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HomeMy WebLinkAboutRBPR-07-2016-24292.TIF �y A •� THIS IS NOT A PERMIT Case # RBPR-07-2016-24292 < CATAWBA COUNTY HEALTH DEPARTMENT 9 . „;o.�f O 4w- PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES } /8412. 9.1 Residential Building Plan Review - Building New #Q •o. d o r:• • IMPROVEMENT - AUTH_CONST- NEW WELL Ve,31ki Applicant S ME AS OWNER, , Owner JEFFREY POPE, 1212 LITTLE RD, NEWTON NC 28658 C:8284556104 NAME TO APPEAR ON PERMIT JEFFREY POPE SITE ADDRESS: 2472 ALBERT DR,NEWTON NC 28658 PIN # 375014426904 NA1-IE of SUBDIVISION: CLIFTON S POPE REVISED Lot# Section/Block PROPERTY SIZE: Square Feet Acres 14.46 DIRECTIONS: STRAIGHT ON MT OLIVE CHURCH RD UNTIL YOU PASS JIMS JUNK YARD, ABOUT 1/2 MILE TURN LEFT ON LITTLE RD IN 1/2 MILE TURN LEFT ON ALBERT DR, TAKE 1st RIGHT AWAY ON RIGHT OFF ALBERT DR (GRAVEL DRIVE WAY) PRIMARY CONTACT: Owner SEWER TYPE: Septic Tank GALLONS PER DAY: 480 WATER SUPPLY: Private Well DESCRIBE WORK: New 4 BdRm House 80x60 with future pool 28x38 w/concrete. 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 BARN EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: 80X60 NUMBER OF EXISTING BEDROOMS: #OF OCCUPANTS: 4 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: House 80x60, future Pool 28x38 w/concrete #OF NEW BEDROOMS:: 4 BASEMENT? No BASEMENT FIXTURES? Yes PLUMBING REQUIRED? 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 E9-chappliadinn 07/I5/2016 16:53 Page 1 of 5 „f 6A CATAWBA COUNTY Case# RBPR-07-2016-24292 ?sly; Public Health Department Subdivision CLIFTON S POPE REVISED < : •Av K Environmental Health Division PIN# 375014426904 °a1 PO Box 389, 100-A Southwest Blvd,Newton,NC 28658 1g42 :. NAME ON PERMIT: (JEFFREY POPE), 1212 LITTLE RD,NEWTON NC 28658 ( JEFFREY POPE) Site Address: 2472 ALBERT DR, NEWTON NC 28658 Property Size: Square Feet Acres 14.46 Directions: STRAIGHT ON MT OLIVE CHURCH RD UNTIL YOU PASS JIMS JUNK YARD, ABOUT 1/2 MILE TURN LEFT ON LITTLE RD IN 1/2 MILE TURN LEFT ON ALBERT DR, TAKE 1st RIGHT AWAY ON RIGHT OFF ALBERT DR (GRAVEL DRIVE WAY) 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 r y --.. r FI Ra I1 ; 1u.� r �.w�,jr � E�.AMOUN41 ) FEENAMEx ill• F F �Ea Authorization to Construct Fee (New/Expansion) 07/15/2016 $300.00 Fee Improvement Permit Fee 07/15/2016 $150.00 Well Permit & Inspection Fee 07/15/2016 $300.00 j 1 14�`j' i TOTAL FEES° • • • I • Eu' a1hl: i iii t ll �•it aiwulilL�frllkfa 1 U41i�._.iIItL?x�.::d1yI1WI11Ltllu6 iAs,.�.:.._ 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-ehapplicat ion 07/15/2016 16:53 Page 2 of 5 $ THIS IS NOT A PERMIT Case # RBPR-07-2016-24292 CATAWBA COUNTY HEALTH DEPARTMENT D ±gri, in m PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES ' . ti /842 SM Residential Building Plan Review - Building New • el la 4. .4 IMPROVEMENT - AUTH CONST- NEW WELL `� s Applicant SAME AS OWNER. . Owner JEFFREY POPE, 2472 LITTLE RD.NEWTON NC 28658 — C:8284556104 NAME TO APPEAR ON PERMIT JEFFREY POPE SITE ADDRESS: 2472 ALBERT DR, NEWTON NC 28658 PIN # 375014426904 NAME of SUBDIVISION: CLIFTON S POPE REVISED Lot# Section/Block PROPERTY SIZE: Square Feet Acres 14.46 DIRECTIONS: STRAIGHT ON MT OLIVE CHURCH RD UNTIL YOU PASS JIMS JUNK YARD, ABOUT 1/2 MILE TURN LEFT ON LITTLE RD IN 1/2 MILE TURN LEFT ON ALBERT DR, TAKE 1st RIGHT AWAY ON RIGHT OFF ALBERT DR (GRAVEL DRIVE WAY) PRIMARY CONTACT: Owner SEWER TYPE: Septic Tank GALLONS PER DAY: 480 WATER SUPPLY: Private Well DESCRIBE WORK: BUILDING NEW 60X80 SINGLE FAMILY DWELLING 4 BEDROOMS 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 BARN EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: 80X60 NUMBER OF EXISTING BEDROOMS: #OF OCCUPANTS: 4 PROPOSED CONSTRUCTION • NEW STRUCTURE DIM:: 60X80 #OF NEW BEDROOMS:: 4 BASEMENT? No BASEMENT FIXTURES? Yes PLUMBING REQUIRED? 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 E9-ehapplication • 07/15/2016 12:34 Page I of5 ,cit-yii A • CATAWBACOUNTY RBPR-07-2016-24292 Case;f v U Public Health Department CLIFTON S POPE REVISED t, �? Subdivision G Environmental Health Division 375014426904 3 a ^C PO Box 389, 100-A Southwest Blvd,Newton.NC 28658 PIN# /g 9 :. NAME ON PERMIT: (JEFFREY POPE),2472 LITTLE RD,NEWTON NC 28658 ( JEFFREY POPE) . Site Address: 2472 ALBERT DR,NEWTON NC 28658 Property Size: Square Feet Acres 14.46 Directions: STRAIGHT ON MT OLIVE CHURCH RD UNTIL YOU PASS JIMS JUNK YARD, ABOUT 1/2 MILE TURN LEFT ON LITTL RD IN 1/2 MILE TURN LEFT ON ALBERT DR, TAKE 1st RIGHT AWAY ON RIGHT OFF ALBERT DR (GRAVEL DRIVE WAY) 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 -'' DATE. FEE AMOUNT Authorization to Construct Fee(New/Expansion) 07/15/2016 $300.00 Fee Improvement Permit Fee 07/15/2016 $150.00 Well Permit& Inspection Fee 07/15/2016 $300.00 TOTAL FEES , R 5750.00.- . q. FEES ARE NON-REFUNDABLE ONCE A SITE VISIT IS MADE OR WORK ON A PLAN REVIEW HAS COMMENCED SYSTEM REDESIGN AND/OR RETRIP WIL-L—INCUR AN ADDITIONAL CHARGE (S FEE1SCHEOULE) _____77 - ....v.-2- - t...., ------_. 7 -/S-----/(0 E9-ehappl'cation 07/15/2016 12:34 Page 2 of 5 CA Teti BA THIS IS NOT A PERMIT COUNTY ,V r �l CATAWBA COUNTY HEALTH DEPARTMENT ,,.,, .... Application for Environmental Services Page 1 Improvement Permit } Authorization to Construct Septic Repair❑ Septic Malfunction❑ Septic Expansion ❑ New Well Permit'aReplacement Well ❑ Well Abandonment❑ Well Repair ❑ Existing System Inspection (Pre-Approval Required) ❑ 1,J /T L Application is for New Construction Existing Facility ❑ Property Address d N7 -Dl' Subdivision I` (\Jel#kzn IVC Rgths1 Lot# Acres • Driving Directions to Property / �/"^ r Section/Block/Phase l,n aal oh his A-- O U Al ber- `-D ,,Q . (9 voQ dr p to-c NAME TO APPEAR ON PERMIT? Owner ❑ Applicant ❑ Contractor Applicant Contact Information Name Address Phone Cell Phone Owner Contact Information Name 5e-FY f-012Q Address S35 '&nn;e '/v- /a„-At.P Phone Cell Phone eraw-'ASS- oh Ni Contractor Contact Information Name Address Phone Cell Phone WHO WILL BE THE PRIMARY CONTACT? fe<Owner ❑ Applicant ❑ Contractor Description of Existing Structures on Site ry (C) Y(rip #of Bedrooms *j' Structure Dimensions #of Occupants Basement ❑ Yes ❑ No Basement Fixtures C Yes C 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. . CI Yes i Does the site contain any jurisdictional wetlands? ® Yes o Does the site contain any existing wastewater systems? ❑Yes o 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? ♦ . Yes No Are there any easements or right of ways on this property? Describe ii[t �� (!� i[Il�net/ ►- Existing water supply in use ❑ Individual Well ❑ Community Well ❑ Semi-Public Well ❑ County/City/Township Water Line Is a public water supply available? ** ❑ Yes ktvo R 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) s i / ❑ Accepted ❑ Alternative ❑ Conventional ❑ Innovative ❑ Other NIX Any CATAWBA THIS IS NOT A PERMIT COUNTY VV__ L7� CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services Page 2 Prop ed Facility Type Primary Residence ❑ New Residence ❑ Addition to Residence # of New Bedrooms *1- Project Description �vi�dt /tt-U) / Jiro Structure Dimensions 0 t #of Occupants Basement ❑ Yes No Basement Fixtures ® Yes 'No S. Accessory Structure(s) Describe a ]L,&& ' 'AI, l .t'.: `e a #of New Bedrooms *t if applicable Structure Dimensions #of Occupants Accessory Dwelling ❑ Yes ❑ No Plumbing ❑ Yes ❑ No Describe Plumbing Needed [J Multi-Family Residence# Units #Bedrooms per Unit*j' Total#Bedrooms *1- 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 laIndividual 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 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 maybe 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 Agefiti/ /L' Date 7—/5-7(9 Printed Name of Owner or A.e " J " II, �s Catawba County Environmental Health � '/ • j �I ' / /7 7 , • ae ,/ �'�.F'( 218.. f It < / ( rye //r r ,..iik"-.7 z„._------2 . 4111r ' i / ''' • . / , / ig r 9a -'35 e•, . _ x0.52 1 / V l /� ///://7,,,/ 77,------- \ (-,,, , i: r � \ t.e, / 4 //e- -" ' ------i o , , ,..-- „1/4,„ ( ' \\ i. rye bo1 t //C / ////// / ?A ,,,z\e) i ‘,-Ca ....., j yr 7 ,, . .. ..„..„, • , ,Cr# '. lik\ / IP / / 440-- :411114k • 4.* • f ir------:\ - $- skilS ofor\ s5 , i / Pi ". — 1:5.‘" 7..:: Parcel: 375014426904, 2472 ALBERT DR 1 in=150ft 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 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 07/15/2016 . Parcel Report Page 1 of 1 • Parcel Report - Catawba County NC Parcel Information: Owner Information: Parcel ID: 375014426904 Owner: POPE JEFFREY DANIEL Parcel Address: 2472 ALBERT DR Owner2: City: NEWTON, 28658 Address: 1212 LITTLE RD LRK(REID): 34749 Address2: Deed Book/Page: 3341/1553 City: NEWTON Subdivision: CLIFTON S POPE REVISED State/Zip: NC 28658-8120 Lots/Block: / School Information: Last Sale: $65,000 on 2007-06-06 School District: COUNTY Plat Book/Page: 66/120 Elementary School: BALLS CREEK Legal: LOT 2 PL 66-120 Middle School: MILL CREEK Calculated Acreage: 14.460 High School: BANDYS Tax Map: 062N 01021B School Map Township: NEWTON State Road #: TaxNalue Information: Tax Rates(pdf) Zoning Information: City Tax District: All in County Zoning District: COUNTY County Fire District: NEWTON RURAL Zoningl: R-30 Building(s) Value: $10,300 Zoning2: • Land Value: $66,400 Zoning3: Assessed Total Value: $76,700 Zoning Overlay: DWMH-O Year Built/Remodeled: / Small Area: BALLS CREEK Current Tax Bill Split Zoning Districts: / Zoning Agency Phone Numbers Miscellaneous: Firm Panel Date: 2007-09-05 Building Permits for this parcel. Firm Panel #: 3710375000J Building Details 2010 Census Block: 3005 WaterShed: 2010 Census Tract: 011300 Voter Precinct: P22 Agricultural District: Proximity 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. V& ySD Sat ldau, . http://gis.catawbacountync.gov/nomap/parcel_report.php?key=375014426904&typ=P 7/15/2016