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HomeMy WebLinkAboutRBPR-06-2016-24111.TIF ys$P® G THIS IS NOT A PERMIT Case # RBPR-06-2016-24111 �\ e® CATAWBA COUNTY HEALTH DEPARTMENT 0 PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES �r i 4 /842 sM Residential Building Plan Review - Building New 0 • p IMPROVEMENT- AUTH CONST o; Owner TRACY HOKE, 2355 BUSS DR, MAIDEN NC 28650 C:828-234-4571 NAME TO APPEAR ON PERMIT TRACY HOKE SITE ADDRESS: 2355 BUSS DR. MAIDEN NC 28650 PIN # 365802899441 NAME of SUBDIVISION: Lot It TR 2 Section/Block PROPERTY SIZE: Square Feet Acres 4.05 DIRECTIONS: Hwy 16 S, turn on Providence Mill Rd, 1/2 mi turn right on Buss, Go all the way down property at end of road PRIMARY CONTACT: Owner SEWER TYPE: Septic Tank GALLONS PER DAY: 360 WATER SUPPLY: Private Well DESCRIBE WORK: New 3 bedroom, Single Family Dwelling, 30x53 with 12x12 patio, 22x22 attached garage with no bonus room, no basement. Will be using existing well on lot. ** Existing Single-wide MUST be removed before House is Finalized per County Zoning" 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? Yes 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 " m FACILITY TYPE: Single Family Residence OTHER DESCRIPTION: DESCRIPTION OF Singlewide (must be removed when home complete) EXISTING STRUCTURES • ON SITE (IF ANY) DIM EXISTING STRUCTURE: 14x70 NUMBER OF EXISTING BEDROOMS: #OF OCCUPANTS: 3 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 30x53 house w/ 12x12 patio, 22x22 att. garage #OF NEW BEDROOMS:: 3 BASEMENT? No BASEMENT FIXTURES? No PLUMBING REQUIRED?Yes Desired system types (Improvement Permit or Authorization to Construct): ACCEPTED: ALTERNATIVE: CONVENTIONAL: OTHER: INNOVATIVE: ANY: YES Other described: E9-ehapplicanon 06/15/2016 15:44 Page 1 014 SBA . CATAWBA COUNTY Case# RBPR-06-20 1 6-24 1 1 1 w if iQy Public Health Department Subdivision . C i " Environmental Health Division :1, PIN# 365802899441 PO Box 389, 100-A Southwest Blvd, Newton.NC 28658 1842 SM NAME ON PERMIT: (TRACY HOKE),2355 BUSS DR, MAIDEN NC 28650 ( TRACY HOKE) Site Address: 2355 BUSS DR, MAIDEN NC 28650 Property Size: Square Feet Acres 4.05 Directions: Hwy 16 S, turn on Providence Mill Rd, 1/2 mi turn right on Buss, Go all the way down property at end of road 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 la eling of all property lines and corners and making the site accessible s• at a complete site evaluation can be performed. Date: CAA /6 Signature of Applicant or Agent — _ / An Environmental Health Specialist will contact you within 5 r 'ng • s of application date. If you need further information or assistance please call 828-466-7291 AREA1 SETBACKS: Exisit Singlewide MUST be removed before House is Finalized FEENAME' DATE FEE AMOUNT Authorization to Construct Fee (New/Expansion) 06/15/2016 5150.00 Fee Improvement Permit Fee 06/15/2016 $150.00 TOTAL FEES . ' - $300.00 , ■ 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-ehapplicarion 06/15/2016 15:44 Page 2 of 4 Ar�-� \ \ 1� THIS IS NOT A PERMIT COUNTY ` ' }�'� CATAWBA COUNTY HEALTH DEPARTMENT cou�r �� „,„„.�,�—,��e Application for Environmental Services Page 1 Improvement Permit Authorization to Construct Septic Repair n Septic Malfunction 1 Septic Expansion New Well Permit n Replacement Well ❑ Well Abandonment U Well Repair _ Existing System Inspection (Pre-Approval Required) ❑ Application is for New Construction Existing Facility n Property Address 9355 Bog Dr. Subdivision Ma. eti NC, cQk650 Lot ti Acres Section/Block/Phase c: r:nhr a+ In-For sec-di, on -ro Prci%dente ,4 Ii4 >?b V� Driving Directions to Property �(7 rare .--I NAME TO APPEAR ON PERMIT? O\rmer ❑ Applicant ❑ Contractor Applicant Contact Information r Name Address Phone I Cell Phone Owner Contact Information Name o r,i Nnc Address r�3 c /.3usi; f)n . mr;,'rie.n All' (911'656 Phone n 4 Cell Phone d&6 6)314- 457 1 Contractor Contact Information Name Address Phone Cell Phone WHO WILL BE THE PRIMARY CONTACT? (Owns Applicant n Contractor Description of Existing Structures on Site �\Jf am # of Bedrooms *j' Structure Dimensions #of Occupants Basement n Yes [ No Basement Fixtures CI Yes 0 No -- The Applicant shall notify the local health department upon submittal of this application if any of the following apply to the prope 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? )(Yes lNo Does the site contain any existing wastewater systems? ID Yes No Is any wastewater going to be generated on the site other than domestic sewage? ® Yes No Is the site subject to approval by any other public agency? 0 Yes b No Are th re 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 <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 " COUNTY,-� '—=�C CATAWBA COUNTY HEALTH DEPARTMENT No,„;;;;-„-, Application for Environmental Services Page 2 Proposed Facility Type El 7 Primary Residence New Residence U Addition to Residence # of New Bedrooms *j J Project Description New To�� r�cr u n All 61,U i a X17 Pn+ Structure Dimensions 3Q �13 c a c2J ft of Occupants 3 Basement [ Yes No Basement Fixtures 0 Yes 0 No Accessory Structure(s) Describe # of New Bedrooms *t if applicable Structure Dimensions #of Occupants Accessory Dwelling n Yes n No Plumbing n Yes n No Describe Plumbing Needed I Multi-Family Residence#Units #Bedrooms per Unit*t Total# Bedrooms *j Structure Dimensions n Food Service Specify Type # Seats Floor Space-Entire Food Service Facility (Sq Ft) #Employees per Shift #of Shifts Dining Area(Sq. Ft.) I 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 ❑ Individual Well n Semi-Public Well n Community Well Abandonment Type ❑ Drilled n Bored Li Dug ❑ Unknown Well Repair Requested n 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. j 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 or Agent 44,‘„,/,, Date 6/x//6 le Printed Name of Owner or Agent_ /�ake, Catawba County Environmental Health ‘ 41110o. I >> • N 'ilt -0) • �) k001 0,s 4.0 , , •. Qc , , • , . • ei 01 \ NN \ y9a • \ �abfl Z \ 1682 • tit'', 9' Parcel: 365802899441, 2355 BUSS DR MAIDEN, 1in=100ft 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 06/15/2016 Catawba County Environmental Health '''s8.so .P '5 Cp J 0 IQ K 1/ • ddb 0 O � n g" Lg 1 O t„. / Parcel: 365802899441, 2355 BUSS DR MAIDEN, 1in=60ft 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 06/15/2016 i Catawba County, North Carolina This map product was prepared from the Catawba County,NC,Geospafial 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 venfication of any data contained on this map product by the user.The County of Catawba,its employees,agents and • ti personnel disclaim,and shall not be held liable for any and all damages,loss or liability,whether direct,indirect or consequential which anses or may arise from this map product or the use thereof by any person or entity. I Selected Parcel Number: 3658-02-89-9441 1 inch = 150 feet Prepared for: El co- xu, -L?> 31.8 25.66A 14.13 14.29 16.33 11.03 23.05 15.93 32.08 ' 0.22 7432 h5) ',------ 12.99A ------\ 2735 • T'62`` 30, \ ' !'38 So •\n 4J. • i 's° 9441 '-k3?3 �ss�� �. 1 s ps ry,• Jd, 11 `-) a0 2 � PIat/40-1g6� op 2355/ c� L 9�' 2.81A 0260, �° I ' Plat 40-136 x2391 11.17A 22.30A u�j (� N N 18 8828 p 0 1200° 32� ° THIS IS NOT A LEGAL DOCUMENT Date Saved: 1/12/2016 Time: 3:09:19 PM Parcel Report Page 1 of 1 Parcel Report - Catawba County NC Parcel Information: Owner Information: Parcel ID: 365802899441 Owner: HOKE TRACY LEE Parcel Address: 2355 BUSS DR Owner2: null City: MAIDEN, 28650 Address: 2355 BUSS DR LRK(REID): 200426 Address2: null Deed Book/Page: 2035/0817 City: MAIDEN Subdivision: null State/Zip: NC 28650-8574 Lots/Block: TR 2/null School Information: Last Sale: School District: COUNTY Plat Book/Page: 40/136 Elementary School: TUTTLE Legal: LOT TR 2 TR2 PL40-136 2355 BUSS DR Middle School: MAIDEN PL 40-136 High School: MAIDEN Calculated Acreage: 4.050 School Map Tax Map: null Township: CALDWELL State Road #: null 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: $0 Zoning2: null Land Value: $25,000 Zoning3: null Assessed Total Value: $25,000 Zoning Overlay: null Year Built/Remodeled: null/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 #: 3710365800J Building Details 2010 Census Block: 1000 WaterShed: null 2010 Census Tract: 011601 Voter Precinct: P20 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 table 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. ©20 Catawba County Government, North Carolina. All rights reserved. Yvei\ e 0 o t * yap kios 30 , s- , `(L)(22 Rte 12x12 http://gis.catawbacountync.gov/nomap/parcel_report.php?key=365802899441&typ=P 6/15/2016