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HomeMy WebLinkAboutRBPR-04-2016-23691.TIF VtA COG THIS IS NOT A PERM-IT Case # RBPR-04-2016-23691 H CATAWBA COUNTY HEALTH DEPARTMENT PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES /842 sM Residential Building Plan Review - Building New , •o . .o ±Ter IMPROVEMENT- AUTH CONST - NEW WELL •' c a Applicant *JASPER BUILDERS INC (SEAN GALLAGHER), 181 W STA'I'ESVILLEAVE, MOORESVILLE NC 28115 B:704-799-9982 C:7042014980F:704-799-9983 JBINFO@JASPERBUILDERS.COM Contractor *JASPER BUILDERS INC (SEAN GALLAGHER), 181 W STATESVILLE AVE, MOORESVILLE NC 28115 B:704-799-9982 C:70420 1 49 80F:704-799-9983 JBINFOrtJASPERBUILDERS.COM Owner ALLEN COLE BAILEY,213 FERNBROOK DR, MOORESVILLE NC 28117 B:7047999193 C:7045764628 NAME TO APPEAR ON PERMIT *JASPER BUILDERS INC (Sean Gallagher) SITE ADDRESS: 1387 LANGDON RD, SHERRILLS FORD NC 28673 PIN # 461901494078 NAME of SUBDIVISION: LANGDON RIDGE PH 2 Lot 1 Section/Block PROPERTY SIZE: Square Feet Acres 0.69 DIRECTIONS: Hwy 150/Sherrills Ford Rd/Right Mollys Backbone Rd/right Azalea Rd /left Dog Leg Rd /first left onto Roundstone Rd/stay Straight onto Langdon Rd/#1387 on left PRIMARY CONTACT: Contractor SEWER TYPE: Septic Tank GALLONS PER DAY: 480 WATER SUPPLY: Private Well DESCRIBE WORK: single family dwelling 70 x 70 /4 bedrooms 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? No APPLICATION FOR: New Structure STRUCTURE TYPE: PRIMARY RESIDENCE FACILITY TYPE: Single Family Residence OTHER DESCRIPTION: DESCRIPTION OF vacant lot EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: NUMBER OF EXISTING BEDROOMS: #OF OCCUPANTS: 2 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 70 x 70 #OF NEW BEDROOMS:: 4 BASEMENT? Yes BASEMENT FIXTURES? Yes PLUMBING REQUIRED?Yes Desired system types (Improvement Permit or Authorization to Construct): ACCEPTED: ALTERNATIVE: CONVENTIONAL: OTHER: INNOVATIVE: ANY: YES Other described: _ APPLICATION FOR WELL CONSTRUCTION PROPOSED WELL TYPE: Individual Well REPLACE WELL?: NO E9-ehapplication 04/21/2016 09:50 Page I of 5 y�A CATAWBA COUNTY Case# RBPR-04-2016-23691 ��air ®C2 Public Health Department Subdivision LANGDON RIDGE PH 2 d -- 4�3 , Environmental Health Division PINT/ 461901494078 PO Box 389. 10(1-A Southwest 131vd-Newton. NC 28658 1842 :x NAME ON PERMIT: *JASPER BUILDERS INC ( SEAN GALLAGHER), 181 W STATESVILLE AVE, MOORESVILLE NC 28115 `JASPER BUILDERS INC ( Sean Gallagher) Site Address: 1387 LANGDON RD, SHERRILLS FORD NC 28673 Property Size: Square Feet Acres 0.69 Directions: Hwy 150/Sherrills Ford Rd/Right Mollys Backbone Rd/right Azalea Rd /left Dog Leg Rd/first left onto Roundstone Rd/stay Straight onto Langdon Rd/#1387 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 t 'FEENAMEi;; I S { ' '' DATE ' FEE AMOUNT i Authorization to Construct Fee (New/Expansion) 04/20/2016 $300.00 Fee Improvement Permit Fee 04/20/2016 $150.00 Well Permit & Inspection Fee 04/20/2016 $300.00 1 's;' ITOTAL FEES ` p r. ' ' ' ;".if $75000 '::ii? ._:,_..c iG.ia... -.-...-,....__�.._.A 4: -,-,.._...- �__- ...ar_ 3a,ro ..hrm- __.- z 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 04/21/2016 09:50 Page 2 of 5 CATAWBA THIS IS NOT A PERMIT ccti,n" a CATAWBA COUNTY HEALTH DEPARTMENT ' ««� c Application for Environmental Services Page 1 Improvement Permit Authorization to Consitruct t Septic Repair❑ Septic Malfunction❑ Septic Expansion ❑ New Well Permit 2 Replacement Well ❑ Well Abandonment❑ Well Repair ❑ Existing System Inspection (Pre-Approval Required) ❑ Application is for New Construction `�J Existing Facility ❑ Property Address 1384- L4.n .&Irk IO-d, ( Subdivision i_4 ttb� e _ koq' is -ora, 11� a-2t13 Lot# 1 00 AcrJ Section/Block/Phase Driving Directions toProperty E u 1-1•tu froWit( O ' g n %IA a U.. �aocklout ; m Asdttu, l2 Sli 44 I� 610-0 jo i ,t3 1 �rs mti}a w1esto nL P it .,Tv ,..a.L. aV ' , . , * :11 64,j_.• NAME TO APPEAR ON PERMIT? ❑ Owner ❑ Applicant (Contractor Applicant Contact Information Name b ed.(:?u lkWSJm L Tu1 .aea * .'r at tit Address UIL__5_ Shit �e /_1L��__ Ytt Ste- N Phone 1 t�, 10101 Q l j-� Cell Phone 5flk-tt-cia Kit{-to+,2-0 <ct sb Owner Contact Information Name CO 1,t, Address 3i 3 h.roe ,t bY u-i- 1 h�Q - sS Jj��� AL 2� g Phone 7o4, -Hq.a! 923 Cell Phone -0.(,, 51G. 440d o Contaac or Contact Information Name �6-ttmn2� Es alp Address Phone � Cell Phone WHO WILL BE TIC PRIMARY CONTACT? ❑ Owner ❑ Applicant [Contractor Description of Existing Structures on Site #of Bedrooms *t Structure Dimensions #of Occupants Basement ❑ Yes ❑ No Basement Fixtures Q Yes No The Applicant shall notify the local health department upon submittal of this application if any of the following apply to the property ' question. If the answer to any question is "yes", applicant must attach supporting documentation. ® Yes Does the site contain any jurisdictional wetlands? O Yes � Does the site contain any existing wastewater systems? ❑ Yes e Is any wastewater going to be generated on the site other than domestic sewage? es is the site subject to approval by any other public agency? ❑ Yes 11211: Are there any easements or right of ways on this property? Describe Existing water supply in use ❑ Individual Well ❑ Community Well ❑ Semi-Public Well ❑ County/City/Township Water Line Is a public water supply available? ** ❑ Yes/XI/No If applying for an Improvement Permit or Authorization to Construct,Please Indicate Desired System Type(s): (systems can be ranked in order of yorr preference) ` / ID Accepted ❑ Alternative 'onventional ❑ Innovative ❑ Other D(f Any CATAWBA THIS IS NOT A PERMIT Con CATAWBA COUNTY HEALTH DEPARTMENT "`; Application for Environmental Services Page 2 P�roiposed Facility Type IQ Primary Residence New Residence ❑ Addition to Residence #of New Bedrooms *'' Project Description 1 Structure Di,�m,��t�tsions 1°I X 110 I #of Occupants ;-- Basement El Yes ❑ No Basement Fixtures "Yes ® No U Accessory Structure(s) Describe #of New Bedrooms *1 if applicable Structure Dimensions #of Occupants Accessory Dwelling ❑ Yes ❑No Plumbing ❑ Yes ❑No Describe Plumbing Needed ❑ Multi-Famil •Residence# Units #Bedrooms per Unit*f Total#Bedrooms *1- Structure Dimensions ] Food Service Specify Type f 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 Individual Well ❑ Semi-Public Well ❑ Community Well Abandonment Type Drilled ❑ Bored ❑ Dug ❑ Unknown Well Repair Requested ❑ Yes ❑ No Describe Calculated Design Flow, Commercial .I Additional information maybe required to determine design.flow front 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 inf., matio provided herein is true,complete and correct. Authorized county and state officials are granted right of entry to conduct nec^,ary in,pections to determine compliance with applicable laws and rules. I understand that-l:am solely responsible for the pro.er id tification and labeling of all property lines and comers and making,the site accessible so that a complete site evaluation can be met .med. Signature of Owner or Agent Date (.f V I/ I (p Printed Name of Owner or Agent 511 CAA ��i\tt,t Rv.e S;t�-e-.� fff y1iLpW7 Ab.ws) -••,••.,-._. .e.ae ,,,,, ,o• ear oJUe nun[JAV Junta I6 002/002 DASD O N ALLEN & ASS OC tATES P. A. "Since 197r Commercial • Residential • Mortgage Surveys • >.iuhi-Family Construction Staking • Subdivision Design * Topographical 111-8 Raceway Drive • Mooresville • NC • 28117 (704) 854-7029 (704) 684-6041 Fox I, certify that this map was drown under my supervision from on actual survey made under my supervision recorded In deed book 1976 __ pwie 706 and/or plot book - e1 page_ 21 , that the ratio of precision Is Q.4E/AV that this mop was prepared In accordance With the General Statutes of North O't>to11%,/rceEpsjer 890, my hand and seal on the _ 9nt , day of _SEPTEMBER - e•!2 Arpir 41:33 01..s' ` !1 __ m f9a WILL3L44S. Ita , 'LS$ _ Osnc CURVE TABLE "�$ �. @ .__... CURVE RADIUS LENGTH BE"j • .- yZ 2. _. Cl 64-4:46' 15,871 I N 49';1 J r ; II tl1l LARK NORMAN - spa.-k ;' <-5_ aI@A,us 9- ta .k rw� 7co'WN1DUR - PIER PEA AV 1)At d � Ns?-` clan suavEr ._.. /4 Per•! w ..;{f Poe N30�T 1961>A,tp . :wNO ' 6661 1 Ew),__, R/t{. _= 4.01' OP UNE - - '-C—— 70r cas123111 —- Ftu00 UA'E \ ���jjj \1 1. 1-... PEA !u2w' S I , �e�5 \ ilF_1p 9URWY C-4- 1 \- .} otoaD uue• - o dll- . 't ._..-..- ; - NVCHBUS `v r5 ' I- L (0 L (( ..• claw • • 0221i M7 21Z-Z. '11^r mil ¢ nm JON CRIGORIAN I I v ' AYH"25-'1 ni i�`z, bg IN r 1941/0938 I r -7 ACRE'S Oz rn LOT 2 I !k m PETER r&RRr I1� 2673/1096•Ip 7 nI 'g I a� I I I .d I Io AA .^ PE Pa S46 51"W u na30.R sPDE REEIAA 98,Ga q roux! N36'3H'16-E re,ND 11%64 R NCDON ROAD 46' RA,. 0' 25' pa' 100' -EW.70 I l--... ii Na1E5 r0, -P.P..pores;eoLs •) 1183 WMPfJTTY NAY.eE'11p.2CT SCALE lb FEET to ANY EA2101Ee19 AN!/e1 p -OUKE PO,ei 1MNS, I I SURVEY !HOMO OP HAY 4 ACCORD. LLV._CfiSANA 4014 3WxD O U N D A R N 2) Apt`ALE COAIPUTED OVINE tPS... /4 RED AR SET I 1) u'p°cao�irzm Por, . R/W NCI:T-Or-KAY OF I 4) NO Opp N,N'aNSNT FUND VMTHIN 0 •wad. #1387 LANGDDN ROAD ZOCO STET, LOT 1 , LANIGIDON RIDGE SCALE FI. _ 5°' MOUNTAIN CREEK TWSPt, ICATAWBA COUNTY, NC nSAfp !Dort me uueiou Poor I.ow ACQUIRED 9Y: JON ALLEN & SUSAN. JILL GRIGORIAN Dc FIFE: ?AA HAD NQ 4e1¢0I_49.407e . y� p y Catawba County Environmental Health• •Id1�lii 1 l l I I Mk, N; �•1 f st� i,{".0 11I'1���t ,'pt4,.'� / ® fr. \7 ayR r 'trjIII u$l it . I ri"rl (' 1M If th.:Il .4iItt; l'ki A. ti#5! :-slifIr;flSt1Kt�� ��,i P �tli l C RS ir 1i t.. 1 t w; i b ti b,�G,� n ,f V� ly I L,�f;., �•4Il KA sly � �� r1 37.99 lir'� I °� 1ts�ry4'i `"I ti� sill E 1 ifi ill �! �E;� i�n;%il,ln 383 7 o • N • J / elleillitr 11/H94 I f 81 � 0' / 1 .51 I I 1 7.76 64,40 + "— — / Parcel: 461901494078, 1387 LANGDON RD 1in=50ft SHERRILLS FORD, 28673 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 04/20/2016 I vrsloavo iwI `01035TI1H8�H1H salmoslry�a � tw � i Riyg HOMENODONYI'IM Jinn �� Md $ $ 9 Aa J o 9 ; , e. I 1 1 1 e. IJ I I •• i I '� �3 /I o5 1 1 I_1—t--4 i — j mm, w gg I I —t—[-1-A s$I ,l _ Ia gm 1 1 � j , i 1 I I i $ i pill r �T1°o j .14.1i a� , I el 3. 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Parcel Report Page 1 of 1 Parcel Report - Catawba County NC Parcel Information: Owner Information: Parcel ID: 461901494078 Owner: BAILEY ALLEN C Parcel Address: 1387 LANGDON RD Owner2: BAILEY TRACIE A City: SHERRILLS FORD, 28673 Address: 213 FERNBROOK DR LRK(REID): 301711 Address2: null Deed Book/Page: 2864/0276 City: MOORESVILLE Subdivision: LANGDON RIDGE PH 2 State/Zip: NC 28117-4404 Lots/Block: 1/ null Last Sale: $395,000 on 2007-09-14 School Information: School District: COUNTY Plat Book/Page: 61/21 Legal: LOT 1 PL 61-21 Elementary School: CATAWBA Middle School: MILL CREEK Calculated Acreage: .690 Tax Map: null High School: BANDYS Township: CATAWBA School Map State Road #: 2675 TaxNalue Information: Tax Rates(pdf) Zoning Information: City Tax District: All in County Zoning District: COUNTY County Fire District: SHERRILLS FORD Zoningl: R-30 Building(s) Value: $5,000 Zoning2: null Land Value: $254,300 Zoning3: null Assessed Total Value: $259,300 Zoning Overlay: CRC-O,WP-O,FPM-O Year Built/Remodeled: null/null Small Area: SHERRILLS FORD Current Tax Bill Split Zoning Districts: null/null Zoning Agency Phone Numbers Miscellaneous: Firm Panel Date: 2008-03-18 Building Permits for this parcel. Firm Panel #: 3710461900K Building Details 2010 Census Block: 2001 WaterShed: WS-IV Critical Area 2010 Census Tract: 011503 Voter Precinct: P21 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 Irom this map/report product or the use thereof by any person or entity. ©2016, Catawba County Government, North Carolina. All rights reserved. 1 , O�, OW I qim c/a) 5ci ► tact, http://gis.catawbacountync.gov/nomap/parcel_report.php?key=461901494078&typ=P 4/20/2016