HomeMy WebLinkAboutRBPR-09-2015-22297.TIF O� THIS IS NOT A PERMIT Case # RBPR-09-2015-22297
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`-)It'--'`' PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES
1842 SM Residential Building Plan Review - Modular ,a. •o °D.0
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Applicant OAKWOOD HOMES, 1265 W CONOVER BLVD,NEWTON NC
H:8284642662 HOME:8284642662
Contact Person MILLER SURVEYING, INC., 328 4TH ST SW, HICKORY NC 28602
OTHER:828.322.4013F:828.322.2453 MILLERSURVEYINGHICKORY @GMAIL.COM
Owner WILLIAM POTTER, PO BOX 213, CALLICOON CENTER NY 12724
H:828-464-2662 HOME:828-464-2662
Paid By HEFNER MASONRY (KIMBERLY HEFNER), 5116 MT OLIVE CHURCH RD, MORGANTON NC
HEFNERMASONRY @YAHOO.COM
NAME TO APPEAR ON PERMIT
William Potter
SITE ADDRESS: 4419 CLARALEE LN, HICKORY NC 28602 PIN # 370011660821
NAME of SUBDIVISION: CLARALEE MEADOWS Lot# 16 Section/Block
PROPERTY SIZE: Square Feet Acres 0.7
1 DIRECTIONS: Zion Church Rd/lot at corner of Claralee Ln
PRIMARY CONTACT: Contact Person SEWER TYPE: Septic Tank
GALLONS PER DAY: WATER SUPPLY: Public Water
DESCRIBE WOR : 8/1/16 revised to 94 x 38 modular dwellin
*Per Al at Oakwood Homes (828-464-2662) it is okay to use the same plan case & fees. *Waiting for new
application & Site Plan from new contractor.*
off frame modular dwelling 32 x 64/3 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? 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
EXISTING STRUCTURES
ON SITE(IF ANY)
DIM EXISTING STRUCTURE:
NUMBER OF EXISTING BEDROOMS: #OF OCCUPANTS: 2
P: 'POSED CONSTRUCTION
NEW STRUCTURE DIM:: 94 x3 udi
inclng front porch no rear deck
#OF NEW BEDROOMS:: 3
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:
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CATAWBA COUNTY Case# RBPR-09-2015-22297
Q G Public Health Department Subdivision
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CLARALEE MEADOWS
v Wit[o, H� Environmental Health Division PIN# 370011660821
PO Box 389, 100-A Southwest Blvd,Newton,NC 28658
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NAME ON PERMIT: ( WILLIAM POTTER), PO BOX 213, CALLICOON CENTER NY 12724
( William Potter)
Site Address: 4419 CLARALEE LN, HICKORY NC 28602
a Size: Square 0.7
Property uare
p S Feet Acres
Directions: Zion Church Rd/lot at corner of Claralee Ln
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 - • ules. I understand that I am solely responsible for the
proper identification and labeling of all property lines and corners and making the site acces. • - .o that a complet`site ev-luation can be performed.
Date: /—/6 Signature of Applicant or Agent r ,� _.� �,_ 41 . lL '
An Environmental Health Specialist will contact you within working days of application date.
If you need further information or assistance please call 828-466-7291
AREA2
I FEENAME __ DATE FEE AMOUNT
Authorization to Construct Fee (New/Expansion) 09/09/2015 $150.00
Fee
Improvement Permit Fee 09/09/2015 $150.00
.TOTAL FEES " .$300.00.
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)
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