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Home My WebLink AboutRBPR-07-2014-19614.TIFTHIS IS NOT A PERMIT Case # RBPR-07-2014-19614 CATAWBA COUNTY HEALTH DEPARTMENT U'� PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES "•, ti Residential Building Plan Review - Building New • T AUTH CONST -NEW WELL Applicant ERIN SIGMAN, 5823 GREEDY HWY, HICKORY NC 28602 C:8283150267 Owner JUSTIN SIGMAN, 5841 GREEDY HWY, NAME TO APPEAR ON PERMIT Justin Sigman SITE ADDRESS: 5823 GREEDY HWY, HICKORY NC 28602 NAME of SUBDIVISION: Lot # PROPERTY SIZE: Square Feet Acres 2.76 DIRECTIONS: Hwy 10 W right on 127 / left greedy hwy / behind 2nd house on left PRIMARY CONTACT: Applicant SEWER TYPE GALLONS PER DAY: 360 WATER SUPPLY DESCRIBE WORK: Single family dwelling / unfinished basement / attached garage 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? Yes APPLICATION FOR: New Structure STRUCTURE TYPE: FACILITY TYPE: Single Family Residence DESCRIPTION OF EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: NUMBER OF EXISTING BEDROOMS: PRIMARY RESIDENCE OTHER DESCRIPTION: 0 PIN # 269913115817 1 Section/Block Septic Tank Private Well # OF OCCUPANTS: 2 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 60 x 60 # OF NEW BEDROOMS:: 3 BASEMENT? Yes BASEMENT FIXTURES? Yes Desired system types (Improvement Permit or Authorization to Construct): ACCEPTED: ALTERNATIVE: OTHER: INNOVATIVE: Other described: PLUMBING REQUIRED? CONVENTIONAL: ANY: YES APPLICATION FOR WELL CONSTRUCTION PROPOSED WELL TYPE: Individual Well REPLACE WELL?: NO E9 - chapplication 07/29/2014 16:21 Page 1 of 4 THIS IS NOT A PERMIT Case # RBPR-07-2014-19614 CATAWBA COUNTY HEALTH DEPARTMENT 0• f� PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES Residential Building Plan Review - Building New AUTH CONST -NEW WELL Applicant ERIN SIGMAN, 5823 GREEDY HWY, HICKORY NC 28602 C:8283150267 Owner JUSTIN SIGMAN, 5841 GREEDY HWY, NAME TO APPEAR ON PERMIT Justin Sigman SITE ADDRESS: 5823 GREEDY HWY, HICKORY NC 28602 NAME of SUBDIVISION: Lot # PROPERTY SIZE: Square Feet Acres 2.76 DIRECTIONS: Hwy 10 W right on 127 / left greedy hwy / behind 2nd house on left PRIMARY CONTACT: Applicant SEWER TYPE: GALLONS PER DAY: 360 WATER SUPPLY: DESCRIBE WORK: Single family dwelling / unfinished basement / attached garage 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? Yes APPLICATION FOR: New Structure STRUCTURE TYPE: FACILITY TYPE: Single Family Residence DESCRIPTION OF EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: NUMBER OF EXISTING BEDROOMS: PRIMARY RESIDENCE OTHER DESCRIPTION: PIN # 269913115817 1 Section/Block Septic Tank Private Well # OF OCCUPANTS: 2 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 60 x 60 # OF NEW BEDROOMS:: 3 Desired system types (Improvement Permit or Authorization to Construct): ACCEPTED: ALTERNATIVE: CONVENTIONAL: OTHER: INNOVATIVE: ANY: Other described: APPLICATION FOR WELL CONSTRUCTION PROPOSED WELL TYPE: REPLACE WELL?: NO E9 - ehapplication 07/29/2014 10:15 Page 1 of 4 �A CATAWBA COUNTY Case # RBPR-07-2014-19614 Public Health Department Subdivision Environmental Health Division PIN# 269913115817 ®� PO Box 389, 100-A Southwest Blvd, Newton, NC 28658 Ig 2 u NAME ON PERMIT: ( JUSTIN SIGMAN), 5841 GREEDY HWY, ( Justin Sigman) Site Address: 5823 GREEDY HWY, HICKORY NC 28602 Property Size: Square Feet Acres 2.76 Directions: Hwy 10 W right on 127 / left greedy hwy / behind 2nd 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 rules. I understand that I am solely responsible for the proper identific tion and I beling of all property lines and corners and making the site ac essible so th t a c�o�mMplet ite evaluation can be performed. Dates) '�l ' lH Signature of Applicant orAgen� �(�� ,L(1l�JJ 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 AREA2 MINIMUM SETBACKS FRONT: 30 SIDE: 15 REAR: 30 MAX HEIGHT: FEENAME DATE FEE AMOUNT Authorization to Construct Fee (New/Expansion) 07/28/2014 $150.00 Fee Well Permit & Inspection Fee 07/28/2014 $300.00 TOTAL FEES $450.00, 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) E9 - ehapplication 07/29/2014 10:15 Page 2 of 4 I CAll "A nTHIS IS NOT A PER -MIT COUNTY.,CATAWBA COUNTY UEAL,rui, DEPARTMENT -'4- Application for I.-Aivironniental Services Page 1 Improvement Permit D Authorization to Construct N. Septic Repair 7 Septic Malfunction ❑ Septic Expansion El New Well Permit NReplacement Well 0 Well Abandonment ❑ Well Repair El Existing System Inspection (Pre -Approval Required) [:1 Application is for New Construction Existing Facility ❑ Property Address (es'3 (ni, A''i` Subdivision Lot 9 Acres it Section/1319-ck/Phase Driving Directions to Property c lav n Irl I I h NAME TO APPEAR ON PERMIT? Owner El Applicant 0 Contractor Applicant Contact Information Narne Address —A Phone Owner Contact Information Lame Address Phone Contractor Contact Information Name] Address Phone 5A: Cc I I ollone Cell Phone ; Cell Phone WHO WILL BETHL PRINIARY CONTACT? NOwner FlApplicant 0 Contractor ...... .. .. . . .... ... . .. ... ... ... ........ ... - .... . . ..... .. ... .......... . ....... ....... .. ... -- .... .... ..... ....... . ......... Description of Existing Structures on Site i4 ,q of Bedrooms *t Structure DilnellSiOnS ........ tt of Occupants Basement F1 Yes FI No Basement Fixtures M Yes f-1 No The pplicant 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 (ILIeSti011 is "yes", applicant must attach supporting documentation. 11 Yes ISt No Does the site contain any.jurisdictional wetlands*? 0 Yes ISNo Does the site contain any existing wastewater systems'? 0 Yes S'N u Is any wastewater going to be generated on the site other than domestic sev,,age? 'Nyes iso Is the site sub . )cct to approval by any other public agency? Vles �SQN 0 Are tliei-eaiiye,-isciiientsot-riglitof%%,aysoii thisproperty? Describe k� .... . . ... ...... .... ... . .. .... ... .... . ........ ....... ...... ..... . ....... . x"', I's t" i, n g- '�' va-t`e"r 's- t i p p y in 'use El N Lndividual Well ❑ co"n,imunity Well ❑ Senii-Public Well ❑ County/Cityffo�vnship Water Line IS ',I Public water supply available? ** F-1 Yes E] No ....... .. ... ...... ... ..... ... . ...... . ---l-I..... . . . . ...... . . .... . ... 1. Indicate i- ', `, b" e -s" j"i . ........... ... ...................... . . .. . .. ... .... ..... . .. f applying for an Improvement Permit or Authorization to Construct,ed System Type(s): (systems can be ranked in order Of your preference) 0 Accepted 0 Alternative 0 Conventional D Innovative Cl Other )S� Any ............. ........... . .. ....... ........ ................ 1.. �A APHIS IS NOT A PERMIT cOuNTY'r ' CATAWBA COUNTY HEALTH .DEPARTMENT Application for Environmental Services page 2 Proposed Facility Type Primarw i2eside,uee New Residence ❑ Addition to Residence # of New Bedrooms *t Project Description i'aLit Structure Dimensions t I ' ; # of Occupants :- . e senlent_ . ❑ s Yes No ❑...r1 eBasement ttory Structure(..,')""".....,....No E3 .,„ Fixture.......,. _..._,....,W ,...._... ..._.._,.,.,..,.,..,.,,..,„......,,,.-, ..._..,...._....__...-. ....C.... s s) Des..... e ne s cnbe _ n of New Bedrooms *f if applicable Structure Dimensions ff of Occupants Accessory Dwelling ❑ Yes ❑ No Plumbing ❑ Yes ❑ No Describe Plumbing Needed _........ ... ,... ..,....,.., _... ............... Multi-FamilyResidence #Bedroot�$per Unit*j_W ._.......... ,,,_ Total # Bedrooms *t Structure Dimensions f ci r Type # Seats floor Space -Entire Food Service Facility (Sq Ft) ❑ .,. Employees a Shift t ....................... .°t ,Shifs......, Dining Area Ft.) .... 8u..s'n ssSpecific Type ofBusiness Retail FloorSpace # of Employees per Shift # of Shifts 61 h' F",. t... _ ......... _. ility” "Type Specify If Church # of Seats Kitchen ❑ Yes ❑ No If Daycare Specify Occupancy Application for Well Constrti . .. rctian/Abanclanment/1".-... ...........�... 2cpair .. 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 + Additional information pray 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 ort 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 tite Authorization to Construct. SYSTEM REDESIGN AND/OR RETRIP WILL INCUR AN ADDITIONAL CHARGE (SEF FEF SCHEDULE} improvement Permits issued as a result of this information are valid for 5 vears 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 Drell Permits are transferrable. Permits may be revoked ifthe information on this application, site plans or intended use changes'foi- the proposed facility, l 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 ` •� �'! Date _/_d' 1r., Printed N- w-ne of Owner or Agent C 't� '� tc; t t�;e�j __.____._._ t s8 CATAWBA COUNTY �Q c� !s �Public Health Department Environmental Health Division PO Box 389, 100-A Southwest Blvd, Newton, NC 28658 C E El Case # IMPV-06-2013-039274 Subdivision PIN# 269913137269 LOT# 1 06 -aa -6- tl+D-6 NAME ON PERMIT: JUSTIN SIGMAN, 5841 GREEDY HWY, HICKORY NC 28602 Site Address: 5823 GREEDY HWY, HICKORY NC 28602 Property Size: Square Feet 119,659.32 Acres 2.747 Directions: Hwy 10 W, right on 127 N, left Greedy Hwy, behind 2nd house on left Improvement Permit Facility: Primary Residence - house Permit Category: New Septic Bedrooms 3 WATER SUPPLY: Private Well Basement? Yes Basement Plumbing? Yes 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: REPAIR SYSTEM SPECIFICATIONS _ Repair System Required? Required Proposed Wastewater System: 25% REDUCTION Type: 111G - 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 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 Disvosal 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. Megen McBride 06/25/2013 AUTHORIZED STATE AGENT APPROVAL DATE Permit Expiration Date: 06/25/2018 No grading or construction activity is allowed in areas designated for system and repair without approval of the Health Department. E9 - chpennit 06/25/2013 08:53 Page I of 3 ZP NPR 05-Zoi3.11�23 5$23 Greedy Nwy, Kic�ary 1 mustf rccoyale ,r i va c /� r � �,o� (�heS S�avJh QYL �r��ostd � l �X- � �ft� � `.� cnt b� � Do n4 arot, PVvc�t, cut, D" fM O�tv 5ec4 c owa .ss well ve, Arca 0 P�P�J 3 s F N«xe 115- 1.6 1s'1.6 /z5�, R�+f t15x85) ZCy,g�, r To Greedy CA ZAVBA Geospatial Information Services Real Estate Search fhf� w�:1:rE 5 Parcel: 269913115817, 5823 GREEDY HWY HICKORY, 28602 Owners: SIGMAN JUSTIN CLAY, Owner Address: 5841 GREEDY HWY Values - Building(s): $0, Land: $13,200, Total: $13,200 1 in=200ft This map/report product was prepared from the Catawba County, NC Geospatial Information Services, Catawba County has made substantial efforts to ensure the accuracy of location and labeling information contained on this map or data on this report. Catawba County promotes and recommends the independent verification of any data contained on this map/report 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/report product or the use thereof by any person or entity. Copyright 2014 Catawba County NC 07/28/2014