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HomeMy WebLinkAboutEHPR-06-2016-24185 (2).TIF 4.1..\\3A O� THIS IS NOT A PERMIT Case # EI-IPR-06-20 1 6-24 1 85 T t" CATAWBA COUNTY HEALTH DEPARTMENT _0 o rte• f !' PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES 'I 0.9 v i Itt 1842 m Environmental Health Plan Review - OSWP o n T r. T IMPROVEMENT _ , r; r' Contractor *OAKWOOD HOMES #712 (ELIOBERTO ALFONSO), 1265 70 H WY W,NEWTON NC 28658 B:(828)217-1862 C:(828)464-2662F:828-464-4301 R712aCLAYTONHOMES.COM Owner DAVID JOHNSON, 1546 GLENNOAKS DR, NEWTON NC 28658 • C:82846I1449 NAME TO APPEAR ON PERMIT David Johnson SITE ADDRESS: 1546 GLENNOAKS DR,NEWTON NC 28658 PIN # 363910453129 NAME of SUBDIVISION: Lot# 2 Section/Block PROPERTY SIZE: Square Feet 175,111.20 Acres 4.02 DIRECTIONS: Hwy 70 West, Left onto Northwest Blvd, Right onot Hwy 10, Left on Jarrett Farm Rd at the stop sign, Go over Grandview Dr onto Glenoaks Dr, Lot is on the Left. PRIMARY CONTACT: Contractor SEWER TYPE: Septic Tank GALLONS PER DAY: 360 WATER SUPPLY: Private Well DESCRIBE WORK: IP Only at this time" New Modular 28x52 w/ Decks: Front & Back 6x6 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? 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: 3 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: Modular 28x52 w/Decks Front& Back 6x6 #OF NEW BEDROOMS:: 3 BASEMENT? No BASEMENT FIXTURES? No PLUMBING REQUIRED? Desired system types (Improvement Permit or Authorization to Construct): ACCEPTED: ALTERNATIVE: CONVENTIONAL: OTHER: INNOVATIVE: ANY: YES Other described: i;)-chapplicatlon 06/28/2016 13:22 Page 1 o14 zy,A r. CATAWBA COUNTY Clue# EHPR-06-2016-24185 iT ti Public Health Department Subdivision < �, .a1 Environmental Health Division PIN# 363910453129 k` PO Box 389, 100-A Southwest Blvd,Newton.NC 28658 18 4%t• NAME ON PERMIT: ( DAVID JOHNSON), 1546 GLENNOAKS DR, NEWTON NC 28658 ( David Johnson) Site Address: 1546 GLENNOAKS DR,NEWTON NC 28658 Property Size: Square Feet 175,111.20 Acres 4.02 Directions: Hwy 70 West, Left onto Northwest Blvd, Right onot Hwy 10, Left on Jarrett Farm Rd at the stop sign, Go over Grandview Dr onto Glenoaks Dr, Lot is on the 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 erstand that I am solely responsible for the proper an identifica'•n d label' g of all property lines and corners and making the site accessible sot co e site evaluation can be performed. Dat .�, de. / Signature of Applicant or Agent ';n Environmental Health Specialist will contact you within 5 work) ays of application date. If you need further information or assistance pleas"all 828-466-7291 AREA1 i llrihiPi - --r" � i74 i Pl' i r ,,nn i1iili Iir: ^5 — i r'T _.,9 iFEFNAME ijil'lii ;� �a Li�c'I;I� ilinigl jl) .-I 11:11litiith�ii�tiiDATE "": gt 1.FFE1ANIOUNMi Improvement Permit Fee 06/28/2016 8150.00 'l��1�ii�l mrl'� i� ki i 1 t�ii11H i Iliii M,. 111 0,. $150 ooii�'o S iii Uihi iJ� TOTAL FE ES 1 1 y fi i11p„ 11 tl j -�� �/ ;G� �i°i i i gJS „-,i,....,.� �.,.! Jli,➢@NCIa1IL._.___a0;i .8...,,. itiliet ....1t,M.11ii'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) EP-ehappl i cation 06/28/2016 13:22 Page 2 of 4 CATAWBA THIS IS NOT A PERMIT COUNTY c gym•.,,* CATAWBA COUNTY HEALTH DEPARTMENT .,,,—,z Application for Environmental Services Page 1 Improvement Permit ❑ Authorization to Construct ❑ Septic Repair ❑ Septic Malfunction ❑ Septic Expansion ❑ New Well Permit ❑ Replacement Well ❑ Well Abandonment❑ RA( l Well Repair ❑ Existing System Inspection (Pre-Approval Required) ❑ -D� 0 /Application is for /Neew(CConstruction Existing Facility ❑ Property Address / 61-& �£l en (, 12.1 I ,S 0f ( tC Subdivision ke.;,J l on. a )c...- ,Q .cy Lot# Acres Section/Block/Phase Driving Directions to Property 70 CO - 1 L on L(u -bc,_iec _Jl/C( ? i- C'n Ciro I A-N ( U I L, o r) er-ret-i- -I--Cr-v ) rl - S F-o p 5 (c-Y-1 [moo 0x( 72r (-(-C=,-1A(iC cup/ OrivC nn (-0 ClenoGCS Or - /0� on Le--1-1— NAME TO APPEAR ON PERMIT? j6wner ❑ Applicant ❑ Contractor Applicant Contact Information '' 1I1111 Name a K LA)C O t"1 ofn e C o-f 0-et ,> C Y� _ Address i. ocC u( . 1 -In ( x )- ok ,1-k-CYL iiC ,--p?-( O� ? Phone R-„_g _q(Q 4 ,,L�'& ell Phone Owner Contact Information Name - -`.L) \cA S(m\-\�v'^\ CS � \f. y ` �--(� Address ( Co -( Jr res , ( ) - 1S or - He WIC 1 NDC-_ :CR J SO Phone 75 3-“( C ( -- ( 4_( 4 9 Cell Phone Contractor Contact Information Name 5G-,-)n e G,' S a,Dp ( ■ C C ' 'P Address V Phone Cell Phone WHO WILL BE THE PRIMARY CONTACT? ❑ Owner ❑ Applicant ❑ Contractor Description of Existing Structures on Site #of Bedrooms *j Structure Dimensions #of Occupants_ Basement ❑ Yes ❑ No Basement Fixtures 0 Yes ® No The Applicant shall notify the local health department upon submittal of this application if any of the following apply to the property - question. If the answer to any question is "yes", applicant must attach supporting documentation. C Yes o Does the site contain any jurisdictional wetlands? ® Yes o Does the site contain any existing wastewater systems? ❑Yes '0-14 Is any wastewater going to be generated on the site other than domestic sewage'? ®Yes fo Is the site subject to approval by any other public agency? ® Yes CO) Are there atyy easements or right of ways on this property? Describe -- Existing water supply in use ' Individual Well ❑ Community Well H Semi-Public Well ❑ County/City/Township t ater 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 our preference) ❑ Accepted ❑Alternative Conventional El ❑ Other 10 Any CATAWBA THIS IS NOT A PERMIT COUNTY -L- CATAWBA COUNTY HEALTH DEPARTMENT ----"" % Application for Environmental Services Page 2 Proposed Facility Type Primary Residence ❑ New Residence ❑ Addition to Residence of New Bedrooms *j'_�----�� Project Description 4 irlto� nn rc e ('YICY �C.L\G'tr ho kyle Structure Dimensions ,-R R" C S� #of Occupants _ R Basement ❑ Yes No Basement Fixtures ® Yes No H Accessory Structure(s) Describe # of New Bedrooms *t if applicable Structure Dimensions # of Occupants Accessory Dwelling ❑ Yes ❑ No Plumbing ❑ Yes ❑ No Describe Plumbing Needed H Multi-Family Residence#Units #Bedrooms per Unit*j' Total #Bedrooms *-t Structure Dimensions H Food Service Specify Type # Seats Floor Space-Entire Food Service Facility (Sq Ft) # Employees per Shift #of Shifts Dining Area (Sq. Ft.) H 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 n No Describe Calculated Design Flow, Commercial j 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 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 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 Agent ■ ' klOye I ak (4 OdüMLte (y)—aq ( CP Printed Name of Owner or Agent , 1 \ 5 e a1, `vY) Q.4-1 CATAWBA Geospatial Real Estate Search °° Informaho . - • - ---------,,L.H.A55 - S°tj 8 il-b t3 i 6.r w i rA- • B of Q 7 2 a w 82.1 ri — 3 Lu gam : a ,O' . )1'3G 9x9 7 . /• Clv § fist c ✓ 86,R2• r1 # itN ,-0, A Bo 117) 4,3p° \ 0 B 0 cs W cC� ¢ ,. o S Its,0 R, I4 6 o .t (1,.•) N 1 in=150ft w--#-E S , Plat Book: 32 Page: 59 st L 061J bogs /0.°E f\cE,'oM, id 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 06/17/2016 Catawba County Environmental Health / / I •.Y. 659) N rti oo • d /n� 0 CC 2 N C co a \\\C) ni LL (Si Et a M a \\N\ / I .rIv ://,...) o l\ ai n co ---1 0�n ` N CC w 9S ra O� 37) co re ----1 \ Parcel: 363910453129, 1546 GLENNOAKS DR 1in=80ft 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 mapheport 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 06/28/2016 Parcel Report Page 1 of 1 Parcel Report - Catawba County NC Parcel Information: Owner Information: Parcel ID: 363910453129 Owner: UNDERWOOD KENNETH WAYNE Parcel Address: 1546 GLENNOAKS DR Owner2: UNDERWOOD CAROLYN S City: NEWTON, 28658 Address: 213 W 20TH ST LRK(REID): 92621 Address2: null Deed Book/Page: 1809/1004 City: NEWTON Subdivision: null State/Zip: NC 28658-2912 Lots/Block: 2/ null Last Sale: School Information: School District: COUNTY Plat Book/Page: 32/59 Legal: LOT 2 2 PL32-59 JARRETT FA PL 32-59 Elementary School: STARTOWN Calculated Acreage: 4.020 Middle School: MAIDEN Tax Map: 070N 04013A High School: MAIDEN School Map Township: NEWTON State Road it: 2056 Tax/Value Information: Tax Rates(pdf) Zoning Information: City Tax District: All in County Zoning District: NEWTON County Fire District: NEWTON RURAL Zoningl: R-20 Building(s) Value: $0 Zoning2: null Land Value: $46,200 Zoning3: null Assessed Total Value: $46,200 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 tf: 3710363900J Building Details 2010 Census Block: 2053 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. • • http://gis.catawbacountync.gov/nomap/parcel_report.php?key=363910453129&typ=P 6/28/2016 "A CD CATAWBA COUNTY TallIOOA SOUTHWEST BLVD !(l � NEWTON, NORTH CAROLINA 28658 RECEIPT a� j aP� PI IONB: 828.465.8399 /U 15 Tuesday, June 28, 2016 8 v vww.catawbacountync.gov PAYOR: *OAKWOOD HOMES #712 *OAKWOOD HOMES#712 (Alfonso, Elioberto) PAYMENTS TRANSACTION NUMBER: 1RC-708650-28-06-2016 PAYMENT DATE : 06/28/2016 PAYMENT TYPE: Check 2193 INVOICE NUMBER FEE NAME FEE AMOUNT 06-16-329903 Improvement Permit Fee $150.00 TOTAL PAYMENTS : S150.00 EHPR-06-2016-24185 CASE TYPE: Environmental Health Plan Review WORK CLASS: OSWP SITE ADDRESS: 1546 GLENNOAKS DR, NEWTON NC 28658 Owner DAVID JOHNSON, 1546 GLENNOAKS DR, NEWTON NC 28658 C:8284611449 Contractor *OAKWOOD HOMES #712, 1265 70 HWY W,NEWTON NC 28658 B:(828)217-I862C:(828)464-2662F:828-464-4301 R712 @CLAYTONHOMES.COM ** NO PEOPLESOFT ACCOUNT ASSIGNED ** receipt 06/28/2016 13:22 Page 1 of I