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HomeMy WebLinkAboutRBPR-07-2016-24261.TIF .„1:Y A ip� THIS IS NOT A PERMIT Case # RBPR-07-2016-24261 , An ' CATAWBA COUNTY HEALTH DEPARTMENT O ' . ;o C O i{I..� PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES ? r i Ig42 sM Residential Building Plan Review - Building New toit •ro •* o s f•• I PROVEMENT- AUTH_CONST o a IL 01 Mintan 4 'I" Contractor *IMPERIAL BUILDERS AND RENOVATIONS, 5037 WALLACE OR, HICKORY NC 28602 B:8283082280F:81833 00092 INFO @I M PERIA LBUI LDERSNC.COM Owner MICHAEL D. & ROXANNE M. BILLS, 5797 GREEDY HWY, HICKORY NC 28602 NAME TO APPEAR ON PERMIT Michael D. & Roxanne M. Bills SITE ADDRESS: 5785 GREEDY HWY, HICKORY NC 28602 PIN # 269913226816 NAME of SUBDIVISION: Lot 6 3 Section/Block PROPERTY SIZE: Square Feet Acres_ 6.52 DIRECTIONS: HWY 127 SOUTH TO GREEDY HWY TURN RIGHT ONTO GREEDY HWY FIRST LEFT TURN ONTO THE PROPERTY 2ND LOT ON LEFT PRIMARY CONTACT: Contractor SEWER TYPE: Septic Tank GALLONS PER DAY: 600 WATER SUPPLY: Private Well DESCRIBE WORK: BUILDING A NEW 5 BEDROOM SINGLE FAMILY DWELLING *will share/use well on neighboring property if possible. 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: New Structure STRUCTURE TYPE: PRIMARY RESIDENCE FACILITY TYPE: Single Family Residence OTHER DESCRIPTION: DESCRIPTION OF VACANT LOT EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: NUMBER OF EXISTING BEDROOMS: #OF OCCUPANTS: 5 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 54X72 #OF NEW BEDROOMS:: 5 BASEMENT? Yes BASEMENT FIXTURES? Yes PLUMBING REQUIRED?Yes Desired system types(Improvement Permit or Authorization to Construct): ACCEPTED: ALTERNATIVE: CONVENTIONAL: OTHER: INNOVATIVE: ANY: YES Other described: P9-ehapplication 07/12/2016 08:33 Page I oI d ,aw t CATAWBA COUNTY Case ti RBPR-07-2016-24261 .Q' ci .4 Public Health Department Subdivision G ®1 �) Environmental Health Division l'11914 269913226816 KrAl li PO Box 389. 100-A Southwest Blvd,Newton,NC 28658 2H.a NAME ON PERMIT: ( MICHAEL D. & ROXANNE M. BILLS), 5797 GREEDY HWY, HICKORY NC 28602 ( Michael D. & Roxanne M. Bills) Site Address: 5785 GREEDY HWY, HICKORY NC 28602 a Size: Square 6.52 Property S P ware Feet Acres Directions: HWY 127 SOUTH TO GREEDY HWY TURN RIGHT ONTO GREEDY HWY FIRST LEFT TURN ONTO THE PROPERTY 2ND LOT ON 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. 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 p! sFEENAMEY �� I " ! (r DATE!: ' FEE AMOUNT l.tuu}w�c .._rrr I } Authorization to Construct Fee (New/Expansion) 07/I1/2016 $300.00 Fee Improvement Permit Fee 07/11/2016 5150.00 { rrL_r-- .— 11 r rno ! ,�.._a tl I�l x1111�I I r 7tip " Ir r lr.:.. �!� Ili` t�bTOTALIFEES 1 11 I h{ °r tlali I Ir ��u d1i11� 11 1m� -ItII� ! tl t $450.09,:lb i�71 t.°.+L.1__«..I'YW'iRJlLL'1.LYLLu .JL ali�u.r.al.l._. '.uIrILIIRt!IiL.Ir' UT. AWL—L:a'e r.11;1..(lilr 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-chapplicauon 07/12/2016 08:33 Page 2 of4 --4 , d! THIS IS NOT A PERMIT Case # RBPR-07-2016-24261 �Q i_. 2 CATAWBA COUNTY HEALTH DEPARTMENT ° v• -j " PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES �� 842 sM Residential Building Plan Review - Building New 41 Ce a.IMPROVEMENT - AUTH_CONSToCo'` Contractor *IMPERIAL BUILDERS AND RENOVATIONS, 5037 WALLACE CIR. HICKORY NC 28602 13:8283082280F:8183300092 INFO @IMPERIALBUILDERSNC.COM Owner MICHAEL D. & ROXANNE M. BILLS, 5797 GREEDY HWY, HICKORY NC 28602 NAME TO APPEAR ON PERMIT Michael D. & Roxanne M. Bills SITE ADDRESS: .GREEDY HWY, HICKORY NC 28602 PIN # 269913226816 NAME of SUBDIVISION: Lot# 3 Section/Block PROPERTY SIZE: Square Feet Acres 6.52 DIRECTIONS: HWY 127 SOUTH TO GREEDY HWY TURN RIGHT ONTO GREEDY HWY FIRST LEFT TURN ONTO THE PROPERTI 2ND LOT ON LEFT PRIMARY CONTACT: Contractor SEWER TYPE: Septic Tank GALLONS PER DAY: 600 WATER SUPPLY : Private Well- DESCRIBE WORK: BUILDING A NEW 5 BEDROOM SINGLE FAMILY DWELLING 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: New Structure STRUCTURE TYPE: PRIMARY RESIDENCE FACILITY TYPE: Single Family Residence OTHER DESCRIPTION: DESCRIPTION OF VACANT LOT EXISTING STRUCTURES ON SITE(IF ANY) DIM EXISTING STRUCTURE: NUMBER OF EXISTING BEDROOMS: #OF OCCUPANTS: 5 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 54X72 #OF NEW BEDROOMS:: 5 BASEMENT? Yes BASEMENT FIXTURES? Yes PLUMBING REQUIRED?Yes Desired system types (Improvement Permit or Authorization to Construct): ACCEPTED: ALTERNATIVE: CONVENTIONAL: OTHER: INNOVATIVE: ANY: YES Other described: E9-chapplication 07/11/2016 1650 Page 1 of 4 • CATAWBA COUNTY Case# RBPR-07-2016-24261•U ' Public Health Department Subdivision 2 ;_ a®',T Environmental Health Division PIN# 269913226816 - / PO Box 389, 100-A Southwest Blvd.Newton.NC 28658 842 NAME ON PERMIT: (MICHAEL D. & ROXANNE M. BILLS), 5797 GREEDY HWY. HICKORY NC 28602 ( Michael D. & Roxanne M. B Site Address: . GREEDY HWY. HICKORY NC 28602 Property Size: Square Feet Acres_ 6.52 Directions: HWY 127 SOUTH TO GREEDY HWY TURN RIGHT ONTO GREEDY HWY FIRST LEFT TURN ONTO THE PROPERTY 2ND LOT ON 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. 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: 0- I I—/( Signature of Applicant or Agent .t.6{/,,,,, �_,/ .( Z/L- 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 FEENAME. DATE FEE AMOUNT Authorization to Construct Fee (New/Expansion) 07/11/2016 $300.00 Fee Improvement Permit Fee 07/11/2016 $150.00 TOTAL,FEES . : $450.00; 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-ehapplication 07/11/2016 16:50 Page 2 of-1 CATAWBA THIS IS NOT A PERMIT coun_r • ° CATAWBA COUNTY HEALTH DEPARTMENT ' i 01- Application for Environmental Services Page 1 Improvement Permit Authorization to Construct' < Septic Repair n Septic Malfunction n Septic Expans on n New Well Permit ❑ Replacement Well ❑ Well Abandonment❑ Well Repair ❑ Existing System Inspection (Pre-Approval Required) ❑ Application is for New Construction ig, Existing Facility n Property Address Subdivision Lot# Acres Section/Block/Phase Driving Directions to Property A . \ l r J' • i L- - ''` '. J INS !J ` j. ONE-) T• i ,2'vvl A + n.,, /. e-1 NAME TO APPEAR ON PERMIT? ,Owner ❑ Applicant :i Contractor Applicant Contact Information Name ‘7"-..44p 4rA( 5,4,'1,4915 ` - hge, v.4 ,l-•e' i-jO Address 5032 ( JMIArr (tv( le Tr keg 1 Phone Cell Phone Owner Contact Information Name XoM-.,9 31))5 Address 4"99`) G. pee )4‘ jAma r ��C,�ary i Phone y4, R 53 3 1 y(, y Z I Cell Phone Contractor Contact Information ) ) / Name ��,Peri9I built/Tic dr gr,vv✓41.1)-'S b/G Address co ?9 k) )) nce. C;sr, /r /-/icko7 wL Phone gZ g 9 p g 2 a g v Cell Phone WHO WILL BE THE PRIMARY CONTACT? ❑ Owner - Applicant Contractor , ' Description of Existing Structures on Site �/ Lot # of Bedrooms *j' y Structure Dimensions 4-9 k 92 # of Occupants 5- Basement 0 Yes ❑ No Basement Fixtures VA Yes 0 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 `No Does the site contain any jurisdictional wetlands? ®Yes VI() Does the site contain any existing wastewater systems? O Yes No Is any wastewater going to be generated on the site other than domestic sewage? *Yes - T No Is the site subject to approval by any other public agency? O Yes XNo Are there any easements or right of ways on this property? Describe Existing water supply in use Individual Well ❑ Community Well ❑ Semi-Public Well County/City/Township 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 your preference) ❑ Accepted ❑ Alternative Conventional El Innovative ❑ Other AnY CATA 1TRA THIS IS NOT APERMIT - e univ CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services Page 2 Proposed Facility Type ❑ Primary Residence New Residence ❑ Additio9 to Residence # of New Bedrooms *j' 5— \ ` Project Description /V/(Q Cc - c-1 r �IF,G Structure Dimensions Cl/ j 97i It of ecupants C Basement Yes ❑ No Basement Fixtures -Yes tj No ❑ Accessory Structure(s) Describe #of New Bedrooms *t if applicable Structure Dimensions # of Occupants Accessory Dwelling ❑ Yes ❑ No Plumbing El Yes ❑ No Describe Plumbing Needed Multi-Family Residence#Units #Bedrooms per Uuit*f 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 ❑ Semi-Public Well I Community Well Abandonment Type I 1 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. *My 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. 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 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 6/.. , �� �/t/�� Date 7 —/1 - /C �j Printed Name of Owner or Agent 1ewr/ Ri'CA4rd WiN1le'r Catawba County Environmental Health L).,A:\\N .. \\:AA. + ...F 41/ \\.... 1 1 �f�) ' 1 1 f 358,48 f6 f \I\ t 1 it M ttt ."15 :11 to t a, cc_ —'— r�G —28.94 t 'i` \. ,fir IIsL • �_ 1 II y 1.1/4,( S. __it, p u,..3 II 15:51. . 9 p 1 `\ lik , . 1 1 k 1T . j ---. Parcel: 2699/13226816, 1 in=100ft 50 "7�') v 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 07/11/2016 Parcel Report Page 1 of 1 Parcel Report - Catawba County NC Parcel Information: Owner Information: Parcel ID: 269913226816 Owner: This parcel is currently being processed Parcel Address: Owner2: null City: Address: null LRK(REID): 101253 Address2: null Deed Book/Page: City: null Subdivision: State/Zip: null null Lots/Block: 3/ School Information: Last Sale: Plat Book/Page: 75/184 School District: null Legal: null Elementary School: null Middle School: null Calculated Acreage: 6.520 Tax Map: null High School: null Township: null State Road #: TaxNalue Information: Tax Rates(pdf) Zoning Information: City Tax District: All in County Zoning District: null County Fire District: All in City Zoningl: Building(s) Value: $0 Zoning2: null Land Value: $0 Zoning3: null Assessed Total Value: $0 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: null Building Permits for this parcel. Firm Panel #: null Building Details 2010 Census Block: null WaterShed: null 2010 Census Tract: null Voter Precinct: null Agricultural District: null 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. Ptad 3(c)-- Yffori)- -( ScisdiVi\d http://gis.catawbacountync.gov/nomap/parcel_report.php?key=269913226816&typ=P 7/11/2016