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HomeMy WebLinkAboutRBPR-02-2016-23228.TIF ,■PA •� THIS IS NOT PERMIT Case # RBPR-02-2016-23228 2 CATAWBA COUNTY HEALTH DEPARTMENT 0 k 179.,:0'' 'c' n w . . 2, PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES}' •. a _ 842 Residential Building Plan Review - Manufactured Home D . • .o +4 .o /,� IMPROVEMENT- NEW WELL • • o VQ�l & (ail t o ., • Applicant I SON BOGGS, 8168 SHERRILLS FORD RD, SHERRILLS FORD NC 28673 C:8282179358 Owner TERESA BOGGS, 2178 ST JOHNS CHURCH RD NE, CONOVER NC 28613 C:8282176807 NAME TO APPEAR ON PERMIT Teresa Boggs SITE ADDRESS: 4681 27TH ST LN NE, HICKORY NC 28601 PIN # 372515524531 NAME of SUBDIVISION: SNOW CREEK COVE Lot# 6 Section/Block A PROPERTY SIZE: Square Feet Acres 0.62 DIRECTIONS: Sulpher Springs RDd, turn left onto 43rd AVE NE, go to end Sharp curve onto 29th ST DR NE,then left onto 28th ST Circle NE, Follow until road forks. I will meet at the fork in road and will lead to property. PRIMARY CONTACT: Applicant SEWER TYPE: Septic Tank GALLONS PER DAY: 240 WATER SUPPLY: Private Well DESCRIBE WORK: New double wide 44x28 w/ Decks: front 6x6, back 4x4. Double wide 44x28 **Home must meet appearance criteria ---Screen or Remove Towing Tongue, Front Deck must be minimum of 36 sq ft, home must be masonry underpinned (can use vinyl if singlewide). Home must be parallel to road and must face front of property **If this new home is a replacement for an existing occupied home—that existing home must be removed from the site within 30 days of the issuance of the Certificate of Compliance** 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: Mobile Home OTHER DESCRIPTION: DESCRIPTION OF Single wide mobile home 12x49 (To Be Removed) EXISTING STRUCTURES ON SITE(IF ANY) DIM EXISTING STRUCTURE: NUMBER OF EXISTING BEDROOMS: #OF OCCUPANTS: 1 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 44x28 #OF NEW BEDROOMS:: 2 Desired system types (Improvement Permit or Authorization to Construct): ACCEPTED: ALTERNATIVE: CONVENTIONAL: OTHER: INNOVATIVE: ANY: YES Other described: APPLICATION FOR WELL CONSTRUCTION PROPOSED WELL TYPE: Individual Well REPLACE WELL?: NO E9-chapplication 02/17/2016 16:26 Page 1 of 5 05• CATAWBA COUNTY Case a RBPR-02-2016-23228 T •t.l Public Health Department Subdivision SNOW CREEK COVE Q rg. `' Environmental Health Division ® Y PO Box 389, 100-A Southwest Blvd,Newton,NC 28658 PINK 372515524531 1• .2 w NAME ON PERMIT: (TERESA BOGGS), 2178 ST JOHNS CHURCH RD NE,CONOVER NC 28613 ( Teresa Boggs) Site Address: 4681 27TH ST LN NE, HICKORY NC 28601 Property Size: Square Feet Acres 0.62 Directions: Sulpher Springs RDd,turn left onto 43rd AVE NE, go to end Sharp curve onto 29th ST DR NE, then left onto 28th ST Circle NE, Follow until road forks. I will meet at the fork in road and will lead to property. 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 AREA2 IFEENAMEg;r, ayrj e .I�`;'':J 41„ 1 Y, );, d ;.*.art n.t1,,iyl `?I DATE I*,;s1i w,-FEEI'AMOUNT j Improvement Permit Fee 02/17/2016 $150.00 Well Permit & Inspection Fee 02/17/2016 $300.00 rillid$PITIM74ridtgE y8tal; irit` t.:.: dw.�' 141"e _' ft Lt± r.5450Sir . , , '„ i s('s 4 l s,v tl k-1:r s s,11,2ni it;;. ,,a�44'2?JI N x.y,.r • a r P lwvlg'sii1.4 is -^a1,ia[l(b4 - • ?}k'kitt 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-ehappliruion 02/17/2016 16:26 Page 2 of 5 THIS IS NOT A PERMIT Case # RBPR-02-2016-23228 YCATAWBA COUNTY HEALTH DEPARTMENT 0 .%„. 1,4 0 /841, PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES 1842 sM Residential Building Plan Review - Manufactured Home '•O:N• o d LLD r} ' . IMPROVEMENT - NEW WELL 0. ° Applicant JASON BOGGS, 8168 SHERRILLS FORD RD, SHERRILLS FORD NC 28673 Owner TERESA BOGGS. 2178 ST JOHNS CHURCH RD NE, CONOVER NC 28613 C:8282176807 NAME TO APPEAR ON PERMIT Teresa Bo• •s SITE ADDRESS: 4681 27TH ST LN NE, HICKORY NC 28601 PIN # 372515524531 NAME of SUBDIVISION: SNOW CREEK COVE Lot 6 Section/13lock A PROPERTY SIZE: Square Feet Acres 0.62 DIRECTIONS: Sulpher Springs RDd, turn left onto 43rd AVE NE, go to end Sharp curve onto 29th ST DR NE,then left onto 28th ST Circle NE, Follow until road forks. I will meet at the fork in road and will lead to property. PRIMARY CONTACT: Applicant SEWER TYPE: Septic Tank GALLONS PER DAY: 240 WATER SUPPLY: Private Well DESCRIBE WORK: Double wide 44x28 **Home must meet appearance criteria ---Screen or Remove Towing Tongue, Front Deck must be minimum of 36 sq ft, home must be masonry underpinned (can use vinyl if singlewide). Home must be parallel to road and must face front of property "If this new home is a replacement for an existing occupied home—that existing home must be removed from the site within 30 days of the issuance of the Certificate of Compliance" 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: PRIMARY RESIDENCE FACILITY TYPE: Mobile Home OTHER DESCRIPTION: DESCRIPTION OF EXISTING STRUCTURES ON SITE(IF ANY) DIM EXISTING STRUCTURE: NUMBER OF EXISTING BEDROOMS: #OF OCCUPANTS: 1 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 44x28 #OF NEW BEDROOMS:: 2 Desired system types (Improvement Permit or Authorization to Construct): ACCEPTED: ALTERNATIVE: CONVENTIONAL: OTHER: INNOVATIVE: ANY: YES • Other described: APPLICATION FOR WELL CONSTRUCTION PROPOSED WELL TYPE: REPLACE WELL?: NO • E9-chapplication 02/17/2016 10:38 Page 1 of 5 yen CATAWBACOUNTY Case# RBPR-02-2016-23228 v if t y Public Health Department Subdivision- SNOW CREEK COVE et • li i Environmental Health Division PIN# 372515524531 a®®.1 PO Box 389, 100-A Southwest Blvd.Newton.NC 28658 1842 « NAME ON PERMIT: (TERESA BOGGS),2178 ST JOHNS CHURCH RD NE, CONOVER NC 28613 ( Teresa Boggs) Site Address: 4681 27TH ST LN NE, HICKORY NC 28601 Property Size: Square Feet Acres 0.62 Directions: Sulpher Springs RDd, turn left onto 43rd AVE NE, go to end Sharp curve onto 29th ST DR NE, then left onto 28th ST Circle NE, Follow until road forks. I will meet at the fork in road and will lead to property. 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 rul--. I understand that I am solely responsible for the proper identification a d la ling of all property lines and corners and making the site - s .le .rat a complete site evaluation can be performed. Date: y`�7�7c. Signature of Applicant orAg• •- AnEnvironmentalHealthSpecialistwillcontactyou n 5 woyll't days of application date. If you need further information or assist.. - please all 828-466-7291 AREA2 ............................................................................................................ . .FEENAME' ^ _ DATE • FEE AMOUNT ; Improvement Permit Fee 02/17/2016 $150.00 Well Permit& Inspection Fee 02/17/2016 $300.00 -,TOTAL FEES , `' Y.. g 5450.00 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-ehapplication 02/17/2016 10:38 Page 2 of 5 R?,,PC( - - ao*D Q3Qa % CATAWBA THIS IS NOT A PERMIT _,ZJ.TS' _,,1 ,Y v°' tit CATAWBA COUNTY HEALTH DEPARTMENT _�"" NoZM1 Laro1L.t Application for Environmental Services Page 1 Improvement Permits Authorization to Con truct ill Septic Repair❑ Septic Malfunction ❑ Septic Expansion ❑ New Well Permit Replacement Well ❑ Well Abandonment❑ Well Repair ill Existing Syst Inspection (Pre-Approval Required) ❑ Application is for New Construction ❑ Existing Facility ❑ - Property Address-, ,,,,„ , , , , , , _ _ Subdivision 4/6 et 677r or Lie ,J5 Nicx-a y Lot# Acres ML Section/Block/Phase / Driving Directions to Property S%Ipke( ,S-pcm)s Roc(' 7Z)/4 ,le/¢ 0.-1 4L3c" /1/i- 64Deel Shp-p C;:.✓e cn11) 2`71 ST DR_ .vie 77 e1 h-cit ok 4c. 2P' Srcie.de AJC, Tow Jn-h) rockcl ForK-s. T I.6, t1 w--tcf at tL_.c ,1- ;-- ccd ,ttiJ WI 1I 1Pae/ lit ,Ovoper{r , NAME TO APPEAR ON PERMIT? "Owner ❑ Applicant ❑ Contractor tApplicant Contact Information \ Name :111s6.A '17-6-5 Address 8/6&- Sltrn//s /crj 121 .s/uwry;//s ivt�/? NC .28L73 Phone Cell Phone g2 8 -2 /7_ j S-r Owner Contact Information Name %2Yese, 270665 Address 2/78- S-,e, r ✓bA„e, CL. /Z./ Ko•,,,, ' ,JC- 2 &13 Phone Cell Phone Sri_ in-6807 Contractor Contact Information Name License# Address Phone Cell Phone WHO WILL BE THE PRIMARY CONTACT? n Owner Kipplicant ❑ Contractor Description of Existing Structures on Site /- J3;;,ylc tuidt ruck;(e Mod.-e ( To be re mooecP ) � � # of Bedrooms *t Structure Dimensions 12 y:. 49' # of Occupants O �r Basement ❑ Yes 111-No Basement Fixtures n Yes R-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. ❑ Yes No Does the site contain any jurisdictional wetlands? Yes ❑ 'o Does the site contain any existing wastewater systems? - yi ❑ Yes No Is any wastewater going to be generated on the site other than domestic sewage? ❑ Yes ' o Is the site subject to approval by any other public agency? ❑ Yes o Are there any easements or right of ways on this property? Describe y`.. • N. Existing water supply in use ❑ Individual Well %Community Well ❑ Semi-Public Well ❑ County/City/Township Water Line Isa public water supply available? ** ❑ Yes t'No �f applying for an Improvement Permit or Authorization to Construct,Please Indicate Desired System Type(s): V(systems can be ranked in order of your preference) ❑ Accepted ❑ Alternative ❑ Conventional ❑ Innovative ❑ Other4ny CATAWBA THIS IS NOT A PERMIT COUNTY CATAWBA COUNTY HEALTH DEPARTMENT .,o„„ Application for Environmental Services Page' Pro sed Facility Type �x '�1 (Primary Residence ["N" �ew Residence n Addition to Residence # of New Bedrooms *t x Ll Project Description �✓ec.l p>-4/r wrct (rep/acn Sin9ic i.a..c on prop"-1/2 Structure Dimensions yw,�1e X aff # of Occupants / Basement n Yes RNo Basement Fixtures n Yes Rico • Accessory Structure(s) Describe #of New Bedrooms *t if applicable Structure Dimensions # of Occupants _ Accessory Dwelling ❑ Yes ❑ No Plumbing ❑ Yes ❑ No Describe Plumbing Needed ❑ Multi-Family Residence# Units #Bedrooms per Unit*t Total # Bedrooms *j' Structure Dimensions ❑ Food Service Specify Type # Seats Floor Space -Entire Food Service Facility (Sq Ft) #Employees per Shift #of Shifts Dining Area(Sq.Ft.) ❑ Business Specific Type of Business Retail Floor Space # of Employees per Shift # of Shifts ❑ Other Facility Type Specify If Church # of Seats Kitchen n Yes ❑ No If Daycare Specify Occupancy Application for Well Construction/Abandonment/Repair Proposed Well Type , Individual Well n Semi-Public Well ❑ Community Well Abandonment Type n Drilled n 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 SCHEDULE) 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. Signature of Owner or Agent 4 A): 7` ' Date 2-11 -14, r Printed Name of Owner or Agent Teresc, tyj s Parcel Report Page 1 of 1 Parcel Report - Catawba County NC Parcel Information: Owner Information: Parcel ID: 372515524531 Owner: BOGGS TERESA BAKER Parcel Address: Owner2: City: HICKORY, 28601 Address: 2178 ST JOHNS CHURCH RD NE LRK(REID): 37707 Address2: Deed Book/Page: 2022/0676 City: CONOVER Subdivision: SNOW CREEK COVE State/Zip: NC 28613-8975 Lots/Block: 6/A Last Sale: School Information: Plat Book/Page: UNRE/UNRE School District: COUNTY Elementary School: SNOW CREEK Legal: Middle School: ARNDT Calculated Acreage: .620 Tax Map: 0710 01004 High School: ST STEPHENS Township: CLINES School Map State Road #: TaxNalue Information: Tax Rates(pdf) Zoning Information: City Tax District: All in County Zoning District: COUNTY County Fire District: ST STEPHENS Zoningl: R-40 Building(s) Value: $0 Zoning2: Land Value: $49,000 Zoning3: Assessed Total Value: $49,000 Zoning Overlay: CRC-O,FPM-O Year Built/Remodeled: / Small Area: ST STEPHENS/OXFORD Current Tax Bill Split Zoning Districts: / Zoning Agency Phone Numbers Miscellaneous: Firm Panel Date: 2007-12-18 Building Permits for this parcel. Firm Panel #: 3710372500K Building Details 2010 Census Block: 1033 WaterShed: 2010 Census Tract: 010301 Voter Precinct: P29 Agricultural District: Parcel Report Data Descriptions List all Owners Deed History Report Assessment Report 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. ©2015, Catawba County Government, North Carolina. All rights reserved. on,N -`•(rifts) 1-Yth ZG h I NU Z1 tgnn http://gis.catawbacountync.gov/nomap/parcel_report.php?key=372515524531&typ=P 2/17/2016 Catawba County Environmental Health ¢—s } k r Mt id' ,, +9� ( � l F L b 3 Y M't b as \ i':L1 �. co uri • ° s` r, 0 in .0, 2 1 s ' '+ 1 itc 260 0 � r4 Idt ; a .rr rn k k jt Q9 fUJ , U v 100 U 1, 4 1..1 a $ irR•. 0,4 z s 41,,,, @ r / ' a " 03. N i . ira i a 'i 7 1• P:Y, tr f a.W�dl , -yr 1�!1. 4Si t ,Zx P. . a , ana...." Y x iJ. A / ... 4,.. 04,....,:. i.,:. ,,, i.,..„,„„*.,:... ,,,...„..„.. : ::.,._ :,..:.,,,,, ,0 t° ; ,,, f/ f 265.5 av , 5 '- P r'I i .1 y } W 2 3' ',fig X ippr 4Sea C. 'r? t ° 1�41i N a 4,. d� • ir1 s 1 "''PIP.:'t , i 2 , ,„,. 65.5 \ . Parcel: 372515524531 , 4886 28TH ST CIR NE 1in=50ft HICKORY, 28601 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 02/10/2016 CATAWBA COUNTY, HEALTH , D.E.PARTD� (704) 465-8270 Lot Evaluation X Improvement Permit k Repair Permit Completion Permit_ Owner/Agent I .l'C.1 4 A�• B - Phone - yd7% i\9 2119 r�� y � Address £..S" &XSY`1 C'O/(�l/EI_ tC Subdivision Section/Bloc "�. LW/ Lot Size Directions: S r $5- -2d '-I 2�? Q') 5.i. 'r cf 5 2c+ LePP -as' 43 ‘-d" st-. Qr6h:t _m.., Cei Cs. Le Pi- 4+ -Frr k lu rarer- - —`, L ke —. Facility: House___ Mobile Home _ Business_____ . Other: Zoning Approval yes/no 11370 Multifamily _ Other . 100% Repair Area/no Bedrooms_ e2: Seats Employees . CPD Flow &lin Application Rate 04/ Hot Tub or Spa yes/Special Fixtures . REPAIR NOTICE: REPAIRS MUST BE WITHIN Basement yes/62 Basement Plumbing yes/67. 30 DAYS OR DAYS FROM DATE OF Water Supply: Privatex Public . PERMIT. ***********************S'****************************************************************** Type of System: Trench ,>( Bed System Other (Specify) Tank Size: Septic Tank IOW _ Pomp Tank-________ Nitrification Field: Total Square Feet_C000 Depth of Stone__(_o_ Bed Size____ -__-. // „ 3Trench Width L.M. Total Length of All Trenches�QC) Number of Trenches Individual Trench Length67/(.. /_�'1/____/ Feet on Center =L.,_ Maximum Trench Depth97 Distance of Nearest Well Lot Evaluation: Approve 40/no (Void After 24 months) ****************************************************************************************** Topo S X Slope I Sketch of lot Evaluation Site - System Design - Final Texture_-G.__Dy I I Structure 45//z/c4f I Clay Min._'" / 1 P"Soi 1 Wetness " I MUST Be Se Soil Depth33- tr �" I Restric. Hoz. at " I /aae- Available spacer&/nol ��,,^ //__ / Overall C1asOPS U I f vntt (/ke f Comments: I � '�/ be I — Mo9 cG mime • 5D kJ I L '' •hi be s ,uIkl a 3X mi" I 1 3X6 r-Alefr ter I ref I 16°1 I • 1 r ************************/#***************************************************************** Permit Date ,G/¢/4 ( improveme t Permit y after 60 months) Owner/Agent L �.L - . Sanitarian _ f. a � /,[.S, Installed By � Date_t/�_5��/. Sanitar.i _%o-. . __ i . -<tl�it t iS. (Note any ranges/informatiofi irf red or by sket h o lack) WHITE-OFFICE COPY ,YFLLBW.OWNER/AGENT COPY