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HomeMy WebLinkAboutRBPR-05-2016-23809.TIF vS$A THIS IS NOT A PERMIT Case # RBPR-05-2016-23809 .77 Via ��. CATAWBA COUNTY HEALTH DEPARTMENT D t!? °TA"+ PLAN-RE-VIEW-APPL-IGA-T-ION-FOR-ENVIRONMEN-T-AL—SERVICES /842 CM Residential Building Plan Review - Building New f U • • v+ IMPROVEMENT - AUTH CONST 0 ti in • Contractor *DENALI HOME BUILDERS LLC (KENTON JACKSON), 1182 WEATHERBY DR, SALISBURY NI 28146 B:7048721591 C:7042241440F:7048721574 DENAL1HOMEBUILDERS @GMAIL.COM Owner CONS HARRILL, 3563 S NC 16 HWY, MAIDEN NC 28650 C:8282385137 NAME TO APPEAR ON PERMIT Connie Harrill SITE ADDRESS: 3563 S NC 16 HWY, MAIDEN NC 28650 PIN # 366802564758 NAME of SUBDIVISION: Lot 4 Section/Block PROPERTY SIZE: Square Feet Acres 3.45 DIRECTIONS: Take HWY 16 south, go thru 8 stop lights then about a mile after the 8th stop light. Blue house on hill on the right PRIMARY CONTACT: Contractor SEWER TYPE: Septic Tank GALLONS PER DAY: 600 WATER SUPPLY: Private Well DESCRIBE WORK: 2 Story-5 bedroom Single family dwelling with attached garage 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? Yes Property Easements Description: 16 easment APPLICATION FOR: New Structure • STRUCTURE TYPE: PRIMARY RESIDENCE FACILITY TYPE: Single Family Residence OTHER DESCRIPTION: DESCRIPTION OF house EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: unknown NUMBER OF EXISTING BEDROOMS: #OF OCCUPANTS: 8 PROPOSED CONSTRUCTION " NEW STRUCTURE DIM:: 75x45 #OF NEW BEDROOMS:: 5 • BASEMENT? No BASEMENT FIXTURES? No PLUMBING REQUIRED? Desired system types (Improvement Permit or Authorization to Construct); ACCEPTED: ALTERNATIVE: CONVENTIONAL: OTHER: INNOVATIVE: ANY: Other described: E9-ehappticarion 05/06/2016 13:02 Page 1 of 4 9w • CATARBACOUNTY Case# RBPR-05-2016-23809 j:n;� Public Health Department Subdivision r < ®` ,ti Environmental Health Division - PIN# 366802564758 -..t. PO Box 389. 100-A Southwest Blvd.Newton.NC 28658 /842 w NAME ON PERMIT: (CONNIE HARRE L), 3563 S NC 16 HWY, MAIDEN NC 28650 ( Connie Harrill) Site Address: 3563 S NC 16 HWY; MAIDEN NC 28650 Property Size: Square Feet Acres 3.45 Directions: Take HWY 16 south, go thru 8 stop lights then about a mile after the 8th stop light. Blue house on hill on the 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 acce ble so that a complete site evaluation can be performed. Date: 5-1.0 2 Cn - Signature of Applicant or Agent 4/u ii 4\((10t) 0 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 FEENANLE ' `? DATE % .'FEE AMOUNT Authorization to Construct Fee (New/Expansion) 05/06/2016 $300.00 Fee Improvement Permit Fee 05/06/2016 $150.00 TOTAL FEES 5450 00 '' FEES ARE NON-REFUNDABLE ONCE A SITE VISIT IS MADE OR WORK ON A.PLAN REVIEW HAS COMMENCED SYSTEM REDESIGN AND/OR RETRIP WILL INCUR AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) E9-ehapplication 05/06/2016 13:02 Page 2 of 4 CATAWBA THIS IS NOT A PERMIT rP oc NCO W I — c)3go9 COUNT% v,,,�' � CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services Page 1 Improvement Permit 1JQ ic Authorization to Construct a- Septic Repair❑ Septic Malfunction _ Septic Expansion ❑ New Well Permit I I Replacement Well n Well Abandonment E Well Repair Li Existing System Inspection (Pre-Approval Required) n Application is for New Construction x- Existing Facility ❑ Property Address 3 M3 S(xt1-ln NC l+wyllr Subdivision ilitO„n fin 1K),(' Lot# Acres Section/Block/Phase Driving Directions to Property Tit\L e . 4- 4-h- a s: (\ ANN ale t`t-ce c� -$ne g ' ak-L.2 731u.e h/-4 c_ ran r) h- - NAME TO APPEAR ON PERMIT? ,Owner n Applicant n Contractor Applicant Contact Information Name Address Phone Cell Phone _Owner Contact Information Name Cbn ie ttnNCi11 Address 3. 03 3hAAn tlw.! 16) n/lnl der 1IC ?Pia) 2p Phone ga0_C)uL}-q1u Cell Phone g02 o�J6 -5137 Contractor Contact Information Name Thr ; me CO 4 i Address 3 NOt- ; La ( • S - v e N C e C kc S Phone 04— • - — y Cell Phone t _ t4 - 1 �� WHO WILL BE THE PRIMARY CONTACT? E:Owner ❑ Applicant ❑ Contractor Description of Existing Structures on Site -tp be .f emoPr.A # of Bedrooms *.f- Structure Dimensions # of Occupants Basement ❑ Yes ❑ 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. ❑ Yes „11-No Does the site contain any jurisdictional wetlands? R Yes ❑ No Does the site contain any existing wastewater systems? ❑ Yes No Is any wastewater going to be generated on the site other than domestic sewage? XYes "No Is the site subject to approval by any other public agency? XYes No Are there any easements or right of ways on this property? Describe / p jglse ryti f Existing water supply in use ,W Individual Well ❑ Community Well ❑ Semi-Public Well ❑ County/City/Township Water Line Is a public water supply available? ** ❑ Yes ❑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) ❑ Accepted ❑ Alternative ❑ Conventional ❑ Innovative ❑ Other ❑ Any cArrA BA THIS IS NOT A PERMIT COUNTY V V .L� CATAWBA COUNTY HEALTH DEPARTMENT „o„„ Application for Environmental Services Page 2 Proposed Facility Type Primary Residence ,'New Residence n Addition to Residence # of New Bedrooms *.t. Project Description New HO—LS E Structure Dimensions 7rj'x {rj ' # of Occupants E Basement ❑ Yes No Basement Fixtures Yes/iallo n Accessory Structure(s) Describe # of New Bedrooms *t if applicable Structure Dimensions # of Occupants Accessory Dwelling ❑ Yes ❑ No Plumbing ❑ Yes ❑ No Describe Plumbing Needed n Multi-Family Residence it Units #Bedrooms per Ural. Total #Bedrooms *j Structure Dimensions ❑ Food Service Specify Type # 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 n Yes ❑ No If Daycare Specify Occupancy Application for Well Construction/Abandonment/Repair Proposed Well Type n Individual Well ❑ Semi-Public Well ❑ Community Well Abandonment Type n Drilled ❑ Bored n 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 depam tment 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 or Agent dSIt4b0/ 110/14.1)j Date 5- Co led Printed Name of Owner or Agent On n n I e )4(),c-(-\\\ CATAWBA Geospatial Information Services Real Estate Search ----- -- \\;>:;:-N. „ 69;;;;;N.Nc..„ i - _ 7 , / � 2si . i 5, 1� 0 3563 v1q . Oita j 9A71,1-71 ‘r + 411t ‘491‘ Ltv 3021 filW �� 4793 zrjt 0 ie . tip, -C\\\\H' 3., • 71- \ a (ii /` ,t N w-+E 1in=100ft S Parcel: 366802564758, 3563 S NC 16 HWY MAIDEN, 28650 Owners: HARRILL CONNIE H, null Owner Address: 3563 S NC 16 HWY Values - Building(s): $77,500, Land: $25,900, Total: $103,400 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 04/13/2016 Catawba County, North Carolina • • This map product was prepared from the Catawba County,NC,Geospatial Information System_ N Catawba County has made substantial efforts to ensure the accuracy of location and labeling information contained on this map.Catawba County promotes and recommends the independent verification of any data contained on this map 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 product or the use thereof by any person or entity. • Selected Parcel Number: 3668-02-56-4758 1 inch=80 feet Prepared for: Ir v 1 �. wJ- v / et \ 6 / G $y . ....„..4-12.‘\ 19 I I ,yO 7 a h 00; ti, / 0 ,s< • I A O w • 4758 / • • I 3250 / 41 .,,,,,,,,..„..,. • 1 • THIS IS NOTA LEGAL DOCUMENT Date Saved: 1/12/2016 Time: 12:11:55 Pikl Parcel Report Page 1 of 1 Parcel Report - Catawba County NC Parcel Information: Owner Information: Parcel ID: 366802564758 Owner: HARRILL CONNIE H Parcel Address: 3563 S NC 16 HWY Owner2: null City: MAIDEN, 28650 Address: 3563 S NC 16 HWY LRK(REID): 4844 Address2: null Deed Book/Page: 3334/0324 City: MAIDEN Subdivision: State/Zip: NC 28650-8915 Lots/Block: / School Information: Last Sale: $42,000 on 1984-02-01 Plat Book/Page: School District: COUNTY Elementary School: BALLS CREEK Legal: PLAT 18-383 HWY 16 Middle School: MILL CREEK Calculated Acreage: 3.450 Tax Map: 005 K 02014A High School: BANDYS Township: CALDWELL School Map State Road #: 16 TaxNalue Information: Tax Rates(pdf) Zoning Information: City Tax District: All in County Zoning District: COUNTY County Fire District: BANDYS Zoningl: R-40 Building(s) Value: $77,500 Zoning2: Land Value: $25,900 Zoning3: Assessed Total Value: $103,400 Zoning Overlay: RP-O Year Built/Remodeled: 1942/null Small Area: BALLS CREEK 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 #: 3710366800J Building Details 2010 Census Block: 2003 WaterShed: 2010 Census Tract: 011601 Voter Precinct: P1 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 thereof by any person or entity. ©2016, Catawba County Government, North Carolina. All rights reserved. iPt/fej NeAkiePhC. aP6©o pea pnnts http://gis.catawbacountync.gov/nomap/parcel_report.php?key=366802564758&typ=P 5/6/2016