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HomeMy WebLinkAboutRBPR-04-2016-23694.TIF A OG THIS IS NOT A PERMIT Case # RBPR-04-2016-23694 CATAWBA COUNTY HEALTH DEPARTMENT ,. El r PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES r r iI 1842 sM Residential Building Plan Review - Building New IMPROVEMENT - AUTH CONSTo ' Owner C ARLES SI-IANKLES,3453 PLATEAU RD,NEWTON NC 28658 C:828-320-6479 NAME TO APPEAR ON PERMIT Charles Shankles SITE ADDRESS: 3455 PLATEAU RD, NEWTON NC 28658 PIN # 269802670590 NAME of SUBDIVISION: Lot# Section/Block PROPERTY SIZE: Square Feet Acres 7.37 DIRECTIONS: Hwy 10 West, Propst Cross Road, Left on Plateau Rd about 1 mile, House is on the Right beside Fred T Foard High School. PRIMARY CONTACT: Owner SEWER TYPE: Septic Tank GALLONS PER DAY: 240 WATER SUPPLY: Public Water DESCRIBE WORK: new accessory dwelling 20 x 30 / 1 bedroom w/ kitchen & bathroom. New System for accessory dwelling. 240 gal/day 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: Single Family Residence OTHER DESCRIPTION: DESCRIPTION OF single family dwelling, Shed EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: House 73 x 65, Shed 24x30 NUMBER OF EXISTING BEDROOMS: #OF OCCUPANTS: 2 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 20 x 30 #OF NEW BEDROOMS:: 1 BASEMENT? No BASEMENT FIXTURES? No PLUMBING REQUIRED?Yes Desired system types (Improvement Permit or Authorization to Construct): ACCEPTED: ALTERNATIVE: CONVENTIONAL: YES OTHER: INNOVATIVE: ANY: Other described: E9-ehapplication 04/21/2016 08:18 Page 1 of5 v,A • CATAWBA COUNTY Case# RBPR-04-2016-23694 Public Health Department Subdivision -t- PINit "Re, „"IS, Environmental I-I ealth Division 269802670590 PO Box 389. 100-A Southwest Blvd,Newton,NC 28658 /842 s. NAME ON PERMIT: ( CHARLES SHANKLES), 3453 PLATEAU RD, NEWTON NC 28658 ( Charles Shankles) Site Address: 3455 PLATEAU RD,NEWTON NC 28658 Property Size: Square Feet Acres 7.37 Directions: Hwy 10 West, Propst Cross Road, Left on Plateau Rd about 1 mile, House is on the Right beside Fred T Foard High School. 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 ************************************************************************************************************ FEENAME 1111 will !till I a CiLauru l ill�I'I�iii' II 7fli y i�l�1i11111", �DATEI��Ir l (`Il�EEIAIIMOUNT I Authorization to Construct Fee (New/Expansion) 04/20/2016 $150.00 Fee Improvement Permit Fee 04/20/2016 $150.00 r3'{IIi�{jjjlli,i;1 IIj TOTA l;FEES,I 1.n'i'?un{bll151r1 1�f1�11{IIII��I�'{{I{{{{{�{II iE: I�i{{�I�F 4I{{��I;) 'ii{�lih1 := $30000I`i�l'I n t.i '{ '114 I + iitnini lwLO:)dnLIIIWW1moutai rm 0J1111iI1U11PI1WUlN 0111 :Jll111111 1.,J1WNWllrr I tidt 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) IE9-ehapplicatinn 04/21/2016 08:18 Page 2 of5 �gA O i THIS IS NOTA PERMIT Case # RBPR-04-20I6-23694 d ...: CATAWBA COUNTY HEALTH DEPARTMENT 0 o + t 0 ` 3 42 PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES �r • I. r r . 842 ^+ Residential Building Plan Review - Building New ,o •o o IMPROVEMENT- AUTH_CONST ro l Owner CHARLES SHANKLES, 3453 PLATEAU RD, NEWTON NC 28658 C:828-320-6479 • NAME TO APPEAR ON PERMIT Charles Shankles SITE ADDRESS: 3455 PLATEAU RD, NEWTON NC 28658 PIN # 269802670590 NAME of SUBDIVISION: Lot N Section/Block PROPERTY SIZE: Square Feet Acres 7.37 DIRECTIONS: Hwy 10 West, Propst Cross Road, Left on Plateau Rd about 1 mile, House is on the Right beside Fred T Foard High School. PRIMARY CONTACT: Owner SEWER TYPE: Septic Tank GALLONS PER DAY: 240 WATER SUPPLY: Public Water DESCRIBE WORK: new accessory dwelling 20 x 30 I 1 bedroom 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: Single Family Residence OTHER DESCRIPTION: DESCRIPTION OF single family dwelling EXISTING STRUCTURES ON SITE(IF ANY) DIM EXISTING STRUCTURE: 73 x 65 NUMBER OF EXISTING BEDROOMS: #OF OCCUPANTS: 2 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 20 x 30 #OF NEW BEDROOMS:: 1 BASEMENT? No BASEMENT FIXTURES? No PLUMBING REQUIRED?Yes Desired system types (Improvement Permit or Authorization to Construct): ACCEPTED: ALTERNATIVE: CONVENTIONAL: YES OTHER: INNOVATIVE: ANY Other described: • • E9-ehapplication 04/20/2016 15.05 Page I of 5 /�A CATAWBA COUNTY Case a RBPR-04-2016-23694 k, G Public Health Department Subdivision ti l 7. - 20" y Environmental Health Division PINT/ 269802670590 `�\J'71 4 ': PO Box 389. 100-A Southwest Blvd.Newton. NC 28658 \842 iii NAME ON PERMIT: (CHARLES SHANKL.ES),3453 PLATEAU RD, NEWTON NC 28658 ( Charles Shankles) Site Address: 3455 PLATEAU RD, NEWTON NC 28658 Property Size: Square Feet Acres 7.37 Directions: Hwy 10 West, Propst Cross Road, Left on Plateau Rd about 1 mile, House is on the Right beside Fred T Foard High School. 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 ace Bible so that complete site evaluation can be performed. Date: ArklL tt 'l.e Signature of Applicant or Agent((j..ec ,-----_____—' An Environmental Health Specialist will contact you w ain 5 work ng clays of application date. If you need further information or assistance please call 828-466-7291 AREA2 FFENAME �' '). -" DATE ''FEE AMOUNT Authorization to Construct Fee (New/Expansion) 04/20/2016 5150.00 Fee Improvement Permit Fee 04/20/2016 $150.00 1111r1::7,;74171.!'2 ,: TOTAL FFFS ;V ' $300 00'-'1: 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 1)4/20/2016 15:05 Page 2 of 5 CATAYY 17A THIS IS NOT A PERMIT COUNTY CATAWBA COUNTY HEALTH DEPARTMENT ' A ''' " North Application for Environmental Services Page 1 Improvement Permit• Authorization to Construct Septic Repair❑ Septic Malfunction ❑ Septic Expansion ❑ New Well Permit [ Replacement Well n Well Abandonment ❑ Well Repair ❑ Existing System Inspection (Pre-Approval Required) ❑ Application is for New Construction Existing Facility n Property Address 3 S P s .;v • • a-n . ...Al. . Subdivision Lot# Acres Section/Block/Phase Driving Directions to Property aw V lO W T To PRO✓&C GRO SS ROAD , LEFT ON PLATEAU 201 APPOD)c ( MIL-C ! MOUSE. LS ON RJGI-lT t3E51D€ FoAftO iktcL-1 SC400L NAME TO APPEAR ON PERMIT? Z'Owner H Applicant ❑ Contractor Applicant Contact Information Name Address Phone Cell Phone Owner Contact Information -t< Name (,i4ARLtS 5-\ .- Kt-ES ' Address 3453 PL 'Teimi AD. Ncu+Tcw NG zg( cx Phone • Cell Phone( ) 320_cog 74 Contractor Contact Information Name License# Address Phone Cell Phone WHO WILL BE THE PRIMARY CONTACT? Z Owner n Applicant n Contractor Description of Existing Structures on Site dettarecnkia=rsteptr St Ai&LsFnmlt.-:1 QLaeL.L1nG-/STl4<su1LTRopesq, # of Bedrooms *•r Structure Dimensions # of Occupants 5 Basement Q Yes H No Basement Fixtures OYes ❑ No S'ol\ ZCIX3p) -r 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 Does the site contain any jurisdictional wetlands? 1,{21 Yes --No Does the site contain any existing wastewater systems? ❑ Yes Z No Is any wastewater going to be generated on the site other than domestic sewage? Yves )— No Is the site subject to approval by any other public agency? ❑ es Z'No Are there any easements or right of ways on this property? Describe Existing water supply in use H Individual Well ❑ Community Well ❑ Semi-Public Well zr County/City/Township Water Line Is a public water supply available? ** gl 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) U ❑ Accepted ❑ Alternative L 'Conventional ❑ Innovative ❑ Other ❑ Any CATAWBA THIS IS NOT A PERMIT c?UNTI ,,,,,._•- CATAWBA COUNTY HEALTH DEPARTMENT „m„,,---;;;;;-_,,, Application for Environmental Services Page 2 Proposed Facility Type Primary Residence n New Residence ❑ Addition to Residence # of New Bedrooms *t Project Description Structure Dimensions # of Occupants Basement n Yes H No Basement Fixtures n Yes ❑ No ytAccessory Structure(s) Describe STi GZ Sot cc A-eeang 6 o0 Sq FT #of New Bedrooms *t if applicable / Structure Dimensions 2,o'x 30 ' 1# of Occupants /—Z. Accessory Dwelling A'Yes n No 1 4 1 " ' Plumbing Z Yes n No Describe Plumbing Needed i<1-«a r A o 1 647,-1 ❑ 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.) n Business Specific Type of Business Retail Floor Space #of Employees per Shift # of Shifts n Other Facility Type Specify If Church ft of Seats Kitchen ❑ Yes H 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 n 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. 1 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. c. Signature of Owner or Agent oCy�E 7�rDate Apezi L zc it e Printed Name of Owner or Agent C-t-W .'--e S 4 4 aRLcS • Catawba County Environmental Health . ,%, ,/, CNN f ) • �, Air H \\‘‘ �9G Ro ) Uy A040 Sl 103`' O 49° ,0� ry� it: ' . .0 1%r. ti030 1( 11111N44),Nt \\\\ CP' r Y INIr ■fr . bir )D \ ?r \ Q . \ I 1000 995 Parcel: 269802670590, 3453 PLATEAU RD tin=150ft 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 mapheport 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 04/18/2016 Parcel Report • Page 1 of 1 Parcel Report - Catawba County NC Parcel Information: Owner Information: Parcel ID: 269802670590 Owner: SHANKLES CHARLES ALLEN Parcel Address: 3453 PLATEAU RD Owner2: SHANKLES JEAN MACE City: NEWTON, 28658 Address: 3453 PLATEAU RD LRK(REID): 4689 Address2: null Deed Book/Page: 1916/1391 City: NEWTON Subdivision: State/Zip: NC 28658-8809 Lots/Block: / School Information: Last Sale: $155,000 on 1995-01-01 Plat Book/Page: School District: COUNTY Legal: 3453 PLATEAU RD Elementary School: BANOAK Calculated Acreage: 7.370 Middle School: JACOBS FORK Tax Map: 005 J 01005 High School: FRED T FOARD Township: JACOBS FORK School Map State Road #: 2036 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: $177,700 Zoning2: Land Value: $41,700 Zoning3: Assessed Total Value: $219,400 Zoning Overlay: Year Built/Remodeled: 1894/1980 Small Area: PLATEAU 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 #: 3710269800J Building Details 2010 Census Block: 3009 WaterShed: null 2010 Census Tract: 011802 Voter Precinct: P3 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,as 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. 00 RC r-bozm 2qo http://gis.catawbacountync.gov/nomap/parcel_report.php?key=269802670590&typ=P 4/18/2016 . • f /D�O� CATAWBA COUNTY HEALTH DEPARTMENT • Telephone: (704) 465-8270 TDD: (7q\4), 465-8200 Improve. Permit I Authorization to Construct Repair Permit//^/,Oper. Permit System Type Owner/Agent U- �'t IK S k,t4.. k L .> • +Phone YC,R.CRr3`"z� Address ,'j6(5-.. %C-4-7-iff,+74 Subdivision _ Lig‹: - Section/lock/Phase Lot#' Lot Size Directions: yr rJ © �---6A'n-i /C-:-/I'. /u n-t / 7 ar i40tr ,cckezi/ -i-/5-.3 /'/4i2 v 2i1 Facility: House ' Mobile Home Business : Other: Tax Map # . Multi-family Other . Zoning Approval # # Bedrooms' # Seats # Employees . Application Rate GPD Flow Hot Tub or Spa yea/no•Special Fixtures . 100% Repair Area yes/no Basement yes/no' . Basement Plumbing yes/no . Water Supply: Private Well .. Public Type of System:. Trench ' Bed Pump Pump/Panel Panel LPP Other ' Tank Size: Septic Tank Size Ey/ 77Arc Pump Tank Size J Nitrification Field: Total Square Feet _____ Depth of Stone / Z__ ' Bed Size /CI)'�/�' Trench Width Total Length of All Trenches Number of Trenches Individual Trench Length / / /_/ Feet on Center ' ' Maximum Trench Depth_ ' Distance of Nearest Well *DO NOT INSTALL WHEN WET* • Topo % Slope • 7, Tr - t. • Texture Structure %J/ �„y w i/5 __—__ ._ Clay Min. �✓- Soil Wetness • / Soil Depth " :111:11111 /) L, �Restric. Hoz. at " - • ✓�,,ri'/J6 • Available space yes/no E 5' ' Overall Class S PS 'I7 . • Comments: ODt 00 . — -- - 1 ��.r • • **NO GUARANTEE OR WARRANTY IS IMPLIED OR GIVEN AS TO THE PERFORMANCE OR LENGTH OF TIME THIS SYSTEM WILL FUNCTION** *Improvement Permit has no expiration date and is transferable, but may be revoked if site plans or intended use changes for the proposed facility. An Authorization to Construct is valid for'(5) five years from date issued and is not transferable. Permit Date /7- ZC/n C� wner/A (nt 1 • '±d A C . ` .( 1 7 Sanitarian /L.' / s! vt���7�_4, . Ins ailed By v9Oir.�, _ /,� Date 3-p0j . ' Sanitarian lai - . I White-Office. Blue-Building Inspection Operation Permit Yellow-Owner/Agent Green-Building Inspection.Aliih^-'-- ' _ �spm t _ �,�ruzi3 6'eYl.