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HomeMy WebLinkAboutRBPR-07-2015-22043.TIFApplicant Owner Paid By THIS IS NOT A PERMIT Case # RBPR-07-201 5-22 043 CATAWBA COUNTY HEALTH DEPARTMENT PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES Residential Building Plan Review - Manufactured Home EXS_SYSTEM OAKWOOD HONIES, 1265 HWY 70 WEST, NEWTON NC 28658 C:704-913-5132 JEFF COOPER OTHER. 828-464-8715 JOSEPH MILLER, 3234 SUTTON LN LOT 43, CLAREMONT NC 28610 C.2323347450 *ELIOBERTO (AL) ALFONSO, 1265 HWY 70 W, NEWTON NC 28658- 0:8282175480 R712@CLAYTONHONIES.COM Parcel Owner PABLO FLORES, 213 LINEBERGER RD. CONOVERNC 28613 H 828-217-9073 C.828-493-7744 HOME:828-217-9073 NAME TO APPEAR ON PERMIT Joseph Miller SITE ADDRESS: 3234 SUTTON LN, CLAREMONT NC 28610 PIN # 376301391169 NAilIE of SUBDIVISION: Lot 4 Section/Block PROPERTY SIZE: Square Feet Acres 2094 DIRECTIONS: 70 to Rockbarn School Rd/Park on left before Oxford School Rd PRIMARY CONTACT: Applicant SEWER TYPE: Septic Tank GALLONS PER DAY: 360 WATER SUPPLY : Public Water DESCRIBE WORK: 16 x 72 singlewide w/3 bedrooms 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: New Structure STRUCTURE TYPE: FACILITY TYPE: Mobile Home DESCRIPTION OF EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: NUMBER OF EXISTING BEDROOMS: 3 PRIMARY RESIDENCE OTHER DESCRIPTION: # OF OCCUPANTS: 3 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 16 x 72 # OF NEW BEDROOMS:: 3 Desired system types (Improvement Permit or Authorization to Construct): ACCEPTED: ALTERNATIVE: OTHER INNOVATIVE Other described. CONVENTIONAL ANY: E9-chapphesnon 07/29/2015 1636 Page l of C18 CATAWBA COUNTv Case RBPR-07-2015-22043 #ZPublic Health Department '�Environmental Health Division Subdivision"rPIN# 376301391169 PO Bos 389. 100-A Southwest Blvd, Nekton. NC 23658 NAME ON PERMIT: ( JOSEPH MILLER), 3234 SUTTON LN LOT 43, CLAREMONT NC 28610 ( Joseph Miller) Site Address: 3234 SUTTON LN, CLAREMONT NC 28610 Property Size: Square Feet Acres 2094 Directions: 70 to Rockbarn School Rd/Park on left before Oxford School Rd 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 correc . Authonzed county and state officials are granted right of entry to conduct necessary inspections to determine compliance with applicable laws n rut I understand that I am solely responsible for the proper identification d ef1n of all property lines and corners and making the site accessi comp) a site evaluation can be performed Date: �� ` Signature of Applicant or Agent An Environmental Health Specialist will contact you within 5 working ays of application date. If you need further information or assistance please call 828-466-7291 AREA2 FEENAME Existing Tank Check Fee TOTAL FEES DATE FEE AMOUNT 07/29/2015 $80.00 $80.00 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 - chapplicatnon 07/29/2015 1636 Pal -0 2 of 4 CATAWBA THIS IS NOT A PERMIT Zcounr�-�CATAWBA COUNTY HEALTH DEPARTMENT �,- Application for Enviromnental 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) Application its for New Construction ❑ Existing Facility ❑ Property Address �a��i X �Y�/rYl LG_ ne 10P -P�3 Subdivision NC Lot # Acres Section/Block/Phase Driving Directions to Property k) /)(0f (oo t—r\ (Ty,\ P F ( mac -CUYr cCCt­)r(A 5-e V\CXD Rei NAME TO APPEAR ON PERNIIT? )/(Owncr ❑ Applicant ❑ Contractor Applicant Contact Information I Name 0 K(,)(.)( -)A o - t'.)eL kcN` Address L Co` a.)v -7o C.J - %) e 1. 4v& KJC_ ( Phone ���-�1o�1 o�lo�a- Cell Phone Owner Contact Information Name �C7.-feh Address .� 3c% i i C I r� -e t Phone Q Cell Phone Contractor Contact Information Name f rY�P �`� l<`�(1.4- I Address Phone Cell Phone WHO WILL BE THE PRIMARY CONTACT? ❑ Owner VApplicant ❑ Contractor Description of Existing Structures on Site t # 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. I] Yes o Does the site contain any)unsdictional wetlands? 9/Yes0 Does the site contain any existing wastewater systems? ❑ Yesto o Is any wastewater going to be generated on the site other than domestic sewage? AYeso Is the site subject to approval by any other public agency? ® Yes Are there any easements or right of ways on this property? Describe Existin water supply in use U Individual Well ❑ Community Well ❑ Semi -Public Well County/City/Township Water Line Is a public water supply available? ** ❑ Yes ❑ No If a0plying 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 0 Conventional ❑ Innovative 0 Other 0 Any C ATAR]B Aj�C� THIS IS NOT A PERMIT cousTt CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services Page 2 posed Facility Type 13 Primary Residence E] New Residence ❑Addition to Residence # of New Bedrooms *t Project Description A �JCk t-,0 (1L'O c)-� !),iobi' le (ltnr? Structure Dimensions 4( „ Y �] (9Y # of Occupants Basement ❑ Yes No Basement Fixtures ® Yes 06�0 ❑ Accessory Structure(s)' Describe # of New Bedrooms *t if applicable Structure Dimensions # of Occupants Accessory Dwelling ❑ Yes ❑ No Plumbing ❑ Yes ❑ No Describe Plumbing Needed U Multi -Family Residence # Units #Bedrooms per Unit*t Total # Bedrooms * t Structure Dimensions U Food Service Specify Type # Seats Floor Space -Entire Food Service Facility (Sq Ft) # Employees per Shift # of Shifts Dining Area (Sq. Ft.) H 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 ❑ Community Well Abandonment Type ❑ Drilled ❑ Bored ❑ Dug ❑ Unknown 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 must be issued with the Authorization to Construct. SYSTEM REDESIGN AND/OR RETRIP WILL INCUR AN ADDITIONAL CHARGE (SEE FEE SCIIEDULE) 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 rales. I understand that I am solely responsible for the proper identification and labeling of all property Imes and comers and making the site accessible so that a complete site evaluation can be performed. Signature of Owner or Agent / �y�)C/b( CX II1 I_,(,(�(flL�..t VSD� /ate /\�, q�1 � / J Printed Name of Owner or Agent 1 In(< Q ��Cl/I1(rn -g"' �' � \ �� Catawba County Environmental Health (3229 L. 3234 1 j (330) Parcel: 376301391169, 3220 SUTTON LN CLAREMONT, 28610 --1251 3255 20 1 in=60ft This map/report product was prepared from the Catawba County, NC Geospafial 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 Catawba County Environmental Health J Parcel: 376301391169, 3220 SUTTON LN CLAREMONT, 28610 1 i n=200ft This map/report product was prepared from the Catawba County, INC Geospalial 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 venficahon of any data contained on this maplreport 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: 376301391169 Parcel Address: 3220 SUTTON LN City: CLAREMONT, 28610 LRK(REID): 66108 Deed Book/Page: 2312/1046 Subdivision: Lots/Block: / Last Sale. $120,000 on 1995-01-01 Plat Book/Page: Legal: 3220 SUTTON LN Calculated Acreage: 20.940 Tax Map: 2400 00017 Township: CLINES State Road #: 1709 Tax/Value Information. Tax Rates(pdo City Tax District: All in County County Fire District: OXFORD Building(s) Value: $24,500 Land Value: $152,900 Assessed Total Value: $177,400 Year BuilURemodeled: / Current Tax Bill Miscellaneous: Building Permits for this parcel Building Details WaterShed: WS -IV Protected Area Voter Precinct: P27 Parcel Report Data Descriptions List all Owners Deed History Report Owner Information: Owner YORK JOHN SUTTON Owner2: Address: PO BOX 1327 Address2: City: CONOVER State/Zip: NC 28613-1327 School Information: School District: COUNTY Elementary School: OXFORD Middle School: RIVER BEND High School: BUNKER HILL School Map Zoning Information: Zoning District: COUNTY Zoningl: R-30 Zoning2: Zoning3: Zoning Overlay: WP -O Small Area: ST STEPHENS/OXFORD Split Zoning Districts: / Zoning Agency Phone Numbers Firm Panel Date 2007-09-05 Firm Panel #: 3710376300J 2010 Census Block: 2004 2010 Census Tract: 010101 Agricultural District. Assessment Report Page 1 of 1 This map/report product was prepared from the Catawba County, NC Geospanal 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 this maptrepod product or the use thereof by any person or entity © 2015, Catawba County Government, North Carolina All rights reserved. tx's��5 bo http://gis.catawbacountync.gov/nomap/parcel_report.php?ke),=376301391169&tvp=P 7/29/2015 N° 1998 A CtATAWBA COUNTY HEALTH DEPA TMENT Telephone: (704) 465-8270 TDD: (704) 465-8200 �7'� Improve. Permit—Authorization /^(�l-tTo Const ruc_t/_Repair Permit is Oper. Permit System Type Owner/Agent I..R es f tY4 (E Phone Address Subdivision S tion/ /g�lock/Phas Lot# "33 -• Lomat Size Direct io/p-ys��:\.�JC1[t� .�'" - .� A+Q. l� Qom„ , - u Facility: House Mobile HomeK Business_ Other: Tax Map # multi -family- Other Zoning Approval 4 # Bedrooms.,_ 4 Seats # Employees Application Rate Q• ¢ GPD Flow -!?�6D Hot Tub or Spa yes/(0)special Fixtures 100% Repair Areay_U/no Basement yes/® Basement Plumbing yes/no Water Supply: Private Well Public .....aaa♦aarau aaaaa♦rasa•arrraaaaaaaaaaaararraaaaaarraaaaaaaaaaaa aaaaaaaaaaaarraaaaaraaaaaaaa♦ Type of System: Trench )(_Bed Pump Pump/Panel PanelLPPOther Tank Size: Septic Tank Size 100 n Pump Tank Size Nitrification Field: Total Square Feet Q19D Depth of Stone /I mi( d' Bed Size I r Trench Width :3 Total Length of All Trenches Ago Number of Trenches 4 Individual Trench Length/ /'i5 /,js /_ Feet on Center, Maximum Trench Depth .36 Distance of Nearest Well ` *DO NOT INSTALL WHEN WET* aaraaaaaaaaraaaaaaaaaaraaaaaa \•ars aaaararaaaaaaaaaaaraaaaaaaaaaaaaaaaaaeaaaaaaaaa ars aaaaaaaaaa Topo Z % Slope / Texture G Structure2>MD Clay Min. ( ' Soil Wetness Soil Depth�'1 Restric. Hoz. at Available space yes/not n � Overall Claes S PS U I .Zqu(le f�+ Comments: \hl L07 3 j 1 144 A3 I **NO GUARANTEE OR WARRANTY IS IMPLIED OR GIVEN AS TO THE PERFORMANCE OR LENGTH OF TIME THIS SYSTEM WILL FUNCTION** aaaraaaaraaa aaaaaraaaaararraaaaaaraaraaaaraaaaaaaaaaaaaaraaaaaaaaaaaaaaraaaaaaaraaraasaaaaaaaaa *Improvement Permit has no expiration date and is transferable, but may be revoked if site plane or intended use changes for the proposed facility. An Authorization to Construct is valid for (5) five years from date issued and is not transferable. Permit Date 80-05-- 97 Owner/Agent S� Sanitari r Installed By '^ iq, Date- Z_ 97 Sanitardan White - Office Blue - Building Inspection Operation Permit Yellow - Owner/Agent Green - Budding Inspec on Authorization to Construct