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HomeMy WebLinkAboutRBPR-05-2016-23804.TIF rv,A �G THIS IS NOT A PERMIT Case # RBPR-05-2016-23804 Ara CATAWBA COUNTY HEALTH DEPARTMENT 0 °1 •o• f EI �' .rth `C PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES = 4Z sM Residential Building Plan Review - Building New opt o 13 IMPROVEMENT- AUTH_CONST- NEW WELL • op Owner \MATTHEW STEELMON, PO BOX 1252,NEWTON NC 28658 C:828-612-8669 NAME TO APPEAR ON PERMIT Matthew Steelmon SITE ADDRESS: 3397 WELLMAN RD, VALE NC 28168 PIN # 266702994220 NAME of SUBDIVISION: Lot# Section/Block PROPERTY SIZE: Square Feet Acres 9.97 DIRECTIONS: 10W , right Rhoney Farm Rd/left Wellmon Rd/approx 1/2 on right PRIMARY CONTACT: Owner SEWER TYPE: Septic Tank GALLONS PER DAY: 360 WATER SUPPLY: Private Well DESCRIBE WORK: 1st y_dwelling w/attached garage w/ unfinished basement Barn 40x60 SITE INFORMATIO 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: 4 --PROPOSED CONSTRUCTION CNEW STRUCTURE DIM:: 42 x 76 Barn 40x60 #OF NEW BEDROOMS:: 3 BASEMENT? Yes BASEMENT FIXTURES? No 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 19-ehapplicai inn 05/05/2016 15:08 Page 1 of d y,• •• CATAWBA COUNTY Case# RBPR-05-2016-23804 C li ..y Public Health Department Subdivision -- —^ r s Environmental Health Division PIN/1 266702994220 ��i� PO Box 389, 100-A Southwest Blvd,Newton,NC 28658 /8a1. 9 NAME ON PERMIT: (MAT-CHEW STEELMON), PO BOX 1252, NEWTON NC 28658 ( Matthew Steelmon) Site Address: 3397 WELLMAN RD, VALE NC 28168 Property Size: Square Feet Acres 9'97 Directions: 10W , right Rhoney Farm Rd/left Wellmon Rd/approx 1/2 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 il mgiII .e„ (r r' a ' . .. :rW & -• n i r . ?( n "Imp i miFEENAMEi fp s „--40,,,,,,, 0 rA'ut ii iiiiiili`-" DATEluiti !EErAMOUNT'p Authorization to Construct Fee 05/05/2016 $150.00 (New/Expansion) Fee Improvement Permit Fee 05/05/2016 $150.00 Well Permit & Inspection Fee 05/05/2016 $300.00 i i r "a•lp I I`� a lr1. l 1 . - 1 1N Itf�ll�ll��� �l�� I „TOTAL TEES 1 +i7%trilH,�SI1a.'A i��il�Ii t .:i�lll! �li�lll�lr� 5600 OO� �S✓ 8 l stul!'LBWIPi ire u ua n ILL IUU��IU In t11J8N"'.l,tnU o,�ltVldAWttttC4Sb�+ hHmatu • ..uult , {ta{,tUl' �k 4Mdk-.L".L 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(cation 05/05/2016 15:08 Page 2 of 4 \3A 0 - THIS IS NOT A PERMIT Case # RBPR-05-2016-23804 2:.;2!i. CATAWBA COUNTY HEALTH DEPARTMENT '4 ; D v 1,19'tom, PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES 'J m- /842 SM Residential Building Plan Review - Building New o 'C IMPROVEMENT- AUTH CONST- NEW WELL o Owner MATTHEW STEELMON, PO BOX 1252, NEWTON NC 28658 C:828-612-8669 NAME TO APPEAR ON PERMIT Matthew Steelmon SITE ADDRESS: 3397 WELLMAN RD, VAI.E NC 28168 PIN # 266702994220 NAME of SUBDIVISION: Lot# Section/Block PROPERTY SIZE: Square Feet Acres 9.97 DIRECTIONS: 10W , right Rhoney Farm Rd/left Wellmon Rd/approx 1/2 on right PRIMARY CONTACT: Owner SEWER TYPE: Septic Tank GALLONS PER DAY: 360 WATER SUPPLY : Private Well DESCRIBE WORK: 1 story dwelling w/attached garage w/ unfinished basement 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: 4 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 42 x 76 #OF NEW BEDROOMS:: 3 BASEMENT? Yes BASEMENT FIXTURES? No 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 05/05/2016 12:25 Page 1 of 4 syg• CATAWBA COUNTY Case 8 RBPR-05-2016-23804•`y, En ..z Public Health Department Subdivision 4 sir Environmental hlealth Division PIN# 266702994220 ' ® PO Box 389, 100-A Southwest Blvd.Newton.NC 28658 /842 ••• NAME ON PERMIT: Site Address: 3397 WELLMAN RD, VALE NC 28168 Property Size: Square Feet Acres 9.97 Directions: 10W , right Rhoney Farm Rd /left Wellmon Rd/approx 1/2 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 lab ling of all property lines and corners and making the site acce so hat m lete site evaluation can be performed. Date: 5/5/(F 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 FEENAMF' � `It . ` " DACE , � , FEE'AMOUNT Authorization to Construct Fee (New/Expansion) 05/05/2016 $150.00 Fee Improvement Permit Fee 05/05/2016 $150.00 Well Permit& Inspection Fee 05/05/2016 $300.00 a ' TOTAL FECS a 1 $600:00- a 6~,/vr :5i4,4-4.1�.»__s lgai'a r -. — n. .__!_r:_ .' ..9nt s,3..ew. :..8 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 05/05/2016 12:23 Page 2 of 4 cArr A�LCbVV 1L➢7B ® THIS IS NOT A PERMIT counJ ` A CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services Page 1 Improvement Permit,4.. Authorization to Construct- Septic Repair n Septic Malfunction ❑ Septic Expansion ❑ New Well PermitReplacement Well ❑ Well Abandonment ❑ Well Repair ❑ Existing System Inspection (Pre-Approval Required) ❑ Application is for New Construction n Existing Facility ❑ 57 ( Property Address 331JC\\mftr4 �tl Subdivision • 6 • ice• Lot# Acres Section/Block/Phase Driving Directions to Property t- \O wc5A- ().c6l.S,- o!` (1,\Aone (lu) cAnc) NAME TO APPEAR ON PERMIT? XOwner ❑ Applicant ❑ Contractor Applicant Contact Information Name Address Phone Cell Phone Owner Contact Information Name {V\Alt tez1MCn,1 Address Q 0-)a � \a S a c\ et c 1\ C )3,6sR Phone Cell Phone yak C>la_4SIa(,°1 Contractor Contact Information Name Address Phone Cell Phone WHO WILL BE THE PRIMARY CONTACT? WOwner n Applicant n Contractor Description of Existing Structures on Site \b(Y;n-T ( of # of Bedrooms *t Structure Dimensions #of Occupants Basement ❑ Yes n 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. D Yes ?% No Does the site contain any jurisdictional wetlands? D Yes ® No Does the site contain any existing wastewater systems? 0 Yes ® No Is any wastewater going to be generated on the site other than domestic sewage? Yes IP)No Is the site subject to approval by any other public agency? D Yes 41 No Are there any easements or right of ways on this property? Describe Existing water supply in use ❑ Individual Well n Community Well n Semi-Public Well n County/City/Township Water Line Is a public water supply available? ** n Yes Ef/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) J ❑ Accepted ❑ Alternative ❑ Conventional ❑ Innovative ❑ Other INATIY r' m,E NN IAA THIS IS NOT A PERMIT cousr/r, CATAWBA COUNTY HEALTH DEPARTMENT �—� ;^ Application for Environmental Services Page 2 Prg osed Facility Type WI Primary Residence © New Residence n Addition to Residence # of New Bedrooms *j* 3 Project Description tStructure Dimensions V. 1 1 (p # of Occupants 4 Basement IYes ❑ No Basement Fixtures ® Yes fl No Accessory Structure(s) Describe 11(/{.) # of New Bedrooms *t if applicable Structure Dimensions 140 ' L0 # of Occupants Accessory Dwelling n Yes ❑ No Plumbing ❑ Yes ❑ No Describe Plumbing Needed I Multi-Family Residence # Units #Bedrooms per Unit*j' Total# Bedrooms *j Structure Dimensions I Food Service Specify Type # Seats Floor Space-Entire Food Service Facility (Sq Ft) #Employees per Shift #of Shifts Dining Area (Sq. Ft.) Li 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 y" Individual Well ❑ Semi-Public Well ❑ Community Well Abandonment Type ❑ Drilled n 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 canabe performed. • Signature of Owner or Agent (L� '� Date Si ti /16 Printed Name of Owner or Agent " `t 0.4,Pi,.) S-tee\A.on Catawba County Environmental Health ...-_______>,.....„.„.._7, . . N0 1391 : / 738.50 z 0 co . 41141\11111111- •SO t r S'/ria boy/ • r s/j —_ • if i 7--------::1---x--i— I /Th\ r / —, 1 Parcel: 266702994220, WELLMAN RD VALE, 1in=150ft 28168 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 05/05/2016 Catawba County Environmental Health I: iii;) i Ilk . eft:" I> , :V 0 i, 4...04 ci;i .ro ir/4: it* .. It., .. , , P! Nil'esiair -. ce ,� o•--........_, „I I I P""mns -—---r_�, __se _..,,,,_vie! .2 IIIIII i Niiiiipi lain 1111: till titre �y t • `S VY IIP .3472 e /> 111, / Parcel: 266702994220, WELLMAN RD VALE, 1in=300ft 28168 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 05/05/2016 Parcel Report Page 1 of 1 Parcel Report - Catawba County NC Parcel Information: Owner Information: Parcel ID: 266702994220 Owner: STEELMON MATTHEW D Parcel Address: WELLMAN RD Owner2: SCHRUM CRYSTAL R City: VALE, 28168 Address: PO BOX 1252 LRK(REID): 6728 Address2: null Deed Book/Page: 3302/1286 City: NEWTON Subdivision: State/Zip: NC 28658-1252 Lots/Block: / Last Sale: $35,000 on 2015-08-07 School Information: School District: COUNTY Plat Book/Page: Elementary School: BANOAK Legal: null Middle School: JACOBS FORK Calculated Acreage: 9.970 Tax Map: 007 B 02019A High School: FRED T FOARD Township: BANDYS State Road #: 1107 TaxNalue Information: Tax Rates(pdf) Zoning Information: City Tax District: All in County Zoning District: COUNTY County Fire District: COOKSVILLE Zoningl: R-40 Building(s) Value: $0 Zoning2: null Land Value: $47,700 Zoning3: null Assessed Total Value: $47,700 Zoning Overlay: WP-0 Year Built/Remodeled: null/null 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 #: 3710266600J Building Details 2010 Census Block: 1006 WaterShed: WS-III Protected Area 2010 Census Tract: 011802 Voter Precinct: P2 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 thereat by any person or entity. ©2016, Catawba County Government, North Carolina. All rights reserve 1 �. 3tgo cic 2d. 3 391gm 3(c /day. http://gis.catawbacountync.gov/nomap/parcel_report.php?key=266702994220&typ=P 5/5/2016