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HomeMy WebLinkAboutRBPR-07-2015-22049.TIFTHIS IS NOT A PERMIT Case # RBPR-07-2015-22049 CATAWBA COUNTY HEALTH DEPARTMENT PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES Residential Building Plan Review - Modular IMPROVEMENT Applicant *OAKWOOD HOMES #712 (ELIOBERTO ALFONSO), 1265 70 HWY W, NEWTON NC 28658 B:(828)217-1862 C:(828)464 -2662F.828-464-4301 R712@CLAYTONHOMES.COM Land Owner BONNIE GRISSOM, 3561 LITTLE RD, SHERRILLS FORD NC 28673 Owner BRANT ROSSON, 3561 LITTLE RD, SHERRILLS FORD NC 28673 C:8284467977 NAME TO APPEAR ON PERMIT Brant Rosson SITE ADDRESS: 3561 LITTLE RD, SHERRILLS FORD NC 28673 PIN # 460702870703 NAME of SUBDIVISION: Lot 4 Section/Block PROPERTY SIZE: Square Feet Acres DIRECTIONS: NC 16S to NC 150 Take left - TL on Slanting Bridge RD, TL onto Stillwater Dr - TR onto Little RD - lot on left PRIMARY CONTACT: Applicant SEWER TYPE: Septic Tank GALLONS PER DAY: 240 WATER SUPPLY: Private Well DESCRIBE WORK:evised 7128/16 - Changed House size to 32x56 28x 2-6x6 decks Modular "Single wide Mobile home must be removed within 30 days of final inspection of modular. 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: Single Family Residence DESCRIPTION OF EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: NUMBER OF EXISTING BEDROOMS: New Structure PRIMARY RESIDENCE OTHER DESCRIPTION: # OF OCCUPANTS: 2 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: QLx5jand 2- 6x6 decks # OF NEW BEDROOMS:: 2 BASEMENT? No BASEMENT FIXTURES? No Desired system types (Improvement Permit or Authorization to Construct) ACCEPTED: ALTERNATIVE: OTHER: INNOVATIVE Other described: PLUMBING REQUIRED? CONVENTIONAL ANY: F9-chapphretu,n 07/28/2016 14 50 Page I o14 CATANN'BA COUNTY Case # RB13R-07-2015-22049 r y Public I-lealth Department Subdivision Environmental I lealth Division PIN# 460702870703 PO Bos 389, 100-A Southwest Idled, Newton, NC 28658 2x2,. NAME ON PERMIT: ( BRANT ROSSON), 3561 LITTLE RD, SHERRILLS FORD NC 28673 ( Brant Rosson) Site Address: 3561 LITTLE RD. SHERRILLS 17ORD NC 28673 Property Size: Square Peet Acres ' Directions: NC 16S to NC 150 Take left - TL on Slanting Bridge RD, TL onto Stillwater Dr - TR onto Little RD - lot on left. 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 ani] labeling of all property lines and corners and making the site accessib o that a complet a evaluation can be performed. Date:X i 7 I it, Signature of Applicant or Agent An Environmental Health Specialist will contact you within 5 working days of application date. If you need further infomtation or assistance please call 828-466-7291 rFEENAME °'U'011'1lNui,y1'"I Improvement Permit Fee •PinllttlJtjll'^!' -Illtp!'jlllljnloll2kL DATE It 'III;,I,FF.F,A'MOUNT:;Ii' 07/30/2015 $150.00 IPd! 4q NOTAL„FEES"Ip1"11'dllUl"P,'pti,';GL;I,1'0'..,11';'r,;4111 Illi i j ' LI II 'IICI,II yplurn "Illllll„ I ",I'll , 1(I IIIIIIi ii111 d 11 i, 1''Ii i I�%11 .. ,� � S 150.00 . ,u pIIL:1VOY '4th im ,�� I 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) 1-9 - chapphcnunu 07/28/2016 14:50 Pa -e 2 of 4 184 !J sM THIS IS NOT A PERMIT Case # RBPR-07-2015-22049 CATAWBA COUNTY HEALTH DEPARTMENT PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES Residential Building Plan Review - Modular IMPROVEMENT loo Cbwetecq &unef 0aA• 4� Applicant *OAKWOOD HOMES #712 (ELIOBERTO ALFONSO), 1265 70 HWY W, NEWTON NC 28658 B:(828)217-1862 C:(828)464 -2662F:828-464-4301 R712@CLAYTONHOMES.COM Land Owner BONNIE GRISSOM, 3561 LITTLE RD, SHERRILLS FORD NC 28673 Owner BRANT ROSSON, 3561 LITTLE RD, SHERRILLS FORD NC 28673 C:8284467977 NAME TO APPEAR ON PERMIT �NC nt Rosson _ SITE ADDRESS: 3561 LITTLE RD SHERRILLS x673 PIN # 460702870703 NAME of SUBDIVISION: Lot # Section/Block PROPERTY SIZE: Square Feet Acres DIRECTIONS: NC 16S to NC 150 Take left - TL on Slanting Bridge RD, TL onto Stillwater Dr - TR onto Little RD - lot on left. PRIMARY CONTACT: Applicant SEWER TYPE: Septic Tank GALLONS PER DAY: 240 WATER SUPPLY: Private Well DESCRIBE WORK: 28x56 and 2-6x6 decks Modular"Single wide Mobile home must be removed within 30 days of final inspection of modular. 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: Single Family Residence OTHER DESCRIPTION: DESCRIPTION OF EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: NUMBER OF EXISTING BEDROOMS: 2 # OF OCCUPANTS: 2 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 28x56 and 2- 6x6 decks # OF NEW BEDROOMS:: 2 BASEMENT? No BASEMENT FIXTURES? No Desired system types (Improvement Permit or Authorization to Construct): ACCEPTED: ALTERNATIVE: OTHER: INNOVATIVE: Other described: PLUMBING REQUIRED? CONVENTIONAL: ANY: 1:9 - ehapplication 10/30/2015 17:05 Page 1 of 4 IgA CATAWBA COUNTY Case # RBPR-07-2015-22049 �Q G� Public Health Department Subdivision v Environmental Health Division PIN# 460702870703 I845� PO Box 389, 100-A Southwest Blvd, Newton, NC 28658 2 NAME ON PERMIT: ( BRANT ROSSON), 3561 LITTLE RD, SHERRILLS FORD NC 28673 ( Brant Rosson) Site Address: 3561 LITTLE RD, SHERRILLS FORD NC 28673 Property Size: Square Feet Acres Directions: NC 16S to NC 150 Take left - TL on Slanting Bridge RD, TL onto Stillwater Dr - TR onto Little RD - lot on left. 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 please call 828-466-7291 FEENAME DATE FEE AMOUNT Improvement Permit Fee 07/30/2015 $150.00 TOTAL FEES = $150.0,0;; ...,... ...hili-`°.., ., 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) F" - chapplicamon 10/30/2015 17:05 Page 2 of 4 Applicant THIS IS NOT A PERMIT Case # RBPR-07-2015-22049 CATAWBA COUNTY HEALTH DEPARTMENT PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES Residential Building Plan Review - Modular IMPROVEMENT I OAKWOOD HOMES n712 (ELIOBERTOALFONSO), 1265 70 HWY W, NEWTON NC 28658 B:(828)217-1862 C:(828)464 -2662F:828-464-4301 Land Owner BONNIE GRISSOM, 3561 LITTLE RD. SHERRILLS FORD NC 28673 Owner BRANT ROSS. 3561 LITTLE RD. SHERRILLS FORD NC 28673 C:8284467977 NAME TO APPEAR ON PERMIT Brant Ross SITE ADDRESS: 3561 LITTLE RD. SHERRILLS FORD NC 28673 PIN # 460702870703 NAME of SUBDIVISION: Lot k Section/Block PROPERTY SIZE: Square Feet Acres DIRECTIONS: NC 16S to NC 150 Take left - TL on Slanting Bridge RD, TL onto Stillwater Dr - TR onto Little RD - lot on left. PRIMARY CONTACT: Applicant SEWER TYPE: Septic Tank GALLONS PER DAY: 240 WATER SUPPLY: Private Well DESCRIBE WORK: 28x56 and 2-6x6 decks Modular "Single wide Mobile home must be removed within 30 days of final inspection of modular. 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: Single Family Residence DESCRIPTION OF EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: NUMBER OF EXISTING BEDROOMS: 2 New Structure PRIMARY RESIDENCE OTHER DESCRIPTION: # OF OCCUPANTS: 2 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 28x56 and 2- 6x6 decks # OF NEW BEDROOMS:: 2 BASEMENT? No BASEMENT FIXTURES? No Desired system types (Improvement Permit or Authorization to Construct): ACCEPTED: ALTERNATIVE OTHER: INNOVATIVE: Other described: PLUMBING REQUIRED? CONVENTIONAL: ANY E9-chapphc:umn 07/30/'015 16:11 Page I of CATAWBA COUNTY Case # RBPR-07-2015-22049 Public Health Department Subdivision 4 w Environmental Health Division PIN# 460702570703 PO Box 389, 100-A Southwest Blvd, Newton. NC 28658 NAME ON PERMIT: ( BRANT ROSS), 3561 LITTLE RD, SHERRILLS FORD NC 28673 ( Brant Ross) Site Address: 3561 LITTLE RD, SHERRILLS FORD NC 28673 Property Size: Square Feet Acres Directions: NC 16S to NC 150 Take left - TL on Slanting Bridge RD, TL onto Stillwater Dr - TR onto Little RD - lot on left. 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 necess inspections to determine compliance with applicable laws and rules. I un rstand that I am solely responsible for the proper identificatio�r do la eh g of all property lines and corners and making the site accessi Il so thaE co plete site eval ation can be performed. Date: II b (� Signature of Applicant orA�ent � , "A A- \ 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 +..a.+.+..�:....:ss*:+x�x.««.��.*<*x*xsrxr�•***••••**.s.x•��.+++..��*���.+s+**x*x+�.�x**x+�.*s***x*r*x*�e�r**r**es**�w FEENAME Improvement Permit Fee ,TOTAL FEES DATE FEE AMOUNT 07/30/2015 $150.00 $150.00 FEES ARE NON-REFUNDABLE ONCE A SITE VISIT IS MADE OR WORK ON A PLAN REVIEW HAS COMMENCED SYSTEM REDESIGN ANDIOR RETRIP WILL INCUR AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) E9 . ehapphcahon 07/30/2015 15 56 Page 2 ora f�ATAWBA TFIIS IS NOTA PERMITa ay couxry CATAWBA COUNTY HEALTH DEPARTMENT Application for Fnvironntcntal Services Page I Improvement Permit ❑ Authorization to Construct ❑ Septic Repair ❑ Septic Malfunction ❑ Septic Expansion ❑ New Well Permit ❑ Replacement Well ❑ Well Abandon ent ❑ Well Repair ❑ Existing System Inspection (Pre -Approval Required) [ Application is for New Construction ❑ Existing Facility El Property Address �5Z O LI t-Nc Rd Subdivision )hp,-_jr r)/Ci 4/C j F(07.Lot # Acres Section/Block/Phase Driving Directions to Propert /LI f (n S i v/ /,(C / ti?� - 7a -Er /e 0 - t"L n i") ,)�C. I �n �ri d i C -TL_ /'l Yl -}-i1 5t, I ( i. ,� �-a� J1� -/f� i)✓T-/C) I , kkIf R6 - Io� on le- r�- NAME TO APPEAR ON PERMIT? 0 Owner ❑ Applicant ❑ Contractor Applicant Contact Information Name i, Kt, ilk( 1 (IXY) -P� Address��(�� Phone Owner Contact Information Name I�—C,n (- Address --�`�ZD I L, Phone `6Q is-Uy(r, - —I CI 17 Contractor Contact Information o V k (P )-E-uYl k)P;�,r(u✓l IUL c)Win�\— k Cell Phone 15herr t'(IS F=ord k 1-;? 1;? Cell Phone Name zavr1 f CS GIl Address v Phone Cell Phone WHO WILL BE THE PRINIAllY CONTACT? ❑ Owner Applicant ❑ Contractor Description of Existing Structures on Site # of Bedrooms *'i Structure Dimensions i °f # of Occupants Basement ❑ Yes ❑ No Basement Fixtures 0 Yes RkNo 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 ''iNo Does the site contain any jurisdictional wetlands? Yes I0 Docs the site contain any existing wastewater systems'? ® Yes ?irk",o Is any wastewater going to be generated on the site other than domestic sewage? NX Yes No Is the site subject to approval by any other public agency? ® Yes No Arc there any easements or right of ways on this property? Describe Existing water supply in use ❑ Individual Well ❑ Conmxmit), 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 your preference) 0 Accepted ❑ Alternative 0 Conventional 11 Innovative 0 Other ❑ Any CATAVV BA •fl -IIS IS NOTA PERMIT coUNn CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services Page 2 Proposed Facility Type n ❑ Primary Residence ❑ New Residence ❑ Addition to Residence # of New Bedrooms *'i t Project Description 0 V cue -e t_r �Lt ) t 1 CY�1 �f kf)"t i( 4c;v' (vi grit. LGA Structure Dimensions a:_ -U MWccupants Z Basement ❑ Yes 'R' No Basement Fixtures ® Yes No ........ ., n 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 Total # Bedrooms *''i ❑ Food Sen•ice Specify Type # Seats Floor Space # Employees per Shift ❑ Business Specific Type of Business # of Employees per Shift ❑ Other Facility •Type Specify #Bedrooms per Unit*''i Structure Dimensions Entire Food Service Facility (Sq Ft) # of Shifts Dining Area (Sq. Ft.) Retail Floor Space # of Shifts If Church # of Seats Hitchen ❑ 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 .i 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 Inure. 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 fors years of nnn, be non -expiring under certain specified conditions. An Authorization to Construct issued by this department is valid lot 151 five years from the date issued and is not transferable: Improvement Permits and Well Permits are transterrable. Permits niay be revoked if the information on this application. site plans or intended use changes for the proposed facility. 1 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 i ides. 1 understand that t am solely responsible for the proper identification and labeling of all property lines and corners and making the site accessible so that it complete site evaluation can be performed. Signatureof0wricrorAgent�00 food s 1f 6'^UI ,Dale Printed Name of Owner or Aecnt j Parcel Report Parcel Report- Catawba County NC Parcel Information: Parcel ID: 460702870703 Parcel Address: 3561 LITTLE RD City: SHERRILLS FORD, 28673 LRK(REID): 13429 Deed Book/Page: 3242/0852 Subdivision: SHERRILL COVE SUBDIV Lots/Block: 1/ BB Last Sale: $12,000 on 1986-12-01 Plat Book/Page: 14/72 Legal: LOT 1 PLAT 14-72 Calculated Acreage: .510 Tax Map: 01 2D 01027 Township: MOUNTAIN CREEK State Road #: Tax/Value Information: Tax Rates(pdf) City Tax District: All in County County Fire District: SHERRILLS FORD Building(s) Value: $5,000 Land Value: $39,500 Assessed Total Value: $44,500 Year Built/Remodeled: / Current Tax Bill Miscellaneous: Building Permits for this parcel. Building Details Watershed: WS -IV Critical Area Voter Precinct: P31 Parcel Report Data Descriptions List all Owners Deed History Report Owner Information: Owner: GRISSOM BONNIE RAE Owner2: Address: 3561 LITTLE RD Address2: City: SHERRILLS FORD State/Zip: NC 28673-9379 School Information: School District: COUNTY Elementary School: SHERRILLS FORD Middle School: MILL CREEK High School: BANDYS School Map Zoning Information: Zoning District: COUNTY Zoningl: R-30 Zoning2: Zoning3: Zoning Overlay: CRC-O,WP-O,FPM-O Small Area: SHERRILLS FORD Split Zoning Districts: / Zoning Agency Phone Numbers Firm Panel Date: 2007-09-05 Firm Panel #: 3710460700J 2010 Census Block: 3004 2010 Census Tract: 011504 Agricultural District: PROXIMITY Assessment Report Page I of 1 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 matcreport 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 haway, whether direct. Indirect or consequential which arises or may apse from this map/report product or the use thereof by any person or entity. © 015, Catawba County Government, North Carolina. All rights reserved. �I- littp:Hgis.catawbacountync.gov/nonlap/parcel_report.php?key=4607025707038 typ=P 7/30/2015 Catawba County Environmental Health Parcel: 460702870703, 3561 LITTLE RD 1in=50ft SHERRILLS FORD, 28673 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 07/30/2015