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HomeMy WebLinkAboutRBPR-06-2016-24148.TIF .�Y3A - THIS IS NOT A PERMIT Case # RBPR-06-20 1 6-241 4 8 /� ga O ..i•,-�•r 4 ° °� "j CATAWBA COUNTY HEALTH DEPARTMENT -'0 Vea PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES 842 set Residential Building Plan Review - Manufactured Home o �r. • �, IMPROVEMENT t�;T '. }.. 122A0d J(QLjii - K� Contractor CLAYTON HOMES (BOBBI *LASAGE), PO BOX 132, TAYLORSVILLE NC 28681 C:8282173168 JWHOLDER @HOTMAIL.COM Owner RAFAEL PEREZ, 1773 RING TAIL RD, CLAREMONT NC 28610 C:828-244-2856 NAME TO APPEAR ON PERMIT RAFAEL PEREZ SITE ADDRESS: 1757 RING TAIL RD, CLAREMONT NC 28610 PIN # 376003420474 NAME of SUBDIVISION: WILSON PARK Lot H 4 Section/Block PROPERTY SIZE: Square Feet Acres 0.61 DIRECTIONS: Hwy 10 East, right on Ringtail Rd, lot all the way down on right. (almost to Love Rd) PRIMARY CONTACT: Contractor SEWER TYPE: Septic Tank GALLONS PER DAY: 240 WATER SUPPLY: Private Well DESCRIBE WORK: New SW 2 BdRm 16x76 w/ Decks: Front & Back 6x6 "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 30 days 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 Camper (to be removed) EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: 12x36 NUMBER OF EXISTING BEDROOMS: 2 #OF OCCUPANTS: 2 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: SW 16x76 w/Decks: Front& Back 6x6 #OF NEW BEDROOMS:: 2 Desired system types (Improvement Permit or Authorization to Construct): ACCEPTED: ALTERNATIVE: CONVENTIONAL: OTHER: INNOVATIVE: ANY: YES Other described: P9-ehapplication 06/22/2016 15:57 Page I o14 CATAWBA COUNTY Case# RBPR-06-2 0 1 6-24 1 4 8 rim� Public Health Department Subdivision WILSON WILSkij Environmental Health Division PIN# 376003420474 PO Box 389, 100-A Southwest Blvd.Newton.NC 28658 ig42 s+. NAME ON PERMIT: (RAFAEL PEREZ), 1773 RING TAIL RD, CLAREMONT NC 28610 ( RAFAEL PEREZ) Site Address: 1757 RING TAIL RD, CLAREMONT NC 28610 Property Size: Square Feet Acres 0.61 Directions: Hwy 10 East, right on Ringtail Rd, lot all the way down on right. (almost to Love 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 AREA1 ' r` I �..... iIw FEENAME •_ I _ DATE ''I IIFEEIAMOUNT • Improvement Permit Fee 06/22/2016 $150.00 h�%51+l�lgfllr IOTA Li,FE ES �i! l,i;}, il� + tl 1a ��I IIII d!f 515000;° 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) 1d`J-ehrippl ication 06/22/2016 15'.57 Page 2 of 4 4A •C- THIS IS NOT A PERMIT Case # RBPR-06-2016-24148 7, rain a CATAWBA COUNTY HEALTH DEPARTMENT °� ^ 7�' ^i /-+ate!° PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES •Wt.::ti 842 su Residential Building Plan Review - Manufactured Home el 1 IMPROVEMENT ' ''' k Contractor CLAYTON HOMES (BOBBI *LASAGE), PO BOX 132, TAYLORSVILLE NC 28681 C:8282173168 JWHOLDERaHOTMAIL.COM Owner RAFAEL PEREZ, 1773 RING TAIL RD, CLAREMONT NC 28610 C:828-244-2856 NAME TO APPEAR ON PERMIT --RAFAEL PEREZ SITE ADDRESS: 1757 RING TAIL RD, CLAREMONT NC 28610 PIN # 376003420474 NAME of SUBDIVISION: WILSON PARK Lot 4 Section/Block PROPERTY SIZE: Square Feet Acres 0.61 DIRECTIONS: Hwy 10 East, right on Ringtail Rd, lot all the way down on right. (almost to Love Rd) PRIMARY CONTACT: Contractor SEWER TYPE: Septic Tank GALLONS PER DAY: 240 WATER SUPPLY: Private Well DESCRIBE WORK: New Singlewide mobile home, 16x76, 2 bedroom, 6x6 front porch and 6x6 back deck. **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 30 days 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 Camper (to be removed) EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: 12x36 NUMBER OF EXISTING BEDROOMS: 2 #OF OCCUPANTS: 2 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 16x76 Singlewide #OF NEW BEDROOMS:: 2 Desired system types(Improvement Permit or Authorization to Construct): ACCEPTED: ALTERNATIVE: CONVENTIONAL: OTHER: INNOVATIVE: ANY: YES Other described: E9-chapplication 06/22/2016 12:58 Page 1 of 4 ,A ---ip\ CATAWBA COUNTY Case# RBPR-06-2016-24148 6TA Gy Public Health Department Subdivision WILSON PARK d ® ,-5' Environmental Health Division PIN# 376003420474 sgz PO Box 389, 100-A Southwest Blvd.Newton.NC 28658 NAME ON PERMIT: (RAFAEL PEREZ), 1773 RING TAIL RD, CLAREMONT NC 28610 ( RAFAEL PEREZ) Site Address: 1757 RING"PAIL RD, CLAREMONT NC 28610 Property Size: Square Feet Acres 0.61 Directions: Hwy 10 East, right on Ringtail Rd, lot all the way down on right. (almost to Love 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 lab li g of all property lines and corners and making the site accessible so that a complete site evaluation can be performed. Date: J/e Signature of Applicant orAeent �a _ An nvironmental Health Specialist will contact you within working says of application date. If you need further information or assistance please call 828-466-7291 AREA1 *******s**..*********************......*************x*******a....+***a******a******************sss*.*raaxr.r :7---.7:.-... _,., REENAME DATE FEE AMOUNT t= Improvement Permit Fee 06/22/2016 $150.00 TOTAL FEES r'. ,4' t. $150.00 I 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(cation 06/22/2016 12:58 Page 2 of 4 c ` I +. ': " r _ THIS IS NOT A PERMIT inaty CATAWBA COUNTY HEALTH DEPARTMENT t;.• Application for Environmental Services Page 1 Improvement PermitX Authorization to Construe.( Septic Repair❑ Septic Malfunction❑ Septic Expansion ❑ New Well Permit❑ Replacement Well ❑ Well Abandonment❑ Well Repair ❑ Existing System Inspection(Pre-Approval Required) ❑ Application is for New Construction ❑ Existing Facility ❑ Property Address 95 / Rlr1gla.IL. RD. Subdivision Pu/A pla12eWtJM4-, MG agenlf Lot# NIL: Acres ktbPxHCOP' Sectio lock/Phase (IIA4 Driving Directions to Property MAIL ID EASY 7V r157 13 Al I 'the - Loa y LItta..1rl o rt1tz i21"91-1-1-64,1most'-tb A)VG RD) NAME TO'APPEAR ON PERMIT? Owner ❑Applicant ❑ Contractor Applicant Contact Information N a m e (p� -� �(�y�5 ;+ 4 �l _^ 2i - 82e-2n -3l Cos Address G� 3o e OrWeae. 131 LAA ,_rsrncverz. N C 28(013 Phone 8215-71-I-31Get:\ Cell Phone e2S 7-31 eaa Owner Contact Information N a m e I/'1eineili( L U I I OM 5 Address 1157 RIn iWL Rd .-ftlavernon+. Nr ag/o4D Phone x2.53- D LILT Cell Phone N Contractor Contact Information IName Address Phone I Cell Phone WHO WILL BE TEE PRIMARY CONTACT? ❑ Owner MApplicant ❑ Contractor Description of Existing Structures on Site COY) t...) #of Bedrooms *t a. Structure Dimensions I 2 310 #of Occupants L Basement ❑Yes rgi No Basement Fixtures CI Yes dc, No The Applicant shall notify the local health department upon submittal of thic 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 gNo Does the site contain any jurisdictional wetlands? AYes ®No Does the site contain any existing wastewater systems? fl Yes M 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? &3 Yes No Are there any easements or right of ways on this property? Describe • Existing water supply in use Al individual 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) �X 1 Sf 1�C7 ❑Accepted ❑Alternative ❑ Conventional ❑Innovative ❑ Other Any • 0 la THIS IS NOT A PERMIT a..-ausr3• .— CATAWBA COUNTY WEALTH DEPARTMENT MCIY3 _ ; Application for Environmental Services Page 2 Pr posed Facility Type �) Primary Residence 14 New Residence ❑ Addition to Residence #of New Bedrooms *t �' �x L Project Description Perrarcet, C'A}yy X24 ftiace .e/ 11.9X71-9 Structure Dimensions I(0)(-1 (Q #of Occupants e1— Basement ❑ Yes 51.,i No Basement Fixtures Yes a' No ❑ AccessoryiStructure(s) Describe _, #of New Bedrooms *t if applicable Structure Dimensions #.ofOccupants •Accessory Dwelling ❑Yes. No - Plumbing ❑ Yes ❑No Describe Plumbing Needed ❑ Multi-Family Residence#Units_ #Bedrooms per Unit Total#Bedrooms *t Structure Dimensions ❑ Food Service Specify Type #Seats Floor Space-Entire Food Service Facility (Sq Ft) #Employees per Shift . . . #,of Shifts. . Dining Area(Sq.-FL) ❑ Business Specific Type of Business Retnil 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 El 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 byrooms 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 SYS'T'EM 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 maybe 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 necessary inspections to determine compliance with applicable laws andrures. I understand that I am solely responsible for the proper identification and labeling of all property-Imes and comers and malting the site arressible so that a complete site evaluation can be.pL fisted I-�/� Signature of Owner or Agent �!' Date (Di 1 A0) 1 Printed Name of Owner or Agent C. ' 1 alk / q p Catawba County Environmental Health • - 111\- : , 95.00 __. *$ --- `, 15.u0 • 110.00 -D A it... .. . . . 42 80 et 110.00 • 236.70 t 1 • . l . / 100.00 233.E 116 II . . 'It 117.66 Parcel: 376003420474, 1757 RING TAIL RD 1 in=50ft CLAREMONT, 28610 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: 376003420474 Owner: PEREZ RAFAEL HERNANDEZ Parcel Address: 1757 RING TAIL RD Owner2: MARTEZ EULALIA CHAVEZ City: CLAREMONT, 28610 Address: 1773 RING TAIL RD LRK(REID): 24124 Address2: null Deed Book/Page: 3244/1198 City: CLAREMONT Subdivision: WILSON PARK State/Zip: NC 28610-8251 Lots/Block: 4/ null Last Sale: $11,500 on 2014-06-13 School Information: Plat Book/Page: 17/199 School District: COUNTY Legal: LOT 4 WILSON PK PLAT 17-199 Elementary School: BALLS CREEK Middle School: MILL CREEK Calculated Acreage: .610 Tax Map: 025 Y 03036K High School: BANDYS School Map Township: CATAWBA State Road #: 1808 Tax/Value Information: Tax Rates(pdf) Zoning Information: City Tax District: All in County Zoning District: COUNTY County Fire District: BANDYS Zoningl: R-30 Building(s) Value: $0 Zoning2: null Land Value: $11,100 Zoning3: null Assessed Total Value: $11,100 Zoning Overlay: DWMH-O,WP-O 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 #: 3710376000J Building Details 2010 Census Block: 3002 Watershed: WS-IV Protected Area 2010 Census Tract: 011402 Voter Precinct: P5 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. ©2016, Catawba County Government, North Carolina. All rights reserved. TIP 15D Zlem Z (de3 http://gis.catawbacountync.gov/nomap/parcel_report.php?key=376003420474&typ=P 6/22/2016 2-06 **tOp. Permit and/or Cert. Op. Required (Must be completed prior to final) 9,4 Q . ' CATA.WES A COUNTY PIEALTH DEPA Ft.'I'MENT • c704) 465-8270 42, Lot Eval. Improve. Permit pair Permit Cert. of Comp. Permit C---Oper. Permit Owner/Agent RQcII1QV D, Q k I / Fo�SlAro1 Pfr,b,.. Phone 445— 7ti E-1- Address 7f k/ Subdivision s . Section/Block/Phase Lot# Lot Size s[ g ' Directions: -.�_ - A", : � d.. _ I. Facility: House Mobile Home V/ Business . Other: Tax•Map # ■ - 3 — . . Multi-family - Other . Zoning Approval # 2 Q / 7 .- 9 Bedrooms off.-- Seats Employees . Application Rate . (1 GPD Flow 07/0 Hot Tub or Spa yes0 Special Fixtures . 100% Repair Area ullizoREPAIR NOTICE: Basement yes/no Bement Plumbing yes/no . REPAIRS MUST BE TH O DAYS OR Water Supply: Private V Public . DAYS FROM DATE OF PERMIT. Type of System: Trench "Bed II Pump Pump/Panel Panel LPP Other Tank Size: Septic Tank / Q C.jOt..0 Pump Tank 00 ./ Nitrification Field: Total Square Feet 600 Depth of Stone /d Bed Size Trench Width 3✓ Total Length of All Trenches C Number of Trenches d4-))3 S Individual Trench Length 3 / 7/_/_/_ Feet on Center 77 / ' Maximum Trench Depth /P/ Distance of Nearest Well j� � Lot Evaluation: Approved/no (Void After 24 months) Topo 3-141. % Slope Sketch of lot Evaluation Site - System Design Texture 5-C lay DO NOT INSTALL Structure SAO, r 2, pp Re WHEN WET pgly� Clay Min. / 1 / Dot tik _ _/ ' 10 Soil Wetness"? �-->f_ _ _3 a�a� '"f'-rte C Soil Depth o!'1- 4,2 - - �' edkZj Restric. Hoz. at 4f " - _ _ Q�j `` \- Available space ex/no �� \ . ' , 11 Overall Class SO U Comments: MI ' • ���� ` 7c----- L#1141 40/7ye diUrcatd we.11 \P' Septic Tank Contractors MUST contact the l , Sanitarian BEFORE ( /� R 1 _IG, j �e 1 &ems 40F OF changing permit. I [� ,} q **NO GUARANTEE OR WARRANTY IS IMPLIED OR GIVEN THROUGH THE ISSUANCE OF THIS PERMIT** Permit Date J- 4 c/ 7 (Improvement� Permit void a fter 60 months) Owner/Agent ► ` Ti.' #4j. ' Sanitarian, . i— Installed By z— K I :wa it Date c-/J -- y. Sanitarian (Note any changes/ nformation in red or by sketch on back) IF A PERMIT HAS TO BE REDESIGNJID AND/OR RETRIPS MADE TO THE PROPERTY, THERE IS AN ADDITIONAL $25 CHARGE. White-Office Blue-Bldg Insp.Comp. Yellow-Owner/Agent Green-Bldg.Insp.I.P. i