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HomeMy WebLinkAboutRBPR-07-2016-24242.tifIgA Ig4sM THIS IS NOT A PERMIT Case # RBPR-07-2016-24242 CATAW13A COUNTY HEALTH DEPARTMENT PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES Residential Building Plan Review - Building New IMPROVEMENT - AUTH CONST - NEW WELL 101$ q4 � (0AAe-d (AA Sed 0L, y �A 0 Applicant AMERICAS HOME PLACE (WAYNE HOOKER), 1206 GREENLAND DR, STATESVILLE NC 2867 H:7047467094B:7048724400 C:3367053235 HOME: 7047467094F:7048724408 WAYNEH@AMERICASHOMEPLACE .COM Owner GEORGE CRENSHAW, PO BOX 1421, MOORESVILLE NC 28115 NAME TO APPEAR ON PERMIT GEORGE CRENSHAW E ADDRESS , 8800 DOG LEG RD, SHERRILLS FORD NC 28673 PIN #461902752332 NAME of SUBDIVISION: SHERWOOD SHORES Lot # 4 8,5 Section/Block B PROPERTY SIZE: Square Feet Acres 0.96 DIRECTIONS: MOLLYS BACKBONE TO AZAELA LEFT ONTO HOME PLACE SIGN PRIMARY CONTACT: Applicant SEWER TYPE: Septic Tank GALLONS PER DAY: 360 WATER SUPPLY: Private Well DESCRIBE WORK: `8/19/16 revised PIN and address as 8812 and 880 have been combined" BUILDING NEW 72X60 3 BEDROOI 2.5 FULL BATHS 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: STRUCTURE TYPE: FACILITY TYPE: Single Family Residence DESCRIPTION OF VACANT LOT EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: NUMBER OF EXISTING BEDROOMS: NEW STRUCTURE DIM:: 72X60 # OF NEW BEDROOMS:: 3 BASEMENT? No New Structure PRIMARY RESIDENCE OTHER DESCRIPTION: # OF OCCUPANTS PROPOSED CONSTRUCTION BASEMENT FIXTURES? 2 PLUMBING REQUIRED? Yes Desired system types (Improvement Permit or Authorization to Construct): ACCEPTED: ALTERNATIVE: CONVENTIONAL: OTHER: INNOVATIVE: ANY: YES Other described: APPLICATION FOR WELL CONSTRUCTION PROPOSED WELL TYPE: Individual Well REPLACE WELL?: NO lig - chapplication 08/19/2016 09:35 Pagel of4 A CATAWBA COUNTY Case # RBPR-07-2016-24242 Public Health Department Subdivision ; G SHERWOOD SHORES Environmental Health Division PIN# 461902752332 184sN PO Box 389, 100-A Southwest Blvd, Newton, NC 28658 2 NAME ON PERMIT: ( GEORGE CRENSHAW), PO BOX 1421, MOORESVILLE NC 28115 ( GEORGE CRENSHAW) Site Address: 8800 DOG LEG RD, SHERRILLS FORD NC 28673 Property Size: Square Feet Acres 0.96 Directions: MOLLYS BACKBONE TO AZAELA LEFT ONTO HOME PLACE SIGN 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 FEENAME Authorization to Construct Fee (New/Expansion) Fee Improvement Permit Fee Well Permit & Inspection Fee TOTAL FEES DATE FEE AMOUNT 07/08/2016 $150.00 07/08/2016 $150.00 07/08/2016 $300.00 $600.00 FEES ARE NON—REFUNDABLE ONCE A SI'Z'E VISI' IS MADE OR WORD ON A PLAN REVIEW HAS COMMENCED SYSTEM REDESIGN AND/OR RETRIP WILL INCUR AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) F9 - ellapplicalion 08/19/2016 09:35 Page 2 of 4 Catawba County Environmental Health % 2 .00 124.7'1 A08.59 Parcel: 461902752332, 8800 DOG LEG RD SHERRILLS FORD, 28673 12010 DOG SSG F -V 08812 136M 3 rF� wr` *8824 �6670 r r 1 in=50ft 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 08/19/2016 Parcel Report Parcel Report - Catawba County NC Parcel Information: Owner Information: Parcel ID: 461902752332 Owner: CRENSHAW GEORGE JOSHUA Parcel Address: 8800 DOG LEG RD Owner2: null City: SHERRILLS FORD, 28673 Address: PO BOX 1421 LRK(REID): 3987 Address2: null Deed Book/Page: 3344/1184 City: MOORESVILLE Subdivision: SHERWOOD SHORES State/Zip: NC 28115-1421 Lots/Block: 4 & 5/ B Agricultural District: Last Sale: School Information: List all Owners Deed History Report School District: COUNTY Plat Book/Page: 15/37 Legal: LOTS 4 & 5 PL 15-37 Elementary School: CATAWBA Middle School: MILL CREEK Calculated Acreage: .960 High School: BANDYS Tax Map: 004AX 02005 School Map Township: MOUNTAIN CREEK State Road #: 2713 Tax/Value Information: Tax Rates(pdf) Zoning Information: City Tax District: All in County Zoning District: COUNTY County Fire District: SHERRILLS FORD Zoningl: R-30 Building(s) Value: $0 Zoning2: null Land Value: $25,000 Zoning3: null Assessed Total Value: $25,000 Zoning Overlay: CRC-O,WP-O Year Built/Remodeled: null/null Small Area: SHERRILLS FORD Current Tax Bill Split Zoning Districts: null/null Zoning Agency Phone Numbers Miscellaneous: Firm Panel Date: 2008-03-18 Building Permits for this parcel. Firm Panel #: 3710461900K Building Details 2010 Census Block: 2005 WaterShed: WS -IV Critical Area 2010 Census Tract: 011503 Voter Precinct: P31 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, 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=461902752332&typ=P 8/19/2016 ygA v _ G �a 1842 sm Applicant THIS IS NOTA PERMIT Case # RBPR-07-2016-24242 CATAWBA COUNTY HEALTH DEPARTMENT PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES Residential Building Plan Review - Building New IMPROVEMENT - AUTH CONST -NEW WELL ANIERICAS HOME PLACE (WAYNE HOOKER). 1206 GREENLAND DR. STATESVILLE NC 281 H:7047467094B:7048724400 C 3367053235 HOME: 7047467094F: 7048724408 WAYNEHrrI AMERICASHOMEPLACE .COM Owner GEORGE CRENSHAW, PO BOX 1421, MOORESVILLE NC 28115 NAME TO APPEAR ON PERMIT GEORGE CRENSHAW SITE ADDRESS: 8812 DOG LEG RD, SHERRILLS FORD NC 28673 PIN # 461902753353 NAME of SUBDIVISION: SHERWOOD SHORES Lot 4 4 Section/Block B PROPERTY SIZE: Square Feet Acres 047 DIRECTIONS: MOLLYS BACKBONE TO AZAELA LEFT ONTO HOME PLACE SIGN PRIMARY CONTACT: Applicant SEWER TYPE: GALLONS PER DAY: 360 1 WATER SUPPLY: DESCRIBE WORK: BUILDING NEW 727,60 3 BEDROOM 2 5 FULL BATHS 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 1s "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: STRUCTURE TYPE: FACILITY TYPE: Single Family Residence DESCRIPTION OF VACANT LOT EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: NUMBER OF EXISTING BEDROOMS: New Structure PRIMARY RESIDENCE OTHER DESCRIPTION: # OF OCCUPANTS PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 72X60 # OF NEW BEDROOMS:: 3 BASEMENT? No BASEMENT FIXTURES? Desired system types (Improvement Permit or Authorization to Construct). ACCEPTED. ALTERNATIVE: OTHER INNOVATIVE: Other described: Septic Tank Private Well 2 PLUMBING REQUIRED? Yes CONVENTIONAL. ANY: YES APPLICATION FOR WELL CONSTRUCTION PROPOSED WELL TYPE: Individual Well REPLACE WELL?: NO E9-ehapplication 07/08/2016 0853 Pace 1 of ,$ CATawBA COUNTY case n RBPR-07-2016-242 42 �T y ;Public Health Department SHERWOOD SHORES Environmental Health Division 461902753353 PO Box 389, IOU -A Southwest Blvd. Newton. NC 28658 Subdivision 8 NAME ON PERMIT: ( GEORGE CRENSI-LAW). PO BOX 1421, b100RESVILLE NC 28115 ( GEORGE CRENSHAW) Site Address: 8812 DOG LEG RD, SHERRILLS FORD NC 28673 Property Size: Square Feet Acres 047 Directions: MOLLYS BACKBONE TO AZAELA LEFT ONTO HOME PLACE SIGN 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 label in of all property lines and corners and making the site a that a complete site evaluation can be performed. Date: �— �' �ro Signature of Applicant or Agent % �—��.�-tea 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 FEENAME DATE FEE AMOUNT Authorization to Construct Fee (New/Expansion) 07/08/2016 5150.00 Fee Improvement Permit Fee 07/08/2016 S150.00 Well Permit & Inspection Fee 07/08/2016 $300.00 TOTAL FEES $600.00 FEES ARE NON-REFUNDABLE ONCE A SITE VISIT IS MADE OR WORK ON A PLAN REVIEW HAS COMMENCED SYSTEM REDESIGN AND/OR RETRIP WILL INCUR AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) E9 - chapphcanon 07/08/2016 08 53 Page 2 of 4 CATAWBA THIS IS NO'f A PERMIT cotsrr CATAWBA COUNTY NEAUCH DEPARTMENT i Application for Environmental Services Page 1 Improvement Permit (t Authorization to Construct k Septic Repair ❑ Septic Malfunction ❑ Septic Expansion ❑ New Well Permit K Replacement Well ❑ Well Abandonment ❑ Well Repair ❑ Existing System Inspection (Pre -Approval Required) ❑ Application is fore New Contraction Property Address �D{, 12 t)t? leo' I A, 4k " t I %-6aA— 'IQC; -),: (67' YK Existing Facility ❑ Subdivision Lot # + t f { �Stection/Bloek/Phase rVi Driving Directions to property i r t d f w1 VjAC.t{,t�i3✓t.K. (��_C,, 1�t�ge,�A- e �'. - J NA!tIE TO APPEAR ON PERMIT? Owner ❑ Applicant ❑ Contractor Applicant Contact Information Acres 7,)✓.+r'1 I Name 11$ SC I Address jXo(o fsR ,,.v tGa t� na. � `1I2 klC- I Phone I Cell Phone V -e ?-,8 - 7 7V Owner Contact Information( t Name 6-eop 54 7. Sk, 4 C2t'�vl.Chl�c..+ j Address X12 b,.1eG (Q .j'Le a 1iS - Rc�- 1J i~ �(�I"7 I Phone / } Cell Phone '70 41- 6(,/,9( Contractor Contact Information ><-t (Name tKke;r- g, rvt� r�l✓+G� I Address 12.06, fsreetnin, na. S tc�c J ttt �L- 1 Phone -9 70e(_ q7)-'Iq,bo I Cell Phone WTIO WILT. BE THE PRIMARY CONTACT? ❑ Owner 'Applicant ❑ Contractor Description of Existing Structures on Site - -- # of Bedrooms *f Structure Dimensions # of Occupants Basement ❑ Yes ❑ No Basement Fixtures Q Yes ® No The Applicant shall notify the local health department upon submittal oPthis 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. 0 Yes 19 -No Does the site contain any jurisdictional wetlands? 0 Yes V!Ro Does the site contain any existing wastewater systems? Q Yes O'No Is any wastewater going to be generated on the site other than domestic sewage? 10'"Ns 0 No Is the site subject to approval by any other public agency? E2 Yes 19<Tc-) Are there any easements or right of ways on this property? Describe . , ❑ community .. . ❑Semi- . . Existtin g water suppl}' in use ❑individual . tire]! Communi Well l l Public Well ❑ County/City/Township Water Line Is a public water supply available? ** ❑ Yes )RTNo 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 0 Ahernatil e 0 Conventional 0 Innovative 0 Other Ji�',Any CT A�.� 7� A THIS IS NOT A PERMIT tl ,Sud^. [�4/D IL�Li1 CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services Page 2 Proposed Facility Type R—Primary Residence New Residence ❑ f Addition to Residence) # of New Bedrooms Project Description Structure Dimensions 7,� XE10 l # of Occupants 2 Basement ❑ Yes X No Basement Fixtures ® Yes 0 No ❑ Accessory Structure(s) Describe # of New Bedrooms *'l if applicable Structure Dimensions # of Occupants Accessory Dwelling ❑ Yes ❑ No Plumbing ❑ Yes ❑ No Describe Plumbing Needed ❑ Multi -Family Residence # Units #Bedrooms per Unit*j' 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 Tvpe 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 X Individual Well ❑ 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 by rooms identified on house plans as a bedroom at the tune 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 RE, TRIP 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 i f 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 �G / 2--� Date 7-7-16, Printed Name of Owner or Agent m1 i .. n Catawba County Environmental Health Parcel: 461902753353, 8812 DOG LEG RD 1 in=50ft SHERRILLS FORD, 28673 This map/report product was prepared from the Catawba County, NC Geospa0al 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 07/07/2016 Parcel Report Parcel Report - Catawba County NC Parcel Information: Parcel ID: 461902753353 Parcel Address: 8812 DOG LEG RD City: SHERRILLS FORD, 28673 LRK(REID): 3986 Deed Book/Page: 3341/1106 Subdivision: SHERWOOD SHORES Lots/Block: 4/ B Last Sale: $25,000 on 2000-05-02 Plat Book/Page: 15/37 Legal: LOT 4 SHERWD SH PL 15-37 Calculated Acreage: .470 Tax Map: 004AX 02004 Township: MOUNTAIN CREEK State Road #: 2713 Tax/Value Information: Tax Rates(pdf) City Tax District: All in County County Fire District: SHERRILLS FORD Building(s) Value: $0 Land Value: $24,500 Assessed Total Value: $24,500 Year Built/Remodeled: null/null Current Tax Bill Miscellaneous: Building Permits for this parcel. Building Details WaterShed: WS -IV Critical Area Voter Precinct: P31 Parcel Report Data Descriptions List all Owners Deed History Report Owner Information: Owner:CRENSHAW GEORGE JOSHUA Owner2: null Address: PO BOX 1421 Address2: null City: MOORESVILLE State/Zip: NC 28115-1421 School Information: School District: COUNTY Elementary School: CATAWBA Middle School: MILL CREEK High School: BANDYS School Map Zoning Information: Zoning District: COUNTY Zoningl: R-30 Zoning2: Zoning3: Zoning Overlay: CRC-O,WP-O Small Area: SHERRILLS FORD Split Zoning Districts: null/null Zoning Agency Phone Numbers Firm Panel Date: 2008-03-18 Firm Panel #: 3710461900K 2010 Census Block: 2005 2010 Census Tract: 011503 Agricultural District: Assessment Report Page 1 of I 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 mavreport product or the use thereof by any person or entity © 2016, Catawba County Government, North Carolina. All rights reserved. ]�-RlAe Ow f3oo well I Nt'J V3°o 3bz 3bO5Pd http://gis.cataxvbacountyiic.gov/nomap/parcel_report.php?key=461902753353&typ=P 7/7/2016 THIS IS TO CERIFYTHATON THE 6 DAY OF August � 16—.ACT SURVEY WAS DONE UNDER MY SUPERVISION OF THE PROPERTY SHOWN HEREON THIS MAP IS 001 INTENDED TO MEET GS 47-30 RECORDING REQUIREMENTS. SIGNED i /�9N!%1• P Bishop Land Surveying, Inc. a, ✓ 10719 Trolley Run Dr. SITES `PSH Cornelius,031 �0�i'�. (70N) 63a89356 Business License #: C-2674 Vicinity Map :a SEAL �'• L-3957 Su o Q III1111`\\ LEGEND FNFAP $Ci9.LN .onraea rN ecu eNrtw4wxcfflevnwa C• RVgIfFU qlf / � RIY VE I I — — .a,oraa n,vmn,wemovaan ru. t I LOTS 4 & 5 w w...00e..x.on wNoaRu�ro ` Q nmua ecceorts,w,um rwauie oawo � P� oez+rrom 1 LOT N 7736'00" E 100.00' wacx e N - DOG LEG ROAD a PUBLICRW CURVE TABLE CURVE I LENGTH I RADIUS I CHORD I BEAHING CI I 6608 1 34107 I 65.98 S72.Oz2M Plot Plan SURVEY OF Lots 4 & 5, Block B, Sherwood Shores Subdivision SCALE 1'= 40' Mountain Creek Twsp., Sherrills Ford, Catawba County, N.C. THE PROPERTY OF George Joshua Crenshaw MAP RECORDED IN BOOK 15 AT PAGE 37 DEED RECORDED IN BOOK 3341 PAGE 1106 FILE:C:LL mProjeW\Calaxba Ccmity%&pIShanwotl Stwns LMSEWS.dq Drawn By: ROB FNFAP $Ci9.LN -10 00, 00 I / I I / v I LOTS 4 & 5 Q I BLOCK 41,818 SO. FT. \ 0.860 ACRES N LOT -114 t T. 1 $ 1^ LOT a PROPOSED I mm.wwi: 11m o RESIDENCE lum, #88 12!$ 2 N m 1 wTri«rt seTiv�K ----- I DOG LEG ROAD a PUBLICRW CURVE TABLE CURVE I LENGTH I RADIUS I CHORD I BEAHING CI I 6608 1 34107 I 65.98 S72.Oz2M Plot Plan SURVEY OF Lots 4 & 5, Block B, Sherwood Shores Subdivision SCALE 1'= 40' Mountain Creek Twsp., Sherrills Ford, Catawba County, N.C. THE PROPERTY OF George Joshua Crenshaw MAP RECORDED IN BOOK 15 AT PAGE 37 DEED RECORDED IN BOOK 3341 PAGE 1106 FILE:C:LL mProjeW\Calaxba Ccmity%&pIShanwotl Stwns LMSEWS.dq Drawn By: ROB