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HomeMy WebLinkAboutRBPR-03-2016-23429.TIF 4A THIS IS NOT A PERNIIT Case # RBPR-03-2016-23429 CATAWBA COUNTY HEALTH DEPARTMENT �xo . . PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES `r'Sg, tip' 1842 SM Residential Building Plan Review - Manufactured Home •or • G 1 a-2 , IMPROVEMENT Ail Applicant *OAKWOOD HOMES #712 (ELIOBERTO ALFONSO), 1265 70 HWY W,NEWTON NC 28658 B:(828)217-1862 C:(828)464-2662F:828-464-4301 R712 @CLAYTONHOMES.COM Owner BENJAMIN RUSSELL. 1754 SIGMON DAIRY RD, NEWTON NC 28658 NAME TO APPEAR ON PERMIT Ben•amin Russell SITE ADDRESS: 1766 SIGMON DAIRY RD, NEWTON NC 28658 PIN # 363909158465 NAME of SUBDIVISION: Lot# Section/Block PROPERTY SIZE: Square Feet Acres 0.52 DIRECTIONS: 321 Bus/right NC 10/left Sigmon Dairy Rd/lot on left PRIMARY.CONTACT: Owner SEWER TYPE: Septic Tank GALLONS PER DAY: 360 WATER SUPPLY: Private Well DESCRIBE WORK: SW mobile home/ 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 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 singlewide mobile home EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: 14 x 66 , NUMBER OF EXISTING BEDROOMS: 3 #OF OCCUPANTS: 3 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 16 x 72 #OF NEW BEDROOMS:: ' 3 Desired system types (Improvement Permit or Authorization to Construct): ACCEPTED: ALTERNATIVE: CONVENTIONAL: OTHER: INNOVATIVE: ANY: YES Other described: E9-chapplicmion 03/21/2016 09:35 Page 1 of SB' CATAWBA COUNTY Case# RBPR-03-2016-23429 ET ;f%2 Public Health Department Subdivision .11� "C Environmental Health Division PIN# 363909158465 .mot- PO Box 389, 100-A Southwest Blvd, Newton.NC 28658 l;., sM NAME ON PERMIT: (BENJAMIN RUSSELL), 1754 SIGMON DAIRY RD, NEWTON NC 28658 ( Benjamin Russell) Site Address: 1766 SIGMON DAIRY RID, NEWTON NC 28658 Property Size: Square Feet Acres 0.52 Directions: 321 Bus/right NC 10/left Sigmon Dairy Rd/lot on left 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 AREA1 FEENAME DATE FEE AMOUNT 1 Improvement Permit Fee 03/18/2016 5150.00 TOTAL FEES $150.00 'j 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 03/21/2016 09:35 Page 2 of4 CATAWBA THIS IS NOT A PERMIT ~ ;-.1 COUNTY CATAWBA COUNTY HEALTH DEPARTMENT cb , Application for Environmental Services Page 1 Improvement Permit j Authorization to Construct❑ Septic Repair❑ Septic Malfunction El Septic Expansion ❑ New Well Permit❑ Replacement Well ❑ Well Abandonment❑ Well Repair ❑ Existing System Inspection (Pre-Approval Required) ❑ Application is for New Constructi on El Existing Facility El Property Address / 7 (p (a 5 Lc OVI Cr,"rl ct-k Subdivision k r , ).�t t.1 C_ a-s'(p Tfe Lot# Acres P D Section/Block/Phase Driving Directions to Property --TIC„ on-1-0 (f - ? en 'or, i) -j 2 0nh J IB-rn (` rL/ - 1,04- i O(-\ fr --P4— NAME TO APPEAR ON PERMIT? C(Owner ❑ Applicant ❑ Contractor Applicant Contact Information Name Oc(s-)vOd i-LSI"n-e S n Nile,_, Address /2_(O5 i-(, -7« (, ) - r� )eL ) EE-,* et lc 8"(a SE” Phone �-a�-L(E0 u{ - t� ( r, CA 'a— Cell Phone Owner Contact Information Name e,i� ;}Q rr, 1 r 1�( 4 SS-e H Address 1( o CDC ,)t C -Y-V 1 Ur t)C V.k Cd - '-)aL.*cn U--)L olv-(_05 S' Phone I Cell Phone Contractor Contact Information Name Some cs ccep C cc, i- Address Phone Cell Phone WHO WILL BE THE PRIMARY CONTACT? ❑ Owner Applicant ❑ Contractor Description of Existing Structures on Site ,1( ngle wil d #of Bedrooms *j' 3 Structure Dimensions /I/ -& to (o #of Occupants L Basement ❑ Yes '0 No Basement Fixtures a Yes �ttIo 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. D Yes o Does the site contain any jurisdictional wetlands? )(Yes o Does the site contain any existing wastewater systems? D Yes o 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? C Yes o Are there an easements or right of ways on this property? Describe Existing water supply in use Individual Well [J Community Well ❑ Semi-Public Well ❑ County/City/Township Water Line Is a public water supply available? ** j9C.Yes ❑No 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 ' .Eonventional ❑ Innovative ❑Other Ally E/ l 910Z-91-EO 'W'd VVEL'd0 ZLLOHW LOEb179, P p CTAWBA THIS IS NOT A PERMIT ` �(0 A. COUNTY CATAWBA COUNTY HEALTH DEPARTMENT ` (p cco Noah Caitlin. Application for Environmental Services Page 1 Pr posed Facility Type Primary Residence ❑ New Residence ❑ ddition to Residence of New Bedrooms *t , Project Description (l. nag (y,.vY' 1 ie Lydia ne,,D `,i`j't-s(e (Ai, cicj Structure Dimensions t(p 4' a` #ofOt;cupants Basement ❑ Yes [(No Basement Fixtures ® Yes No U Accessory Structure(s) 'Describe #of New Bedrooms *t if applicable Structure Dimensions #of Occupants Accessory Dwelling ❑ Yes ❑ No Plumbing ❑ Yes ❑No Describe Plumbing Needed U Multi-Family Residence#Units #Bedrooms per Unit*t Total#Bedrooms *t Structure Dimensions U Food Service Specify Type #Seats Floor Space-Entire Food Service Facility (Sq Ft) #Employees per Shift #of Shifts Dining Area (Sq. Ft.) U 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 ❑ Individual Well ❑ Semi-Public Well ❑ Community Well Abandonment Type El Drilled ❑ Bored El 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 a k ' • /\ '' (04DS Date -" (CI9 /-1 `P Printed Name of Owner or Agent�e 11 l SE_ 1, 'iYr 1 �(j r WCX I I0YLe S £/Z 9102-91-£0 'wd LE:£L:ZO ZLLJHW 10E1749178Z8 CATAWBA Geospatial Real Estate Search :.. Information Services • to N o X30 DL'4 N WtE 1 in=75ft Vs Parcel: 363909158465, 1766 SIGMON DAIRY RD NEWTON, 28658 Owners: RUSSELL BENJAMIN CHAD, RUSSELL STEPHANIE LEIGH Owner Address: 1754 SIGMON DAIRY RD Values - Building(s): $1,000, Land: $10,000, Total: $11,000 11 Pm\.Q.. Oho viNtr i-k ex%fts.-zdc hrot 5 locate( 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 03/16/2016 E/E 9 L0Z-9L-E0 'w'd LS:EL:ZO ZLOHW LO£b17928Z8 Catawba County Environmental Health / N / / N N / \ a iii: ‘...4)) 0 /9-J\ p J Itir 4 N. 1 Z 1 1281 j"9 xy0 • N N \ a J \ \ $ li X2801 \ 1/4) ' Parcel: 363909158465, 1766 SIGMON DAIRY 1 in=50ft RD NEWTON, 28658 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 03/16/2016 Parcel Report d 3 W a ct Page 1 of 1 Parcel Report - Catawba County NC Parcel Information: Owner Information: Parcel ID: 363909158465 Owner: RUSSELL BENJAMIN CHAD Parcel Address: 1766 SIGMON DAIRY RD Owner2: RUSSELL STEPHANIE LEIGH City: NEWTON, 28658 Address: 1754 SIGMON DAIRY RD LRK(REID): 36882 Address2: Deed Book/Page: 3233/0495 City: NEWTON Subdivision: State/Zip: NC 28658-8605 Lots/Block: / Last Sale: $15,000 on 2014-03-17 School Information: School District: COUNTY Plat Book/Page: Elementary School: STARTOWN Legal: Middle School: MAIDEN Calculated Acreage: .520 Tax Map: 070N 04001B High School: MAIDEN Township: NEWTON School Map --)1? State Road #: 2013 I Tax/Value Information: Tax Rates(pdf) Zoning Information: City Tax District: NEWTON Zoning District: NEWTON <( ., ern C) 1'� County Fire District: All in City Zoningl: R-20 Jam)} f I 009 Building(s) Value: $1,000 Zoning2: --)01°%0S—' Land Value: $10,000 Zoning3: Assessed Total Value: $11,000 Zoning Overlay: ` 1 _ k9Ca Year Built/Remodeled: / Small Area: (I J+VYt `yJ� Current Tax Bill Split Zoning Districts: / CO M11 '\c }find' Zoning Agency Phone Numbers • Mr' Y Miscellaneous: Firm Panel Date: 2007-09-05 Building Permits for this parcel. Firm Panel #: 3710363900J 1OU l Building Details 2010 Census Block: 2052 WaterShed: 2010 Census Tract: 011701 Voter Precinct: P34 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 f.\ thereof by any person or entity. ©2015, Catawba County Government, North Carolina. All rights reserved. rrl e DItc0 Re LT http://gis.catawbacountync.gov/nomap/parcel_report.php?key=363909158465&typ=P 3/16/2016