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HomeMy WebLinkAboutRBPR-07-2016-24243.TIFTHIS IS NOT A PERMIT Case # RBPR-07-2016-24243 CATAWBA COUNTY HEALTH DEPARTMENT PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES Residential Building Plan Review - Accessory Structure IMPROVEMENT - AUTH_CONST Redly $19111P A(V %be( Contractor SAME AS OWNER, Owner JOHNNY BARBER, 8462 DOG LEG RD, SHERRILLS FORD NC 28673 NAME TO APPEAR ON PERMIT JOHNNY BARBER SITE ADDRESS: 8462 DOG LEG RD, SHERRILLS FORD NC 28673 PIN # 461901465310 NAME of SUBDIVISION: Lot # Section/Block PROPERTY SIZE: Square Pect Acres DIRECTIONS: Azalea Rd, left on Dog Leg Rd, left between 1st and 2nd houses. property on right PRIMARY CONTACT: O�w��err SEWERTYPE: Septic Tank DAY: GALLONS PER W R SUPPLY : Private Well DESCRIBE WOR : 8/8%1_6 no bedrooms allowed in accessory building 10� * NOTA DWELLING NO OCCUPANTS ***BUILDING A 30X40' ACCESSORY BUILDING ON CONCRETE SLAB WITH A FULL BATH ROOM PER JULIA * 45 RIGHT OF WAY -LOT IS DIVIDED BY 45' RIGHT OF WAY* 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? Yes APPLICATION FOR: STRUCTURE TYPE: FACILITY TYPE: Accessory Structure New Structure ACCESSORY STRUCTURE OTHER DESCRIPTION: DESCRIPTION OF SINGLE FAMILY DWELLING EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: 66X75 NUMBER OF EXISTING BEDROOMS: NEW STRUCTURE DIM:: 30X40 BASEMENT? No # OF OCCUPANTS: PROPOSED CONSTRUCTION BASEMENT FIXTURES? No Desired system types (Improvement Permit or Authorization to Construct). ACCEPTED ALTERNATIVE: OTHER INNOVATIVE: Other described: PLUMBING REQUIRED? CONVENTIONAL: ANY. 139 - ehappheauou 0870812016 16:26 Page I of 4 e CATANVBA COUNTY Case #. , . _ RBPR-07-2016-24243 f Public Health Department Subdivision Environmental Health Division PIN# 461901465310 PO Box 389, 100-A Southwest Blvd, Neo4on. NC 28658 IH4Z ,x NAME ON PERMIT: ( JOHNNY BARBER), 8462 DOG LEG RD, SHERRI LLS FORD NC 28673 ( JOHNNY BARBER) Site Address: 8462 DOG LEG RD, SHERRILLS FORD NC 28673 Property Size: Square Feet Acres Directions: Azalea Rd, left on Dog Leg Rd, left between 1st and 2nd houses property on right 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: �� `�- �� (G _ Signature of Applicant or Agent_ 692..-C An Environmental Health Specialist will contact you wit in 5 working days of application date. If you need further information or assistance please call 828-466-7291 AREA1 ,:.... -:." FEENAME : " ' Imo...,. ,, : DATEC FEE_"AMOUNT; ",' , :..� .., Authorization to Construct Fee (New/Expansion) 07/08/2016 $150.00 Fee Improvement Permit Fee 07/08/2016 $150.00 41 -µ _;, , •r'I 'TO FEES A441, , 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 - ehappfLcawn 08/08/2016 16 26 Pave 2 of 4 Contractor THIS IS NOT A PERMIT Case # RBPR-07-2016-24243 CATAWBA COUNTY HEALTH DEPARTMENT PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES Residential Building Plan Review - Accessory Structure IMPROVEMENT - AUTH CONST SAYIEAS OWNER.. Owner JOHNNY BARBER. 8462 DOG LEG RD, SI IERRILLS FORD NC 28673 NAME TO APPEAR ON PERMIT JOHNNY BARBER SITE ADDRESS: 8462 DOG LEG RD. SHERRILLS FORD NC 28673 PIN # 461901465310 NAME of SUBDIVISION: Lot 4 Section/Block _ PROPERTY SIZE: Square Feet Acres DIRECTIONS: A PRIMARY CONTACT: Owner GALLONS PER DAY: 240 SEWER TYPE: Septic Tank WATER SUPPLY: Private Well DESCRIBE WORK: NOTA DWELLING NO OCCUPANTS —BUILDING A 30X40' ACCESSORY BUILDING ON CONCRETE SLA WITH A FULL BATH ROOM 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? Yes APPLICATION FOR: STRUCTURE TYPE: New Structure ACCESSORY STRUCTURE FACILITY TYPE: Accessory Structure OTHER DESCRIPTION: DESCRIPTION OF I SINGLE FAMILY DWELLING EXISTING STRUCTURES I ON SITE (IF ANY) DIM EXISTING STRUCTURE: 66X75 NUMBER OF EXISTING BEDROOMS: NEW STRUCTURE DIM:: 30X40 BASEMENT? No # OF OCCUPANTS: PROPOSED CONSTRUCTION BASEMENT FIXTURES? No Desired system types (Improvement Permit or Authorization to Construct): ACCEPTED: ALTERNATIVE OTHER: INNOVATIVE: Other described: PLUMBING REQUIRED? CONVENTIONAL. ANY: 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 far 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 E9-chapplication 07/08/2016 11 38 Page I of �8 CATAWBA COUNTY Health Depattment Case q T Public Hea Subdivision Environmental Health Division PINd PO Box 389. 100-A Southwest Blvd. Newton. NC 28658 Ig i. w NAME ON PERMIT: (JOHNI NY BARBER), 8462 DOG LEG RD, SHERRILLS FORD NC 28673 ( JOHNNY BARBER) Site Address: 8462 DOG LEG RD. SI-IERRILLS FORD NC 28673 Property Size: Square Feet Acres Directions: A RBPR-07-2016-24243 461901465310 FEENAME DATE FEEAMOUNT Authorization to Construct Fee (New/Expansion) 07/08/2016 $150.00 Fee Improvement Permit Fee 07/08/2016 $150.00 TOTAL FEES 5300.00 FEES ARE NON-REFUNDABLE ONCE A SITE VISIT IS MADE OR WORK ON A PLAN REVIEW HAS COMMENCED SYSTEM REDESIGN AND/OR RETRIP WILL INCUR AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) E9 - ehappbcanon 07/08/2016 11:38 Page 2 of 4 Q-ov-//_b t,. C;ATAWBA ,COUNTY HEALTH DEPARTMENT '' kd Telephone: (828)'465-8270 TDD: (828) 465-8200 WLS dd 20 / -n/.78•4 IP_x_ AC X.Rpr. Prmt. Opr. Print. Sys. Type 3G Well Prmt.�Replacement Well—Well Rpr. Prmt. OwnerlAgent-)-Q/,liV/UV /3A/7z---3F Phone �_ ,zS-y�fr-327,P Address XqK•? .Drsc..lF,G- 'eol;z Subdivision /-?)eZID _N, C , AE, 7 Section/Block/Phase Lot# Lot Size 7, (7$ �ae2a'Directions :�S jF�F,J FD/LI 7)Aa) CGS YYi7�[/. _QAC llltdlt/E'a717A1) A Za66;4 27» t-a Isle /0r7 tits n 0Q, U -r Property Address�Q'��, .Z, j7 C G- LL-¢. ,p pj zG] Facility: Ilouse Mobile Home Business_Multi-family_ Other: Pin Number F'/9 e" / 41r �/(7 Other . Zoning Approval # # Bedrooms N3 # Seats # Employees . Application Rate GPD Flow 3 60 Hot Tub or Spa ye, QnSpecial Fixtures Basement ye ro . 100% Repair Are yes no Basement Plumbing yes4o> Water Supply: Private Well'4— Public Semi-Public_ f rffi4Yii4#*ik##fiti#4#+##4titW+WWW+WtWWW#+#####+###rtrt+t###t#t###rt4rt44♦#ti#t+###iitt#ttik+YtWWi#tfi4itiiit#illi#ff t4WtW+### Type of System: Trench_ Bed — Pump= Pump/Panel= Panel LPP Other '��-��9--Fbu�Ti'o.✓ -s�i$ Septic Tank Size /Qon Pump Tank Size Nitrification Field: Total Square Feet /3722 Depth of Stone Ja " Bed Size --- Trench Width -3, Total Length of All Trenches 2-57 Number of Trenches ' Trench Length S6/r`l6 /BE/S:L< I — Feet on Center Maximum Trench Dept.i-Distance of care I eII .SD '-I *DO NOT INS'T'ALL SEPT C WHEN WET* , 'WELL RECORD REQUIRED AT COMPLETION* +r•+trt++#+rt+W{#rtttit#r/qrt++it+iti#ttiti ifitti#+.#rtr+r+++r+r#+.+.++###ti+#+4++#iri##++###frfff##+,�.#f#4##.####4.##rttt+i+i Topo (n> % Slope Texture GCfyY&y Structure .5/3<3 Clay Min. Soil Wetness I �� Soil Depth 9�, I I Restric. Hoz. at,2g� I l I� Z Available spacees o I 'may i Overall Class S PW3 la �� Comments: I_ v w ��osii.r C 6� I ` I �o Filler Required 7 . v N IN 1\ �1 Riser required when r N� \ Qi N �r tank is more than 6 . incites deep. g **NO GUARANTEE OR WARRANTY IS INI I VOR GIVEN AS TO THC PERFORMANCE OR LENGTH OF TIN E THIS SYSTEM WILL FUNCTION** *Improvement Permit has no expiration date and is transferable, but may,[ a revoked if site plans or intended use el • ages for the proposed facility. An Authorization to Construct is valid for (5) five years from dal�i fsucd and is not transferable. Well Peit valid for 5 years provided site conditions do not change. Well location, installation, and pro ection must meet state and local regulations, and must be inspected and approved by a representative of the Catawba County Health Department before an portion or the installation is put into use. The siting of the well by the Health Department staff is to provide protection from known possible sources of contamination. No volume of water is guaranteed at any, site by the Health Department. Permit DateU . 'Z/ GHS Owner/Agent _ Septic Tank Installed ByDF'NNIS k/iLL/e" SFR7n Datep� EHS_� Well Installed By_cLg5! zC- 4/2t. Well Grout Approval Date02 J 7-0.L Well Head Approval Dateo t/-//- G 2 Date Sample Collected Date of Results Results EIIS White - Office Blue - Building Inspection Operation Permit Yellow - Owner/A&Fit Green - Budding Inspection Amhorizaiion to Construct CAT AWBA 'I`HTS IS NOT A PERMIT Cou•�UT�n CATAWBA COUNTY HEALTH DEPARTMENT Application for } nviro nnlentaI Services Page I Improvement Permit Authorization to Construct, Septic Repair El Malfunction El' Septic Expansion ❑ New Well Permit ❑ Replacement Well ❑ WeII Ahandonment ❑ Well Repair ❑ Existing System Inspection (Pre -Approval Required) ❑ Application is for New Construction ❑ Existing Facility ❑ Property Address110 ,."" ef Subdivision .2 Y67 ? Lot # Acres Section/Block/Phase Driving Directions to Property O O4D rw i�p _ f, .u� Qoeri /� 2,_• �, �(vhe(441) tqn 64)kf- - t NAME TO APPEAR ON PERMIT? ❑ Owner ❑ Applicant ❑ Contractor Applicant Contact Information Name Address urr r�62 ' Q.el ft .D SR4 t -� a1 Sl d 7 Phone U Cell Phone '%61F -?6 �6u%'f Owner Contact information If—(? Name Address Phone Contractor Contact Information Name Address Phone I Cell Phone I Cell Phone WHO WELL BE THE PRIMARY CONTACT? ❑ Owner ❑ Applicant ❑ Contractor Description of Existing Structures on Site # of Bedrooms *f_ / Structure Dimensions [Put i` # of Occupants �2 Basement ❑ Yes R�No Basement Fixtures ® Yes C1 No The Applicant shall notify the local health department upon submittal of this application if any of the following apply to the property iq yuestion. If the answer to any question is "yes", applicant must attach supporting documentation. 17 Yes o Does the site contain anyjurisdictional wetlands? plx Yes K3 To Docs the site contain any existing wastewater systems? i} YesI Is any wastewater going to be generated on the site other than domestic sewage? ® Yes o Is the site subject to approval by any other public agency? ErYes 0 No Are there any easements or right of ways on this property'? Describe Alf j �! � Existing water supply in use ['Individual Well D 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) 0 Accepted 11 Alternative 0 Conventional 0 Innovative 0 Other 0 Any Aix VTATI-IIS IS NOT A PERMIT CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services Proposed Facility Type ❑ Primary Residence ❑ New Residence ❑ Addition to Residence # of New Bedrooms *f Project Description Structure Dimensions Basement ❑ Yes ❑ No # of Occupants Basement Fixtures ® Yes 0 No ❑ Accessory Structure(s) Describe v #of New Bedrooms *I if applicable O Structugl3imeensi/on: # of Occupants /) Accessory Dwelling F1 Yes LLK0 Plumbing ['Yes F-1No Describe Plumbing Needed .,at�w.p.. ❑ Multi -Family Residence # Units #Bedrooms per Unit*t Total # Bedrooms 'I Structure Dimensions ❑ Food Service Specify Type # Seats Floor Space -Entire Food Service Facility (Sq Ft) # Employees per Shift # of Shifts Dining Arca (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 ❑ Semi -Public Well ❑ Community Well Abandonment Type ❑ Drilled ❑ Bored ❑ Dug ❑ Unknown Well Repair Requested ❑ Yes ❑ No Describe Page 2 Calculated Design Flow, Commercial I 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. 'Chis may prevent the need for septic system size increase in the future. f 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 comers and making the site accessible so that a complete site evaluation can be performed. Signature of Owner or Agent Pa Qd � Date / ✓S� `a d Printed Name of Owner or Agent (%o i n/ n/ X P!( Parcel Report Parcel Report - Catawba County NC Parcel Information: Owner Information: Parcel ID: 461901465310 Owner: BARBER JOHNNY P SR Parcel Address: 8462 DOG LEG RD Owner2: BARBER ELIZABETH City: SHERRILLS FORD, 28673 Address: 8462 DOG LEG RD LRK(REID): 3711 Address2: null Deed Book/Page: 2277/1243 City: SHERRILLS FORD Subdivision: State/Zip: NC 28673-7722 Lots/Block: 2/ School Information: Last Sale: $65,000 on 2001-06-06 School District: COUNTY Plat Book/Page: 55/90 Elementary School: CATAWBA Legal: LOT 2 PL 55-90 Middle School: MILL CREEK Calculated Acreage: 4.520 High School: BANDYS Tax Map: 004 X 02004D School Map Township: MOUNTAIN CREEK State Road #: 1836 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: $75,400 Zoning2: Land Value: $29,500 Zoning3: Assessed Total Value: $104,900 Zoning Overlay: WP -O Year Built/Remodeled: 2002/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: 2002 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 I of 1 This map/report product was prepared from the Catawba County, NC Geospatial Information Services Calawba 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, lass 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. 19 pd hitp:Hgis.catawbacounlync.gov/nomap/parcel_rcport.plip?key=461901465310&typ=P 7/8/2016 Catawba County Environmental Health Parcel: 461 901 46531 0, 8462 DOG LEG RD 1 in=150ft SHERRILLS FORD, 28673 Per sue, &►lbc+en A.csx-lo-t5 are Ind hooked --(ensidercd I lot This map/report product was prepared from the Catawba County, NC Geospahal 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 07/08/2016