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HomeMy WebLinkAboutRBPR-06-2016-24150.TIF st3A CMG THIS IS NOT A PERMIT Case # RBPR-06-20 1 6-24 1 5 0 15 r. ¢ CATAWBA COUNTY HEALTH DEPARTMENT r+mnAll' v �''P PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES '?� r /842 5At Residential Building Plan Review - Modular a t' 'o b. IMPROVEMENT- AUTH_CONST ° � � r ' " Contractor LAYTON HOMES (BOBBI *LASAGE), PO BOX 132, TAYLORSVILLE NC 28681 C:8282173168 JWHOLDER/HOTMAIL.COM Owner MOHAMMAD RAHMAN,2065 21ST ST SE APT N, HICKORY NC 28602 C:828-217-3168 NAME TO APPEAR ON PERMIT MOHAMMAD RAHMAN SITE ADDRESS: 3177 SANDY FORD RD,NEWTON NC 28658 PIN # 371016835243 NAME of SUBDIVISION: Lot# Section/Block PROPERTY SIZE: Square Feet Acres - DIRECTIONS: Old Conover Startown Rd, right on Startown Rd, left on Sandy Ford Rd, PRIMARY CONTACT: Contractor SEWER TYPE: Septic Tank GALLONS PER DAY: 480 WATER SUPPLY: Public Water DESCRIBE WORK: New 4 BdRm Modular 32x76 w/ Decks: Front 8x26, Back 8x16 Future Pool 30x30 w/ Concrete Greenhouses/Business at the front of the property has an existing septic system. This new system will be for the modular only. 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: Single Family Residence OTHER DESCRIPTION: DESCRIPTION OF Greenhouses/Business EXISTING STRUCTURES ON SITE(IF ANY) DIM EXISTING STRUCTURE: NUMBER OF EXISTING BEDROOMS: #OF OCCUPANTS: 3 _ PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 32x76 Modular w/Decks: F 8x26, B 8x16 #OF NEW BEDROOMS:: 4 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-ehaprl icat„a 06/22/2016 15.13 Page 1 of 4 /c A CATAWBA COUNTY Case n RBPR-06-2016-24150 1 Public Health Department Subdivision ) ^<•1 Environmental Health Division PIN91 371016835243 PO Box 389, 100-A Southwest Blvd.Newton.NC 28658 g¢2 a NAME ON PERMIT: (MOHAMMAD RAHMAN), 2065 21ST ST SE APT N, HICKORY NC 28602 ( MOHAMMAD RAHMAN) Site Address: 3177 SANDY FORD RD, NEWTON NC 28658 Property Size: Square Feet Acres Directions: Old Conover Startown Rd, right on Startown Rd, left on Sandy Ford Rd, 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 Area 2 ***************S******************** ***k************SFr**************************************************** I llgl li wl III I III pli�r� 't i�i i� i. m.�J I.Lr,T 11�Ni' '1 h rl '14d 1I FEENAME I(! t Ui' DAT ■• FEF,AMOUNT Authorization to Construct Fee (New/Expansion) 06/22/2016 5300.00 Fee Improvement Permit Fee 1 06/22/2016 $150.00 Ill[(:j 1. 1'171 op i11 • 111 FII1 API UI IY 111 + 1r■ {I��I�j i11F))�'II�TO TAL FEES n III' 1� �i�llt d�IG 11�4h� �ll�ll! 'II1L11�c 5450 OO lslyp•N1IILI�kA'... _.IHa aY'•I w.A_u.!ln 1 ,121 � _ r.. .M1�_..!uhl.Itlllht!1'u'�7..1.__ 1•., htlllA ._. 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) 1/9-ehapplicauon 06/22/2016 15:13 Page 2 of 4 •AgA •G THIS IS NOT A PERMIT Case # RBPR-06-2016-24150 t4t ,.,H,� H CATAWBA COUNTY HEALTH DEPARTMENT ® `. ; b m ) � 9° �' PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES �r :ii.' Sit �v !� sM Y• •: k \84 Residential Building Plan Review - Modular �� IMPROVEMENT- AUTH CONST ��'' ''• m K •• Contractor CLAYTON HOMES (BOBBI *LASAGE), PO BOX 132, TAYLORSVILLE NC 28681 C:8282I73168 JWHOLDERnHOTMAIL.COM Owner MOHAMMAD RAHMAN, 2065 21ST ST SE APT N, HICKORY NC 28602 C:828-217-3168 NAME TO APPEAR ON PERMIT MOHAMMAD RAHMAN • SITE ADDRESS: 3177 SANDY FORD RD, NEWTON NC 28658 PIN # 371016835243 NAME of SUBDIVISION: Lot P Section/Block PROPERTY SIZE: Square Feet Acres . DIRECTIONS: Old Conover Startown Rd, right on Startown Rd, left on Sandy Ford Rd, PRIMARY CONTACT: Contractor SEWER TYPE: Septic Tank GALLONS PER DAY: 480 WATER SUPPLY: Public Water DESCRIBE WORK: New 32x76 Modular, 8x26 front porch and 8x16 deck porch, no basement, 30x30 area for future pool 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: Single Family Residence OTHER DESCRIPTION: DESCRIPTION OF Green House and Business EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: NUMBER OF EXISTING BEDROOMS: #OF OCCUPANTS: 3 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 32x76 Modular #OF NEW BEDROOMS:: 4 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-ehapplication 06/22/2016 13:00 Page 1 of 4 v,A • CATAWBA COUNTY Case it RBPR-06-2016-24150 •rr i n 2 Public Health Department Subdivision . • Q. — -i Environmental Health Division PIN# 371016835243 PO Box 389. 100-A Southwest Blvd. Newton,NC 28658 IS 2 w NAME ON PERMIT: (MOHAMMAD RAHMAN), 2065 21ST ST SE APT N, HICKORY NC 28602 ( MOHAMMAD RAHMAN) Site Address: 3177 SANDY FORD RD,NEWTON NC 28658 Property Size: Square Feet Acres Directions: Old Conover Startown Rd, right on Startown Rd, left on Sandy Ford Rd, 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 a • •ely responsible for the proper identification a d l-.e.n. o all property lines and corners and making the site accessible o that . ..r.fete site - . uation can be performed. Date: (J}n� (./ Signature of Applicant or Agent / n Env onmental Health Specialist will contact you within 5 working days of application date. If you need further information or assistance please call 828-466-7291 Area 2 FEENAME DATE FEE AMOUNT . Authorization to Construct Fee (New/Expansion) 06/22/2016 $300.00 Fee Improvement Permit Fee 06/22/2016 5150.00 TOTAL FEES S450.00 FEES ARE NON-REFUNDABLE ONCE A SITE VISIT IS MADE OR WORK ON A PLAN REVIEW I-IAS COMMENCED SYSTEM REDESIGN AND/OR RETRIP WILL INCUR AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) F_9-chuppl s:ation 06/22/2016 13:00 Page 2 of d eov`NT`Y ` ` ' CATAWBA COUNTY HEALTH DEPARTMENT ,,,„„ ; Application for Environmental Services Page 1 Improvement Permit V Authorization to Construct[ Septic Repair ❑ Septic Malfunction ❑ Septic Expansion ❑ New Well Permit C Replacement Well ❑ Well Abandonment❑ Well Repair [ Existing System Inspection (Pre-Approval Required) ❑ Application�i1s(for New Construction Existing Facility ❑ Property Address 3177 S (..( ' /� iv Subdivision fHP'.Ij _ J Lot# Acres S�e�c./t�ion/Block/Phase Driving Directions to Property /(J ZA & QhhS) ©/U' eiSYIl �/ s /L-7ZZ.DV'742 fu4' e, nF atfP S �ti led 7l,<-2,`, [e-F- in1 5A kroV 1 / Po9 A-r3177 NAME TO APPEAR ON PERMIT? 0 Owner ❑Applicant ❑ Contractor Applicant Contact Information- f !!!! Name Y V 10 k uri /Yl/t'-t>i� R po Vln'l ?xi Address -7 5corf`� L ' Rd N,eUJf Al Phone gee() - 3aa- ai i 39 Cell Phone Owner Contact Information `f Name 0 t6U,t /-hA/ vr-LeS #s/ Address / d b rry)n, c /lJ G „kid,' Phone 32 2 1 -) - 3 /spy Cell Phone (S)237 j 7 3,/Ic'S Contractor Contact Information Name License# Address Phone Cell Phone WHO WILL BE THE PRIMARY CONTACT? ❑ Owner ❑Applicant Contractor Description of Existing Structures on Site E -- it . —A2-4 # of Bedrooms *t Structu - Dimensions #of Occupants Basement ❑Yes s 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 'No Does the site contain any jurisdictional wetlands? ,Yes it 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? ❑Yes Io Is the site subject to approval by any other public agency? ❑Yes r _ro Are there any easements or right of ways on this property? Describe E ' 'i g water supply in use ❑ Individual Well ❑ Community Well El Semi-Public Well V County/City/Township Water Line Is a public water supply available? ** [ es ❑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 CATAT'6 BA THIS IS NOT A PERMIT : COUNTY „, emu---7. CATAWBA COUNTY HEALTH DEPARTMENT . S ` North c,;,--01,—,,;-..„ Application for Environmental Services Page 2_ _—�—'�( Proposed Facility Type E s0 AlPrimary Residence ] New Residence ❑ Addition to Residence #of New Bedrooms *t ep;l W Project Description 3 2X —7! a 1'`Cl X`li,llar Structure Dimensions 3 ay, 7 Go #of Occupants 5 Basement C Yes 0 No Basement Fixtures ❑ Yes k (No Accessory Structure(s) Describe 1 r 1 • t w lb , .X • (..) •l, 1_4 #of New Bedrooms *t if applicable Structure Dimensions #of Occupants Accessory Dwelling ❑ Yes ❑No Plumbing ❑Yes ❑No Describe Plumbing Needed ❑ Multi-Family Residence#Units #Bedrooms per Unit*t 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 ❑ Yes ❑No If Daycare Specify Occupancy Application for Well Construction/Abandonment/Repair Proposed Well Type ❑ Individual Well ❑ Semi-Public Well ❑ Community Well Abandonment Type ❑ Drilled ❑ 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 WITT,INCUR AN ADDITIONAL CHARGE (SPE 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 Age�I Date L/l�/i� Printed Name of Owner or Agent 2 ,, , 0 ` Catawba County Environmental Health • C - " g \ -• ' • • • 0 \ • I'1 4 nn o — — 43 A t. M ': O 379.62 C) A 91'!" • lc ‘3,611 Fri NA • 1 CO r \\ 910 �b �l� 611 B -�o� n 9 Nr 1 • 1 • • • N Al 4 All Rr. / - - _ 38. . ,, e ./ Parcel: 371016835243, 3177 SANDY FORD RD 1in=60ft NEWTON, 28658 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 06/22/2016 Catawba County Environmental Health Ili0 * c::::;) 1 , i Ar ("----C._ It Cr /► I \ s 90.0?..-'•rp•.- \ 2‘.\ • • 9 siimidit . . 1 I 67 .: 1/14 :1.! ..-• \ !iJtj/7/f*2 9iu \ \ ttiWI A �Ci .-- iiit t. Z` \ ' 940 \_ • za e,ss _ .I. \S. — 905 y • figicso I —y 1� . 5_ ^ J Parcel: 371016835243, 3177 SANDY FORD RD 1in=150ft NEWTON, 28658 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 06/14/2016 Parcel Report Page 1 of 1 Parcel Report - Catawba County NC Parcel Information: Owner Information: Parcel ID: 371016835243 Owner: RAHMAN MOHAMMAD ZIAUR Parcel Address: 3177 SANDY FORD RD Owner2: RAHMAN FARISHA City: NEWTON, 28658 Address: 2065 21ST ST SE APT N LRK(REID): 92014 Address2: null Deed Book/Page: 3340/1669 City: HICKORY Subdivision: null State/Zip: NC 28602-3588 Lots/Block: PT 2/ null Last Sale: School Information: Plat Book/Page: 39/31 School District: COUNTY Legal: LOT 2 PL 39-31 Elementary School: BLACKBURN Middle School: JACOBS FORK Calculated Acreage: 4.850 Tax Map: 049N 01005E High School: FRED T FOARD Township: NEWTON School Map State Road #: 1143 Tax/Value Information: Tax Rates(pdf) Zoning Information: City Tax District: All in County Zoning District: COUNTY County Fire District: NEWTON Zoningl: R-20 RURAL/HICKORY RURAL Zoning2: null Building(s) Value: $22,500 Zoning3: null Land Value: $39,400 Zoning Overlay: Assessed Total Value: $61,900 Small Area: STARTOWN Year Built/Remodeled: null/null Split Zoning Districts: null/null Current Tax Bill Zoning Agency Phone Numbers Miscellaneous: Firm Panel Date: 2007-09-05 Building Permits for this parcel. Firm Panel #: 3710371000J Building Details 2010 Census Block: 2022 WaterShed: null 2010 Census Tract: 011701 Voter Precinct: P34 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. S -mot ■(,,S . 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