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HomeMy WebLinkAboutRBPR-04-2016-23759.TIF 4 A • THIS IS NOT A PERMIT Case # RBPR-04-2016-23759 . CATAWBA COUNTY HEALTH DEPARTMENT CI WS , PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES /842 5M Residential Building Plan Review - Building New 7ap.•a G r a IMPROVEMENT- AUTH_CONST - NEW WELL 0 ''u1 a Applicant CHONG SMITH, 702 6TH AV NE, CONOVER NC 28613 C:8655566689 Owner STEWART COOK, 1015 ROLLING GREEN DRIVE,NEWTON NC 28658 NAME TO APPEAR ON PERMIT CHONG SMITH SITE ADDRESS: 2150 MILTON ST,NEWTON NC 28658 PIN # 372012853846 NAME of SUBDIVISION: AVIAN WOODS PH 3 Lot# 47 Section/Block PROPERTY SIZE: Square Feet Acres 0.95 DIRECTIONS: Settlemyer Bridge Rd, left on Startown, left on Milton, Property on Left. Corner lot. PRIMARY CONTACT: Applicant SEWER TYPE: Septic Tank GALLONS PER DAY: 360 WATER SUPPLY: Private Well DESCRIBE WORK: NEW STICK BUILT HOME, 3 BEDROOMS, NO BASEMENT, 2 CAR GARAGE, NO BONUS ROOM 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? No 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 EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: NUMBER OF EXISTING BEDROOMS: #OF OCCUPANTS: 1 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 74X80 • #OF NEW BEDROOMS:: 3 BASEMENT? No BASEMENT FIXTURES? PLUMBING REQUIRED? 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 04/28/2016 12:13 Page I of 4 gA CATAWBA COUNTY Case# RBPR-04-2016-23759 all 2 Public Health Department Subdivision AVIAN WOdDS PH-3 C *co , Environmental Health Division PIN# 372012853846 PO Box 389, 100-A Southwest Blvd,Newton, NC 28658 1842 w NAME ON PERMIT: (CHONG SMITH),702 6TH AV NE, CONOVER NC 28613 ( CHONG SMITH) Site Address: 2150 MILTON ST,NEWTON NC 28658 Property Size: Square Feet Acres 0.95 Directions: Settlemyer Bridge Rd, left on Startown, left on Milton, Property on Left. Corner lot. 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 understa.:that I am solely responsible for the proper identification nd labelinP of all property lines and corners and making the site ac sibl- so that a compl: a site e . .. ion .n be performed. Date:identification c/ /6 Signature of Applicant or Age dads, t_„/ An Environmental Health Specialist will contact you within 5 w. mg •ays of application date. If you need further information or assistance please call 828-466-7291 AREA2 FEENAME DATE' '' FEE AMOUNT Authorization to Construct Fee (New/Expansion) 04/28/2016 $150.00 Fee Improvement Permit Fee 04/28/2016 $150.00 Well Permit& Inspection Fee 04/28/2016 5300.00 ' TOTAL FEES 5600.00 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-chappl ication 0428/2016 12:13 Page 2 of 4 e• Jk\ Ej jy 1 n1J to 1NU t H r CKrvu 1 cour} CATAWBA COUNTY HEALTH DEPARTMENT .,. tan . ;;T I.R.. Application for Environmental Services Page 1 Improvement Perm ns Authorization to C truct' Septic Repair ❑ Septic Malfunction ❑ Septic Expansion New Well Permit Replacement Well ❑ Well Abandonment❑ Well Repair ❑ Existing System Inspection/(Pre-Approval Required) ❑LI, Application is for New Construction Existing Facility ❑ Property Address c I rru Non O Yee4 Subdivision k) alb (iood5 AletukY1 / A--1C a V&576 Lot# Acres .9, Section/Block/Phase, 3 Driving Directions to Property 41 t _ - 1 a.. r \ i le-4 cn m; ■*rt- i 7rn¢ex--\ on \eYr, C(arcer tok Ca#- Po', IC NAME TO APPEAR ON PERMIT? Owner Applicant ❑ Contractor Applicant Contact Information Name l - UY1 30(\ 114-411 Address1oL et y4 Cana aliter d e 2J1 13 Phone S s 6 -66s-cf. Cell Phone Owner Contact Information /� Name 6.)-ea ou k !'i..c Crn K 1 A Ova_. J.. C _r CA1 Address o�/5U /�7/4r t, vt d ee{ //to t-ca , Are & K66-3 Phone Cell Phone Contractor Contact Information Name Address Phone Cell Phone WHO WILL BE THE PRIMARY CONTACT? ❑ Owner Applicant ❑ Contractor Description of Existing Structures on Site \j( 'C -1 (_j( # of Bedrooms *t Structure Dimensions # of Occupants Basement ❑ Yes ❑ No Basement Fixtures 0, 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. C Yes fiNo Does the site contain any jurisdictional wetlands? In Yes y.No Does the site contain any existing wastewater systems? ® Yes ref No Is any wastewater going to be generated on the site other than domestic sewage? AYes s-No Is the site subject to approval by any other public agency? C Yes ::s No Are there any casements or right of ways on this property? Describe Existing water supply in use Li Individual Well LJ Community Well U Semi-Public Well ❑ County/City/Township Water Line Is a public water supply available? ** ❑ Yes cliNo 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 <I C ^TA ]BA 1THiS IS NUT A PERMIT COUNTY , CATAWBA COUNTY HEALTH DEPARTMENT �ww o , Application for Environmental Services Page 2 , Prpposed Facility Type • Primary Residence New Residence ❑ Addition to Residence # of New Bedrooms *I- li Project•Description LcP 0 12}4 1 f kL f- Q Structure Dimensions /..4(...F. e..ft2( %-Q #of Occupants Basement ❑ Yes No Basement Fixtures ® Yes a-No ❑ Accessory Structure(s) Describe #of New Bedrooms *t if applicable Structure Dimensions # of Occupants Accessory Dwelling ❑ Yes ❑ No Plumbing ❑ Yes ❑ No Describe Plumbing Needed ❑ Multi-Family Residence# Units #Bedrooms per Unit*t Total# Bedrooms *t Structure Dimensions ❑ Food Service Specify Type # Scats 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 if 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 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 orAgen '�y� �i- /� Date 7e71-7 ��j� Printed Name of Owner or Agent sk-,S11 1:--1:-.€01 ,SFSLL a „0,LL.00 S Q I r-\ m M im m B - Y0V9!3S aV34 „0-,0£ N -1 W I I I I 19 I N I I J m1 a'L tu U °m 0 1 N T I p 0 I .n ' 1m 0 - - -! D" �I I / W � / 0 1 6� . Catawba County Environmental Health I \\<\:„..N.N\:::::•, 1 l l l l L. S 290 S. 5# / / v 243.52 cNn is re fool y % l� it t ,., , ilik ''ll 111 I I ' h �l, z it q NµNµM c o !II Iii l�" ���M �� a 07 61.69 , 114 .._... Illy , l a I ll��lh ill Ilill' \1‘ 50 943 Parcel: 372012853846, 2150 MILTON ST 1 in=50ft 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 04/27/2016 Parcel Report Page 1 of 1 e 1, 65 Parcel Report - Catawba County NC Parcel Information: Owner Information: Parcel ID: 372012853846 Owner: COOK STEWART H Parcel Address: 2150 MILTON ST Owner2: COOK TAMBRA B City: NEWTON, 28658 Address: 1015 ROLLING GREEN DRIVE LRK(REID): 903076 Address2: null Deed Book/Page: 3176/0879 City: NEWTON Subdivision: AVIAN WOODS PH 3 State/Zip: NC 28658-9229 Lots/Block: 47/null Last Sale: $38,000 on 2013-03-07 School Information: School District: COUNTY Plat Book/Page: 54/133 Legal: LOT 47 47 PL54-133 AVIAN WOODS PL Elementary School: STARTOWN Middle School: MAIDEN 54-133 Calculated Acreage: .950 High School: MAIDEN Tax Map: null School Map Township: NEWTON State Road #: 1241 TaxNalue Information: Tax Rates(pdf) Zoning Information: City Tax District: All in County Zoning District: COUNTY County Fire District: NEWTON RURAL Zoningl: R-20 Building(s) Value: $0 Zoning2: null Land Value: $37,100 Zoning3: null Assessed Total Value: $37,100 Zoning Overlay: null Year Built/Remodeled: null/null Small Area: STARTOWN 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 #: 3710372000J Building Details 2010 Census Block: 2002 WaterShed: null 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 Geaspatial 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 that 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. • --vcp pe_9 ,yNetyl http://gis.catawbacountyne.gov/nomap/parcel_report.php?key=372012853846&typ=P 4/27/2016