L Landscape Horizon .1941 .1941 E Position/ Depth Structure/ Consistence # Slope% (IN.) Texture Mineralogy 1 LL 2% 0-6" topsoil 6-36" SCL SS,SP,SEXP,FR 36-48" SC 2 3 Description iAvailable Space (.1945) (System Type(s) (Site LTAR Sheet: Property ID: Lot #: File #: AppID: EHPR 3-14-18645 Applicant: Date Evaluated: 3/19/2014 Property Size: Property Recorded: [ J Spring (] Other [ J Cut [ ] Mixed b 48" PS .3 0-6" PROFILE FACTORS 48" PS .3 .1942 SS SP SEXP FR Soil .1943 .1956 .1944 Profile Wetness/ Soil Sapro Restr Class Color Depth (IN.) Class Horiz & LTAR IIIG IIIG PS .3 .3 48" Site Classification (.1948): PS same as 1 48" PS .3 0-6" top soil 48" PS .3 6-36" SCL SS SP SEXP FR 36-48" SC I Initial System Repair System Other Factors (.1946): PS PS Soil Evaluation By: Jason Bovd IIIG IIIG Others Present: Randv Howard .3 .3 Site Classification (.1948): PS Site Evaluation By: Others Present: COMMENTS: Landscaoe Position Grout) Texture R -Ridge 1 S -Sand SS -Shoulder Slope LS -Loamy Sand LS -Linear Slope SS -Slightly Sticky FS -Foot Slope II SL -Sandy Loam NS -Nose Slope L -Loam HS -Head Slope NP -Non -Plastic CC -Concave Slope III SI -Silt CV -Convex Slope SICL-Silty Clay T -Terrace Loam FP -Flood Plain CL -Clay Loam SCL-Sandy Clay Loam IV SC -Sandy Clay SIC -Silty Clay C -Clay Consistence Consistence Moist Wet VFR-Very Friable NS -Non -Sticky FR -Friable SS -Slightly Sticky FI -Firm S -Sticky VFI-Very Firm VS -Very Sticky EFI-Extremely Firm NP -Non -Plastic 0.6-0.3 SP -Slightly Plastic P -Plastic VP -Very Plastic P Sheet: FILE #: .1955 LTAR Structure 1.2-0.8 SG -Single Grain M -Massive CR -Crumb 0.8-0.6 GR -Granular SBK-Subangular Blocky ABK-Angular Blocky 0.6-0.3 PL -Platy PR -Prismatic 0.4-0.1 Mineraloav SEXP-Slightly Expansive EXP -Expansive Sketch of Soil Evaluation Locations