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HomeMy WebLinkAboutRBPR-07-2015-21899.TIFContractor THIS IS NOT A PERMIT Case # RBPR-07-2015-21899 CATAWBA COUNTY HEALTH DEPARTMENT PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES Residential Building Plan Review - Building New IMPROVEMENT - AUTH CONST - NEW WELL `PAINT MASTERS AND COMPANY. INC (BARRY HARBINSON). 3570 DIVOT DR. MAIDEN NC 28650- B:828-428-2204 C:828 -312-6222F:828-428-2909 BARRY_HARBINSON@HOTMAIL COM Owner PAINT MASTERS AND COMPANY INC. 3570 DIVOT DR, MAIDEN NC 28650 C:828-312-6222 NAME TO APPEAR ON PERMIT *PAINT MASTERS AND COMPANY, INC (Barry Harbinson) SITE ADDRESS: 1927 FRIENDLY LN, NEWTON NC 28658 PIN # 365917012652 NAYIE of SUBDIVISION: ALTAMONT SPRINGS SEC 3 Lot # 28 Section/Block PROPERTY SIZE: Square Feet Acres 0.61 DIRECTIONS: 321 S/ left at Highway Patrol Station/ cross over St James Church Rd/ on Smyre Farm Rd/ right on Hermit Trail/ right on Friendly Ln/ left on Layton / lot on far corner PRIMARY CONTACT: Contractor SEWER TYPE: Septic Tank GALLONS PER DAY: 360 WATER SUPPLY: Private Well DESCRIBE WORK: 2 Story dwelling w/ 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? No APPLICATION FOR: STRUCTURE TYPE: FACILITY TYPE: Single Family Residence DESCRIPTION OF vacant lot EXISTING STRUCTURES ON SITE (IF AN DIM EXISTING STRUCTURE: NUMBER OF EXISTING BEDROOMS: NEW STRUCTURE DIM:: 50 x 80 # OF NEW BEDROOMS:: 3 New Structure PRIMARY RESIDENCE OTHER DESCRIPTION: # OF OCCUPANTS: 4 PROPOSED CONSTRUCTION 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: APPLICATION FOR WELL CONSTRUCTION PROPOSED WELL TYPE: Individual Well REPLACE WELL?: NO E9-ehapplicauon 07/08/2015 09 15 Page I oft eA CATAWBACOUNTY Case# RBPR-07-201 -21899 y Public Health Department Subdivision ALTAMONT SPRINGS SEC 3 Environmental Health Division PIN# 365917012652 PO Bos 389. 100-A Southwest Blvd. Newton. NC 28658 NAME ON PERMIT: *PAINT MASTERS AND COMPANY, INC ( BARRY HARBINSON), 3570 DIVOT DR, MAIDEN NC 28650 - 'PAINT MASTERS AND COMPANY, INC ( Barry Harbinson) Site Address: 1927 FRIENDLY LN, NEWTON NC 28658 Property Size: Square Feet Acres 061 Directions: 321S/ left at Highway Patrol Station/ cross over St James Church Rd/ on Smyre Farm Rd/ right on Hermit Trail/ right on Friendly Ln/ left on Layton / lot on far corner 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 L�uthonzed county and state officials are granted right of entry to conduct necessary inspections to determine compliance with applicable laws nd rules tl, nde99stand that I am solely responsible for the proper identification and labeling of all property lines and corners and making the site access Ile so th , 2 complete site evaluation can be performed Date: 7- -7 !S Signature of Applicant or Aeent /"moi ijk�� t ,II An Environmental Health Specialist will contact you within 5 wor ri days of application date. If you need further information or assistance please call 828-466-7291 AREA1 FEENAME Authorization to Construct Fee (New/Expansion) Fee Improvement Permit Fee Well Permit & Inspection Fee r TOTAL FEES DATE FEE AMOUNT 07/08/2015 $150.00 07/08/2015 $150.00 07/08/2015 5300.00 5600.00 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 - ehapphcahon 07/082015 09'15 Page'- of -I C�� THIS IS NOT A PERMIT tLL1 i _ -- --`CATAWBA COUNTY HEALTH DEPARTMENT F „a Application for Environmental Services Page 1 Improvement Permit Authorization to Construct Septic Repair ❑ Septic rMalfunction ❑ Septic Expansion ❑ tJew Well PermitXReplacement Well ❑ Well Abandonment ❑ Well Repair Existing System Inspection (Pre -Approval Required) ❑ Application is for New Construction Ix Existing Facility E:1- Property Address lgri-7 jc gensjLL 4A-n.� Subdivision /1))--7,4,4'1e,,7-—r,412 e, 5 -4-3 'Os6 q, Lot tt Acres J nl (> All 3 /p59/ �7D1a 1p �02 Section/Block/Phase Driving Directions to Property & Z/ S r 1 <, - Le t T C // eve 2 $T �i.4ic s o v ��h ,�P t 9�2 . — /�i��5� o � Ne_o'..1" T72,aL Z_ olL, — / �ltoti LILi�ti�i�-y �fin,e — �eFT an. .L.?-yTar� - �7� F.<i2 Core.n.cyL NAME TO APPEAR ON PERMIT?/ ❑ Owner ❑ Applicant Contractor Applicant Contact Information Name Address 1 Phone Cell Phone Owner Contact Information Name,q-[i�nGP! S 4 �'OYt�t�aYl� j Address 1 Phone Cell Phone 1 Contractor Contact Information Name ✓J/l%� 5 G 7/v c Address �4 7v ' ,1171 ✓0 7 Phone ! I Cell Phone 9Z - 3/7 - 4, Z y L WHO WILL BE THE PRIMARY CONTACT? ❑ Owner ❑ Applicant �] Contractor Description of Existing Structures on Site # of Bedrooms *j ---,-3� Structure Dimensions # of Occupants Basement ❑ Yes [X No Basement Fixtures Yes No The Applicant shall notty the local health department upon submittal of this application if any of the following apply to the property j'n question. If the answer to any question is "yes", applicant must attach supporting documentation. ® Yeso Does the site contain any jurisdictional wetlands? ® Yeso Does the site contain any existing wastewater systems? • Yes No Is any wastewater going to be generated on the site other than domestic sewage? Ayes /No Is the site subject to approval by any other public agency? ® Yes ONO Are there any easements or right of ways on this property? Describe Existing water supply in use ❑ Individual \Fell ❑ 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 yo, rpreference) ❑ Accepted 0 Alternative Conventional 0 Innovative 0 Other Any TAJ VT Cc` y'n _ . CATAWBA COUNTY HEALTH DEPARTMENT Application for Enviromnental Services Page 2 Proposed Facility Type Primary Residence New Residence Addition tQ Residence n# of New Bedrooms * j ProjectDescriptionn ni sQ wl r l/1/(Uwe' Structure Dimensions -6 x .5 O # of Oc�iipams-" Li Basement ❑ Yes No Basement Fixtures 0 Yes 9 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 ❑ Sfulti-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 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/AbandonmentlRepair 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 j 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. j 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 perform /. Signature of Owner or Agent ✓� Date 7 —7—�5 '� Printed Name of Owner or Agent B/tJ�r 44 P--8,i✓5 ,✓ Catawba County Environmental Health Parcel: 365917012652, 1927 FRIENDLY LN 1in=50ft NEWTON, 28658 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 07/08/2015 Parcel Report. Page 1 of 1 Parcel Report- Catawba County NC Parcel Information: Parcel ID: 365917012652 Parcel Address: 1927 FRIENDLY LN City: NEWTON, 28658 LRK(REID): 902874 Deed Book/Page: 1094/0256 Subdivision: ALTAMONT SPRINGS SEC 3 Lots/Block: 28/ Last Sale: Plat Book/Page: 53/115 Legal: LOT 28 PLAT 53-115 Calculated Acreage: .610 Tax Map: Township: NEWTON State Road #: Tax/Value Information: Tax Rates(pdf) City Tax District: All in County County Fire District: NEWTON RURAL Building(s) Value: $0 Land Value: $20,800 Assessed Total Value: $20,800 Year Built/Remodeled: / Current Tax Bill Miscellaneous: Building Permits for this parcel. Building Details WaterShed: Voter Precinct: P32 Parcel Report Data Descriptions List all Owners Deed History Report Owner Information: Owner: PAINT MASTERS AND COMPANY INC Owner2: STAMEY DAVID L Address: 3570 DIVOT DR Address2: City: MAIDEN State/Zip: NC 28650-8040 School Information: School District: COUNTY Elementary School: TUTTLE Middle School: MAIDEN High School: MAIDEN School Map Zoning Information: Zoning District: COUNTY Zoningl: R-40 Zoning2: Zoning3: Zoning Overlay: DWMH-O Small Area: BALLS CREEK Split Zoning Districts: / Zoning Agency Phone Numbers Firm Panel Date: 2007-09-05 Firm Panel #: 3710365900J 2010 Census Block: 1004 2010 Census Tract: 011601 Agricultural District: PROXIMITY Assessment Report 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 materepod 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 mapheport product or the use thereof by any person or entity © 2015, Catawba County Government, North Carolina. All rights reserved. ay, ly,, Wel) X300 http://gis.catawbacountync.gov/nomap/parcel_report.php'?key=365917012652&typ=P 7/8/2015