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HomeMy WebLinkAboutRBPR-06-2016-24153.TIF THIS IS NOT A PERMIT Case # RBPR-06-2016-24153 <� GG CATAWBA COUNTY HEALTH DEPARTMENT 0 • fi �` 0 cir x11„” PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES ti ' a 1842 541 Residential Building Plan Review - Manufactured Hume d IMPROVEMENT PA Ya, lip '. o., . . ,. Contractor CLAYTON HOMES (BOBBI *LASAGE), PO BOX 132, TAYLORSVILLE NC 28681 C:8282173168 JWHOLDER @HOTMAIL.COM Owner DOLLY PARLIER, 1484 DICKINSON RD, HICKORY NC 28602-9000 NAME TO APPEAR ON PERMIT DOLLY PARLIER SITE ADDRESS: 1490 DICKINSON RD, HICKORY NC 28602 PIN # 279007586472 NAME of SUBDIVISION: Lot# Section/Block PROPERTY SIZE: Square Feet Acres 44.04 DIRECTIONS: Hwy 10 W to Hwy 127 N, right on Dickinson Rd, go to the end, singlewide on left PRIMARY CONTACT: Contractor SEWER TYPE: Septic Tank GALLONS PER DAY: 360 WATER SUPPLY: Private Well DESCRIBE WORK: Change out- SW 3 BdRM 16x72 w/ Decks: Front & Back 6x6 There are 3 trailers & 1 house on the property. Owner has advised that all homes have their own septics. 1 well on property that all homes share. **Home must meet Appearance criteria: Screen or Remove Towing Tongue, Front Deck must be minimum of 36 sf, home must be masonry underpinned (can use vinyl if singlewide). Home must be parallel to the road and must face front of property. If this new home is replacement for an existing occupied home- that existing home must be removed from site within 30days of the issuance of the Certificate of Compliance** 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 SW to be removed EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: 14x68 NUMBER OF EXISTING BEDROOMS: 3 #OF OCCUPANTS: 2 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: SW 16x72 w/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: H)-ehmpplicaiiun 06/22/20 t6 15•30 Page I of4 _s CATAWBA COUNTY Case RBPR-06-2016-24153 Public Health Department Subdivision ,^ Environmental Health Division PIN# 279007586472 `•aW PO Box 389. 100-A Southwest Blvd,Newton,NC 28658 18.2 9 NAME ON PERMIT: ( DOLLY PARLIER), 1484 DICKINSON RD, HICKORY NC 28602-9000 ( DOLLY PARLIER) Site Address: 1490 DICKINSON RD, HICKORY NC 28602 Property Size: Square Feet Acres 44.04 Directions: Hwy 10 W to Hwy 127 N, right on Dickinson Rd, go to the end, singlewide 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. I f you need further information or assistance please call 828-466-7291 AREA2 7 lint n't hIa ��ii 1e II 1 1:p IiII 1 i �4 1i1 1'9 i{I`�i �t jai I U iaFEENAME - i�.1�a�.�l9�tw�.!J9-ll i�iuiY),dw,). _ .�,�t�Illlh���f1����edI:DATEhI"1rdl, I FEE;4'MOUNT Improvement Permit Fee 06/22/2016 $150.00 °fl i1 iipil(i 11 ��)... 1'( 1'A LIEEES rhrlllniil00; 111j1lryn 1111 IM1111 al Iylt ��1 y� 'l i 111n1�1111 i1 I 11 1111 .��n11! i l�lii �a��a�l�f i1 D-1�Yi� S l$U 0014 { (II����ru.l 116d'L.i iu _..!... hl.�ir` .�,1.W�Ilillu4.,' ..�..1u.a:LaHt1111L��._.NIILLILIe_:__• 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) 19-ellapplicauon 06/22/2016 15:30 Page 2 of 4 ti 4$A • THIS IS NOT A PERMIT Case # RBPR-06-2016-24153 ql.: ti CATAWBA COUNTY HEALTH DEPARTMENT F� u , r ��t PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES i IS 2 su+ Residential Building Plan Review - Manufactured Home a% IMPROVEMENT , LW,n• j Contractor CLAYTON HOMES (BOBBI *LASAGE), PO BOX 132, TAYLORSVILLE NC 28681 C:8282173168 J WHOLDER @ HOTMAIL.COM Owner DOLLY PARLIER, 1484 DICKINSON RD, HICKORY NC 28602-9000 NAME TO APPEAR ON PERMIT DOLLY PARLIER SITE ADDRESS: 1490 DICKINSON RD, HICKORY NC 28602 PIN # 279007586472 NAME of SUBDIVISION: Lot# Section/Block PROPERTY SIZE: Square Feet Acres 44.04 DIRECTIONS: Hwy 10 W to Hwy 127 N, right on Dickinson Rd, go to the end, singlewide on left PRIMARY CONTACT: Contractor SEWER TYPE: Septic Tank GALLONS PER DAY: 360 WATER SUPPLY: Private Well DESCRIBE WORK: 16x72 singlewide, 3 bedroom, 6x6 front porch and 6x6 back porch 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 Singlewide EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: 14x68 NUMBER OF EXISTING BEDROOMS: 3 #OF OCCUPANTS: 2 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 16x72 singlewide #OF NEW BEDROOMS:: 3 Desired system types (Improvement Permit or Authorization to Construct): ACCEPTED: ALTERNATIVE: CONVENTIONAL: OTHER: INNOVATIVE: ANY: YES Other described: E9-chappllcation 06/22/2016 13:22 Page 1 of 4 ,yv,A CATAWBA COUNTY Case# RBPR-06-2016-24153 • ,C i.ra , , Public Health Department Subdivision d „ �f -1-1/ Environmental Health Division PIN# 279007580472 ' • `43- PO Box 389, 100-A Southwest Blvd.Newton,NC 28658 18.2 s. NAME ON PERMIT: (DOLLY PARLIER), 1484 DICKINSON RD, HICKORY NC 28602-9000 ( DOLLY PARLIER) Site Address: 1490 DICKINSON RD, HICKORY NC 28602 Property Size: Square Feet Acres 44.04 Directions: Hwy 10 W to Hwy 127 N, right on Dickinson Rd, go to the end, singlewide 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 an la elfin of I property lines and corners and making the site accessible so th complete site evaluation can be performed. Date: CV/ L Signature of Applicant or Agent An E vironmental 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 i ,FEENAME? "3 tfhd ∎DATE FEEAMOUNT Improvement Permit Fee 06/22/2016 $150.00 TOTAL EEES $I50 00a � FEES ARE NON-REFUNDABLE ���� ONCE A SITE VISIT 1S MADE OR WORK ON A PLAN REVIEW HAS COMMENCED SYSTEM REDESIGN AND/OR RETRIP WILL INCUR AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) E9-chapplication 06/22/2016 13:22 Page 2 of4 PHIS IS NOT A PERMIT uNn-v . - CATAWBA COUNTY HEALTH DEPARTMENT JT- Application for Environmental Services Page 1 Improvement Permit.] Authorization to Construct❑ Septic Repair❑ Septic Malfunction❑ Septic Expansion ❑ New Well Permit El Replacement Well ❑ Well Abandonment❑ Well Repair ❑ Existing System Inspection (Pre-Approval Required) ❑ Application is for New Construction ❑ Existing Facility Property Address 1410 DICKItiSON.1 RA. Subdivision /J/4 ► : -P, Lot# MM((/k Acres • Section/Block/Phase Driving Directions to Property -� ( ! At 12) H411 1 a7 nil - AL2/v bAit D Cci<IAL 5Ot 12-4n co -ft) 'tine_ eYld Stns lewiato It s ON -j Le-E f (= • • rim n�t#L-caN w e LStn9{P�.�7d L) NAME TO APPEAR ON PERMIT? i A Owner ❑Applicant ❑ Contractor Applicant Contact Information Name U1oty- it -tFnres ti &''t'b i 3t a 12- 3710 8 Address 12 Oncw - ' f ta IN 0,MC_S1le,c N7. 2,,k t ) Phone 42M-212-31671 1 Cell Phone#(t4 Owner Contact Information Name/Alga rnsKu Address )14010 DiCKiNSDN Rol cX4' '1 A/c a$PO Phone 3 Z i 2 3$ O5t J g Cell Phone NiA Contractor Contact Information Name Address • Phone Cell Phone WHO WILL BE 11.11E PRIMARY CONTACT? ❑ Owner ■.'4 Applicant . ❑ Contractor Description of Existing Structures on Site 14 X LP EILS. rflttM CAl " ' #of Bedrooms *j' 3 Structure Dimensions ( )46, S # f Occupants c . Basement ❑-Yes t'1 No Basement Fixtures Yes ty, 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 IONo Does the site contain any existing wastewater systems? Yes PX1 No Is any.wastewater going to be generated on the site other than domestic sewage? es o Is the site subject to approval by any other public agency? in Yes I-. No Are there any easements or right of ways on this property? Describe Existing water supply in use Individual Well ❑ Community Well ❑ Semi-Public Well ❑ County/City/Township ater Line Is a public water supply available? ** ❑ Yes XNo 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) 'S-n U ID Accepted ❑A tmve ❑ Conventional 0 Innovative ❑ Other Any i ou A THIS IS NOT A PERMIT � +s wry'. ---,--. CATAWBA COUNTY HEALTH DEPARTMENT „,"--; Application for Environmental Services Page 2 1 (p)c0 Proposed Facility Type i l (-e gPrimary Residence YY New Residence ❑ Addition to Residence #of New Bedrooms *t 3 Project Description tie- 6k! Sin5tos.i at_ - Rep 14-02. txyArei.1 skto JAN dlu Structure Dimensions u "73. #of Occupants o2 Basement ❑Yes ' No ;Basement Fixtures Yes , No A II Accessory Structure(s)' Describe . #of New Bedrooms *t if applicable Structure Dimensions #.of Occupants . Accessory Dwelling ❑Yes ❑No ' Plumbing Dyes ❑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 1. . . `#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 plane as a bedroom at the time of building permit issuance. This may prevent the need for septic system size increase in the firizre. 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 WIT,T,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 maybe revoked if the information on this application, site plans dr 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 nerresary inspections to determine compliance with applicable laws andrules. I understand that I am solely responsible for the proper identification and labeling of all property•liries and comers and making the site accessible so that a complete site evaluation ran be perfun.ued Signature of Owner or Agent IOW � Z Date 16/ Printed Name of Owner or Agent LIIMsee if Catawba County Environmental Health --\ • \4 70 ii: NN-NN, T. 18 1045 <� nII -------.----------i GO N Ns:. 7& t,ii;,Q`' Voao 11) 14111114I IS_ • 7 ..07 To 0.5. 'oos / 1010, Parcel: 279007586472, 1484 DICKINSON RD 1in=80ft HICKORY, 28602 • 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 . --.....__________, -1/2,.N......,:.„:„...: 2 ) 39I I X301 1: tf O�■ t N0 �, ,� 'PA colS 18 (7) I, i .. I ile SI. o`' ,So 7,6.0 . ,,..<-7.-------7),. . __ ... Parcel: 279007586472, 1484 DICKINSON RD 1in=100ft HICKORY, 28602 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 r . abg . 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I ,,,,,,,,...., „,„,.\\ .., , ..„, _ t . ,, o . , ,,,,,, . ,.: , .. „.....,. , ,,, „ ., , . ,, ,.... • 0.,.. ., --sv :1117"-- .4.7 .ATCZI".41434-74r is ' 7" s\;,,,k'it \ ......%r Ili •morjr ,•s, a I of% r•Is Irolymp c1/2 . ..rif„. s t i p GLENVIEW OR 'i _el _ I , A.6.-ki's ILO feir.0; tPAPIII ■•,4000 - RP .�,� �E +yam~ Parcel: 279007586472, 1484 DICKINSON RD 1in=400ft HICKORY, 28602 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 Parcel Report Page 1 of 1 Parcel Report - Catawba County NC Parcel Information: • Owner Information: Parcel ID: 279007586472 Owner: PARLIER DOLLY WHITENER Parcel Address: 1484 DICKINSON RD Owner2: null City: HICKORY, 28602 Address: 1484 DICKINSON RD LRK(REID): 59362 Address2: null Deed Book/Page: 1349/0543 City: HICKORY Subdivision: null State/Zip: NC 28602-9000 Lots/Block: null/ null Last Sale: School Information: School District: COUNTY Plat Book/Page: Legal: 1484 DICKINSON RD Elementary School: MOUNTAIN VIEW Middle School: JACOBS FORK Calculated Acreage: 44.040 Tax Map: 175H 03046 High School: FRED T FOARD Township: HICKORY School Map State Road #: 1130 Tax/Value Information: Tax Rates(pdf) Zoning Information: City Tax District: All in County Zoning District: COUNTY County Fire District: MOUNTAIN VIEW Zoningl: R-20 Building(s) Value: $63,600 Zoning2: null Land Value: $241,200 Zoning3: null Assessed Total Value: $304,800 Zoning Overlay: WP-O Year Built/Remodeled: 1959/null Small Area: MOUNTAIN VIEW 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 #: 3710279000J Building Details 2010 Census Block: 2000 WaterShed: WS-III Protected Area 2010 Census Tract: 011801 Voter Precinct: P24 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. II ©2016, Catawba County Government, North Carolina. All rights reserved. 1�0 ?ilYCk\eiS Hme. S- r !t R \SCE2 ?I-Wm 0 c, ac k J. t SO rS *SiSQ ciik i-C►���,hc sA H S Q,i (;� r Tyr http://gis.catawbacountync.gov/nomap/parcel_report.php?key=279007586472&typ=P 6/22/201