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HomeMy WebLinkAboutRBPR-02-2016-23272.TIF S4 A THIS IS NOT A PERMIT Case # RBPR-02-2016-23272 d K-2.1t,jiii61., CATAWBA COUNTY HEALTH DEPARTMENT D 11 • o ,:.v CI \5) �` PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES 7:7,....t,l•• { 11 ` '1ti r .1 \842 s Residential Building Plan Review - Manufactured Home ' o• o In.% 'c ..• IMPROVEMENT - AUTH_CONST .-'' �r 'o, ,o rEk Applicant AMANDA WILLIAMS, 3964 ZONNIE SCRIONCE RD, VALE NC 28168 C:8284094749 Owner JANET DAVIS,3964 ZONNIE SCRONCE RD, VALE NC 28618-6777 NAME TO APPEAR ON PERMIT Amanda Williams SITE ADDRESS: 3958 ZONNIE SCRONCE RD, VALE NC 28168 PIN # 360703136601 NAME of SUBDIVISION: Lot# Section/Block PROPERTY SIZE: Square Feet. Acres 0.99 — DIRECTIONS: Turn right off of Macedonia Church Rd onto Zonnie Scronce Rd/Go 3 Driveways on right/after 3rd drive there is a roughed in drive PRIMARY CONTACT: Applicant SEWER TYPE: Septic Tank GALLONS PER DAY: 360 WATER SUPPLY: Private Well DESCRIBE WORK: New 3 Bedroom Doublewide - Existing well on property/will tie into existing well/home beside lot uses well 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? APPLICATION FOR: New Structure STRUCTURE TYPE: PRIMARY RESIDENCE FACILITY TYPE: Mobile Home OTHER DESCRIPTION: DESCRIPTION OF Dry Storage Building EXISTING STRUCTURES ON SITE (IF ANY) - DIM EXISTING STRUCTURE: 30 x 40 NUMBER OF EXISTING BEDROOMS: #OF OCCUPANTS: 5 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 26 x 66 - #OF NEW BEDROOMS:: 3 Desired system types (Improvement Permit or Authorization to Construct): ACCEPTED: ALTERNATIVE: CONVENTIONAL: OTHER: INNOVATIVE: ANY: YES Other described: • E9-ehapplication 02)25/2016 09:57 Page 1 of 5 ,/,(13,A CATAWBA COUNTY case# RBPR-02-2016-23272 ¢- ^ Public Health Department ' ' L1 Subdivision Environmental Health Division PIN# 360703136601 J' PO Box 389. 100-A Southwest Blvd,Newton. NC 28658 8 2 w NAME ON PERMIT: (AMANDA WILLIAMS), 3964 ZONNIE SCRIONCE RD, VALE NC 28168 ( Amanda Williams) Site Address: 3958 ZONNIE SCRONCE RD. VALE NC 28168 Property Size: Square Feet Acres 0.99 Directions: Turn right off of Macedonia Church Rd onto Zonnie Scronce Rd/Go 3 Driveways on right/after 3rd drive there is a roughed in drive 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 acce .ible so that a complete site evaluation can be performed. Date:45-25-AD 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 FEENAME. - DATE i_ FEE AMOUNT Authorization to Construct Fee (New/Expansion) 02/25/2016 $150.00 Fee Improvement Permit Fee 02/25/2016 $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) E9-chapplicmion 02/25/2016 09:57 Page 2 of 5 CATAWBA THIS IS NOT A PERMIT COUNTY CATAWBA COUNTY HEALTH DEPARTMENT '",, tiC Application for Environmental Services Page I - Improvement Permit Authorization to Construct Septic Repair n Septic Malfunction ❑ Septic Expansion ❑ New Well Permit ❑ Replacement Well ❑ Well Abandonment ❑ Well Repair ❑ Existing System Inspection (Pre-Approval Required) ❑ Application is for New Construction X., Existing Facility n KProperty Address ■; S • • ' • , '{ s' # ed Subdivision t )61QD , ,J Y. d a (p 2 Lot# Acres _ nn . ection/Block/Phase 'C' Driving Directions to Property O eZYI. ea; , • ant a U• —ail• ■ •v :. a 'eA J p (r :! . ■ _ . _ r J I - On F-(;�� Al °V c,c{-ew. 3d cvLvE i.(i._4 e2- Cs ex ervc .tkock ( (l_aIeLOC—,. NAME TO APPEAR ON PERMIT? n Owner (Ypplicant ❑ Contractor —Applicant Contact Information f Name a \ns i,1� CY, 1 ■. ill �.� Address 1 (a • i I�" E � X Phone e. il i «gli Cell Phone Owner Contact Information yF Name TS.tl - Bni fLO Address 'r I .4-1C) •_ _ s. 1•• k �: -a Phone y — 7 8 - e- 7a6 Cell Phone Contractor Contact Information Name License# Address Phone Cell Phone WHO WILL BE THE PRIMARY CONTACT? n Owner ISApplicant ❑ Contractor Description of Existing Structures on Site %r _Ixq[Al. 4 I s a A ill # of Bedrooms *fi Structure Dimensions . +X1--j6 # of■ cupants 1 Basement n Yes _ No Basement Fixtures n Yes No The Applicant shall notify the local health department upon submittal of this application if any of the following apply to i the property in question. If the answer to any question is"yes", applicant must attach supporting documentation. ❑ Yes o Does the site contain any jurisdictional wetlands? ❑ Yes r•`- o Does the site contain any existing wastewater systems? ❑ Yes _:.No Is any wastewater going to be generated on the site other than domestic sewage? %Yes ❑ No Is the site subject to approval by any other public agency? ❑ Yes Wo Are there any easements or right of ways on this property? Describe Existing water supply in use Individual Well { i Community Well n Semi-Public Well ❑ County/City/Township Water Line Is a public water supply available? ** n Yes ZNo 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) �/ ❑ Accepted ❑ Alternative ❑ Conventional ❑ Innovative ❑ Other gAny CATAWBA THIS IS NOT A PERMIT COUNTY CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services Page 2 1 kS' Proposed Facility Type ❑ Primary Residence cNew Residence n Addition to Residence #of New Bedrooms *j 3 70C. 1-frci Project Description 10oncy orktli C (AC) &L C !� Structure Dimensions (G62( _ # of Occupants C5 Basement n Yes 'No Basement Fixtures ❑ Yes No ❑ Accessory Structure(s) Describe # of New Bedrooms *j if applicable Structure Dimensions # of Occupants Accessory Dwelling n Yes n No Plumbing n Yes ❑ No Describe Plumbing Needed ❑ Multi-Family Residence# Units #Bedrooms per Unit*t Total # Bedrooms *t 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 ❑ Yes (— No If Daycare Specify Occupancy Application for Well Construction/Abandonment/Repair Proposed Well Type n Individual Well n Semi-Public Well ❑ Community Well Abandonment Type ❑ 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 �t,._ . - ) • Date Printed Name of Owner or A t tYncA 5h cot, �h tl� g 2 —1r-F Sheen DnyIS Parcel Report Page 1 of 1 Parcel Report - Catawba County NC Parcel Information: Owner Information: Parcel ID: 360703136601 Owner: DAVIS JANET SHEAN Parcel Address: 3958 ZONNIE SCRONCE RD Owner2: City: VALE, 28168 Address: 3964 ZONNIE SCRONCE RD LRK(REID): 8798 Address2: Deed Book/Page: 1705/0394 City: VALE Subdivision: State/Zip: NC 28168-6777 Lots/Block: / School Information: Last Sale: Plat Book/Page: School District: COUNTY Legal: 3958 ZONNIE SCRONCE RD Elementary School: BANOAK Middle School: JACOBS FORK Calculated Acreage: .990 High School: FRED T FOARD Tax Map: 009 J 05027B School Map Township: JACOBS FORK State Road it: 2078 TaxNalue Information: Tax Rates(pdf) Zoning Information: City Tax District: All in County Zoning District: COUNTY County Fire District: PROPST Zoningl: R-40 Building(s) Value: $6,600 Zoning2: Land Value: $9,800 Zoning3: Assessed Total Value: $16,400 Zoning Overlay: DWMH-O Year Built/Remodeled: / Small Area: PLATEAU Current Tax Bill Split Zoning Districts: / Zoning Agency Phone Numbers Miscellaneous: Firm Panel Date: 2007-09-05 Building Permits for this parcel. Firm Panel It: 3710360600J Building Details 2010 Census Block: 4019 WaterShed: 2010 Census Tract: 011802 Voter Precinct: P3 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. eXiS 3e ill Cn ?. 7. f C, Ni)1 fig ) vie() J [erne sc� 3IAPin . loTek L 3 (I , http://gis.catawbacountync.gov/nornap/parcel_report.php?key=360703136601&typ=P 2/25/2016 Catawba County Environmental Health J * ti- 318.44 $.11 IN 99 /' us, ( / 51) 1 (291) i -- a S 108.19 (183) A 0C0S 985 _ rn .r en in m N. N. 0 o r ) a 163.86 _nom 101 J / / Parcel: 360703136601, 3958 ZONNIE 1in=50ft SCRONCE RD VALE, 28168 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 02/24/2016