HomeMy WebLinkAboutRBPR-06-2016-24149.TIF �F3A • THIS IS NOT A PERMIT Case # RBPR-06-2016-24149
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4 ,ro ., CATAWBA COUNTY HEALTH DEPARTMENT I i 0
'i° PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES V ti• 3�
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Residential Building Plan Review - Manufactured dome o
IMPROVEMENT - AUTH_CONST � P
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(1?a,V2d Yalta
Applicant JLANCE GREGORY, 2532 17TH AVE NE, HICKORY NC 28601
C:8282708745
Contractor CLAYTON HOMES (BOBBI *LASAGE), PO BOX 132, TAYLORSVILLE NC 28681
C:8282173168 JWHOLDER @HOTMAIL.COM
Owner MARCIE HUTCHINSON, 1426 32ND STREET CT NE, CONOVER NC 28613
C:828-270-8745
NAME TO APPEAR ON PERMIT
LANCE GREGORY
SITE ADDRESS: 2980 SPENCER RD NE, CONOVER NC 28613 PIN # 372319523493
NAME of SUBDIVISION: Lot# Section/Block
PROPERTY SIZE: Square Feet Acres 1.37
DIRECTIONS: Hwy 70 to Fairgrove Church Rd, Right onto Highland Ave NE, righ onto Spencer Rd NE, Property on Left
PRIMARY CONTACT: Contractor SEWER TYPE: Septic Tank
GALLONS PER DAY: 360 WATER SUPPLY: Public Water
DESCRIBE WORK: New DW 3 BdRm 28x76 w/ Decks: Front & Back 6x6
**HICKORY ZONING ON FILE**
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: Mobile Home OTHER DESCRIPTION:
DESCRIPTION OF Vacant Lot
EXISTING STRUCTURES
ON SITE (IF ANY)
DIM EXISTING STRUCTURE:
NUMBER OF EXISTING BEDROOMS: #OF OCCUPANTS: 2
PROPOSED CONSTRUCTION
NEW STRUCTURE DIM:: DW 28x76 w/Decks: F & B 6x6
#OF NEW BEDROOMS:: 3
Desired system types (Improvement Permit or Authorization to Construct):
ACCEPTED: ALTERNATIVE: CONVENTIONAL:
OTHER: INNOVATIVE: ANY: YES
Other described:
19-chapplicati„lI 06/22/2016 16:02 Page I o14
�v,� � CATAWBA COUNTY Cased RBPR-06-2016-2}149
.� (. �, Public Health Department Subdivision
Figopt Environmental llealth Division PINS!
44:7_,2 PO Box 389. 100-A Southwest Blvd, Newton. NC 28658 372319523493
NAME ON PERMIT: (LANCE GREGORY), 2532 17TH AVE NE, HICKORY NC 28601
( LANCE GREGORY)
Site Address: 2980 SPENCER RD NE, CONOVER NC 28613
Property Size: Square Feet Acres 1.37
Directions: Hwy 70 to Fairgrove Church Rd, Right onto Highland Ave NE, righ onto Spencer Rd NE, 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
AREA2
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; FEFNAME;u,1aa11 l�A .'_..., r. -'tii il�,,,.iIiI:i00ddIDATE imrr< FEEIAMOUNT,
Authorization to Construct Fee (New/Expansion) 06/22/2016 $150.00
Fee
Improvement Permit Fee 06/22/2016 5150.00
gtf;+ 117.11 l .. i Ii1,1PI.IfPII. li i . 1 1` 1jP 1
�I ,n,)i It1� � i1� TOTAL FEES � 7 � rrl i��I� !�ui y n Iji;,� VI � 5300.064
it 1a ihn,i L 011:0_I- 11
I
1 I it Na i u! ._..�.... .a'°..a?.,�iA!S i'!..:.r 1...::.i:.k..r-,dHtWiw. ...,414. .�6t! it..__.n1
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-rhapplicatiun 06/22/2016 16:02 Page 2 o14
.0Jk • THIS IS NOT A PERMIT Case # RBPR-06-2016-24149
CATAWBA COUNTY HEALTH DEPARTMENT ° I•'�''*'b
,t +` PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES ' 4 { ,
184" SM Residential Building Plan Review - Manufactured Hume �1 :
IMPROVEMENT- AUTH_CONST
Applicant LANCE GREGORY, 2532 17TH AVE NE, HICKORY NC 28601
C:8282708745
Contractor CLAYTON HOMES (BOBBI *LASAGE), PO BOX 132, TAYLORSVILLE NC 28681
C:8282I73I68 JWHOLDER @HOTMAIL.COM
Owner MARCIE HUTCHINSON, 1426 32ND STREET CT NE, CONOVER NC 28613
C:828-270=8745
NAME TO APPEAR ON PERMIT
LANCE GREGORY
SITE ADDRESS: 2980 SPENCER RD NE,CONOVER NC 28613 PIN # 372319523493
NAME of SUBDIVISION: Lot# Section/Block
PROPERTY SIZE: Square Feet Acres 1.37
DIRECTIONS: Hwy 70 to Fairgrove Church Rd, Right onto Highland Ave NE, righ onto Spencer Rd NE, Property on Left
PRIMARY CONTACT: Contractor SEWER TYPE: Septic Tank
GALLONS PER DAY: 360 WATER SUPPLY: Public Water
DESCRIBE WORK: New 28x76 Doublewide, 3 bedroom, 6x6 front porch and 6x6 back porch **HICKORY ZONING ON FILE**
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: Mobile Home OTHER DESCRIPTION:
DESCRIPTION OF none
EXISTING STRUCTURES
ON SITE(IF ANY)
DIM EXISTING STRUCTURE:
NUMBER OF EXISTING BEDROOMS: #OF OCCUPANTS: 2
PROPOSED CONSTRUCTION
NEW STRUCTURE DIM:: 28x76 Doublewide with Decks
#OF NEW BEDROOMS:: 3
Desired system types (Improvement Permit or Authorization to Construct):
ACCEPTED: ALTERNATIVE: CONVENTIONAL:
OTHER: INNOVATIVE: ANY: YES
Other described:
E9-chapplication 06/22/2016 13:27 Page 1 of4
zeta CATAWBACOUNTY Case# RBPR-06-2016-24149
,-�on , Public Health Department Subdivision
2 e . Environmental Health Division PIN# 372319523493
PO Box 389, 100-A Southwest Blvd,Newton,NC 28658
is 2 sm
NAME ON PERMIT: ( LANCE GREGORY),2532 17TH AVE NE, HICKORY NC 28601
( LANCE GREGORY)
Site Address: 2980 SPENCER RD NE, CONOVER NC 28613
Property Size: Square Feet Acres 1.37
Directions: Hwy 70 to Fairgrove Church Rd, Right onto Highland Ave NE, righ onto Spencer Rd NE, 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 .n. labelin. of all property lines and corners and making the site accessible o that complete site aluation can be performed.
Date: / • Signature of Applicant or Agent
An Env ron ental 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= _. _ 1
FEENAME h DATE „ FEE AMOUNT 1
Authorization to Construct Fee (New/Expansion) 06/22/2016 $150.00
Fee
Improvement Permit Fee 06/22/2016 $150.00
s; , TOTAL FEES ' S .. ii..,. . -i. - ,5300 00 -i'
4 ..M. .- ;;
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-chappl ication 06/22/2016 13'.27 Page 2 of 4
i; -( EM this IS NOT A PERMIT 3`7 Z 3 — 1952 -3� 19 3
o
roT;vrti• • _ CATAWBA C®UlITTYHEALTH DEPARTMEIeTT •
° . ., �-7 Application for Rnvironmental Services " Page 1
Improvement Permit A Authorization to Construct Septic Repair❑ Septic Malfunction❑
Septic Expansion ❑ New Well Permit❑Replacement Well ❑ Well Abandonment❑
Well Repair ❑ Existing System Inspection (Pre-Approval Required) ❑ "
'3fin Application is for New IConstruction I0 Existing Facility ❑
Property Address S eel-- Rd, I V E Subdivision {l t
(e Vf i-INC. GADI ) Lot# Ni IA Acres / A</Pi
. , Section/Block/Phase
'
Driving Directions to Property �q 7n To n le /cve (likaA/ n /z 00. R) R i g ri l--
On N140/aO4 Ave, N E . 1t ti5ii-f- 0AS� Spenceiefcp
t\l C — PRoPe,Cr l I S eroded n t -
NAME TO APPEAR ON PERMIT? I,k Owner ❑Applicant ❑ Contractor
Applicant ContactInformation
Name 0 a‘.)-17)11 -j-n c eS 4131 - a -in -eat-3 - ai-7-3/4,08
Address 1,-2- (p 0r>t-v -c2 P Iu-1 u) rrlrvsurfie 1.1c._28/0/3
Phone 623 _z-1'-"7--Nt_ Cell Phone E.-32p) . 244.04_O2 co f
Owner Contact Information
Name LAO Ce (� )f2L
Address a53a 1'7v ,AVE- Nc LI__Gl400 i' Mc 8/,ol .
Phone S a 3_07'70 _ 'r7z4s I Cell Phone
Contractor Contact Information
Name
Address
Phone Cell Phone
WHO WILL BE LEW PRIMARY CONTACT? ❑ Owner ' big; Applicant ❑ Contractor
Description of Existing Structures on Site Nil A. YYIpti le f
#of Bedrooms st Pir Structure Dimensions #of Occupants .-
Basement ❑Yes 15 No Basement Fixtures a Yes ONo
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.
El Yes No Does the site contain any jurisdictional wetlands?
r3 Yes No Does the site contain:any existing wastewater systems?
ID Yes p No Is any wastewater going to be generated on the site other than domestic sewage?
• Yes o Is the site subject to approval by any other public agency?
Yes r No • ' Are there any easements or right of ways on this property? Describe
Bxisdn water supply in use ❑ TnAividual Well ❑ Community Well ❑ Semi-Public Well
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 fl' Any
•
viTA THIS IS NOT A PERMIT
cr�urs CATAWBA COUNTY HEALTH DEPARTMENT
Application for Environmental Services Page 2 ,=- ���(
Proposed Facility Type �-t/"
❑ Primary Residence SINewResidence ❑ Addition�toResidence #of New Bedrooms *t i n)(�
Project Description �� ; (910C-7(o bctzb!eu)1c LQ, lSi
Structure Dimensions 0$X 7 Co #of Ocenp c
Basement ❑ Yes *No Basement Fixtures b Yes / No
•
❑ Accessory Structure(s) Describe
#of New Bedrooms*1.if applicable Structure Dimensions
#of Occupants Accessory Dwelling ❑Yes ❑No
Plumbing ❑Yes 0 N 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 Cl Drilled ❑ Bored ❑ Dug ❑ Unlmown
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 member of bedrooms will be confirmed by rooms identified on house plans as a bedroom at the time
of building permit issuance. This mayprevent the need for septic system size increase in the future.
fi 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 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 ofentryto conduct necessary inspections to determine compliance with applicable laws and-rates. I
understand that I am solely respon able for the proper identification and labeling of all property lb es and,°onus and making the site
accessible so that a complete site evaluation can be performed.
Signature of Owner or Ag-i ��1t�� Date lLJ
Printed Name of Owner or Agent a *AL CV •
Catawba County Environmental Health
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Parcel: 372319523493, CONOVER, 28613 1 in=80ft
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: 372319523493 Owner: HUTCHINSON MARCIE JEAN BEARD
Parcel Address: Owner2: null
City: CONOVER, 28613 Address: 1426 32ND ST COURT NE
LRK(REID): 55845 Address2: null
Deed Book/Page: 3200/0814 City: CONOVER
Subdivision: null State/Zip: NC 28613-8620
Lots/Block: null/null
Last Sale: $7,000 on 1977-07-01 School Information:
School District: COUNTY
Plat Book/Page:
Legal: SPENCER RD Elementary School: ST STEPHENS
Middle School: ARNDT
Calculated Acreage: 1.370
Tax Map: 164H 02018 High School: ST STEPHENS
Township: HICKORY
State Road #: 1441
Tax/Value Information: Tax Rates(pdf) Zoning Information:
City Tax District: All in County Zoning District: HICKORY
County Fire District: ST STEPHENS Zoningl: R-1
Building(s) Value: $0 Zoning2: null
Land Value: $18,700 Zoning3: null
Assessed Total Value: $18,700 Zoning Overlay: null
Year Built/Remodeled: null/null Small Area: null
Current Tax Bill Split Zoning Districts: null/null
Zoning Agency Phone Numbers
Miscellaneous: Firm Panel Date: 2007-09-05
Building Permits for this parcel. Firm Panel #: 3710372300J
Building Details 2010 Census Block: 2064
WaterShed: null 2010 Census Tract: 010304
Voter Precinct: P28 Agricultural District: Proximity
Parcel Report Data Descriptions
List all Owners Deed History Report Assessment Report
This map/report product was prepared from the Catawba County,NC Geospatial Information Services.Catawba County has made substantial efforts to ensure
the accuracy of location and labeling information contained on this map or data on this report.Catawba County promotes and recommends the independent
verification of any data contained on this map/report product by the user.The County of Catawba,its employees,agents,and personnel,disclaim,and shall not be
held table for any and all damages,loss or liability,whether direct,indirect or consequential which arises or may arise from this map/report product or the use
thereof by any person or entity.
Government,2016, Catawba County ernment, North Carolina. All rights reserved.
INN 1cidrs ` Z s c 2c .7?
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http://gis.catawbacountync.gov/nomap/parcel_report.php?key=3 723 1 95 23493&typ=P 6/22/2016
/A C� CATAWBA COUNTY
G 100A SOUTHWEST BLVD
ti # i 76. NEWTON,NORTH CAROLINA 28658 RECEIPT
at-
U ->-j{ PHONE: 828.465.8399
\\,../8$as Wednesday, June 22, 2016
��
42 sa, wmw.catawbacount}nc.gov
PAYOR: Clayton Homes
Clayton Homes(*Lasage, Bobbi)
PAYMENTS
TRANSACTION NUMBER: TRC-699319-22-06-2016
PAYMENT DATE : 06/22/2016
PAYMENT TYPE: Check 2568
INVOICE NUMBER FEE NAME FEE AMOUNT
06-16-329729 Authorization to Construct Fee 8150.00
(New/Expansion) Fee
06,:16329729 ` s °°'Jmproveme t Permit-Fee _ $150:OQ
TOTAL PAYMENTS : 8300.00
RBPR-06-2016-24149
CASE TYPE: Residential Building Plan Review WORK CLASS: Manufactured Home
SITE ADDRESS: 2980 SPENCER RD NE,CONOVER.NC 28613
Applicant LANCE GREGORY, 2532 17TH AVE NE,1-IICKORY NC 28601
C:8282708745
Owner MARCIE HUTCI-IINSON, 1426 32ND STREET CT NE, CONOVER NC 28613
C:828-270-8745
Contractor CLAYTON HOMES, PO BOX 132,TAYLORSVILLE NC 28681
C:8282173168 JWHOLDER @HOTMAIL.COM
**NO PEOPLESOFT ACCOUNT ASSIGNED **
receipt 06/22/2016 12:52 Page 1 of 1