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HomeMy WebLinkAboutRBPR-09-2015-22302.TIF �$A G • THIS IS NOT A PERMIT Case # RBPR-09-201 5-22302 S CATAWBA COUNTY HEALTH DEPARTMENT 0 '-a 0 { 0 (mp PL AN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES 'I r 7842 sM Residential Building-Plan-Review--.Building New C •v o:c IMPROVEMENT- AUTH_CONST Ate. ,o- A „P h`lG• Pni;,:)MM,4 ED 3 Biz Ql 4e-plan. Applicant *MADISON HOME BUILDERS, LLC (W KELVIN ANDERSON), 1721 E BOULEVARD, CHARLOT NC 28203 B:7043349339 C:8284648870E:7043740686 SUE@MADISONHOMEBUILDERS.NET Owner JAMES FLYNN, PO BOX IS I, DENVER NC 28037 C:980-722-8862 NAME TO APPEAR ON PERMIT James Flynn SITE ADDRESS: 3890 DAVIS RD, MAIDEN NC 28650 PIN # 366703041295 NAME of SUBDIVISION: Lot 4 Section/Block PROPERTY SIZE: Square Feet Acres 2.97 DIRECTIONS: Hwy 16 S/right Buffalo Shoals Rd/right Davis Rd/lot approx 3/4 mile on right PRIMARY CONTACT: Applicant SEWER TYPE: Septic Tank GALLONS PER DAY: (360) WATER SUPPLY: Public Water DESCRIBE WOR • 2/9/16 revised to edroom' *waiting for public water-wanting to connect/ line is not under construction yet*" new singe amily dwelling 66 x 34 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: New Structure STRUCTURE TYPE: PRIMARY RESIDENCE FACILITY TYPE: Single Family Residence OTHER DESCRIPTION: DESCRIPTION OF vacant lot EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: NUMBER OF EXISTING BEDROOMS: #OF OCCUPANTS: 3 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 66 x 34 #OF NEW BEDROOMS•• BASEMENT? o BASEMENT FIXTURES? No PLUMBING REQUIRED?Yes Desired system types (Improvement Permit or Authorization to Construct): ACCEPTED: ALTERNATIVE: CONVENTIONAL: OTHER: INNOVATIVE: ANY: Other described: 59-ehapplication 02/09/2016 13:25 Page 1 of4 ° CATAWBA COUNTY Case# RBPR-09-2015-22302 ;, f• tin y 2 Public Health Department Subdivision < 4®y p,Environmental Health Division PIN# 366703041295 PO Box 389. 100-A Southwest Blvd,Newton, NC 28658 1842 54 NAME ON PERMIT: (JAMES FLYNN), PO BOX 181 I, DENVER NC 28037 ( James Flynn) Site Address: 3890 DAVIS RD, MAIDEN NC 28650 Property Size: Square Feet Acres 2.97 Directions: Hwy 16 S/right Buffalo Shoals Rd/right Davis Rd/lot approx 3/4 mile on 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 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 underst d that I am solely responsible for the proper identification ,fa eli of all property lines and corners and making th slte;acce\le so that a complete si AY-•alu•tion can be performed. Date: �' d j Signature of Applicant or Agent � \ JJJJ n Environmental Health Specialist will contact you withir work g days of application date. If you need further information or assistance p2ase-c 828-466-7291 AREA1 � ME5 p n» ' vE � f AE FEENAr z "4y • tti45 dr D 3FEE AMOUNT °! ..ri' rti i Authorization to Construct Fee (New/Expansion) 09/10/2015 5300.00 Fee Authorization to Construct Fee (New/Expansion) 02/09/2016 $150.00 Fee Improvement Permit Fee 02/09/2016 $150.00 xri�;E'11� 1 -TOTAL FEES tib�l i d' �° h L.kia. i u�� .ii t . 0 0 ..i L. I_n-�`i t...0 '3 _1, ,., Pii_I•„ _. _s„x;f3'�KEtil't ;1 Nit• iNafs..a d:= . =r.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) E9-chappl ical ion 02/09/2016 13:25 Page 2 of 4 • • . • Catawba County Environmental Health . / 4,,h,,, 288.06 ,14' 11 3 6 a (fi a 9j ki . V\ a rn _ z a. y .../ 14. `d I 1 X3890 22.86 $�6 \9` .. 7-o V N s r N N. i N. . Y .60 3 \ F Parcel: 366703041295, 3890 DAVIS RD 1 in=60ft MAIDEN, 28650 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 02/09/2016 ..pA co • CATAWBA COUNTY t" �� I 00A SOUTHWEST BLVD NEWTON, NORTH CAROLINA 28658 RECEIPT :,aP PHONE: 828A65.8399 C3 yt ''G� Tuesday, February 9, 2016 1842 sm www.catawbacountync.gov PAYOR: Flynn,James PAYMENTS TRANSACTION NUMBER: TRC-617916-09-02-2016 PAYMENT DATE : 02/09/2016 PAYMENT TYPE: Credit Card 157282872 INVOICE NUMBER FEE NAME FEE AMOUNT 02-16-325183 Authorization to Construct Fee $150.00 (New/Expansion) Fee 0216 325183"x7 r m ylmprovement PermirFee v} 1E,cr 4 ,w $150.00= TOTAL PAYMENTS : $300.00 RBPR-09-2015-22302 CASE TYPE: Residential Building Plan Review WORK CLASS: Building New SITE ADDRESS: 3890 DAVIS RD, MAIDEN NC 28650 Applicant *MADISON I-TOME BUILDERS, LLC, 1721 E BOULEVARD, CHARLOTTE NC 28203 B:7043349339C:8284648870F:7043740686 SUEnMADISONI-IOMEBUILDERS.NET Owner JAMES FLYNN, PO BOX 1811, DENVER NC 28037 C:980-722-8862 **NO PEOPLESOFT ACCOUNT ASSIGNED ** receipt 02/09/2016 13:23 Page 1 of 1