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HomeMy WebLinkAboutRBPR-06-2016-24071.TIF gTHIS IS NOT A PERMIT Case # RBPR-06-2016-24071 CATAWBA COUNTY HEALTH DEPARTMENT o , ' e't 0 NL?Sr C � g !' PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES 'Ire 842 SM Residential Building Plan Review - Building New a ra D 1 , IMPROVEMENT- AUTH CONST - D Contractor *MILLER BUILT HOMES, INC. (TODD MILLER),4168 L B PROPST DR, CONOVER NC 28613- B:8282568218 C:8283123081 F:8282563888 MILLERBUILTHOMES @CENTURYLINK.NET Owner DWIGHT FOWLER, 5577 BROOKWOOD LN, HICKORY NC 28602 NAME TO APPEAR ON PERMIT DWIGHT FOWLER SITE ADDRESS: 3210 RANT DRUM RD, MAIDEN NC 28650 PIN # 367804718198 NAME of SUBDIVISION: Lot# Section/Block PROPERTY SIZE: Square Feet Acres 7.5 DIRECTIONS: Hwy 16 S,turn right on Rant Drum Rd, property on Left PRIMARY CONTACT: Contractor SEWER TYPE: Septic Tank GALLONS PER DAY: 480 WATER SUPPLY: Private Well DESCRIBE WORK: New 4 bedroom single family 51'4 x 42'8 w/ partially finished basement 43x26 detached garage w/ unfinished bonus area. Existing well on the property. 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 Barn EXISTING STRUCTURES ON SITE(IF ANY) DIM EXISTING STRUCTURE: NUMBER OF EXISTING BEDROOMS: #OF OCCUPANTS: 3 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: House 51'4 x 4218&43x26 Detached Garage #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: E9-eliapplication 06/09/2016 17:00 Page 1 of 4 0 • CATAWBA COUNTY Case# RBPR-M6-2O16-24071 ,y Public Health Department Subdivision Icto Environmental Health Division PIN# 367804718198 PO Box 389, 100-A Southwest Blvd,Newton,NC 28658 18.2 SM NAME ON PERMIT: (DWIGHT FOWLER), 5577 BROOKWOOD LN, HICKORY NC 28602 ( DWIGHT FOWLER) Site Address: 3210 RANT DRUM RD, MAIDEN NC 28650 Property Size: Square Feet Acres 7.5 Directions: Hwy 16 S, turn right on Rant Drum Rd, property 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 fiFEENAME; igi I IIM!lIllU llhtIigi sLl � W tJJ�C L !� D�ATE'Gi'`t^ I IaFEEJAMOUNT« Authorization to Construct Fee (New/Expansion) 06/09/2016 $300.00 Fee Improvement Permit Fee 06/09/2016 $150.00 AU IIFEES 1!��illlrtIhiftipil:ifllilni -,,mi"n"1plli 1IIII➢1111 11 ""1111111IU rr'.r 111111IJIIII1115450. 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-ehapplicaurni 06/09/2016 17:00 Page 2 of 4 . $A • THIS IS NOT A PERMIT Case # RBPR-06-2016-24071 d n CATAWBA COUNTY HEALTH DEPARTMENT 017 oY EI ;!'` PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES 174-..c.ti'; t 1842 ss Residential Building Plan Review - Building New o' ' •a 'v3 :. • IMPROVEMENT - AUTH CONST •O' t .J _ .off: Contractor *MILLER BUILT HOMES, INC. (TODD MILLER), 4168 L B PROPST DR, CONOVER NC 28613- B:8282568218 C:8283123081F:8282563888 MILLERBUILTHOMES @CENTURYLINKNET Owner DWIGHT FOWLER, 5577 BROOKWOOD LN, HICKORY NC 28602 NAME TO APPEAR ON PERMIT DWIGHT FOWLER SITE ADDRESS: 3210 RANT DRUM RD, MAIDEN NC 28650 PIN # 367804718198 NAME of SUBDIVISION: Lot Section/Block PROPERTY SIZE: Square Feet Acres 7.5 DIRECTIONS: Hwy 16 S, turn right on Rant Drum Rd, property on Left PRIMARY CONTACT: Contractor SEWER TYPE: Septic Tank GALLONS PER DAY: 489, WATER SUPPLY: Private Well DESCRIBE WORK: New 4 bedroom single family, 480 gpd, 51'4x42'8, paritially finished basement, 43x26 detached garage w/ unfinished bonus area. 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 EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: NUMBER OF EXISTING BEDROOMS: #OF OCCUPANTS: 3 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 51'4 x 42'8 Single family&43x26 Detached Garage #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: • E9-ehapplication 06/09/2016 14:37 Page 1 of4 .fit. CATAWBACOUNTY Case# RBPR-06-2016-24071 • 1 i ,,,® Public Health Department Subdivision Lc fs®? Y Environmental Health Division PIN# 367804718198 PO Box 389. 100-A Southwest Blvd.Newton,NC 28658 /g 2 ,. NAME ON PERMIT: (DWIGHT FOWLER), 5577 BROOKWOOD LN, HICKORY NC 28602 ( DWIGHT FOWLER) Site Address: 3210 RANT DRUM RD, MAIDEN NC 28650 Property Size: Square Feet Acres 7.5 Directions: Hwy 16 S, turn right on Rant Drum Rd, property 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 cor.-ct. Authorized runty and state officials are granted right of entry to conduct cessa inspections to determine compliance with applicable laws an. les. I under d at I am solely responsible for the proper identification nd a n o II property lines and corners and making the site accessi.'- ..t ;I- o ite evaluation can be performed.r Date: / / /f) Signature of Applicant orAaent, ,j / - At An Environmental Health Specialist will contact you within 5 .rkina days of application date. If you need further information or assistance please call 828-466-7291 AREA1 **************************..»,..********************************************�*******�**��********�********* . „. FEENAME - DATE FEE AMOUNT Authorization to Construct Fee 06/09/2016 $300.00 (New/Expansion) Fee Improvement Permit Fee 06/09/2016 $150.00 TOTAL FEES '°;' $450.00 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 06/09/2016 14:37 Page 2 of 4 �+ it THIS IS NOT A PERMIT t`U�'A� 1 �� COUNTY n ° CATAWBA COUNTY HEALTH DEPARTMENT ...7Z,;77-.. Application for Environmental Services Page 1 Improvement Permit Authorization to Construct Septic Repair n Septic Malfunction El Septic Expansion ❑ New Well Permit❑ Rep acement Well ❑ Well Abandonment❑ Well Repair ❑ Existing System Inspection (Pre-Approval Required) ❑ Application is for New Construction Existing Facility Property Address SJ 10 Ad-Arum t. Subdivision 4 Alm ��(( Lot# Acres ii ectionBloc hase Driving Directions to Property r fl a G 1 a M/" IIMb D NAME TO APPEAR ON PERMIT? _ Owner ❑ Applicant Contractor Applicant Contact Information Name Address Phone Cell Phone 4 Name Owner Contact I formatirS I �l moil Address 21 ark 1C[ C. .,n . He K oy A` c.:2kwa.. Phone Cell Phone Contractor Contact Infor atio Name %A1 l I ler 7R U ; *nip-S 4j 1I . ll �i Address C.ak Prtt 1- Dr. CoraW' JYc-�C6& -i Phone -2_76 ,k' Cell Phone 3/.4• "iGk WHO WILL BE THE PRIMARY CONTACT? ❑ Owner E.%Applicant 14 Contractor Description of Existing Structures on Site )(0,(∎() # of Bedrooms *t Structure Dimensions # of Occupants Basement ❑ Yes ❑ No Basement Fixtures Q Yes 0 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 No Does the site contain any jurisdictional wetlands? 0 Yes No Does the site contain any existing wastewater systems? d Yes 9'i No Is any wastewater going to be generated on the site other than domestic sewage? IiisYes No Is the site subject to approval by any other public agency? 0 Yes No Are there any easements or right of ways on this property? Describe Existing water supply in use Individual Well E. Community Well ❑ Semi-Public Well El 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 * My C ArTA-v 7f p THIS IS NOT A PERMIT counut � CATAWBA COUNTY HEALTH DEPARTMENT „C e Application for Environmental Services Page 2 Proposed Facility Type (J n Primary Residence New Residence fA"�d��d�ition t 'Ryesidei e # of New Bedrooms *t ll Project Description /iey(/(.,t)A Y uV.DI'1 C 6r1 Structure Dimensions-S/10°X sign # Occupants .3 Basement Yes ❑ No Basement Fixtures Yes C2 No ❑ Accessory Structure(s) Describe _3 Cud• Q. # of New Bedrooms *.t if applicable Ni Structure Dimensions y 3 j� # of Occupants Accessory Dwelling Yes n No Plumbing ❑ Yes X No Describe Plumbing Needed si 1 Multi-Family Residence#Units #Bedrooms per Unit*j Total#Bedrooms *t Structure Dimensions Li 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 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 n Community Well Abandonment Type n Drilled n Bored n Dug n Unknown Well Repair Requested ❑ 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. **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 perform' / Signature of Owner or Agent ad" �� Date d/4 Printed Name of Owner or Agent Al; /kr Catawba County Environmental Health L 45.13 ilin 312.42 $ 255.30 co e3163 4 250. \ V e 3210 (246) A 4e Ill � SI 1 1 , 169) lit N 1 t II 4,,,, T.,in 4 i .II' J Parcel: 367804718198, 3210 RANT DRUM RD 1in=100ft MAIDEN, 28650 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 06/09/2016 Parcel Report Page 1 of 1 Parcel Report - Catawba County NC Parcel Information: Owner Information: Parcel ID: 367804718198 Owner: FOWLER DWIGHT DOUGLAS JR Parcel Address: 3210 RANT DRUM RD Owner2: FOWLER SHANNON MICHELLE City: MAIDEN, 28650 Address: 5577 BROOKWOOD LN LRK(REID): 5945 Address2: null Deed Book/Page: 3314/1290 City: HICKORY Subdivision: State/Zip: NC 28602-5507 Lots/Block: / Last Sale: School Information: School District: COUNTY Plat Book/Page: Elementary School: BALLS CREEK Legal: null Middle School: MILL CREEK Calculated Acreage: 7.500 Tax Map: 006 K 01020 High School: BANDYS Township: CALDWELL School Map State Road #: 1816 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: $1,000 Zoning2: Land Value: $65,200 Zoning3: Assessed Total Value: $66,200 Zoning Overlay: WP-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: 2007-09-05 Building Permits for this parcel. Firm Panel #: 3710367800J Building Details 2010 Census Block: 2026 WaterShed: WS-IV Protected Area 2010 Census Tract: 011501 Voter Precinct: P1 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/repod 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. Days Nail coRfoRict . } ? , 4c-bo LI Vc/1E1Y) qb0 91 ld�� http://gis.catawbacountync.gov/nomap/parcel_report.php?key=367804718198&typ=P 6/9/2016