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HomeMy WebLinkAboutRBPR-04-2016-23653.TIF BA THIS IS NOT A PERMIT Case # RBPR-04-2016-23653 GG CATAWBA COUNTY HEALTH DEPARTMENT 0 _vo 0 •PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES Ig42 5, Residential Building Plan Review - Manufactured Home rod • p 0 2, �, p • EXS_SYSTEM 0 > D U Applicant KOOL PARK SERVICES LLC (FREDRICK AKKER), PO BOX 138, REDMOND WA 98052-0138 C:2065104180 Owner KOOL PARK SERVICES LLC, 3102 KOOL PARK RD NE, HICKORY NC 28601 Paid By ERIC SALOMON, , H:828962198I HOME:828962198I NAME TO APPEAR ON PERMIT Kool Park Services LLC SITE ADDRESS: 3102 KOOL PARK RD NE 64, HICKORY NC 28601 PIN # 372419517897 NAME of SUBDIVISION: Lot# Section/Block PROPERTY SIZE: Square Feet Acres DIRECTIONS: From Springs Rd, west on Kool Park Rd NE, approx 1 mile park entrance on right/home site is next to lot 65 wiich is labeled, location of proposed home and porch is staked PRIMARY CONTACT: Owner SEWER TYPE: Septic Tank GALLONS PER DAY:. 240 WATER SUPPLY: Community Well DESCRIBE WORK:<1991 SW mobile home 14 x 66 with 5x20 front porch & 3x5 rear steps} 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 vacant EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: NUMBER OF EXISTING BEDROOMS: #OF OCCUPANTS: 4 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 14 x 66 with 5x20 ft deck& 3 x 5 rear steps #OF NEW BEDROOMS:: 2 Desired system types (Improvement Permit or Authorization to Construct): ACCEPTED: ALTERNATIVE: CONVENTIONAL: OTHER: INNOVATIVE: ANY: YES Other described: E9-chupplicatlon 04/142016 15:19 Page 1 of 5 ■\3A CATAWBA COUNTY Cased RBPR-04-2016-23653 :7 .'I�j Public Health Department Subdivision d :�51�r Environmental Health Division PIN# 372419517897 I'O Box 389. 100-A Southwest Blvd,Newton,NC 28658 /842 s. NAME ON PERMIT: KOOL PARK SERVICES LLC ( ), 3102 KOOL PARK RD NE, HICKORY NC 28601 Kool Park Services LLC ( ) Site Address: 3102 KOOL PARK RD NE 64, HICKORY NC 28601 Property Size: Square Feet Acres Directions: From Springs Rd,west on Kool Park Rd NE, approx 1 mile park entrance on right/home site is next to lot 65 wiich is labeled, location of proposed home and porch is staked 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 FEEIN�AM I!I I 1�I I II , IIF, ;I I111Ii�II�II1 rTintiATE Im�I�i`EE AmMOUNT'�i _. ._ � �.Iu t llri j�itii II.VI ILA �Gea <' mac,L![Il 1 .. Existing Tank Check Fee 04/14/2016 $80.00 )h� l�l �I� �OTAI�F ES;I�'��11EInI t 5 ��161111�{I�IIIII h1�.? IiifhIIIhIi�,. ;)sIIIiIIIhIII�' -riN680 00 � 1 IIh II�i II I. i TVA, s2flU iI11;I" �'t i"1° �INJiII11U11WWtG;..�IuIpIWL;.::laNllll�l to a t '9 NWlr attl, 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 04/14/2016 15:19 Page 2 of 5 • F' A ' eG THIS IS NOT A PERMIT Case # RBPR-04-2016-23653 .. ` a CATAWBA COUNTY HEALTH DEPARTMENT El 121� � PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES f� /842 SM Residential Building Plan Review - Manufactured Home ro • o r�o i. • EXS_SYSTEM — po Applicant KOOL PARK SERVICES LLC (FREDRICKAKKER), PO BOX 138, REDMOND WA 98052-0138 C:2065104180 Owner KOOL PARK SERVICES LLC, 3102 KOOL PARK RD NE, HICKORY NC 28601 Paid By ERIC SALOMON, , H:8289621981 HOME:8289621981 NAME TO APPEAR ON PERMIT Kool Park Services LLC SITE ADDRESS: 3102 KOOL PARK RD NE 64, HICKORY NC 28601 PIN # 372419517897 NAME of SUBDIVISION: Lot# Section/Block PROPERTY SIZE: Square Feet Acres DIRECTIONS: From Springs Rd, west on Kool Park Rd NE, approx 1 mile park entrance on right/home site is next to lot 65 wiich is labeled, location of proposed home and porch is staked PRIMARY CONTACT: Owner SEWER TYPE: Septic Tank GALLONS PER DAY: 240 WATER SUPPLY: Community Well DESCRIBE WORK: 1991 SW mobile home 14 x 66 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 vacant EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: NUMBER OF EXISTING BEDROOMS: #OF OCCUPANTS: 4 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 14 x 66 with 5-20 ft deck& 3 x 5 rear steps #OF NEW BEDROOMS:: 2 Desired system types(Improvement Permit or Authorization to Construct): ACCEPTED: ALTERNATIVE: CONVENTIONAL: OTHER: INNOVATIVE: ANY: Other described: E9-ehapplication 04/14/2016 15:12 Page of 5 s\y,A •� • CATAWBA COUNTY Case# RBPR-04-2016-23653 `Q Gtia .4 Public Health Department Subdivision -i•® q Environmental Health Division PIN# 372419517897 Tii PO Box 389, 100-A Southwest Blvd,Newton,NC 28658 I: s■ NAME ON PERMIT: KOOL PARK SERVICES LI.,C ( ), 3102 KOOL PARK RD NE, HICKORY NC 28601 Kool Park Services LLC ( ) Site Address: 3102 KOOL PARK RD NE 64, HICKORY NC 28601 Property Size: Square Feet Acres Directions: From Springs Rd,west on Kool Park Rd NE, approx 1 mile park entrance on right/home site is next to lot 65 wiich is labeled, location of proposed home and porch is staked 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 o ... . ... . r a' . ti o 4.1s 11R d 6. tt t� r t .FEENAME' za 5t stl - r ' ut DATE FEE AMOUNT' Existing Tank Check Fee 04/14/2016 $80.00 i rF TOTAI�FEES rE Mini �„ r r,h I`' F3 iE '` $800017.4 v > .i FEES ARE NON-REFUNDABLE . ONCE A SITE VISIT IS MADE OR WORK ON A PLAN REVIEW HAS COMMENCED SYSTEM REDESIGN AND/OR RETRIP WILL INCUR AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) E9-ehapplication 04/14/2016 15:12 Page 2 of 5 CATAWVBA COUNTY rte. Case RBPR-04-2016-236531., �t Public I leahh D c attmcnt " , , # '' u { P - Subdn�i3ion ft t I'vituonmentall,lealth Iitision k 1)1' .. 372419517897 1'0 t3o�a$r),°I pU Southwest I31vd.Newton NC.2tS658. NAMEON PERMIT: 1(OOL PARK SERVICE'S LLC ( ), 3102'KOOL PARK RI)NE, HICKORY'NC 28601 I : " r Kool Park'Services L-LC:( ) Site Address 3102 KOOL PARK RD NE 64, HICKORYNC;2860 i o Y e f e` ' ' s P e rt Size A "-Directions.'` • 'From Spnngg'Rd;west on,Kool Park Rd NE;approx 1.mile park entrance on right/home site is next to lot 65 witch is ' :labeled(location of propose'dhome and porch is staked Improvement Permits issued as a result of this Information are valid,for 5 years or may be non-expiring under certain specified conditions.An j' Authorization to.Construct Issued by this department is valid for(5)five years from the date is_sued.and is not transferable;Improvement Permits and Well ' ' Permits are transferrable. Permits maybe revoked if the information on this`application, site plans or intended use changes for the proposed facility. it I ii a I have read this application and,certify that the information provided herein Isltrue,complete and correct. Authorized county and state officials are granted right of entry to conduct necessary Inspections to determine compliance with1applicable laws;and rules understand that I am solely responsible for the • proper Identificati and I belle of all property lines and•corners and making the siteacc ible so tha': coma ete site evaluation can be performed. Date' -: "1' "a/Q (G Signature of Applicant or Agent r y,,,_. An'Ensirorinienial 1,.lealith'. Specialist will contactyYnulvithin Stt•txking days-of application date. Ifyou need further information yr,assistance please call 828-466=7391 AREA2 1 RCNAY U?' }'*#}i#%t#}}k%}##%#%%kk%}4}#}t#4}ti# t * }#kk#*#}##}**k#4%#k s*}*}}***}k#*#}***4****#####*k**A% - T# # *# k t l'''.1-71:1;` Fla 3 r4 - rm.': ' i. * . s ▪ r 7n '' a DAi I y, RE CAMOINr E EnEY 2 -_ Existing Tank Check Fee _ 04/14/2016 - 880 00 r+tt;�xnr -.,lOT4▪ l" Nf I.S' <,a ~s ,n,µ.. .,X� ? -a ''. .,...<a ,,""t„e',, .S8o 110w .,. k i4 fs_e' ....,a w_J._ACn t;'•: ,a ' nY, to Y,r S,..j .,a: x- :air.,, .:YSr,ti?"K.v^,'`_, ,.?..5:. ' FEES ARE N. NO -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 (SEEtFEE SCHEDULE) • , 1 . F #. ? 5T p,{. L% • ' f9 rhqp htauon` - . 04/14/2016 15:03 4 Page 2'of5 4 1 J .'ties .. '.... ... ..,i.. ...: .... -.. . `I .,::.�... 1✓ '.i . . ,.. c T wB e THIS IS NOT A PERMIT COUNTY , , CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services Page I Improvement Permit n Authorization to Construct n Septic Repair ❑ Septic Malfunction ❑ Septic Expansion ❑ New Well Permit ❑ Replacement Well E Well Abandonment❑ Well Repair ❑ Existing System Inspection (Pre-Approval Required) n Application is for New Construction n Existing Facility n Property Address 3102 Kool Park Rd NE Lot 64 Subdivision Parcel ID: 372419517897 Hickory NC 28601 Lot# 64 Acres 12.400 Section/Block/Phase Driving Directions to Property From Springs Rd, West on Kool Park Rd NE, approx 1 mile park entrance on Right, home site is next to lot 65 which is labeled, Location of proposed home and porch is staked. NAME TO APPEAR ON PERMIT? IX Owner n Applicant Contractor Applicant Contact Information Name Kool Park Services, LLC Attn: Frederick Akker, Member/Manager Address 3102 Kool Pard Rd NE #1 Hickory, NC 28601 Phone 828-216-5907 Cell Phone 828-216-5907 Owner Contact Information Name Kool Park Services, LLC Address 3102 Kool Pard Rd NE #1 Hickory, NC 28601 Phone 828-216-5907 Cell Phone 828-216-5907 Contractor Contact Information Name N/A Address Phone Cell Phone WHO WILL BE THE PRIMARY CONTACT? El Owner n Applicant n Contractor Description of Existing Structures on Site # of Bedrooms *t Structure Dimensions # of Occupants Basement n Yes n No Basement Fixtures Q Yes C 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 0 No X Does the site contain any jurisdictional wetlands? X0 Yes ® No Does the site contain any existing wastewater systems? Existing Septic System On Site 0 Yes ® NoX 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 ® No X Are there any easements or right of ways on this property? Describe Existing water supply in use n Individual Well El Community Well n Semi-Public Well ❑ County/City/Township Water Line Is a public water supply available? ** El Yes n 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) N/A ❑ Accepted ❑ Alternative ❑ Conventional ❑ Innovative ❑ Other ❑ Any CATAWBA THIS IS NOT A PERMIT COUNTY CATAWBA COUNTY HEALTH DEPARTMENT „o„„c„; Application for Environmental Services Page 2 Proposed Facility Type © Primary Residence © New Residence n Addition to Residence # of New Bedrooms *t 2 Project DescriptionPlace 14x66 2 Br Home on Existing Lot in Mobile Home Park, with 5x20 Front Porch and 3x5 Structure Dimensions 14x66 # of Occupants 4 back steps. Basement n Yes n No Basement Fixtures ® Yes ® No [ Accessory Structure(s) Describe # of New Bedrooms *t if applicable Structure Dimensions # of Occupants _ Accessory Dwelling Yes ❑ No Plumbing n Yes n No Describe Plumbing Needed ❑ Multi-Family Residence ft Units #Bedrooms per Unit*t Total # Bedrooms *t Structure Dimensions IT Food Service Specify Type # Seats Floor Space-Entire Food Service Facility (Sq Ft) # Employees per Shift # of Shifts Dining Area (Sq. Ft.) n 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/Albandonment/Repair Proposed Well Type n Individual Well ❑ Semi-Public Well n Community Well Abandonment Type ❑ Drilled n Bored ❑ Dug n Unknown Well Repair Requested [ Yes n 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 comers and making the site accessible so that a complete site evaluation can be performed. / (1 ttv� 4/12/16 Signature of Owner or Agent Date Printed Name of Owner or Agent Frederick Akker, member/manager for Kool Park Services, LLC 4 or e_. ii • ,.o.1 • Tif'n. /.. r..r. •. ...... .., ,,• .0. ' I. . Nt 4%. .._ ., .. , ,. , , .. ...... ..,. . ...!..ir . ... 144 .o• c — ,. . 44 -'•,, •• 'S:4 Nix. . N-4..." •. . leop. . e tt : ' '.• ',.• • ri nil I irk:.'..._ . '--•Oct — , , . at ... .,. '. • Zi* , - IL • . . . . 411111-# . . l• ...1 E 0 ;43 0 N • S • tki r • , I. 4 2 ii .c ..- e •‘ •P i 'c36 \ Ibt- E .8 ..c .. *At 0 ...... . . .. . - . CL Ln , 13 = c QC) kr) • • "c5 911r*Ssiass.2 -o - . - ' . Ct. e , . _ • - • , • . . t air , it iitio ' ri ., • 1 CO ..le A': I= v.. .. . 03 /. .. _ .,. .t.. ...„ E / . -— r te f (.4 .91 ' . .I , 4f. / 1 -. I,. ...* 4#444114tik .130 !4citi, . - -.4411.1e 41" qr .1 , . . , Al r q. , ,,,i'"" - ...., .41- . 4 r` 4.• • :..* ,, ' . ,., . ,•' ilr ' 4. im ni-.' ..e. Ow , I ' * o 0 lo 'e / ol ..... 0 c , .6, a / e.. . ,. -e= t- • Iv . .e. . . ,-,.... • Catawba County Environmental Health 1 ! • "'yam \ So � / 13. . St i CZ • ��d 133 44 % \ 0, g, 0 r.ct, Qe •z • • •. „.. 'Fo 1.15 ye N1/2NNNN-N...„.„...„.........„„:1/2„ ..,0 , 'PQ ' 180) • • (...7 t 4, - oel V % .../9 .. .•. ‘1% ... \ . Parcel: 372419517897, 3102 KOOL PARK RD 1in=100ft NE 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. Coovriaht 2014 Catawba County NC Parcel Report Page 1 of 1 Parcel Report - Catawba County NC • • Parcel Information: Owner Information: Parcel ID: 372419517897 Owner: KOOL PARK SERVICES LLC Parcel Address: 3102 KOOL PARK RD NE Owner2: null City: HICKORY, 28601 Address: PO BOX 138 LRK(REID): 56171 Address2: null Deed Book/Page: 3139/0400 City: REDMOND Subdivision: State/Zip: WA 98052-0138 Lots/Block: / Last Sale: School Information: Plat Book/Page: School District: COUNTY Legal: null Elementary School: SNOW CREEK Calculated Acreage: 12.400 Middle School: ARNDT Tax Map: 165H 01001 High School: ST STEPHENS Township: HICKORY School Map State Road #: 1400 Tax/Value Information: Tax Rates(pdf) Zoning Information: City Tax District: All in County Zoning District: HICKORY County Fire District: ST STEPHENS Zoningl: R-1 Building(s) Value: $89,300 Zoning2: Land Value: $237,600 Zoning3: Assessed Total Value: $326,900 Zoning Overlay: Year Built/Remodeled: null/null Small Area: null 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 #: 3710372400J Building Details 2010 Census Block: 1002 WaterShed: null 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. ©2016, Catawba County Government, North Carolina. All rights reserved. 2 v 5.hM Syskrit n yee t kj X60 ?3R )05 pd http://gis.catawbacountync.gov/nomap/parcel_report.php?key=372419517897&typ=P 4/12/2016