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HomeMy WebLinkAboutRBPR-07-2015-21874.TIF184 SM Applicant Contact Person THIS IS NOT A PERMIT Case # RBPR-07-2015-21874 CAIAWBA COUT'TY II.AL'I'H DEPARTMENT PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES Residential Building Plan Review - Manufactured Home IMPROVEMENT THERESA LAIL. 1034 PHIL DR, CONOVER NC 28613 C:8283120692 LARRY R TRAVIS (LARRY 'LRAVIS ), 206 N MCLIN CREEK RD, CONOVER NC 28613 6:8284580995 C:82831206921':828-459-1197 TRAVISDRYWALL3aYAHOO .COM Owner CHRISTOPHER TRAVIS, PO BOA 817, CONOVER NC 28613 C:8283120692F:8284591197 TRAVISDRYWALLaYAHOO.COM NAME TO APPEAR ON PERMIT Christopher Travis SITE ADDRESS: 5468 BUDDY ST, CONOVER NC 28613 PIN # 373412968830 NAME of SUBDIVISION: HOUSTON lot 8 19 Section/Block _ _ PROPERTY SIZE: Square Fect Acres 0.35 DIRECTIONS: Springs Rd - cut left on to Houston Mill Rd take 1st Left into Houston Meadows Trailer Park - Buddy St. Lot #19 PRIMARY CONTACT: Contact Person SEWER TYPE: Septic Tank GALLONS PER DAY: 360 WATER SUPPLY: Public Water DESCRIBE WORK: 1978 Single Wide Metal on Metal Mobile Home - to be placed in same location as previous home (already removed) due to location of existing septic tank. Must be vinyl underpinned / min 36 sf deck on front 1 screen or remove towing tongue 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? APPLICATION FOR: STRUCTURETYPE: FACILITY TYPE: Mobile Home DESCRIPTION OF EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: NUMBER OF EXISTING BEDROOMS: 3 New Structure PRIMARY RESIDENCE OTHER DESCRIPTION: # OF OCCUPANTS: 3 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 28 x 70 # OF NEW BEDROOMS:: 3 Desired system types (Improvement Permit or Authorization to Construct): ACCEPTED: ALTERNATIVE: OTHER: INNOVATIVE: Other described: CONVENTIONAL: ANY: YES E9 • ehappiieatwn 07102/2015 1025 Page I of 4 CATAWBA COUNTY Case RBPR-07-2015-21874 F' Public Ilealth Department Subdivision z�d HOUSTON Cnrironmentl Hcalth Division PIN# PO Box 389, 100-A Southwest Blvd, Newton, NC 28658 373412968$34 I` 2 NAME ON PERMIT: ( CHRISTOPHER TRAVIS), PO BOX 817, CONOVERNC 28613 ( Christopher Travis) Site Address: 5468 BUDDY ST, CONOVER NC 28613 Property Size: Square Pect Acres 0.35 Directions: Springs Rd - cut left on to Houston Mill Rd. take 1st Left Into Houston Meadows Trailer Park - Buddy St. Lot #19 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 nd labeling of all property lines and corners and making the site acre e o that a co ete de va uaf can be performed. Date: :.__ �a„pJ � Signature of Applicant orAgenf� [�, An Environmental Health Specialist will contact you within 5 working days of application date. If you need further information or assistance please call 828-466-7291 AREA2 FEENAME Improvement Permit Fee TOTAL FEES DATE FEEAMOUNT 07/02/2015 $150.00 $150.00 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 - ehapplieation 07/02,2015 16.2.4 Page 2 of 4 C Ti i TRIS IS NOT A PERIvI1T nn , ` VV, COUNTY . �- CATAWBA COUNTY HEALTH DEPARTMENT 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) ❑ t 'Application is for New Construction El Existing Facility `i' ❑ Property Address S � V � I � Subdivision .6L,t_ td4 54. Lot# "I Acres • 3 S i Section/Block/Phase Driving Directions to Property S ��lv 1c5 ��i • - r1A+ L_P-Pi . 01J 4--o i-�n L, -s 4L N\ rn I 1vf ��Y T b!,i -A-Z� ?Dl 6u% 51. LZ+ IS -SN 4 P- NAAIIE TO APPEAR ON PERMIT? M Owner ❑ Applicant ❑ Contractor Applicant Contact Information Name 7 tie ("e5 P �A i Address Phone Owner Contact Information Name p2Rta Tl'au-�S Address �t-s. I�c� - Ck. �Lv Phone Contractor Contact Information Name Address I Phone ``ofit) Vee- CeI1 Phonebto Cell Phone Cell Phone 8 ?b -,3 1-7- U LO YL WHO WILL BE THE PRIMARY CONTACT? ❑ Owner ❑ Applicant ❑ Contractor ig 60-4d-41 Description of Existing Structures on Site # of Bedrooms *j' Structure Dimensions # 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 question. If the answer to any question is "yes", applicant must attach supporting documentation. ® Yes 15—No Does the site contain any jurisdictional wetlands? Yes ®No Does the site contain any existing wastewater systems? 0 Yes -®-N'o is any wastewater going to be generated on the site other than domestic sewage? -49-Yes © No Is the site subject to approval by any other public agency? ® Yes -9;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 Lute 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 ❑ Alternative 0 Conventional 0 Innovative 0 Other Any ,CAT tf'^ aTHIS IS NOT A PERN41T 4`CGUNTY CATAWBA COUNTY HEALTH DEPARTMENT - Application for Enviromnental Services Page 2 Proposed Facility Type ❑ Primary Residence ® New Residence ❑ Addition to Residence # of New Bedrooms *f J Project Description rnob:l¢ t.A• Structure Dimensions e18X I)o # of Occupants J Basement [—]Yes No Basement Fixtures ® Yes No ❑ Accessory Structure(s) Describe # of New Bedrooms *-I if applicable Structure Dimensions # of Occupants Accessory Dwelling ❑ Yes ❑ No Plumbing ❑ Yes ❑ No Describe Plumbing Needed ❑ Multi -Family Residence # Units #Bedrooms per Unit* j 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 Abandonment Type ❑ Drilled ❑ Bored Well Repair Requested ❑ Yes ❑ No Describe ❑ Community Well ❑ Dug ❑ Unknown Calculated Design Flow, Commercial f 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 revolted if the information on this application, site plans or intended use changes for the proposed facility. I have read this application and certify that dne 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. l 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 o� gen) Printed Name of Owner or Agent ( � tY-e5A Date 7— '�2 — au -w5 - Printed u-f5 E C I Band/or Cert. Op. Required !!4.:st be completed prier to '::iai) �- %86s I VBA COUNTY REALIFIR DEPARTMENT O Improve 004) 465-82?0 Permit F• Rapai (rPermic_Cert. of Comp. Permit J ,Oiler. Permit -/,�. Agent 1�• UAACC / I-.S�L--rte Phone .., ,ess Subdivision I-l`,Q-1r<' z J Sect an./.�B}ock/Phase _' Lot# (y-. Size Directions:12U1(7 i �) .%�itrPeity SYrLCtY— A)�t,c Facility: House Mobile Home Business,— Other: Tax Map # multi -family_ Other Zoninc Approval # Bedrooms 3 Seats Employees_____ Application Rate `��_ GPD Flow f-1 Hot Tub or Spa yes/as-Special Fixtures 100% Repair Area vis/no REPAIR OTICE: Basement yes/D¢_ Basement Plumbing yes/no REPAIRS MUST BE WITHIN 30 DAYS OR Water Supply: Private, Public -X— DAYS FROM DATE OF PERMIT. Type of System: TrenchX—Bed_Pump____Pump/Panel—Pdrlel_LPp_—other jj Tank Size: Septic Tank tcoo =Pump rank Nitrification Field: Total Square Feet 0 Depth ^of Stone IZ(llet� Bed Size_ Trench Width 3-�ii Total Length of All Trenches s.G Number of Trenches J o- individual Trench Length 1CL,11001LC;�21__-1J Feet on center Maximum Trench Depth 36 Distance of Nearest Well t"110 Lot Evaluation: Approved.yes/no Ovoid After 24 months) Topo Z- t Slope Sketch of lot Evaluation Site - System Design - Final Texture_�� DO NOT tto INSTALL Structure 47%/ �~ ` WHEN WET Clay Min. i,( Soil wetness I Soil Depth" Restric. Hoz. at -- " Available space ,,L�no; Overall Class S PS U Comments: (,-s -05 V4 C.+y �I- tit's T 1 4 Septic Tank Contractors MUST contact the �=^-- Sanitarian BEFORE changing permit. **NO GUARANTEE OR WAF.R iTY IS iM?LIED OR GIVEN THi�CL`CH THE �-nUANCE OF THIS PERMIT** #x####x#f####k4##*###x4#*tt#YR###xtxY##Y#x}Yfxx##1#####4x ##tx*#*### #f#### f#f##4+###### Permit Date 07r�^'`)�� (Improveme rm' •��o)i - F` r 60 months) Owner/Agent h{,i �r F. f'lc1..- �"� Sanitariar, � 1/I! L Installed B Date ^-,-t5-`t-5 Sanitaria '\K (Note any changes/information in red or by sket n be *******IF A PERMIT HAS TO BE REDESIGNED AND/OR RETRIPS MADE TO THE PROPERTX, IS AN ADDITIONAL $25 CHARGE. 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L 0 may., N w+E 1 to=60ft 5 Parcel: 373412968830, 5468 BUDDY ST CONOVER, 28613 Owners: TRAVIS CHRISTOPHER R, TRAVIS KIMBERLY L Owner Address: PO BOX 817 Values - Building(s): $0, Land: $8,000, Total: $8,000 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 07/02/2015