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HomeMy WebLinkAboutRBPR-06-2016-24170.TIF va\3A Co t v THIS IS NOT A PERMIT Case # RBPR-06-2016-24170 LT .,,� H CATAWBA COUNTY HEALTH DEPARTMENT 0 i• .CI v :4° ' PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES /842. sti+ Residential Building Plan Review - Building New . • •u • •.o �o IMPROVEMENT - AUTH_CONST • . 0 Applicant JOHN CHRISTENSEN, 25030 MCINTOSH RD, C:3017513102 Contact Person DEBBY BULLOCK-BENFIELD, 1154 LENOIR RHYNE BLVD SE, HICKORY NC 28602 C:8282171983 Land Owner JAMES HOLZIER. 215 WEST BANDERA ST STE 114-43, BOERNE TX 78006 NAME TO APPEAR ON PERMIT John Christensen SITE ADDRESS: 1070 25TH AVE DR NW, HICKORY NC 28601 PIN # 370414248378 NAME of SUBDIVISION: Lot# Section/Block PROPERTY SIZE: Square Feet Acres 0.9 DIRECTIONS: right 127 N in Hickory/go left on 25th Ave NW go .7 miles turn right on 25th Ave Dr Nw/go .5 miles to 1070 25th AVe Dr NW PRIMARY CONTACT: Contact Person SEWER TYPE: Septic Tank GALLONS PER DAY: 360 WATER SUPPLY: Public Water DESCRIBE WORK: single family dwelling / no basement 70 x 70 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? No Are there any easements or right-of-ways on this property? APPLICATION FOR: New Structure STRUCTURE TYPE: PRIMARY RESIDENCE FACILITY TYPE: Single Family Residence OTHER DESCRIPTION: DESCRIPTION OF vacant EXISTING STRUCTURES • ON SITE (IF ANY) DIM EXISTING STRUCTURE: NUMBER OF EXISTING BEDROOMS: #OF OCCUPANTS: 2 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 70 x 70 BASEMENT? No BASEMENT FIXTURES? No PLUMBING REQUIRED?Yes Desired system types (Improvement Permit or Authorization to Construct): CONVENTIONAL: ACCEPTED: ALTERNATIVE: OTHER: INNOVATIVE: ANY: YES Other described: E9-ehapplication 06/24/2016 17:02 Page I of 4 �y9,A CATAWBA COUNTY Casco RBPR-06-2016-24170 G Public Health Department Subdivision 2 < V.,o K Cnvironmental Health Division PINK 370414248378 \4- PO Box 389. 100-A Southwest Blvd.Newton. NC 28658 18.2 rx NAME ON PERMIT: (JOHN CHRISTENSEN),25030 MCINTOSH RD. ( John Christensen) Site Address: 1070 25TH AVE DR NW, HICKORY NC 28601 Property Size: Square a y 0.9 p S Feet Acres Directions: right 127 N in Hickory/go left on 25th Ave NW go .7 miles turn right on 25th Ave Dr Nw /go .5 miles to 1070 25th AVe Dr NW 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 I' FELNA a � ME. _ DATE FEE AMOUNT ' Authorization to Construct Fee (New/Expansion) 06/24/2016 S 150.00 Fee Improvement Permit Fee 06/24/2016 $150.00 t o-u ,TOTAL F EES : E .,: $3,90.90:>:.‘,, a , - E , ' :- � H .. _ 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-ehapplica[ion 06/24/2016 17:02 Page 2 of 4 rAmAAA, it S IS NOTAPERM aLitt10 couant --A CATAWBA COUNTY HEALTH DEPARTMENT Mor11,Curallno Application for Environmental Services Page 1 Improvement Permit Authorization to Construct Septic Repair ❑ Septic Malfunction ❑ Septic Expansion ❑ New Well Permit I I Replacement Well ❑ Well Abandonment ❑ Well Repair n Existing System Inspection (Pre-Approval Required) ❑ Application is for New Construction Existing Facility ❑ Property Address /070 26-t1 Ave Dr. N W Subdivision HI ko✓y, N C .2 /oOl Lot# Acres f 8S o� Section/Block/Phase Driving Directions to Property R.T 1217 hS c&rN- i n: l�-i cl cony ,3 o (rr F r oA 2 C IWC/fill lo 437 L raftm TZ(c kt oAl 2S_ e A R • ,ilvJ • L 7 0 I S ,vt t-C 5 -Ea 1010 2 Cis Ave P4I'E /J il. £ Qa (> flr — NA TO APPEAR ON PERMIT? El Ow Owner S Applicant ❑ Contractor Applicant ontact Information Name f kN ). 0.-k2,s�e-,sere -&f'--It) - Address 2-0•:30 MCrNt*osln -go 4-4 Phone 301 _ 7 s — 3 1 DZ I Cell Phone �30 2 1� -751 -31 o Owner Centact7nfnrnation L ' f_AXThP,C- Name jknAE t}ot_ zIC2 � Address 21 S L/65t i3AN eP D -U Sr 5-rE 1/4-43 / 30(Ruc -7,-t- 7`do(Xo-2 -to Phone I Cell Phone , , . . . . CIfl-)-(Ai c-rtir—) Name 'Pe c 1 'OaLuocLC— i b)F- eLT) Address I ( 3-1/' Lehi 0iR /2ktyn/K 3L✓E S6- “IcWo2t� VJC 2S of Phone&labi B nfielA� Cmnt t CZ r Cell Phone 9 Z-S -- Z 17 — 1 9 93 WHO WWL BE THE PRI Y CONTACT? ❑ Owner in Applicant ❑ Contractor 4/ankl :It?won • Description of Existing Structures on Site 'G'(1- (_ y- # of Bedrooms *j' Structure Dimensions #of Occupants Basement ❑ Yes in 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 ejno Does the site contain any jurisdictional wetlands? O Yes 11-o Does the site contain any existing wastewater systems? O Yes LittAlo Is any wastewater going to be generated on the site other than domestic sewage? ® Yes P'No Is the site subject to approval by any other public agency? '4Ate/fLz� Z 90 ArYes 0 No Are there any easements or right of ways on this property? Describe /A /t .. Existing water supply in use E. 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) •3 ❑ Accepted ❑ Alternative 1,_onventional ❑ Innovative ❑ Other A ° CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services Page 2 Proposed Facility Type TI Primary Residence New Residence n Addition to Residence # of New Bedrooms *t 3 Project Description /---(e✓K E Structure Dimensions_ 70 )( 7 D ) # of Occupants Z Basement U Yes g No Basement Fixtures Yes n No Accessory Structure(s) Describe # of New Bedrooms *t if applicable Structure Dimensions # of Occupants Accessory Dwelling Yes n No Plumbing Yes ❑ No Describe Plumbing Needed ( I Multi-Family Residence# Units #Bedrooms per Unit*t 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. 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 n Semi-Public Well n Community Well Abandonment Type n Drilled ❑ Bored ❑ Dug n Unknown Well Repair Requested n Yes U 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 he 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 RETRTP WILL INCUR AN ADDITIONAL CHARGE (SEE FEE SCFfFDULE) 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. \i z, Signature of Owner or Agent t ' • 4. 4 'ry (o Printed Name of Owner or Agent. &at sted5G'iJ Mori E• jr i s +-e+'1 5 e. l"1 ,J. MIKE'HONEYCUTT HONEYCUTT LAND SURVEYING, P.A. RANDAL W. HONEYCUTT NC PLS 1360 22 SOUTH MAIN AVE,-SUITE 102A FIRM #C - 3570 SC PLS 5027 P.O. Box 1103 Newton, N.O. 28658 Phone: 828-464-0702 NC PLS 4399 srrE . I CERTIFY THAT THIS MAP WAS DRAWN UNDER MY SUPERVISION FROM AN ACTUAL SURVEY MADE 0 114^11 UNDER MY SUPERVISION (DEED DESCRIPTION RECORDED IN BOOK 3247, PAGE 864 & PLAT \y F4 BOOK 65 PAGE 27); THAT THE BOUNDARIES NOT SURVEYED ARE INDICATED AS DRAWN FROM is i5 °'i INFORMATION IN BOOK PAGE THAT THE RATIO OF PRECISION OR P4 -" . RACY 4 IS 1.1000: AND THAT THIS MAP MEETS THE REQUIREMENTS OF "THE S, •-!.H • •i-.. CE 41` N FOR LAND SURVEYING' IN NORTH CAROLINA (21 NCAC 56.1600).' 9 4444°'4444.4 ITHIS 22ND DAY OF JUNE / �.•pF�sSp1 9 �/ M" -r•L AL ser-ii VICINITY MAP NOT TO SCALE '0NDAL W. He'EY UTT i P3. y y ¢4s 4O�IV SU V O .: BEING ALL OF THE LOT SHOWN EASEMENT LINE DATA -- W°O' ,, • ON PLAT ROOK 65 PAGE 27 HO COURSE' BEARING , DISTANCE 4, L 1 N 72'21'.39" E 42.39' 0" L2 I N 18'44'13" W 10,19' e4 L3 i N 50'51'37" W 66.72' j e" . boa eJ LAKE HICXORY F� N 56'57'47"E pJ _ 106.17' TOTAL R 1/20q00 45.49 Si..: S B 9\ I sSEWER EASEMENT .0 u\ �a:24*, 'eB, c� I'PIPE r—— \. / v: \ 'I1,9' Z _ FLOWERS LMNG TRUST 1 . \ \ TusTsitit \) I y 0.B.J382 PG. 1880 £ N\ �\ m I I Wrttlw A nrvvv O1\ , / ' W 58.333' C.PRATT O DEUJI F4 WO • . O p\ Tn O‘ \ t' 0 \ p I rn NOTES: Il I. THE PURPOSE OF THIS SURVEY IS A A. BOUNDARY SURVEY ON SUBJECT PARCEL \'F' NO: 3704-14-24-8378 1/2'REBAR \\- 2. THIS SURVEY WAS PERFORMED WITHOUT � \ ml'T'wc THE BENEFIT OF A TITLE SEARCH. THIS / C%7 iSe@ —.J PROPERTY MAY BE SUBJECT TO RIGHTS OF / *P WAYS OR EASEMENTS NOT SHOWN HEREON. / ,N'° I ,.c 6 .34' J. PROPERTY ADDRESS 1070 25TH AVE DR I sr„ 65 40'SZ°W 3/a PIPE BENT NW, HICKORY, N.C. 28601. nxc m 4. OWNER: JAMES K & CHRISTINE L. 1 114-43 BOERNE, TEXAS 78006-2820. t\ 60' /WH AVE' ER NW 5. PROPERTY Ws IV CRITICAL WATERSHED WATERSHED S / '-F��, 7 S RECORDS AREA. CURVE DATA CURVE RADIUS LENGTH DELTA CHORD CHORD BEAR. 0.88 ACRES CI 50.00' 49.26' 5627'00" 47.29' N 89'32'22" W BY COORDINATE COMPUTATION SURVEY FOR: JOHN & MARY CHRISTENSEN • A' fi—_ LOCATION: 1070 25TH AVE DR SW HICKORY, NC 2860; www.h oneyouttsvrvey,com HICKORY TSP., CATAWBA CO., NC P.LN.: 3704-14-24-8378 6,0 30 0 60 I TINS PROPERTY IS NOT IN A SPECIAL FLOOD WIZARD ARE, DATE: 06-22-2016 ' LIIIIIMIMI A PORTION or TINS PROPERTY IS IN A SP:'CL4L FLOOD HAZARD AREA GRAPHIC SCALE : I-- 60' FEW FIRM PANEL N 3710370400K DEED: 3247-864 • EXISTING IRON (TYPE NOTED) JOB p': 16067654.OWG EFFECTIVE DATE: 07-07-09 SET IRON SET (TYPE NOTED) PLAT BOOK 65 PAGE 27 X COMPUTED POINT FILE: L-156 Catawba County Environmental Health FI j '�4{Ut1M1 it t',. g H :„, wt , �,ry 1' ,Itti b;. !..3. 1 �` I r 0110 '%I t N� .Yiliitaiiir n pt{. r+rr a -'�,. M 9.7 111 t rt 3 t l { i I hi 1 4 I i✓" y li it g r{ ',Ill' d t';i • hi4.kilt f/,�k�hi{,iii,s Jt1 i {Ilti Ilii r ti i ' i u �t.Qµ�', 111, it •4Ii ''I�I::�x l � .�� 1 ' ,` i�l2t'vg't'* I I� 1 . f) Ll� . i ,, {. UI I ", . SIG , 1M1.i t , ,MM �I qq + II 1u11 t q;cp'll �� I) � l' 1j) ��?I' l��1.1 I ry I �jr 111 �1tI1rc Ii I 1 1111�� I fy t)Il.i ' I ' I11) 1 ''t1�h� t I I 1 rkh I ti ' , i, li �it$•4Y�?' a hI r�. I �l CI S(�I�! 'tthit ul 9t '� �I.I q �� II I I ^A{', `j'll,ryry It,;a :• I IY I S rj , ill , vi0 II 1�1 i Il t o 7, l) r{ a: I Ilrk � 111 U 'Yt �ot���� � I° �� . 4, °�! fi .:Ii I .,II II i 71.1 !I o .I)(1.,,J, II 1 f ?lit ill{ 11°''1, 'I� .� 1 : r1b— ,.-- * '' Ke vp N. �2g '�. 1) N. N. i N N N. N. ii* N (54) X691 1 'le...9 45.0 • 25THpV��Io 26.10 1\ 60 a Parcel: 370414248378, 1070 25TH AVE DR NW 1in=50ft HICKORY, 28601 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 06/24/2016 Parcel Report Page 1 of 1 • Parcel Report - Catawba County NC Parcel Information: Owner Information: Parcel ID: 370414248378 Owner: HOLZIER JAMES K Parcel Address: 1070 25TH AVE DR NW Owner2: HOLZIER CHRISTINE L City: HICKORY, 28601 Address: 215 WEST BANDERA ST STE 114-43 LRK(REID): 61311 Address2: null Deed Book/Page: 3247/0864 City: BOERNE Subdivision: null State/Zip: TX 78006-2820 Lots/Block: null/null Last Sale: $250,000 on 2014-07-03 School Information: School District: HICKORY Plat Book/Page: 65/27 Legal: LOT 1 PLAT 65-27 Elementary School: JENKINS Middle School: NORTHVIEW Calculated Acreage: .900 Tax Map: 190H 01072A High School: HICKORY Township: HICKORY School Map State Road #: 1356 Tax/Value Information: Tax Rates(pdf) Zoning Information: City Tax District: All in County Zoning District: HICKORY County Fire District: HICKORY RURAL Zoningl: R-2 Building(s) Value: $0 Zoning2: null Land Value: $231,800 Zoning3: null Assessed Total Value: $231,800 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: 2009-07-07 • Building Permits for this parcel. Firm Panel #: 3710370400K Building Details 2010 Census Block: 1066 WaterShed: WS-IV Critical Area 2010 Census Tract: 010502 Voter Precinct: P36 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 hold 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 l&-1011 c3LCO Stl /dc J' http://gis.catawbacountync.gov/nomap/parcel_report.php?key=370414248378&typ=P 6/24/2016