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HomeMy WebLinkAboutRBPR-07-2014-19602.TIFApplicant Contractor THIS IS NOT A PERMIT Case # RBPR-07-2014-19602 CATAWBA COUNTY HEALTH DEPARTMENT 0 �0 PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES t Residential Building Plan Review - Building New • T IMPROVEMENT - AUTH CONST TIMOTHY MARKHAM, 1132 BUGLE LN, NEWTON NC 28658 C:8283029805 D KEMP SIGMON CONSTRUCTION CO INC (KEMP SIGMON), 4860 S DEPOT ST, CLAREMONT P 28610- 2:8286157444 C:(828)850 -9488F:8286157447 CHRISTYSIGMON@GMAIL.COM Parcel Owner GLENN MORRISON, 3630 HURSEY AV, CLAREMONT NC 28610 NAME TO APPEAR ON PERMIT Timothy Markham SITE ADDRESS: 2458 GENELIA DR, CLAREMONT NC 28610 PIN # 376107774761 NAME of SUBDIVISION: CHARLOTTES CROSSING Lot # 10 Section/Block PROPERTY SIZE: Square Feet Acres 1.77 DIRECTIONS: 10E / left Bethany Church Rd/ right Old Catawba Rd/ go about 1 mile into Charlotte's Crossing on Genelia Dr / lot on left PRIMARY CONTACT: Contractor SEWER TYPE: Septic Tank GALLONS PER DAY: 360 WATER SUPPLY: Public Water DESCRIBE WORK: 1 story dwelling w/ attached garage (no basement) 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: PRIMARY RESIDENCE FACILITY TYPE: Single Family Residence OTHER DESCRIPTION: DESCRIPTION OF vacant lot EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: NUMBER OF EXISTING BEDROOMS: # OF OCCUPANTS: 2 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 54 x 60 # OF NEW BEDROOMS:: 3 BASEMENT? No BASEMENT FIXTURES? No PLUMBING REQUIRED? Yes Desired system types (Improvement Permit or Authorization to Construct): ACCEPTED: ALTERNATIVE: CONVENTIONAL: OTHER: INNOVATIVE: ANY: YES Other described: E9 - chapplication 07/28/2014 09:42 Page 1 of 4 �$A CATAWBA COUNTY Case 9 RBPR-07-2014-19602 �Q Public , Health *Department Subdivision CHARLOTTES CROSSING j Environmental Health Division PIN# 376107774761 rPO Box 389, 100-A Southwest Blvd, Newton, NC 28658 18 L SM NAME ON PERMIT: ( TIMOTHY MARKHAM), 1132 BUGLE LN, NEWTON NC 28658 ( Timothy Markham) Site Address: 2458 GENELIA DR, CLAREMONT NC 28610 Property Size: Square Feet Acres 1.77 Directions: 10E / left Bethany Church Rd/ right Old Catawba Rd/ go about 1 mile into Charlotte's Crossing on Genelia Dr / lot 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 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. Date: •>Z �" /Y. Signature of Applicant or Agent (' LZL ,�cJi ae An Environmental Health Specialist will contact you within 2 working rays of application date. If you need further information or assistance please call 828-466-7291 AREA2 ************************************************************************************************************ MINIMUM SETBACKS FRONT: 0 SIDE: 0 REAR: 0 MAX HEIGHT: FEENAME, Authorization to Construct Fee (New/Expansion) Fee Improvement Permit Fee TOTAL FEES DATE FEE AMOUNT 07/28/2014 $150.00 07/28/2014 $150.00 $300.00 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) E9 - chapplication 07/28/2014 09:42 Page 2 of 4 CA, ARTBA THIS IS NOT A PERMIT -CUNTY CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services Page 1 Improvement Permit Ei' 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 Subdivision C11ct.r'lc�-�-1 PS L rd SS in NC 2eC,10 Lot# /® Acres /,%? � Section/Block/Phase Driving Directions to Property /O C -i /2J NAME TO APPEAR ON PERMIT? ❑ Owner ❑ Applicant ["Contractor Applicant Contact Information Names Ph�ne Cell Phone 04ner Contact Information , Nate / ►nom �ti� Address J/3Z X1.1 G l -2 �^Cl �n P_ z� -i tsv� c- Z �S6 � q Phone u�S-13p� , q �OS J I Cell Phone Contractor Contact Information Name lip M a S , VhGn Address PQ /3�,4 / Z 7c3 C, l ct e-tiy)n,4-- N C Phone !?-311 —'CoSr SFr C_ 1 I Cell Phone Y,2 - 3, WHO WILL BE THE PRIMARY CONTACT? ❑ Owner ❑ Applicant Contractor Description of Existing Structures on Site N©Ae-. # of Bedrooms *t 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 any of the following apply to the property in question. If the answer to any question is "yes", applicant must attach supporting documentation. 11 Yes Wgo Does the site contain any jurisdictional wetlands? a Yes ®'leo Does the site contain any existing wastewater systems? 0, Yes ®'IGo Is any wastewater going to be generated on the site other than domestic sewage? WYes EMo Is the site subject to approval by any other public agency? Yes Rkito 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 Permit or Authorization to Construct, Please Indicate Desired System Type(s): (systems can be ranked in order of your preference) 0 Accepted 0 Alternative 0 Conventional ❑ Innovative 0 Other Any CATAWBA THIS IS NOT A PERMIT { OUNTY- - " <-- CA` AWBA COUNTY HEALTH DEPARTMENT Application for Enviromnental Services Page 2 Proposed Facility Type Primary Residence <Cw Residence ❑ Addition to Residence # of New Bedrooms * j Project Description Structure Dimensions of Occupants Basement ❑ Yes 2- No Basement Fixtures 0 Yes ONO ❑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. 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 maybe 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 /C e „�,<-nom„ Gct �2cCc �z-Date % ` S 7" Printed Name of Owner or Agent 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: 3761-07-77-4761 1 inch = 60 feet Prepared for: --,___z r_._i_-r_v , CP T 1.52A 3990 7A w� 11 It .9 10 1.77A 34.45 N 341.97 /IWIT M, • 60 1.20 zov � c2 4573Cy THIS IS NOT A LEGAL DOCUMENT / Dat aved: 6/11 X014 T' e: 9:13:56 A f . CATAWBA COUNTY NC.- Parcel Report Information Regarding Selected Parcel(s) Parcel ID: 3761-07-77-4761 Name: MORRISON GLENN D Name2: MORRISON LESLIE S Address: 3630 HURSEY AVE Address2: City: CLAREMONT State: NC Zip: 28610-9539 Account: Calc Acreage: 1.77 Tax Map: LRK: 402395 Deed Book: 2690 Deed Page: 0445 Subdivision Name: CHARLOTTES CROSSING Subdivision Block: Lots: 10 Plat Book: 47 Plat Page: 138 Building Number: 2458 Street Name: GENELIA DR Site Zip: 28610 Township: CLINES Fire Dist: City/Tax: CLAREMONT State Road: Total Bldgs Value: Land Value: $26,900 Total Value: $26,900 Year Built: Year Remodeled: Last Sale Date: 8/31/2005 Last Sale Amount: $26,000 Neighborhood: 117 Watershed: WS -IV Protected Area Watershed Split: NO Voter Precinct: P6 E911 District: CLAREMONT Zoning: R-1 Zoning2: Zoning3: Zoning Split: N Zoning Overlay: Zoning District: CLAREMONT Split Zoning Dist: N Split Zoning Dist(1): 0 Split Zoning Dist(2): 0 School District: COUNTY Elementary School: CLAREMONT Middle School: RIVER BEND High School: BUNKER HILL School Split: NO P&Z Case Number: Census Tract 2010: 011401 Census Block 2010: 2018 Small Area Plan: Agricultural District: Printed: Monday, July 28, 2014 09:13 AM 1P1AC 3 �� CATAWBA COUNTY HEALTH DEPARTMENT 'ry r Telephone: (828) 465-8270 TDD: (828) 465-8200 WLS # s�Qnc--)- 00 CQ2 Improvement Pernu AC Repair Permit. Operation Permit. System Type Well Permit. Replacement Well Owner/Agent ' 1 P. r. A M (j1t'2-12 i n f`: Phone Address' CS -7A C,luw,- it Subdivision NL V L 0 ), Section/Block/Phase Lot# Lot Size f .7 7. Directions: `7 C E 1 ,wf o (,1w+,,. -, vl�� rfsi 1 Property Address A 2,LF5Y Gnq /P9 h� Facility: House_ Mobile Home Business Multi -family Other: Pin Number "7-7 6/v777 47 6 l Other . Zoning Approval # # Bedrooms # Seats # Employees . Application Rate d GPD Flow 4,( o Hot Tub or Spa yes/no Special Fixtures Basement /no . 100% Repair Area yes/no Basement Plumbing yes/no Water Supply: Private Well Public V Semi -Public Type of System: Trench V' Bed Pump Pump/Panel Panel LPP Other 2 0f', Q,6t arj Septic Tank Size j 0 V Pump Tank Size Nitrification Field: Total Square Feet j 028 Depth of Stone~ Bed Size Trench Width Total Length of All Trenches Number of Trenches Trench Length on Center f Maximum Trench Depth '— Distance of Nearest Well *DO NOT INSTALL SEPTIC WHEN WET* *WELL RECORD REQUIRED AT COMPLETION* Topo % Slope Texture Structure I Clay Min. Soil Wetness, Soil Depth j Restric. Hoz. at Available space ytt s/no Overall Class S PS U 'I Comments: f x I S Ifi7 6 Wwr+ ili y- 1 lvi Filter Req red Riser rel ed when tank is mo than 6 ?/Y . inches deet **NO GUARANTEE OR WARRANTY IS IMPLIED OR GIVEN AS TOTHE PERFORMA ENGTH OF WILL FUNCTION** THIS SYSTEM *********************** -'1�R�I2tkiJt�tl�t'P.1'�C�.��M��",�'iai�'.4�„d� 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 any portion of the installation is put into use. The siting of the well by the Health Department staff is to provide protection from known possible sources of contamination. No volume of water is guaranteed at asite by the Health Department. Permit Date Y—� j�v,5— EHS Owner/Agent ),jP 0„^ �f yj'f e n i�,G� Septic Tank Installed By Date A EHS Well Installed By Well Grout Approval Date Well Head Approval Date Date Sample Collected Date of Results Results EHS White -Office Yellow - Owner/Agetu Pink - Building Inspection Authorization to Construct /. DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES Sheet —_ of_, DIVISiON OF ENVIRONMENTAL HEALTH PROPERTY ID #: ON-SITE WASTEWATER SECTION COUNTY: SOIL/SITE EVALUATION for ON-SITE WASTEWATER SYSTEM OWNER:0� APPLICATION DATE ADDRESS: DATE EVALUATED: PROPOSED FACILITY: PROPOSED DESIGN FLOW (.1949): PROPERTY SIZE: LOCATION OF SITE: PROPERTY RECORDED: WATER SUPPLY: 0 Private Q Public 0 Well 0 Spring 0 Other EVALUATION METHOD: Q Auger Boring 0 pit 0 cut TYPE OF WASTEWATER: Q Sewage Q Industrial Process Q Mixed J 9 C SOILA10 Tm , ......... ..... .... ... . ... ....... i .ii:to ... .. . ........ . .. . ....... .. . ..... .942:: ... - .. .... .. . .... . ... .. - t, '194t: 19-4 . .. ... .... ... . 44 . ....... :;:­PROF11Xtq EN W 'STk:'t CLASS .... .. ::�DEPTHti! j]EXTUREt: t: L ........ JN't: MjNERA OGYi .:,COLOR 0- ...... ..... ;:t :t�t;t: : . ... .. .... .. ... . .... :jCL' t:-, jk .. ... ... E J 9 C Lr 36 49 1,TC T[ k Pr 3 E E E �. r[L Vbk ,rzv DESCRIPTION INITIAL SYSTEM REPAIR SYSTEM OTHER FACTORS (.1946): Available Space (.1945) SITE CLASSIFICATION(. 1948): Systm Type(s) EVALUATED BY: OTHER(S) PRESENT: Site LTAR COMMENTS: DENR (######) Review (####t) jam= V LEGEND use the following standard abbreviations r.. r rr is r V, W"; 6 air a . .rrJiil--«• _ _ - SOIL CONVENTIONAL LPP MINERALOGY/ LANDSCAPE POSITION GROUP TEXTURE .1955 LTAR* .1957 LIAR* CONSISTENCE STRUCTURE CC (Concave Slope) I S (Sand) 1.2-0.8 0.6 - 0.4 NEXP (Non -expansive) G (Single Grain) CV (Convex Slope) LS (Loamy Sand) SUP (Slightly Expansive) M (Massive) D (Drainage Way) EXP (Expansive) CR (Crumb) DS (Debris Slump) U SL (Sandy Loam) 0.8 - 0.6 0.4 -0.3 GR (Granular) FP (Flood Plain) L (Loam) SBK (Subangular Blocky) FS (Foot Slope) ABK (Angular Blocky) H (Head Slope) III SCL (Sandy Clay Loam) 0.6-0-3 Q.3 - 0.15 PL (Platy) L (Linear Slope) SiL (Silt Loam) PR (Prismatic) N (Nose Slope) CL (Clay Loam) R (Ridge) SiCL (Silty Clay Loam) MOIST WET S (Shoulder Slope) Si (Silt) T (Terrace) VFR (Very Friable) NS (Non -sticky) TV SC (Sandy Clay) 0.4-0.1 0.2-0.05 FR (Friable) SS (Slightly Sticky) SiC (Silty Clay) F) (Finn) S (Sticky) C (Clay) VFl (Very Finn v. Very Sticky) VS (Very Sticky) O (Organic) None EFI (Extremely Firm) NP (Non -plastic) SP (Slightly Plastic) *Adjust LTAR due to depth, consistence, structurc, soil wetness, landscape, position, wastewater now and quality. P (Plastic) NOTES VP (Very Plastic) HORIZONDEPTH In inches below natural soil surface DEPTHOFFILL In inches from land surface RESTRICTIVE HORIZON Thickness and depth from land surface SAPROLITE Stsuitable) or U(unsuitable) -- SOIL WETNESS Inches from land surface to fee water or inches from land surface to soil colors with chroma 2 or less - record Munsell color chip designation CLASSIFICATION S (Suitable), PS (Provisionally Suitable), or (Unsuitable) Evaluation of saproli(e shall be by pits. ' Long -tern Acceptance Rate (LTAR): gal/day/W Show profile locations and other site features (dimensions, reference or benchmark, and North). DENR (######) Review (####t) jam= V