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HomeMy WebLinkAboutRBPR-05-2016-23878.TIF \,A �G THIS IS NOT A PERMIT Case # RBPR-05-2016-23878 a CATAWBA COUNTY HEALTH DEPARTMENT 0 tip.? 0 U e, m A°u, PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES �� 4� �84� I 2 sM Residential Building Plan Review - Manufactured Home 1:1)-1111/2° + ro , IMPROVEMENT •0 o 0 rn Contractor CLAYTON HOMES (BOBBI *LASAGE), PO BOX 132, TAYLORSVILLE NC 28681 C:8282173168 JWHOLDER @HOTMAIL.COM Owner CYNTHIA MOOSE,2010 35TH ST NE, HICKORY NC 28601 NAME TO APPEAR ON PERMIT Cynthia Moose SITE ADDRESS: 3770 MACKLIN ST, CLAREMONT NC 28610 PIN # 376119724327 NAME of SUBDIVISION: Lot# 25 Section/Block B PROPERTY SIZE: Square Feet Acres 0.67 DIRECTIONS: Hwy 10 East, left on Bethany Church Rd, Right on Boggs Rd, Left on Hogan Dr, left on Macklin, Lot on right PRIMARY CONTACT: Contractor SEWER TYPE: Septic Tank GAL R DAY: 360 WATER SUPPLY: Private Well ESCRIBE WO : Changing out doublewide, new 28x60, 3 bedroom, Decks: Front& Back 6x6 Existing well & septic. Must have min 36 sq ft decks on front/ must be parallel with the road I must have masonry underpin! must have screen or remove towing tongue 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: Mobile Home OTHER DESCRIPTION: DESCRIPTION OF Old Home has been removed EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: NUMBER OF EXISTING BEDROOMS: 3 #OF OCCUPANTS: 2 PROPOSED CONSTRUCTION N W STRUCTURE DIMj DW 28x60, Decks: Front& Back 6x6 #OF NEW BEDROOMS:: 3 Desired system types (Improvement Permit or Authorization to Construct): ACCEPTED: ALTERNATIVE: CONVENTIONAL: OTHER: INNOVATIVE: ANY: YES Other described: 09-chappllcauun 05/17/2016 08:32 Page 1 of 4 ,,v,A , CATAWBA COUNTY Case a RBPR-05-2016-23878 Public Health Department Subdivision 4 :��5 '�C� Environmental Health Division PING 376119724327 �a'td PO Box 389, 100-A Southwest Blvd,Newton,NC 28658 7g.2 s+ NAME ON PERMIT: (CYNTHIA MOOSE), 2010 35TH ST NE, HICKORY NC 28601 ( Cynthia Moose) Site Address: 3770 MACKLIN ST, CLAREMONT NC 28610 Property Size: Square Feet Acres 0.67 Directions: Hwy 10 East, left on Bethany Church Rd, Right on Boggs Rd, Left on Hogan Dr, left on Macklin, Lot 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 PFEENAME yN tl ailk;:i„° rrlQiJs�t iji'pitilt"IIiI;llGilllmll��Ll.����� I+ TE9s h ^�i:IF A'MOUNTI , Improvement Permit Fee 05/16/2016 8150.00 :MEP roTAEFEES nt� l;„ Nahlrl �� IINII�itlIRli�ll8 � ttl111 ' ~loit 1lll+l t;IIIIII 51 50100 ll i 1h Q t 1L 81hIIII1t1111-' a 2N 7WmituWua t aIW11RiP i uatu of Wt6 e9Mrkg„ IM:Hth 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) 129-chapplication 05/17/2016 08:32 Page 2 of4 S t THIS IS NOT A PERMIT Case # RBPR-05-2016-23878 CATAWBA COUNTY HEALTH DEPARTMENT 0 ��` 0 �' PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES ,t� ti 4. , 1842 ^+ Residential Building Plan Review - Manufactured Home ire —D d I a IMPROVEMENT } o`y.4'a ELI . 1:s T Contractor CLAYTON HOMES (BOBBI *LASAGE), PO BOX 132. TAYLORSVILLE NC 28681 C:8282 1 73 168 JWHOLDER @HOTMAIL.COM Owner CYNTHIA MOOSE. 2010 35TH ST NE. HICKORY NC 28601 NAME TO APPEAR ON PERMIT Cynthia Moose SITE ADDRESS: 3770 MACKLIN ST, CLAREMONT NC 28610 PIN # 376119724327 NAME of SUBDIVISION: Lot 4 25 Section/Block B PROPERTY SIZE: Square Feet Acres 0.67 DIRECTIONS: Hwy 10 East, left on Bethany Church Rd, Right on Boggs Rd, Left on Hogan Dr, left on Macklin, Lot on right PRIMARY CONTACT: Contractor SEWER TYPE: Septic Tank GALLONS PER DAY: 360 WATER SUPPLY: Private Well DESCRIBE WORK: Changing out doublewide, new 28x60, 3 bedroom, 6x6 front porch and 6x6 back deck/ Must have min 36 sq ft decks on front/ must be parallel with the road / must have masonry underpin/ must have screen or remove towing tongue 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? APPLICATION FOR: New Structure STRUCTURE TYPE: PRIMARY RESIDENCE -- FACILITY TYPE: Mobile Home OTHER DESCRIPTION: DESCRIPTION OF Old Home has been removed EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: NUMBER OF EXISTING BEDROOMS: 3 - #OF OCCUPANTS: 2 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 28x60 Doublewide #OF NEW BEDROOMS:: 3 Desired system types (Improvement Permit or Authorization to Construct): ACCEPTED: ALTERNATIVE: CONVENTIONAL: OTHER: INNOVATIVE: ANY: YES Other described: E9-ehapplicarion 05/16/2016 15:34 Page 1 of 4 ,8A CATAWBA COUNTY case RBPR-05-2016-23878 CPublic Health Department Subdivision <i , /`7 Environmental Health Division � ..� -. �; PIN# 376119724327 \\,�,/// P6 Box 389, 100-A Southwest Blvd,Newton.NC 28658 x842 NAME ON PERMIT: ( CYNTHIA MOOSE),2010 35TH ST NE. HICKORY NC 28601 ( Cynthia Moose) Site Address: 3770 MACKLIN ST,CLAREMONT NC 28610 Property Size: Square Feet Acres 0.67 Directions: Hwy 10 East, left on Bethany Church Rd, Right on Boggs Rd, Left on Hogan Dr, left on Macklin, Lot 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 an lab ing of all property lines and corners and making the site accessibl` . o that a co .fete site evaluation can e performed. Date: 6\ Le It , Signature of Applicant or Agent f ..at An nvironmental Health Specialist will contact you within 5 working days of applicati date. If you need further information or assistance please call 828-466-7291 AREA2 FEENAMEF DATE FEE AMOUNT , Improvement Permit Fee 05/16/2016 $150.00 - TOTAL FEES 'A'Y: $ 5150.00 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-chapplication 05/16/2016 15 34 Page 2 of 4 CATAWBA THIS IS NOT A PERMIT CATAWBA COUNTY HEALTH DEPARTMENT -"� „..„o„no Application for Environmental Services Page 1 Improvement Permit X, Authorization to Construct❑ Septic Repair❑ Septic Malfunction ❑ Septic Expansion ❑ New Well Permit❑ Replacement Well ❑ Well Abandonment❑ (� Well Repair ❑ Existing System Inspection (Pre-Approval Required) ❑ �j._ 1U1 Application is for New Construction L i Existing Facility C W Property Address 3'71-m MNIGNI sr. Subdivision MIA J (aVPa lCAr "1 kit 2 fto ( D Lot# /tT/,4 Acres milt ,R hi Phase _ Dri ing Directions to Pro.e .t i __LB _tilA Virg ` ` S _ a �� :�_I_ _I _ ��_' altati t. t, NAME TO APPEAR ON PERMIT? g Owner ❑ Applicant ❑ Contractor Applicant Contact Information Name /7Iacv fames kk-81 {robot Laget.y—> Address (o`Z a3 (On/tbVtj Mud .u, 1 C&\o�2/UC> ZRIo13 �-7 Phone BZer - 21 -7 . 31 (,g Cell Phone gze--2,1 1 -3i(4a Owner Contact Information Name Cynth t4, nito Address 0770 jylA-CJ -U/J 5--3.5--S G! '" DMf AFC. Phone Eze 40E4� Cell Phone 10/4. Contractor Contact Information Name Address Phone Cell Phone WHO WILL BE THE PRIMARY CONTACT? ❑ Owner Applicant ❑ Contractor Description of Existing Structures on Site S. I. _AO t. Ir a T mu o # of Bedrooms *j' Structure Dimensions #of Occupants Basement LJ 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. o Yes %No Does the site contain any jurisdictional wetlands? yi 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? Intill No Is the site subject to approval by any other public agency? • Yes fNo Are there any easements or right of ways on this property? Describe Existing water supply in use gi Individual Well ❑ Community Well ❑ Semi-Public Well ❑ County/City/Township Water Line Is a public water supply available? **y 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 ZAny CA AU]f A THIS IS NOT A PERMIT coun•T JL)L A CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services Page 2r • Proposed Facility Type C" glPrimary Residence 01 New Residence n/�Addditi�on to Residence # of New Bedrooms *j 3 LoX� ,�t� Project Description a ekLoo _-ozete!� Structure Dimensions e IFX(fl # of Occupants Basement ❑ Yes 12 No Basement Fixtures ® Yes No ❑ Accessory Structure(s) Describe # of New Bedrooms *t if applicable Structure Dimensions # of Occupants Accessory Dwelling n Yes n No Plumbing ❑ Yes n No Describe Plumbing Needed ❑ 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.) n Business Specific Type of Business Retail Floor Space # of Employees per Shift # of Shifts n 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 n Semi-Public Well ❑ Community Well Abandonment Type n Drilled ❑ Bored ❑ Dug 11 Unknown Well Repair Requested n Yes n 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. ** ifNo,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 or Agent �/ _ Date 5/l/yA0 Printed Name of Owner or Agent fil rs A • 2 A Catawba County Environmental Health J /0 / _ aPti: / J , J 9a ` �/ \ mil ?QSS y N /.46:5 ,,,,.i.&? Arapid. Ili ) . . nce° clireet 2,9-„, , .. • • • co 0 • -4C 97.25 coo 44.89 '.95 . _ 37.94 • • MACKLIN ST • • � - Parcel: 376119724327, 3770 MACKLIN ST tin=50ft CLAREMONT, 28610 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 05/16/2016 Parcel Report • Page 1 of 1 Parcel-Report---Catawba-County-NC Parcel Information: Owner Information: Parcel ID: 376119724327 Owner: MOOSE CYNTHIA J Parcel Address: 3770 MACKLIN ST Owner2: null City: CLAREMONT, 28610 Address: 3780 MACKLIN ST LRK(REID): 24235 Address2: null Deed Book/Page: 3297/0372 City: CLAREMONT Subdivision: null State/Zip: NC 28610-8233 Lots/Block: 25/ B School Information: Last Sale: $8,500 on 2015-07-01 School District: COUNTY - Plat Book/Page: 16/255 Elementary School: CATAWBA Legal: LOT 25 BLOCK B PL 16-255 Middle School: RIVER BEND Calculated Acreage: .670 High School: BUNKER HILL Tax Map: 025AY 04014 School Map Township: CATAWBA State Road #: null TaxNalue Information: Tax Rates(pdf) Zoning Information: City Tax District: All in County Zoning District: COUNTY County Fire District: CLAREMONT RURAL Zoningt: R-20 Building(s) Value: $0 Zoning2: null Land Value: $10,300 Zoning3: null Assessed Total Value: $10,300 Zoning Overlay: WP-O Year Built/Remodeled: null/null Small Area: CATAWBA 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 #: 3710376100J Building Details 2010 Census Block: 2027 WaterShed: WS-IV Protected Area 2010 Census Tract: 011401 Voter Precinct: P5 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 from this map/report product or the use thereof by any person or entity. ©2016, Catawba County Government, North Carolina. All rights reserved. ?3x COO DSO kS; coxcpc 3 r&.P( 7\ Act to 1d(5. 1n5 s1510,m /Yvef. http://gis.catawbacountync.gov/nomap/parcel_report.php?key=376119724327&typ=P 5/16/2016 *�05569 CATAWBA COUNTY HEALTH DEPARTMENT �/ (704) 465-8270 Lot Eva?. X Improve. PermitX_Repair Permit_Cert. of Comp. Permit,X_Oper. Permit Owner/Agent K431Z&1 th Par kele Phone Address /1 Subdivision Section/Block/Pha - Lot# Lo Size Directions: JD .d - a it. ' . U. - S .Co 'R le / • ! U-( - - D • .t v 4z1.Y• 1 - a e CA"'- a y3Doo34t/ Facility: House_ Mobile HomeX Business_ . Other: Zoning Approval I /no # Multi-family_ Other . Tax Map # oR o AY- 44-/ - Bedrooms 3 Seats Employees . Application Rate/0, V GPD Flow 34D Hot Tub or Spa yes/6 Special Fixtures . 100% Repair Area yes/no REPAIR NOTICE: Basement yes Basement Plumbing yes/01-6) . REPAIRS MUST BE WITHIN 30 DAYS OR Water Supply: Private )C Public_ . DAYS FROM DATE OF PERMIT. Type of System: Trench x Bed Pump_Pump/Panel_Panel_LPP_Other Tank Size: Septic Tank 1000 Pump Tank Nitrification Field: Total Square Feet 9 p O0 Depth of Stone /27-14.642 Bed Size Trench Width 3 ARi. Total Length of All Trenches 300 Number of Trenches .3 i Individual Trench Length CCV /0D//00/ / Feet on Center 7 Maximum Trench Depth Distance of Nearest Well Lot Evaluation: Approved yes/no (Void After 24 months) Topo z % Slope Sketch of lot Eval ation Site - System Design Final Texture ��. i Structure Lif/ E ` •Clay Min. V V / u ( I a �SoiI l Wetness36 d ' ` I Soil Depth LfR " d J Q- Restric. Hoz. at3b " Available space e/no ' i Overall Class S PPS y U y I . ) I � 1� Comments: JJJ 0 -� � h eiB vs s(gr ll�e (r a b / N \\Deft/ A eece f ev cry P t / JD n\ s Ikd Vs,: hoK— � H Q \ no den � / Septic Tank Contractors lhGAeO MUST contact the I Sanitarian BEFORE I /3y changing permit. I l Street **NO GUARANTEE OR WARRANTY IS IMPLIED OR GIVEN THROUGH THE ISSUANCE OF THIS PERMIT** 7' g Permit Date ' /1 3 (Improveme.tt Pe,,ii voiq ter 60 months) Owner/Agent 4-/___ s__ t, • , Sanitaria 1!3 . F- ,'w Installed By • Pµ ti tau.- Date Li-W-93 Sanitarian /��=41W %-?7 .. . (Note ny changes/information in red or by sketch on bick" IF A PERMIT HAS TO BE REDESIGNED AND/OR RETRIPS MADE TO THE PROPERTY, w'ir IS AN ADDITIONAL $25 CHARGE. White-Office Blue-Bldg. Tnsn. Comn. Yellow-Owner/Agent Green-Bldg. Insn. I.P.