HomeMy WebLinkAboutRBPR-01-2016-23046.TIF y�BP THIS IS NOT A PERMIT Case # RBPR-01-2016-23046
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0. CATAWBA COUNTY HEALTH DEPARTMENT 0 1; 0
7 1 A I r
PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES el I
/842 sM Residential Building Plan Review - Accessory Structure • Util
IMPROVEMENT - AUTH_CONST •.o4 o
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Contractor *DBA/BROOKINS CONSTRUCTION, LLC (MICHAEL BROOKINS), 10127 DIVISION DR, RALEI
NC 27603
B:9193074134 C:9194225596 JEFF @BROOKINSCONSTRUCTION.COM
Owner FRYING PAN LLC (RAYMOND VON DREHLE),612 3RD AV NE, HICKORY NC 28601
NAME TO APPEAR ON PERMIT
FRYING PAN LLC (Raymond Von Drehle)
SITE ADDRESS: 4820 16TH ST DR NE, HICKORY NC 28601 PIN # 372518227484
NAME of SUBDIVISION: Lot# Section/Block
PROPERTY SIZE: Square Feet Acres 11.58
DIRECTIONS: Hwy 127 North Left on Cloninger Rd Left on 16th Street Dr property on Right one mile
PRIMARY CO _ • •• actor SEWER TYPE: Septic Tank
GALLONS PER DAY: 100 WATER SUPPLY: Private Well
D CRIBE WORK: Revised 6/16/16 - Per Mike Cash changing septic to 100 GPD for barn with 1 full back &washer/dryer.
2 Accessories - 75 x 150 covered horse arena & 75 x 150 Barn with Full bath
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: ACCESSORY STRUCTURE
FACILITY TYPE: Accessory Structure OTHER DESCRIPTION:
DESCRIPTION OF house
EXISTING STRUCTURES
ON SITE (IF ANY)
DIM EXISTING STRUCTURE: 46 x 55 house 65 x 30 barn
NUMBER OF EXISTING BEDROOMS: 3 #OF OCCUPANTS:
PROPOSED CONSTRUCTION
NEW STRUCTURE DIM:: 75 x 150 barn and 75 x 150 arena
BASEMENT? No BASEMENT FIXTURES? No PLUMBING REQUIRED?Yes
Desired system types (Improvement Permit or Authorization to Construct):
ACCEPTED: ALTERNATIVE: CONVENTIONAL: YES
OTHER: INNOVATIVE: ANY:
Other described:
E9-eliapplication 06/16/2016 12:21 Page 1 of 4
v=$q• \ CATAWBA COUNTY Case# R13PR-01-2016-23046
r I1 , Public Health Department Subdivision
4,
G a Environmental Health Division PIN# 372518227484
K / PO Box 389, 100-A Southwest Blvd,Newton,NC 28658
282/sm
NAME ON PERMIT: FRYING PAN LLC (RAYMOND VON DREHLE),612 3RD AV NE, HICKORY NC 28601
FRYING PAN LLC ( Raymond Von Drehle)
Site Address: 4820 16TH ST DR NE, HICKORY NC 28601
a Size: Square 11.58
Property uare
P S Feet Acres
Directions: Hwy 127 North Left on Cloninger Rd Left on 16th Street Dr property on Right one mile
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 acc- sibs=so th tp a c.. -•et'-site evaluation can be performed.
Date: &-/I( i& Signature of Applicant or Agent
An nvironmental Health Specialist will contact you within - o ing days of application date.
If you need further information or assistance please call 828-466-7291
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rim J you�� rutt 'u lots i'l: All 4 f 41 91IDATE!I a dFEE4AMOUNITiI"31011 pgc !NI
Authorization to Construct Fee (New/Expansion) 01/15/2016 $150.00
Fee
Improvement Permit Fee 01/15/2016 $150.00
Re Trip or Redesign Fee 06/16/2016 $70.00
(IIIP ° TOTAL�F6.... I r�'11) g ��l ism ptnl ih"` ! 4 $370100
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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-ehapplicalion 06/16/2016 12:21 Page 2 of 4
, ØA CATAWBA COUNTY
,� 100ASOUTHWESTBLVD
NEWTON,NORTH CAROLINA 28658 RECEIPT
""" 'VaV1 PHONE: 828.465.8399
U\ R I,' a'�°vr C Thursday, June 16, 2016
\$42 Sh+ nw.catawbacountync.gov
PAYOR: FRYING PAN LLC
FRYING PAN LLC(Von Drehle, Raymond)
PAYMENTS
TRANSACTION NUMBER: TRC-693118-16-06-2016
PAYMENT DATE : 06/16/2016
PAYMENT TYPE: Cash
INVOICE NUMBER FEE NAME FEE AMOUNT
06-16-329517 Re-Trip or Redesign Fee $70.00
TOTAL PAYMENTS : $70.00
RBPR-01-2016-23046
CASE TYPE: Residential Building Plan Review WORK CLASS: Accessory Structure
SITE ADDRESS: 4820 16TH ST DR NE, HICKORY NC 28601
Owner FRYING PAN LLC, 612 3RD AV NE, HICKORY NC 28601
**NO PEOPLESOFTACCOUNTASSIGNED **
Contractor *DBA/ BROOKINS CONSTRUCTION, LLC, 10127 DIVISION DR, RALEIGH NC 27603
B:9193074134C:9194225596 JEFF @BROOKINSCONSTRUCTION.COM
receipt 06/16/2016 12:20 Page 1 of 1