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HomeMy WebLinkAboutRBPR-07-2016-24234.TIFPYA 1842 sm Contact Pcrson Contractor Owner THIS IS NOT A PERMIT Case # RBPR-07-2016-24234 CATAWBA COUNTY HEALTH DEPARTMENT PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES Residential Building Plan Review - Building Addition IMPROVEMENT - AUTH CONST m EXPANSION UNDERWOOD, RICHARD WAYNE (RICHARD WAYNE UNDERWOOD ), 510 MATHESON RD, TAYLORSVILLE NC 28681- 13:8283123536 C:828-312-3536 RICH UNDERWOODF:NA RICH2140@GMAIL.COM THOMAS JONES CONSTRUCTION (THOMAS JONES), 2955 SANDY FORD RD, NEWTON NC 21 13:8282944733 C.828612325817:8283300155 THOMASJONES8280aGMAIL.COM PATRICK DAILY, 3864 SERENITY DR, HICKORY NC 28602 C 8283123536 NAME TO APPEAR ON PERMIT PATRICK DAILY SITE ADDRESS: 3864 SERENITY DR, HICKORY NC 28602 NAME of SUBDIVISION: MELROSE PLACE PROPERTY SIZE: Square Feet Acres 0.54 PIN # 371009254361 Lot # 44 Section/Block DIRECTIONS: TURN OFF RIVER ROAD INTO MELROSE PLACE -TAKE 1ST RIGHT ONTO SERENITY DRIVE -HOUSE AT END OF ROAD-CULDESAC PRIMARY CONTACT: Contractor SEWER TYPE: Septic Tank GALLONS PER DAY: 480 WATER SUPPLY : Public Water DESCRIBE WORK: ADDING A MASTER BEDROOM & BATH ON MAIN LEVEL 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: Existing Structure STRUCTURE TYPE: PRIMARY RESIDENCE FACILITY TYPE: Single Family Residence OTHER DESCRIPTION: DESCRIPTION OF SINGLE FAMILY DWELLING EXISTING STRUCTURES ON SITE (IF ANY DIM EXISTING STRUCTURE: 61X22 NUMBER OF EXISTING BEDROOMS: 3 # OF OCCUPANTS: 2 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 14X32 # OF NEW BEDROOMS:: 1 BASEMENT? No BASEMENT FIXTURES? No PLUMBING REQUIRED? Desired system types (Improvement Permit or Authorization to Construct). ACCEPTED: ALTERNATIVE: CONVENTIONAL: YES OTHER- INNOVATIVE: ANY Other described. F-1; - ehapphcdnon 09/02/2016 11 22 Page I of �n CATAWBA COUNTY Case # RBPR-07-2016-24234 .T 4 Public Health Department Subdivision MELROSE PLACE 2 Y Environmental I lealth Division PIN# 371009254361 PO Box 389. 100-A Southwest Blvd. Newton, NC 28658 / 2 w NAME ON PERMIT: ( PATRICK DAILY), 3864 SERENITY DR, HICKORY NC 28602 ( PATRICK DAILY) Site Address: 3864 SERENITY DR, HICKORY NC 28602 Property Size: Square Feet Acres 0.54 Directions: TURN OFF RIVER ROAD INTO MELROSE PLACE -TAKE 1 ST RIGHT ONTO SERENITY DRIVE -HOUSE AT END OF ROAD-CULDESAC 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 IIIANla �:�IIi'�mr°T{"s^Im,v+-*�-^,.'.•r..,�nrDr�AlnnTm.l.tE.1.l.llnl1l „jlj•'ul,rl, � , FimEmErlrI, A� MFEENIE OUaNirTIlli',( Authorization to Construct Fee (New/Expansion) 07/07/2016 $300.00 Fee Improvement Permit Fee 07/07/2016 $150.00 II,. I Iial�"„ITOTALFEE,S HI!! ,, ;,r ,ip 11. , 5150.00' u��I� �li 11 I I III .. r..n. I,II „i,! 1, •"a' :'. t tll r ISI l �h f� Lill.. �UC'S��I' Ii IIL I i �ll.h�l., I II Ivhl y .i,lrvix.l..,,.r, 9'"!:9r h'1i ll,ldu'IP '+iI11111in 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) F9 - ehapphc'I I' 11 09/02/2016 11 22 Page 2 of 4 Contractor THIS IS NOT A PERMIT Case # RBPR-07-2016-24234 CATAWBA COUNTY HEALTH DEPARTMENT PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES Residential Building Plan Review - Building Addition IMPROVEMENT - AUTH CONST - EXPANSION ❑� FE -31 THOMAS JONES CONSTRUCTION (THOMAS JONES), 2955 SANDY FORD RD, NEWTON NC B:8282944733 C 8286123258P:8283300155 THOMASJONES828LGMAIL.CONI Owner PATRICK DAILY, 3864 SERENITY DR, HICKORY NC 28602 NAME TO APPEAR ON PERMIT PATRICK DAILY SITE ADDRESS: 3864 SERENITY DR, HICKORY NC 28602 PIN # 371009254361 NAME of SUBDIVISION: MELROSE PLACE Lot 44 Section/Block_ PROPERTYSIZE: Square Feet Acres 0.54 DIRECTIONS: TURNOFF RIVER ROAD INTO MELROSE PLACE -TAKE 1ST RIGHT ONTO SERENITY DRIVE -HOUSE AT END OF ROAD-CULDESAC PRIMARY CONTACT: Contractor SEWER TYPE: Septic Tank GALLONS PER DAY: 480 WATER SUPPLY: Public Water DESCRIBE WORK: ADDING A MASTER BEDROOM & BATH ON MAIN LEVEL 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: Existing Structure STRUCTURE TYPE: PRIMARY RESIDENCE FACILITY TYPE: Single Family Residence OTHER DESCRIPTION: DESCRIPTION OF SINGLE FAMILY DWELLING EXISTING STRUCTURES ON SITE (IF ANY DIM EXISTING STRUCTURE: 61X22 NUMBER OF EXISTING BEDROOMS: 3 # OF OCCUPANTS: 2 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 14X32 # OF NEW BEDROOMS:: 1 BASEMENT? No BASEMENT FIXTURES? No Desired system types (Improvement Permit or Authorization to Construct). ACCEPTED. ALTERNATIVE: OTHER INNOVATIVE Other described. PLUMBING REQUIRED? CONVENTIONAL: YES ANY E9-chapphcauon 07/07/2016 11 03 Page 1 of ySA CATANVBA COUNTY Case it RBPR-07-2016-242')4 Public Health Department MELROSE PLACE Environmental Health Division Sut+drvrsmn i PO Bos 389, 100-A Southwest Blvd, NeMon, NC 28658 PIN# 371009254361 NAME ON PERMIT: ( PATRICK DAILY), 3864 SERENITY DR, HICKORY NC 28602 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 1 and and that I am solely responsible for the proper identification�and)abeling of all property lines and corners and making the site acce�s/s� I so that a co pl a site evaluation can be performed Date 7/7 / ((o Signature of Applicant or Agent An Environmental Health Specialist will contact you within 5 working dayst f application date. If you need further information or assistance please call 828-466-7291 AREA2 FEENAME DATE FEEAMOUNT Authorization to Construct Fee (New/Expansion) 07/07/2016 5300.00 Fee Improvement Permit Fee 07/07/2016 $150.00 TOTAL FEES 5450.00 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) EQ - ehapphcanon 07/07/2016 11 03 Page 2 of ( PATRICK DAILY) Site Address: 3864 SERENITY DR, HICKORY NC 28602 Property Size: Square Feet Acres 0.54 Directions: TURN OFF RIVER ROAD INTO MELROSE PLACE -TAKE 1ST RIGHT ONTO SERENITY DRIVE -HOUSE AT END OF ROAD-CULDESAC 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 1 and and that I am solely responsible for the proper identification�and)abeling of all property lines and corners and making the site acce�s/s� I so that a co pl a site evaluation can be performed Date 7/7 / ((o Signature of Applicant or Agent An Environmental Health Specialist will contact you within 5 working dayst f application date. If you need further information or assistance please call 828-466-7291 AREA2 FEENAME DATE FEEAMOUNT Authorization to Construct Fee (New/Expansion) 07/07/2016 5300.00 Fee Improvement Permit Fee 07/07/2016 $150.00 TOTAL FEES 5450.00 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) EQ - ehapphcanon 07/07/2016 11 03 Page 2 of THIS IS NOT A PERMIT CATAW13A COUNTY 11EALTH DEPARTMENT Application for Enviromnental Services Page 2 Proposed Facility Type ❑ Primary Residence ❑ New Residence �XAddition toResidence 4ofNew Bedrooms *j� _ Project Description At)f) S n iZoot> /R/47// i/ 044 FtR,' r Structure Dimensions iq K 3Y # of Occupants Z Basement ❑ Yes V No Basement Fixtures 0 Yes No _.-.... . Accessory Structures) Describe _ # of New Bedrooms * j if applicable— Structure Dimensions # of Occupants Accessory Dwelling ❑ Yes ❑ No Plumbing ❑ Yes ❑ No Describe Plumbing Needed L] Multi -Family Residence # Units #Bedrooms per Unit*j' Total # Bedrooms *'r Structure Dimensions ❑ Food Service Specify'fype # Seats Floor Space -Entire Food Service Facility (Sq Ft) # Employees per Shift # of Shifts Dining Area (Sq. Ft.) ❑ }lushness Specific. Type of Businc's' - ... -'. Ss _ RctailFfoorpace,_ # of Employees per Shift # of Shifts ❑ Other Facility Type Specify It'Church # of Seats Kitchen ❑ Yes ❑ No If Daycare Specify` Occupancy Application for Well Construction/AbandonmentlRepair Proposed Well Type ❑ Individual Well ❑ Semi -Public Well Abandonment'rype ❑ Drilled ❑ Bored ttrell Repair Requested ❑ Yes ❑ do Describe ❑ Community Well ❑ Dug ❑ Unknown Calculated Design Flow, Commercial T Additional information may be required to determine design flow from certain facilities. This value will be determined daring consultation with on-site staff. Any room that will be intended for sleeping at the time of construction or for future consideration shoo *Any Id be noted as a bedroom and counted on all applications. The number of bedrooms will be confinned 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 RETRIP WILL INCUR AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) Improvement Permits issued as aresuIt 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 trasfarrable. Permits maybe revoked if the information on this application, site plans or intended use changes for the proposed facility. 1 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 comers and making the site accessible so that a complete site evaluation can be performed. Signature of Owner or Agent Date 717//j ' t Printed Name of Owner or Agent Lf 447-.52L6 AI r- < CATAWBA THIS IS NOT A PERMIT LOOM � CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services Page I Improvement PermitX utborization to Construct Septic Repair 11 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 35?(n4- Srgr iT-Y bRkVE- Subdivision MEI-ROS:C PLP -CE y1i1CKU(t Y .AJC 1,8"61 C) 2 Lot # Acres Sectiion/Block/Phaw Driving Directions to Property I Lt2tJ ZWEr? .RoAO IAJro _MFLA-6F IOL4CF — 44C 5'- 9�t c OMTn <P7 RF -r -MIL/=' — NOLA,51- A -r F -NV 0P P0AD tCft�<a�--._ NAME TO APPEAR ON PERMIT? Owner (_? Applicant ❑ Contractor Applicant Contact Information Name Address Picone Cell Phone Owner Contact Information Name i'ATRII i DAIL.y Address 3 (o4- -Tc R.ENCrY A7i?iUF' - t&40RY J -1C - -X'&0z Phone 3C){6 Cell Phone 5;^c Contractor Contact Information Name i (I0,.1,t A4 S \1 d Afr 5 - Address Address .2,? SS S!#i1I(? V Fd (2 i-) -- ,SEE J7 -61Y C'- .2 i� S' 8 '1 I Phone C, 12- ?'�S" R I Cell Phone 5'/J-jy1� WHO WILI, Bl THE PRIMARY CONTACT? ❑ Owner ❑ Applicant RrContractor Description of Existing Structures on Site 2 5',-Vfz )e Muir 5"1 # of Bedrooms *j' S Structure Dimensions & i X 22 # of Occupants '— Basement ❑ Yes ©'No Basement Fixtures ® Yes KD 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 O No Does the site contain any jurisdictional wetlands? ;'Yes 0 No Does the site contain any existing wastewater systems? ID Yes G""No is any wastewater going to be generated on the site other than domestic sewage? M(Yes -No Is the site subject to approval by any other public agency? 0 Yes 13�No Are there any easements or right of ways on this property? Describe Existing water supply in use ❑ Individual Well [J 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 Autborization to Construct, Please Indicate Desired System Type(s): (systems can be ranked in order of your preference) ❑ Accepted 0 Alternative ErConventional 11 Innovative 0 Other 0 Any Parcel Report Parcel Report - Catawba County NC Parcel Information: Owner Information: Parcel ID: 371009254361 Owner: DAILY PATRICK T Parcel Address: 3864 SERENITY DR Owner2: DAILY DONNA L City: HICKORY, 28602 Address: 3864 SERENITY DR LRK(REID): 600484 Address2: null Deed Book/Page: 1971/1360 City: HICKORY Subdivision: MELROSE PLACE State/Zip: NC 28602-8901 Lots/Block: 44/ null Zoning3: null Assessed Total Value: $153,900 School Information: Last Sale: $118,000 on 1996-03-01 Small Area: MOUNTAIN VIEW Current Tax Bill School District: COUNTY Plat Book/Page: 34/68 Zoning Agency Phone Numbers Elementary School: BLACKBURN Legal: LOT 44 44 P34-68 MELROSE PL PL 34-68 Middle School: JACOBS FORK Calculated Acreage: .540 High School: FRED T FOARD Tax Map: 170H 03039 School Map Township: HICKORY State Road #: 2944 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: $136,200 Zoning2: null Land Value: $17,700 Zoning3: null Assessed Total Value: $153,900 Zoning Overlay: ED -0 Year Built/Remodeled: 1994/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 #: 3710371000J Building Details 2010 Census Block: 2003 WaterShed: null 2010 Census Tract: 011102 Voter Precinct: P23 Agricultural District: Parcel Report Data Descriptions List all Owners Deed History Report Assessment Report Page 1 of 1 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, Rs 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/repod product or the use thereof by any person or entity © 2016, Catawba County Government, North Carolina All rights reserved. vlk v4nsim' 3 e6,51 bedtv�rnn A" billt"/I:ry"- httpllgis.cata-Nvbacountyne.gov/nomap/parcel_report.plip?key-3710092 4361&typ—P 7/7/2016 /U�0_0 AY 6777 • *'*Op. Permit and/or Cert. Op, Required_ (Must be completed prior to final) C A T A W S A C O U N T Y H E A L T H D E P A R T M E N T (704) 465-8270 Lot Eval._Improve. Permit (,""Repair Permit_Cert. of Comp. Permit_� �Oper. Permit_ Owner/Agent /Coles_ Phone aQ Y — l y 3`S Address 7/ L.,,n QiL: ,l v:n (/ ✓i- // �1he- Subdivision Section/Block/Phase Lot# �/L/ Lot S' C G Jr Direcgtions: / /S' 1- u �i- (U d Q' l� �-7 Facility: House E,�'Mobile Home_ Business_ Other: Tax Map # / / 0 17 - _S Multi -family^ Other Zoning Approval # 2y SAO / 6 -L-W Bedrooms Seats Employees Application Rate GPD Flow J 6 Q Hot Tub or Spa yes/nb Special Fixtures 100% Repair Area a /no REPAIR NOTICE: Basement yesO n Basement Plumbing yes/no REPAIRS MUST BE 30 DAYS OR Water Supply: Private Public DAYS FROM DATE OF PERMIT. ttiwAtrA irwwtwwAwwAwww,iwwwww wwwww wwwwwwwwffwwwwwwwwwwwwwwwRwwwwwwwwwRtww wwwwwwtwwtwwwwRww Type of System: Trenchd_Pump Pump/panel _Panel_LPP_ Other Tank Size: Septic Tank � L Pump Tank Nitrification Field, Total Square/ Feet 9 Depth of Stone / o�Bed Size Trench Width J / Total Length f All Trenches 3v O / Number of Trenches Individual Trench Length _////_/_ Feet on Center_ h Maximum Trench Dept Distance of Nearest Well_�Lot Evaluation: Approved yes/no (Void After 24 months) w wllwwf wwA AItAAAwAwAAA Ae:: w11!•TAA'w A�w RtwAwAt AAAAAAAAf AAA AwAtAAAAwwwwwww AwAAwwwwwwwww wwwwwwww• Topo s Slope Sketch of lot Evaluation Site - System Design - Final Texture / Structure_/ � ) Clay Min. E // I P Soil Wetness Soil Depth Restric. Hoz. at Available space yes/no[ Overall Class S PS U Comments: I ( F_ S" Septic Tank Contractors \ / MUST contact the Sanitarian BEFORE V changing permit. *ANO GUARANTEE OR WARRANTY IS IMPLIED OR GIVEN THROUGH THE ISSUANCE OF THIS PERMIT" •www wwwwwwwwwwwwwwwwwww wwwwwwwtn►A,.wwwwwwwwww•wwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwww wwwww Permit Date2 — 7>> (Improvement Permit void after 60 ,months) Owner/Agent//'�^�� �^ / Gle- Sanitarian /n7nI_11c .P �(/� S✓ Installed By Date 9'-91/ Sanitarian e'?, (Not any changes/information in red or by sketch on back) w*w*w**IF A PERMIT HAS TO BE REDESIGNED 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.