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HomeMy WebLinkAboutRBPR-04-2016-23625.TIF Y A OG THIS IS NOT A PERMIT Case # RBPR-04-2016-23625 Q a CATAWBA COUNTY HEALTH DEPARTMENT 0 , . No. E.0 PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES FF2'0 v • 1842 sM Residential Building Plan Review - Manufactured Home o •o S.o 4 IMPROVEMENT- AUTH CONST :_ . : 9Pq)%1 Yit ContractorOL PARK PUMPING, INC (KELLY ISENHOUR), 1535 VICTORIAN HILLS CIR,CONOVER NC B:8282562926 C:8282171596F:828-256-2926 SAME AS PHONE ISENHOUR4@EMBARQMAIL.C( Owner DONNA BAYNE, 1271 TURTLE DOVE RD, CONOVER NC 28613 NAME TO APPEAR ON PERMIT Donna Bayne SITE ADDRESS: 4272 BETTY'S HOLLOW RD, CONOVER NC 28613 PIN # 374310457837 NAME of SUBDIVISION: LIZA STAFFORD HOUSTON UNREC Lot# 6 Section/Block PROPERTY SIZE: Square Feet Acres 1.14 DIRECTIONS: Lee Cline turn right onto Stafford St turn right on to Betty Hollow Rd Last lot on right PRIMARY CONTACT: Contractor SEWER TYPE: Septic Tank GALLONS PER DAY: 360 WATER SUPPLY: Public Water DESCRIBE WORK: 14 x 76 SW mobile home with Decks: Front 8x10, Back 4x6 *Will extend water line from Stafford St. 3 BR/2 Bath vinyl underpin / must screen or remove towing tongue/ must be parrel to road /front deck 8 x 10/ back deck 4 x 6 / must extend water line from Stafford St 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 EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: NUMBER OF EXISTING BEDROOMS: #OF OCCUPANTS: 3 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: SW 14 x 76, Decks: F 8x10, B 4x6 #OF NEW BEDROOMS:: 3 Desired system types(Improvement Permit or Authorization to Construct): ACCEPTED: ALTERNATIVE: CONVENTIONAL: YES OTHER: INNOVATIVE: ANY: Other described: E9-ehapplical ion 04/11/2016 15:26 Page 1 of �y.A CATAWBA COUNTY Case# RBPR-04-2016-23625 s T .� 12 Public Health Department Subdivision LIZA STAFFORD HOUSTON UI � � a —•� „� Environmental Health Division PIN# 374310457837 a�- PO Box 389, 100-A Southwest Blvd,Newton. NC 28658 N.184 w NAME ON PERMIT: (DONNA BAYNE), 1271 TURTLE DOVE RD, CONOVER NC 28613 ( Donna Bayne) Site Address: 4272 BETTY'S HOLLOW RD, CONOVER NC 28613 Property Square a Size: q 1.14 P S Feet Acres Directions: Lee Cline turn right onto Stafford St turn right on to Betty Hollow Rd Last lot on right 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 i 'FEEN4AME '' I�RF I _.m `, S' ug f:E,4/5 Half(. DATE r L aWEE AMOUNTi Authorization to Construct Fee (New/Expansion) 04/11/2016 $150.00 Fee Improvement Permit Fee 04/11/2016 $150.00 {P LW OW 0 Hal,ll.hd a ..,. „-.tRzfr _u.-.,..!,... n!i.P:.e+:'vlx:ik..F. ...+ri:!0:1li '6s.........-.9r..,zim:e.z-.ztLt l,.-ifl . "') FEES ARE NON-REFUNDABLE ONCE A SITE VISIT IS MADE OR WORK ON A PLAN REVIEW HAS COMMENCED SYSTEM REDESIGN AND/OR RETRIP WILL INCUR AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) 89-ehapplicai ion 04/11/2016 15:26 Page 2 of 5 S$A®® THIS IS NOT A PERMIT Case # RBPR-04-2016-23625 rt l! ' -,,, ? CATAWBA COUNTY HEALTH DEPARTMENT 0 . v n �, PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES 5R ti ; A 2 SAI Residential Building Plan Review - Manufactured Home G .e rD 0 1F ti T IMPROVEMENT- AUTH CONS 6� 14 • Contractor COOL PARK PUMPING, INC (KELLY ISENHOUR). 1535 VICTORIAN HILLS CIR, CONOVER NC B:8282562926 C:8282171596F:828-256-2926 SAME AS PHONE ISENHOUR4rDEMBARQMAIL.C( Owner DONNA BAYNE, 1271 TURTLE DOVE RD, CONOVER NC 28613 NAME TO APPEAR ON PERMIT Donna Bayne SITE ADDRESS: 4272 BETTY'S HOLLOW RD. CONOVER NC 28613 PIN # 374310457837 NAME of SUBDIVISION: LIZA STAFFORD HOUSTON UNREC Lot f 6 Section/Block PROPERTY SIZE: Square Feet Acres 1.14 DIRECTIONS: Lee Cline turn right onto Stafford St turn right on to Betty Hollow Rd Last lot on right PRIMARY CONTACT: Contractor SEWER TYPE: Septic Tank GALLONS PER DAY: 360 WATER SUPPLY: Public Water DESCRIBE WORK: 14 x 76 mobile home 3 BR/2 Bath vinyl underpin / must screen or remove towing tongue/ must be parrel to road /front deck 8 x 10/ back deck 4 x 6 / must extend water line from Stafford St 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 EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: NUMBER OF EXISTING BEDROOMS: #OF OCCUPANTS: 3 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 14 x 76 #OF NEW BEDROOMS:: 3 Desired system types (Improvement Permit or Authorization to Construct): ACCEPTED: ALTERNATIVE: CONVENTIONAL: YES OTHER: INNOVATIVE: ANY: Other described: • E9-ehapplication 04/11/2016 14:15 Page 1 of 5 3,A \ CATAWBA COUNTY Case# RBPR-04-2016-23625 • U Public Health Department Subdivision LIZA STAFFORD HOUSTON UI Environmental Health Division PIN# 374310457837 <4411-05,t PO Box 389. 100-A Southwest Blvd, Newton,NC 28658 2842 NAME ON PERMIT: (DONNA BAYNE), 1271 TURTLE DOVE RD, CONOVER NC 28613 ( Donna Bayne) Site Address: 4272 BETTY'S HOLLOW RD, CONOVER NC 28613 Property Size: Square Feet Acres 1.14 Directions: Lee Cline turn right onto Stafford St turn right on to Betty Hollow Rd Last lot on right 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: 14- I I - I (a Signature of Applicant or Agent C._ - • 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 FEE AMOUNT' r Authorization to Construct Fee (New/Expansion) 04/11/2016 $150.00 Fee Improvement Permit Fee 04/11/2016 $150.00 TOTAL FEES ' ;• 5300.00 FEES ARE NON-REFUNDABLE ONCE A SITE VISIT IS MADE OR WORK ON A PLAN REVIEW HAS COMMENCED . SYSTEM REDESIGN AND/OR RETRIP WILL INCUR AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) • E9-ehapplication 04/11/2016 14:13 Pagc2 of 5 • .;-AX - CAT.AW BA THIS IS NOT A PERMIT a$- 4&S-8)76 counre br rg;L CATAWBA COUNTY HEALTH DEPARTMENT Ne;;F;;;;;,. ` Application for Environmental Services Page 1 Improvement Permit Authorization to Construe Septic Repair Septic Malfunction ❑ Septic Expansion n New Well Permit❑ Replacement Well ❑ Well Abandonment ❑ A Well Repair ❑ Existing System Inspection (Pre-Approval Required) ❑ eusc Odd hid ti titid SS per Application is for New Construction ❑ Existing Facility 6ret25- Property Address k: `) a 2, "at 's H0110, Subdivision Cost o'e f /�-o 867 3 Lot# Acres Le_P i4'3 e_ wr.� Section/Block/Phase Driving Directions to Property T rerpt, 5\��tc� �} Aur,7 R-l- on 1-D T3 i b Mao Do I-0+ iZGt NAME TO APPEAR ON PERMIT? Owner ❑ Applicant ❑ Contractor Applicant Contact Information Name Ca '- o n Address 1 E& - 1 -rv-c A-ve Phone 9 ag - alb-- coot( ( 0..41 ec-)' Cell Phone 1:,s-v a— `IS ?og-6-R-s Owner Contact Information Name Address Phone Cell Phone Contractor Contact Information Name Ke-1 1.3 is e n \'L0 r' License# Address Phone 5 cc) — Zcj Z(D Cell Phone WHO WILL BE THE PRIMARY CONTACT? Nc Owner ❑ Applicant `PI Contractor Description of Existing Structures on Site — # of Bedrooms *j Structure Dimensions # of Occupants Basement ❑ Yes ❑ No Basement Fixtures ❑ Yes ❑ 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 Ej No�� Does the site contain any jurisdictional wetlands? `�., ❑ Yes M1 o Does the site contain any existing wastewater systems? �,eG�iv Oct tc ❑ Yes Quo Is any wastewater going to be generated on the site other than domestic sewage? 17 t� Yes o Is the site subject to approval by any other P ublic agency? Y ;1keiet af J ❑ Yes ❑ 51 Are there any easements or right of ways on this property? Describe _ Existing water supply in use ❑ Individual Well n Community Well ❑ Semi-Public Tell ❑ County/City/Township Water Line Is a public water supply available? ** 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 ❑ Conventional ❑ Innovative ❑ Other Any cAr(AA 7a, A THIS IS NOT A PERMIT COUNTY . 1-` CATAWBA COUNTY HEALTH DEPARTMENT „o„„ z Application for Environmental Services Page 2 Proposed Facility Type�� ❑ Primary Residence New Residence n Addition to Residence # of New Bedrooms *t - Q Project Description ;��`E v�; diz ^ 3 b; m d T c 4 . - r•ont peek= OKIO Structure Dimensions ILI x —�(42 # of Occupants > Zecilt beck. 440 Basement ❑ Yes n Basement Fixtures ❑ Yes KiNo n Accessory Structure(s) Describe # of New Bedrooms *t if applicable Structure Dimensions #of Occupants .3 Accessory Dwelling n Yes n No Plumbing acres ❑ 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 n 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 n Drilled n Bored ❑ Dug n Unknown Well Repair Requested ❑ Yes ❑ No Describe C, + p") -0err_ 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. j 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 transferable. 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 Age )Y�vv � ��rcyl,v Date 1 — ) Co Printed Name of Owner or Agent Don n c,_ n e- Catawba County, North Carolina This map product was prepared from the Catawba County.NC,Geospatial Information System. • N Catawba County has made substantial efforts to ensure the accuracy of location and labeling information contained on this map_Catawba County promotes and recommends the independent yerific tton of any A data contained on this map product he the user The County of Catawba its employees gents 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 product or the use thereof by any person or entity. Selected Parcel Number: 3743-10-45-7837 1 inch =50 feet Prepared for: 6A'IG II i 33 I 3 �. t X 1 S ��1 b e `3591 `' N' 6 i �5 1 .14A :Er. y 1 7837 1 13501 Cn o 5 1 . 17A 7752 OD 0 13401 THIS IS NOT A LEGAL DOCUNIEN Date Saved: 1/12/2016 Time: 1:12:09 PM Catawba County Environmental Health So a EPLOCCI 1 Lk addiummild14111 00aubor 60 N S "'Pr N a O O z O \ ...... , 3 �y of \—\\ • \\*5\N Parcel: 374310457837, CONOVER, 28613 1 in=60ft 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 04/11/2016 Parcel Report Page 1 of 1 Parcel Report - Catawba County NC Parcel Information: Owner Information: Parcel ID: 374310457837 Owner: BAYNE EDWARD L Parcel Address: Owner2: BAYNE DONNA KAYE • City: CONOVER, 28613 Address: 1271 TURTLE DOVE RD LRK(REID): 65918 Address2: null Deed Book/Page: 3273/1716 City: CONOVER Subdivision: LIZA STAFFORD HOUSTON State/Zip: NC 28613-8550 UNREC Lots/Block: 6/ null School Information: School District: COUNTY Last Sale: $6,000 on 2015-01-16 Plat Book/Page: Elementary School: LYLE CREEK Middle School: RIVER BEND Legal: null Calculated Acreage: 1.140 High School: BUNKER HILL Tax Map: 2300 00086H Township: CLINES State Road #: null Tax/Value Information: Tax Rates(pdf) Zoning Information: City Tax District: All in County Zoning District: COUNTY County Fire District: CONOVER RURAL Zoningl: R-20 Building(s) Value: $0 Zoning2: null Land Value: $5,800 Zoning3: null Assessed Total Value: $5,800 Zoning Overlay: null Year Built/Remodeled: null/null Small Area: ST STEPHENS/OXFORD Current Tax Bill Split Zoning Districts: null/null Zoning Agency Phone Numbers Miscellaneous: Firm Panel Date: 2007-09-05 Building Permits for this parcel. Firm Panel #: 3710374300J Building Details 2010 Census Block: 1024 WaterShed: null 2010 Census Tract: 010202 Voter Precinct: P33 Agricultural District: PROXIMITY 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. ©2016, Catawba County Government, North Carolina. All rights reserved. 3a2 .319D5P� $300 f c n http://gis.catawbacountync.gov/nomap/parcel_report.php?key=3 743 1 045 783 7&typ=P 4/11/2016