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HomeMy WebLinkAboutRBPR-07-2015-22037.TIF�ygA G 1842 sM Contractor Owner Paid By THIS IS NOT A PERMIT Case # RBPR-07-2015-22037 CATAWBA COUNTY HEALTH DEPARTMENT PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES Residential Building Plan Review - Building Alteration IMPROVEMENT - AUTH CONST - EXPANSION SAME AS OWNER, . RONNIE GAUWAIN, 1040 35TH ST PL NE, CONOVER NC 28613 C:8282162051 RANDY GAUWAIN, 1040 35TH ST PL NE, CONOVER NC 28613 NAME TO APPEAR ON PERMIT Ronnie Gauwain SITE ADDRESS: 1040 35TH ST PL NE. CONOVER NC 28613 NAME of SUBDIVISION: PROPERTY SIZE: Square Feet Acres 0.46 PIN # 372320802797 Lot Section/Block DIRECTIONS: Hwy 40 to McDonald Prkway N to turn Right to Spencer Rd turn left onto 35th ST PL NE. 2nd house on the right PRIMARY CONTACT: Owner SEWER TYPE: Septic Tank GALLONS PER DAY: 600 WATER SUPPLY: Private Well DESCRIBE WORK: Finishing basement - 1 bedroom, bathroom and kitchen and living room area 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: Existing Structure STRUCTURE TYPE: PRIMARY RESIDENCE FACILITY TYPE: Single Family Residence OTHER DESCRIPTION: DESCRIPTION OF single family dwelling EXISTING STRUCTURES ON SITE (IF ANY DIM EXISTING STRUCTURE: 64x40 NUMBER OF EXISTING BEDROOMS: 3 # OF OCCUPANTS: 5 PROPOSED CONSTRUCTION BASEMENT? Yes BASEMENT FIXTURES? Yes PLUMBING REQUIRED? Desired system types (Improvement Permit or Authorization to Construct): ACCEPTED: ALTERNATIVE: CONVENTIONAL: OTHER: INNOVATIVE ANY* YES Other described: - E9 - ehapphcation 07/29/2015 10 39 Page 1 of 4 ew CATAWBA COUNTY Case# RBPR-07-2015-22037 Public Health Department Subdivision Environmental Health Division YIN# 372320802797 .. PO Box 389, 100-A Southwest Blvd, Newton. NC 28658 7g 2 w NAME ON PERMIT: (RONNIE GAUWAIN), 1040 35TH ST PL NE, CONOVER NC 28613 ( Ronnie Gauwain) Site Address: 1040 35TFI ST PL NE, CONOVER NC 28613 Property Size: Square Feel Acres 0.46 Directions: Hwy 40 to McDonald Prkway N to turn Right to Spencer Rd turn left onto 35th ST PL NE. 2nd house on the right. 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 ccs or intended use changes for the proposed facility I have read this application and certify that the information provided herein is true, complete Ini Authorized county and state officials are granted right of entry to conduct necessary inspections to determine compliance with applicable laws andl ulesl I understand that I am solely responsible for the proper identification and ]apelin of all property lines and corners and making the site accessible soh a complete site evaluation can be performed Date: 7 1 �,a / / ` 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 FEENAME Authorization to Construct Fee (New/Expansion) Fee Improvement Permit Fee TOTAL FEES k DATE -FEE AMOUNT 07/29/2015 5300.00 07/29/2015 $150.00 $450.00 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 - ehapphuuion 07/29/2015 1039 Pa6e 2 of -I �g.*� f q Tl -IIS IS NOT A PERMIT ao i 5 -,,)Q 0 3,1 TL+lJ�lfi AL cora n - CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services Page I Improvement Permit ❑ Authorization to Construct ❑ Septic Repair ❑ Septic Malfunction ❑ Septic Expansion ❑i rNew Well Permit ❑ Replacement Well ❑ Well Abandonment ❑ Well Repan( ❑ Existing System Inspection (Pre -Approval Required) ❑ Application is for El "Construction ❑ Existing Facility Q Property Address /d /d 3S ,-1 / / !e� Subdivision C y 4 7 2- Lot # Acres Section/BlocIdPhase Driving Directions to Property 4 o +o M cAoria (� PC W L, A/ 4-6 <S'.00 --of C_ e.- rQ , 9n g S- IY4 & A✓e_� NAME TO APPEAR ON PERMIT? [T]/Owner Applicant Contact Information Name h v"Ie- I r..,_ wG1n Address AA -mac,- Phone - Owner Contact Information Name t 6rAA Q Ce Address Phone Contractor Contact Information Name Address ❑ Applicant ❑ Contractor Cell Phone Cell Phone Phone I Cell Phone WHO WILL BE THE PRIMARY CONTACT? 1J✓Owner ❑ Applicant ❑ Contractor Description of Existing Structures on Site Li o # of Bedrooms *j' Structure Dimension Of f x NO # of Occupants C Basement 0-yesF-1No Basement Fixtures �1 Yes ®Into 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 - EJ Does the site contain anyjurisdictional wetlands? es go Does the site contain any existing wastewater systems? ® Yes VNo Is any wastewater going to be generated on the site other than domestic sewage? A Yes ® No Is the site subject to approval by any other public agency? ® Yes 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 Line Is a public water supply available? ** ❑ Yes ❑ No If -a' -pp iyi n gfor 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 ,1"T��'-g� THIS IS NOT A PERMIT COUNTY-=�—.L-� CATAWBA COUNTY HEALTH DEPARTMENT Application for Enviromnental Services Page 2 Proposed Facility Type ❑ Primary Residence ❑ New Resid�"ence F-1Addition to Residence # of New Bedrooms * j Prol.pP,� ectDescription Dr\Q CS5N - V-4C�AQP,t f tl gr �C (in.) -'ulna Iii Structure Dions # of O cupants Done Basement Yes [:]No Basement Fixtures - Yes ®No ❑ Accessory Structure(s) Describe # of New Bedrooms 'PT if applicable Structure Dimensions # of Occupants Accessory Dwelling ❑ Yes ❑ No Plumbing ❑ Yes ❑ No Describe Plumbing Needed ❑ Multi -Family Residence # Units_ Total # Bedrooms *j ❑ Food Sence Specify Type #Bedrooms per Unit"'I Snuctme Dimensions # 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 ❑ Other Facility Type Specify If Church # of Seats # of Shifts Kitchen ❑ Yes ❑ No If Daycare Specify Occupancy Application for Well Construction/Abandonment/Repair Proposed Well Type ❑ Individual Well ❑ Semi -Public Well ❑ Cotmnunity''Vcll 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. j If structure is pltunbed 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 RE, TRIP 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 untended 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 responsibleNor the proper identification and labeling of all property -lines and comers and making the site accessible so that a complete site rvaluVjion can be performed. Signature of Owner or Agent Printed Name of Owner or Agent I \ Dr6r "� �iA V rx)") Date 7/d,--, I /U Catawba County Environmental Health Parcel: 372320802797, 1040 35TH ST PL NE CONOVER, 28613 1 in=50ft This map/report product was prepared from the Catawba County, INC 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 07/29/2015 Parcel Report Parcel Report- Catawba County NC Parcel Information: Parcel ID: 372320802797 Parcel Address: 1040 35TH ST PL NE City: CONOVER, 28613 LRK(REID): 56740 Deed Book/Page: 3216/1700 Subdivision: Lots/Block: / Last Sale: $134,000 on 2013-08-30 Plat Book/Page: Legal: Calculated Acreage: .460 Tax Map: 166H 02059F Township: HICKORY State Road #: 1621 Tax/Value Information: Tax Rates(pdf) City Tax District: All in County County Fire District: ST STEPHENS Building(s) Value: $111,300 Land Value: $12,800 Assessed Total Value: $124,100 Year Built/Remodeled: 1972/ Current Tax Bill Miscellaneous: Building Permits for this parcel. Building Details WaterShed: Voter Precinct: P28 Parcel Report Data Descriptions List all Owners Deed History Report Page 1 of 1 Owner Information: Owner: GAUWAIN RONNIE MEARL Owner2: GAUWAIN DANIELLE ELIZABETH Address: 1040 35TH ST PL NE Address2: City: CONOVER State/Zip: NC 28613-8638 School Information: School District: COUNTY Elementary School: ST STEPHENS Middle Si ARNDT High School: ST STEPHENS School Map Zoning Information: Zoning District: HICKORY Zoningl: R-1 Zoningl: Zoning3: Zoning Overlay: Small Area: Split Zoning Districts: / Zoning Agency Phone Numbers Firm Panel Date: 2007-09-05 Firm Panel #: 3710372300J 2010 Census Block: 2053 2010 Census Tract: 010303 Agricultural District: 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 map/report product by the user. The County of Catawba, its employcns, 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. © 2015, Catawba County Government, North Carolina. All rights reserved. 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