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HomeMy WebLinkAboutRBPR-07-2015-21897.TIF'A o THIS IS NOT A PERMIT Case # RBPR-07-201 5-21897 CATAWBA COUNTY HEALTH DEPARTMENT PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES Residential Building Plan Review - Manufactured Hume IMPROVEMENT Land Owner BETTY ISENHOUR, 3225 24TH ST NE, HICKORY NC 28601 Owner DALE ABBOTT, 5358 B J DR, CONOVER NC 28613 0:7042075996 NAME TO APPEAR ON PERMIT Dale Abbott SITE ADDRESS: 5358 BJ DR, CONOVER NC 28613 PIN # 374412767526 NAD1E of SUBDIVISION: Lot# B-2 Section/Block_ PROPERTY SIZE: Square Peet Acres 045 DIRECTIONS: Springs Rd to Lee Cline Rd/ turn on Eckard/ B J Dr on right/ where B J Dr forks / driveway on left of fork PRIMARY CONTACT: Owner SEWER TYPE: Septic Tank GALLONS PER DAY: 360) WATER SUPPLY: Private Well DESCRIBE WORK: 'Revised 9/8/15 - Changed from 2 Bedrooms to 3 Bedrooms. New Site Plan to change placement of home to meet Zoning setbacks. 'Revised 7/20/15 - Purchased a New Mobile Home 14x70, front deck is 6x6 1/2, 1 back deck 8x16"'zoning needs to sign zoning permit "`1986 Class E SW mobile home "okay per zoning for metal on metal home placement/ " Screen or Remove Towing Tongue, Deck must be 36 sq ft deck on front, Must be underpinne( 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 applied9 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? No APPLICATION FOR: STRUCTURE TYPE: FACILITY TYPE: House DESCRIPTION OF EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: 14x60 NUMBER OF EXISTING BEDROOMS: New Structure PRIMARY RESIDENCE OTHER DESCRIPTION: # OF OCCUPANTS: 2 PROPOSED CONSTRUCTION NEW STRUCTURES^. -=;4--_170 w/6 x 6 1/2 F Deck & 8x16 B Deck �# OFNEW BEDROOM_ S : 3 Desired system types (Improvement Permit or Authorization to Construct)' ACCEPTED ALTERNATIVE: OTHER: INNOVATIVE Other described CONVENTIONAL: ANY YES L9 - chapplicatwa 09/09/2015 10 27 Page I of 4 s� CATAWBA COUNTY Case k RBPR-07-2015-21897 T �f Public Health Department Subdivision Environmental Health Division 374412767526 8 � � PO Bos 389. 100-A Southwest Blvd. Newton. NC 28658 I IN11 NAME ON PERMIT: ( DALE ABBOTT), 5358 B J DR, CONOVER NC 28613 ( Dale Abbott) Site Address: 5358 BJ DR, CONOVER NC 28613 Property Size: Square feet Acres 0.45 Directions: Springs Rd to Lee Cline Rd/ turn on Eckard/ B J Dr on right/ where B J Dr forks / driveway on left of fork 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 identification7a d 1 beling of all property lines and corners and making the site ac ssible so t a complete site can be performed Date: �/� �/S Signature of Applicant or Agent �_� C.Zi - 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 IrIIJrI'IIiIg11110@" °h !!!�I�II� ri, i t�'''. il�l�l!71`'i: ; I inl',''"'- ""'!hn1t, e it • r. I FEENAME u.� ' ' !., 7' 1__..."'Iud1u811!''t a 1i%�I,mli;!I .� !il'ii,.��''l�DATE to FEF.�AMOUNT,. Improvement Permit Fee 07/07/2015 pp $150.00 Ir.i, �19G �i`IN �p1'TOTA L'FEE$�1 !�•II !•il!i,:i �.J61�Ir�i�Il!II'Ii1 ,,, i�p II �i ,i.11111111!I" Al;171a �....' .ii,,',I''14 Iw Illn' i',i., !III,III•i18:dlVllilllll+lllli . I, 1sJso.oti 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) 17.9 - elmpphcauun 09/08/2015 11 29 Page 2 of 4 ti 83.67 g5 9 Catawba County Environmental Health i Parcel: 374412767526, 5358 BJ DR CONOVER, 28613 1 in=50ft 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 09/08/2015 �i V B. TFIIS IS NOTA PERMITc,uvcs -_ -- CATAWBACOUNTY HE, ALTHDEPART.WNT Application for Envirotnnental Services Page I Improvement Perim< Authorization to Construct ❑ Septic Repair ❑ Septic Malfunction ❑ Septic Expansion ❑ New Well Permit ❑ Replacement Well [7 Well Abandomnenl ❑ Well Repair ❑ Existing System Inspection (Pre -Approval Required) ❑ Applicationisfor New Construction"CK Existing Facility ❑ Property Address 600 ~� \J�f 1'V Subdivision re-.Y�over- , n?C. cSt ( Lot# Acres 1� Section/Block/Phase Driving Directions to Property e her �Glzc��1 0 3 3 NAME TO APPEAR ON PERIIIIT? ❑ Owner Applicant Contact Information (Name 0q(e 0-V=- Address S' S _5 � S (� r� __ Phone "7 e `{ - J 7- S 9 4 �, Owner Contact Information Name Address Phone Contractor Contact Information Name Address Phone ❑ Applicant ❑ Contractor Cell Phone Ceti Phone Cell Phone WHO WILL BE THE PRDIARY CONTACT? ❑ Owner 91 Applicant ❑ Contractor - ....._. .... - ._ ... _... Description_of Existing Structures on Site Y"\ # of Bedrooms *j- `-") Structure D mensions Vn 13e OQ k OW- .Occupants Basement ❑ Yes 1;�P No Basement Fixtm-es Q Yes fp No 1 he Applicant shall no'.iiy the local health department upon subin t}aI 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. Pry Yes WNTo Does the site contain any jurisdictional wetlands? '06es U No Does the site contain any existing wastewater systems? In Yes SON Is any wastewater going to be generated on the site other than domestic sewage? MrYes 0 No Is the site subject to approval by any other public agency? 0 Yes QrNTo e there any , asemems or right of ways on this property? Describe Existing water supply in use ,. ..- -- -_ ........ - _ . .......-- - �. Q I y" Individual TiJeL ❑Community Well [� Semi -Public �iJall ❑ County/City/Township Water I,ine'5hq tet Is a public water supply available? ** ❑ Yes If applying for an Improvement Permit or Authorization to Construct, Please Indic p ate Desired System Type(s): (systems can be ranked in order of your preference) 0 .Accepted 0 Alternative 0 Conventional ❑ Innovative ❑ Other � Anv , .LkT � �i THIS IS NOT A PERTvIIT DO' V - CATAWBA COUNTY HEALTH DEPARTMENT hun _niv Lno Application for Environmental Services Page 2 Pro osed Facility Type Primary Residence New Residennnce ❑ Addition to Residence # of New Bedrooms Project Descriptio (V Y ? V Structure Di pensions # of Occupants Basement ❑ Yes No Basement Fixtures Yes NO No ❑ Accessory Structure(s) Describe # of New Bedrooms *j 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 * j Structure Dimensions ❑ Food Service Specify Type # Seats Floor Space -Entire Food Service Facility (Sq Ft) # Employees per Shift # of Shifts Dining Arca (Sq. Ft.) ❑ Business Specific Type of Business Retail Floor Space # of Employees per Shift # of Shifts ❑ Other Facility Type Specifv 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 -r 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 maybe 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 Ilse 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 Tines and comers and malting the site accessible so that a complete site evaluation can be performed. Signature of Owner or Agent Date Printed Name of Owner or Agent leL- THIS IS NOT A PERMIT Case # RBPR-07-2015-21897 CATAWBA COUNTY HEALTH DEPARTMENT PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES Residential Building Plan RevieNv - Manufactured Home IMPROVEMENT 1WV4 O)A(A F-� I Land Owner BETTY ISENHOUR, 3225 24TH ST NE, HICKORY NC 28601 Owner DALE ABBOTT, 5358 B J DR, CONOVER NC 28613 C:7042075996 NAME TO APPEAR ON PERMIT Dale Abbott SITE ADDRESS: 5358 B1 DR, CONOVER NC 28613 PIN # 374412767526 NAME of SUBDIVISION: Lot 4 B-2 Section/Block _ PROPERTY SIZE: Square Peet Acres 0.45 DIRECTIONS: Springs Rd to Lee Cline Rd/ turn on Eckard/ B J Dr on right/ where B J Dr forks / driveway on left of fork PRIMARY CONTACT: Owner SEWER TYPE: Septic Tank GALLONS PER DA 240 WATER SUPPLY • Private DESCRIBE WOR Revised 7/20/15 - Purchased a New Mobile Home 14x70, front deck is 6x6 1/2, 1 back deck 8x16' zoning needs to sign zoning permit —1986 Class E SVV mo5ild'home "okay per zoning for metal on metal home placement/ " Screen or Remove Towing Tongue, Deck must be 36 sq ft deck on front, Must be underpinne( 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? 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? No APPLICATION FOR: STRUCTURE TYPE: FACILITY TYPE: House DESCRIPTION OF EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: 14x60 NUMBER OF EXISTING BEDROOMS: New Structure PRIMARY RESIDENCE OTHER DESCRIPTION: # OF OCCUPANTS: 2 �— — EROPOSED,CONSTRUCTION NEW STRUCTURE DIM:: 14 x 70 w/6 x 6 1/2 F Deck & 8x16 B Deck ',4-Q±_NEW B OOMS::-2 Desired system types (Improvement Permit or Authorization to Construct): ACCEPTED: ALTERNATIVE: OTHER. Other described: INNOVATIVE. CONVENTIONAL. ANY YES E9-chapphcauon 07/20/2015 14:03 Page I of C484 CATANNBACOUNTI' Case 4 RBPR-07-2015-21897 Public I leallh Department Subdivision Environmental Health DivisionPINtI374412767526 PO Box 389. 100-,4Southwest 131vd, Newlon. NC 2R658 NAME ON PERMIT: ( DALE ABBOTT), 5358 B J DR, CONOVER NC 28613 ( Dale Abbott) Site Address: 5358 BJ DR, CONOVER NC 28613 Property Size: Square Feet /Acres 0.45 Directions: Springs Rd to Lee Cline Rd/ turn on Eckard/ B J Dr on right/ where B J Dr forks / driveway on left of fork 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 law a rules. I understand that I am solely responsible for the proper identification and labeling of all property lines and corners and making the site cessibl so t a corpplete"sit anon can be performed Date: 720 1 3— Signature of Applicant or Agent Ct 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 ############################################################################################################ ri!L!(nlf!ulQuli21 fig !}i1�r'�I 1 rII ^Prt j°li�; '7j'Inl Je !�N%in�;,r'!'''ll�� i"�'+�IIIIIIt16ilY. b"if 1 h 11 t 1 A FEENAME1�iiu ` ftl'IIIt'lµh�. i'i %II1'!u9ii.'i:." �iIDATE W�II�IIGI!�FEEhAMOUNT,i! Improvement Permit Fee 07/07/2015 $150.00 $1 0 { i�)'I i }I� 'illi ...1 �� IITOTALIFEE5; ,Ig41;'i! i�1?;tl¢iIIYIIIEIiF, ijijt.11pp,.Illi{I .00I il �i i1tU II �Y��"Pili Ai li it lull Jill :.. i., i ,fl'. {�('li A -I Ilii^Y" li.l il� Il �o ��.'��� J.9lLYItI e I p_L f nnlilyl. Gs.:iL! ,ignla ..�.�:�7u14CIWl . .•^ 6VII1"ur"-. � ',�ILI9WdhWfwliWf11L1!plf . 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) F9 - ehapphcduan 07/20201 i 13 56 Page 2 of 4 82.38 83.67 �r 5352 g Catawba County Environmental Health \5364 ` 7 \ C 1 �L P 1 y0 15 h �� 2b S, 9 5356 �'sJ m Parcel: 374412767526, 5358 BJ DR CONOVER, 28613 (185) 1 in=50ft This map/report product was prepared from the Catawba County, NC Geospabal 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 07/20/2015 THIS IS NOT A PERMIT Case # RBPR-07-201-21897 CATAWBA COUNTY HEALTH DEPARTMENT PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES Residential Building Plan Review - Manufactured Home IMPROVEMENT i�15�15 �PJIs�r+ dofA fnttc! Land Owner BETTY ISENHOUR, 3225 24TH ST NE, HICKORY NC 28601 Owner DALE ABBOTT, 5358 B J DR, CONOVER NC 28613 C:7042075996 NAME TO APPEAR ON PERMIT Dale Abbott SITE ADDRESS: 5358 BJ DR, CONOVER NC 28613 PIN # 374412767526 NAME of SUBDIVISION: Lot# B-2 Section/Block_ PROPERTY SIZE: Square Peet Acres 0.45 DIRECTIONS: Springs Rd to Lee Cline Rd/ turn on Eckard/ B J Dr on right/ where B J Dr forks / driveway on left of fork PRIMARY CONTACT: Owner SEWER TYPE: Septic Tank GALLONS PER DAY: 240 WATER SUPPLY: Private Well DESCRIBE WORK: ***zoning needs to sign zoning permit ***1986 Class E SW mobile home **okay per zoning for metal on metal home placement/ ** Screen or Remove Towing Tongue, Deck must be 36 sq ft deck on front, Must be 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? 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? No APPLICATION FOR: STRUCTURE TYPE: New Structure PRIMARY RESIDENCE FACILITY TYPE: Meat Market OTHER DESCRIPTION: DESCRIPTION OF singlewide mobile home EXISTING STRUCTURES ON SITE (IF ANY DIM EXISTING STRUCTURE: 14 x 65 NUMBER OF EXISTING BEDROOMS: 3 # OF OCCUPANTS: 2 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 14 x 60 w/6 x 6 F Deck & 44 B Deck & 6x6 patio # OF NEW BEDROOMS:: Desired system types (Improvement Permit or Authorization to Construct). ACCEPTED: ALTERNATIVE: CONVENTIONAL: OTHER: INNOVATIVE: ANY Other described: F9-diapphcan11 07/15/2015 0853 Page I nf4 CATAWBA COUNTY Case a RBPR-07-2015-21897 Public Health Department Subdivision Environmental Health Division P1Nit 374412767526 PO Box 389. 100-A Southwest Blvd. Newton, NC 28658 18 2 w NAME ON PERMIT: ( DALE ABBOTT), 5358 B J DR, CONOVER NC 28613 ( Dale Abbott) Site Address: 5358 BJ DR, CONOVER NC 28613 Property Size: Square Feet Acres 0.45 Directions: Springs Rd to Lee Cline Rd/ turn on Eckard/ B J Dr on right/ where B J Dr forks / driveway on left of fork 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. 1 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: Signature of Applicant or Agent 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 ih{ert:•. ;.� w� It. �,::, . {�: J n v XEENAME';. g,' ;,,°„ �firpail'+pll �Il��I�;i�i�il�Iln!{n;mtc-. '.°':�I4"P�{ Iaunu.,. {:,aolll. -n: 8i is '�:Y {'. '� -.�"ii'.', : DATE �II'FF,FIAMOUNT,�'u ., uitll7�l,C!iL- Improvement Permit Fee 07/07/2015 S150.00 f I ! TOTAL FEES1��1;1 ,,,.,, di.I I I! I. il{ ,iinnnnu:.. ,,,.4,:0��,.�i;" 5150•nm{0�r: LSI ,,.., .•r., +, `• " ' ' I r an{ndI^w.-'r @ hI ";,Hell uJ�L u J il l I If11WI w{ � 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) G9 - chnpphcauon 07/15/2015 08.53 Page 2 of 4 Land Owner Owner THIS IS NOT A PERNHT Case # RBPR-07-2015-21897 CATAWBA COUNTY HEALTH DEPARTMENT PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES Residential Building Plan Review - Manufactured Home IMPROVEMENT BETTY ISENHOUR, 3235 34TH ST NE, HICKORY NC 28601 DALE ABBOTT, 5358 B J DR, CONOVER NC 28613 C:7042075996 NAME TO APP AR ON PERMIT Dale Ob oN" SITE ADDRESS: 5358 BJ DR, CONOVER NC 28613 NAME of SUBDIVISION: PROPERTY SIZE: Square Feet Acres 0.45 PIN # 374412767526 Lot B-2 Section/Block DIRECTIONS: Springs Rd to Lee Cline Rd/ turn on Eckard/ B J Dr on right/ where B J Dr forks / driveway on left of fork PRIMARY CONTACT: Applicant SEWER TYPE: Septic Tank GALLONS PER DAY: 240 WATER SUPPLY: Private Well DESCRIBE WORK: "`zoning needs to sign zoning permit ***1986 Class E SW mobile home "okay per zoning for metal on metal home placement/ " Screen or Remove Towing Tongue, Deck must be 36 sq ft deck on front, Must be 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? 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? No APPLICATION FOR: New Structure STRUCTURE TYPE: PRIMARY RESIDENCE FACILITY TYPE: Meat Market OTHER DESCRIPTION: DESCRIPTION OF I singlewide mobile home EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: 14 x 65 NUMBER OF EXISTING BEDROOMS: 3 # OF OCCUPANTS: 2 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 14 x 60 w/6 x 6 F Deck & 4x4 B Deck & 6x6 patio Desired system types (Improvement Permit or Authorization to Construct): ACCEPTED ALTERNATIVE: CONVENTIONAL: OTHER: INNOVATIVE ANY Other described' E9 - ehapphcauon 07/07/2015 1641 Page I of 4 yw CATANvBA COUNTY Case # RBPR-07-2015-21897 T Public Health Department Subdivision 2 Environmental I1ealth Division PIM374412767526 w PO Bos 389. 100-A Southwest Blvd, Newton. NC 28658 IR 2 su NAME ON PERMIT: Site Address: 5358 BJ DR, CONOVER NC 28613 Property Size: Square Feet Acres 045 Directions: Springs Rd to Lee Cline Rd/ turn on Eckard/ B J Dr on right/ where B J Dr forks / driveway on left of fork 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: Signature of Applicant or Agent An Environmental Health Specialist will contact you within 5 working days of application date. If you need further information or assistance plea iqall 828,-466-729 1 .,.....7/,/..............................AREA2..» ..............,...... FEENAME DATE FEE AMOUNT Improvement Permit Fee 07/07/2015 $150.00 TOTAL FEES' ', 5150.00 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 - chappl icanon 07/07/2015 16 41 Page 2 of 4 C�AWBA , THIS IS NOT A PERMITLn-';ur+ CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services Page 1 Improvement Permit W 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 ,-,2 Subdivision Cc),-,ovp-r , NC. `ok.*(o13 Lot# Acres Driving Directions to Property s 6J -q -A a %c�:uz L. )C-, v Sip,-„nQ s �twV4L- NAME TO APPEAR ON PERMIT? ❑ Owner Applicant Contact Information Name p,Xp 'R6k, p 1 Address r'& S%B QS Cc4mae '70`4- x *T(. Owner Contact Information Name Address Phone Contractor Contact Information Name Address Section/Block/Phase A -O L, if r- C��e- r- I U --I— ON o�. 2�c�hd �nlltiate a — 0=ullL, s C Fuivc- [Applicant ❑ Contractor Co,^aver , ,v a -t (a Cell Phone `7.0 `f — a -DZ - $� 4 Cell Phone Phone I Cell Phone WHO WILL BE THE PRIDIARY CONTACT? ❑ Owner Applicant ❑ Contractor Description of Existing Structures on Site M ob.le �LaJ` t # of Bedrooms *I 1� Structure Dimensions T O be- r COY Osupants Basement ❑ Yes No Basement Fixtures ® Yes �To 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 (!9Q0 Does the site contain any jurisdictional wetlands? p'es ONO Does the site contain any existing wastewater systems? r) Yes ENO Is any wastewater going to be generated on the site other than domestic sewage? 0 Yes Q No Is the site subject to approval by any other public agency? In Yes QNTO 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 Lines,r\Qrea 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) ❑ Accepted 0 Alternative ❑ Conventional ❑ Innovative ❑ Other Any CATA'"ATHIS IS NOT A PERMIT UGUNrCATAWBA COUNTY HEALTH DEPARTMENT oe o Application for Environmental Services Page 2 Proposed Facility Type ^ b F-1PrimaryResidence 19 New Residence ❑ Addition to Residence # of New Bedrooms * t .' + (o ti Project Description I Li 'A L O 6%0(o F=-\ %0^A- Si&UL r Ll \6q bAA-U1 LCS.9-) t7q lJC Structure Dimensions # of Occupants r! Basement ❑ Yes N? No Basement Fixtures ® Yes 27"m No ❑ 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 WeLI Type ❑ Individual Well ❑ Semi -Public Well ❑ Community Well Abandonment Type ❑ Drilled ❑ Bored ❑ Dug ❑ Unktiown 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 nmst be issued with the Authorization to Construct. SYSTEM REDESIGN AND/OR RETRHP WILL INCUR AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) Improvement Permits issued as a result of this mformation 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 ruFes. 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 oorl� / Date —77 Printed Name of Owner or Agent T)c, le- /4 40 n Catawba County Environmental Health 83.67` PD 959 Cr L tnA a 160 ZO oa 155 r- /� ✓ � � of \ Parcel: 374412767526, 5358 BJ DR CONOVER, 28613 r (185) (ts5) 1 in=50ft This map/repos product was prepared from the Catawba County, NC Geospahal Intormanon Services. Catawba County has made substantial efforts to ensure the accuracy of location and labeling information contained on this map or data on this repos. 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, lass or liability, whether direct, indirect or consequential which asses or may arise from this map/report product or the use thereof by any person or enti ty. Copyright 2014 Catawba County NC 07/07/2015 Parcel Report Parcel Report- Catawba County NC Parcel Information: Owner Information: Parcel ID: 374412767526 Owner: ISENHOUR BETTY JEAN Parcel Address: 5358 BJ DR Owner2: City: CONOVER, 28613 LRK(REID): 54797 Deed Book/Page: 2014E/0107 Subdivision: Lots/Block: B-2/ Last Sale: Plat Book/Page: 26/166 Legal: LOT B-2 PLAT 26-166 Calculated Acreage: .450 Tax Map: 1605 03018 Township: CLINES State Road #: Tax/Value Information: Tax Rates(pdf) City Tax District: All in County County Fire District: OXFORD Building(s) Value: $0 Land Value: $7,400 Assessed Total Value: $7,400 Year Built/Remodeled: / Current Tax Bill Miscellaneous: Building Permits for this parcel. Building Details WaterShed: Voter Precinct: P33 Parcel Report Data Descriptions List all Owners Deed History Report Address: 3225 24TH ST NE Address2: City: HICKORY State/Zip: NC 28601-8298 School Information: School District: COUNTY Elementary School: LYLE CREEK Middle School: RIVER BEND High School: BUNKER HILL School Map Zoning Information: Zoning District: COUNTY Zoningl: R-20 Zoningl: Zoning3: Zoning Overlay: DWMH-O Small Area: ST STEPHENS/OXFORD Split Zoning Districts: / Zoning Agency Phone Numbers Firm Panel Date: 2007-09-05 Firm Panel #: 3710374400J 2010 Census Block: 2005 2010 Census Tract: 010201 Agricultural District: PROXIMITY Assessment Report Page 1 of t 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 anses or may arise from tras map/report product or the use thereof by any person or entity © 2015, Catawba County Government, North Carolina. All rights reserved. http://gis.catawbacount3,nc.goN,/nomap/parcel_report.php?key=374412767526&typ=P 7/7/2015 ***Op. Permit and/or Cert. Op. Required_ (Must be completed prior to final) CA'WAWBA CauNTY HEAI.,'I'H 00F>ART INT T ( 704) 465-8270xJ_f Lot Eval._Improve. Permit X Repair Permit Cert. of Comp. Permit Oper. Permit Owner/Agent /1 rZ Y -,c rw y u r{ Phone 7 Address 3 z z S z 5 i 2,F _. __b /Ce 7Z4 Subdivision ,�Zal)z lh�vi� Section/Block/Phase Lot#�f Lot Size YG .4 c- Directions: s ra-k,-rGs _ t /f T v C-Nl U < (rC t4-4rLr) C`{ 14 i r I �'S� IZ.�.) �T' 2 I t%� L CS�'3� cv--L Facility: House_ Mobile Home Business . Other: Tax Map # 1G,11,�-- j - / V Multi -family` Other Zoning Approval # Zai �n 111 2 Bedrooms___ Seats Employees Application Rate GPD Flow' Hot Tub or Spa4es/tiotSpecial Fixtures 100% Repair Area yes/no REPAIR NOTICE: Basement yes /v Basement Plumbing yes/no REPAIRS MUST BE WITHIN 30 DAYS OR Water Supply: PrivatePublie DAYS FROM DATE OF PERMIT. Type of System: Trench�Bed—Pump_Pump/Panel—Panel_LPP�Other Tank Size: Septic Tank m 10 r--4-t_L,<TL--f Pump Tank Nitrification Field: Total Square Feet �Id O Depth of Stone �Z // Bed Size Trench Width 3 ( 11 Total Length of All Trenches S 00/ Number of Trenches Individual Trench Length/'?z//Oj /t60/_/_ Feet on Center � Maximum Trench Depth z L ri Distance of Nearest Well Lot Evaluation: Approved yes/no (void After 24 months) Topo Z % Slope f Sketch of lot Evaluation Site - Svstem DPsign - Final Texture 1 Structure ?, re. ) Clay Min. / I _ Soil Wetness X1%2 M( It Soil Depth L! Rastric. Hoz. a*44 AvailablespacenofOverall Class S II Comments: F{2.rfN-t w Septic Tank Contractors MUST contact the Sanitarian BEFORE changing permit. ) **NO GUARANTEE OR WARRANTY IS IMPLIED OR GIVEN THROUGH THE ISSUANCE 0£ THIS PERMIT** Permit Date Q G -T 0 6��_. / 1 g (Improvement Permit fter 60 months) Owner/Agent' ! .;�X .�y _ Sanitarian�. Installed By pate -li- j Sanita` aan /{..j aA-1 (Note aYy changes/information in red or by sketch on back)` *******IF A PERMIT HAS TO BE REDESIGNED AND/OR RETRIPS MADE To THE PROPERTY, THERRE******** TS AN ADDTTIONAL S25 CHARGE.