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HomeMy WebLinkAboutRBPR-08-2016-24478.TIF qA THIS IS NOTA PERMIT Case # RBPR-08-2016-24478 LIP CATAWBA COUNTY HEALTH DEPARTMENT 0Eafo Y�. 0 {p!' PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES 1842 SM Residential Building Plan Review - Building New +■rte roo A 112\,1\ 20 \^/'//�� 4 2/�� //��1 //�\ IMPROVEMENT , or: Applicant DWGLAS BURNETT, 7887 MOUNTAIN SHORE DR, SHERRILLS FORD NC 28673 C:9192100657 Contractor *BURNETT I-TOME BUILDERS (DOUGLAS BURNETT), 7887 MOUNTAIN SHORE DR, SHERRIL: FORD NC 28673 C:9192100657 DBURNXXVI@MSN.COM Owner RANDOLPH SALTER,4879 N HWY 16, NAME TO APPEAR ON PERMIT Randolph Salter SITE ADDRESS: 7656 SKYLINE DR, SHERRILLS FORD NC 28673 PIN # 460604646536 NAME of SUBDIVISION: MOBILE HOME ESTATE Lot# 39 Section/Block PROPERTY SIZE: Square Feet Acres 0.46 DIRECTIONS: 150to slanting bridge road turn right cross the slanting bridge second road wild life lane to the right. then turn onto skyline house is on the right. PRIMARY CONTACT: Contractor SEWER TYPE: Septic Tank GALLONS PER DAY: 240 WATER SUPPLY: Private Well DESCRIBE WORK: New 31x56, 2 BdRm house. Using existing back deck. Removing the existing mobile home 14x47, 2 BdRm. 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 Mobile home w/ Deck EXISTING STRUCTURES ON SITE(IF ANY) DIM EXISTING STRUCTURE: Mobile Home 14x47 (to be removed) NUMBER OF EXISTING BEDROOMS: 2 #OF OCCUPANTS: 2 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 31'X56' Desired system types (Improvement Permit or Authorization to Construct): ACCEPTED: ALTERNATIVE: CONVENTIONAL: OTHER: INNOVATIVE: ANY: YES Other described: 09-elmppli cation 08/09/2016 13:06 Page 1 ofd SpA CATAWBA COUNTY Case i RBPR-08-2016-24478 Public Health Department Subdivision MOBILE HOME ESTATE < GBS'®i ,� Environmental Health Division PIN# 460604646536 „ PO Box 389, 100-A Southwest Blvd,Newton,NC 28658 /8.2 ,4 NAME ON PERMIT: ( RANDOLPH SALTER),4879 N HWY 16, ( Randolph Salter) Site Address: 7656 SKYLINE DR, SHERRILLS FORD NC 28673 Property Size: Square Feet Acres 0.46 Directions: 150to slanting bridge road turn right cross the slanting bridge second road wild life lane to the right. then turn onto skyline house is on the 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: 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 ; tftnr E rrrn .. "" II I I liIII9I 1I WE IlalluGSlr; a' � 1 j l 11 i'II ili�I ilii IDEATE jl'lI IL, FEEIAMOUNT' Improvement Permit Fee 08/09/2016 5150.00 Tri 1 C11i,j t'N;ITOTAL1FEEi � ;llltlilili�llilili Illi'"'�I1"x.;, ' ' ;'Il,,ia!111ltFiII IiIIli�i l 1Y311111 'IIiIIIGIi}Isiso1oo Jill i:i "� (I 'WOIIIiliu untaIlu6IiuIliilliilui1Ju„Wu ",'W➢W41L"Jiit, �tll{IlIli,.,_..'!il!'ll@IWI„ILiINh�iNJf.� 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) 1 9-ehappl ication 08/09/2016 13:06 Page 2 of 4 vJ$A • THIS IS NOT A PERMIT Case # RBPR-08-2016-24478 . �I n:. 2 ;,-� CATAWBA COUNTY HEALTH DEPARTMENT ❑® �rsr`�'[ ❑° PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICEST>:-.-,N9:14 .1:11.} _ y842 s� Residential Building Plan Review - Building New l •n o h IMPROVEMENT .-d:01‘. 6._' .• " ❑ere' e . fa • Applicant DOUGLAS BURNETT, 7887 MOUNTAIN SHORE DR. SHERRILLS FORD NC 28673 C:9192100657 Contractor *BURNETT HOME BUILDERS (DOUGLAS BURNETT),7887 MOUNTAIN SHORE DR.SHERRIL FORD NC 28673 C:9192100657 DBURNXXVI@MSN.COM Owner RANDOLPH SALTER,4879 N HWY 16. NAME TO APPEAR ON PERMIT Randolph Salter SITE ADDRESS: 7656 SKYLINE DR, SHERRILLS FORD NC 28673 PIN # 460604646536 NAME of SUBDIVISION: MOBILE HOME ESTATE Lot`9 3g Section/Block PROPERTY SIZE: Square Feet Acres 0.46 DIRECTIONS: 150to slanting bridge road turn right cross the slanting bridge second road wild life lane to the right. then turn onto skyline house is on the right. PRIMARY CONTACT: Applicant SEWER TYPE: Septic Tank GALLONS PER DAY: 240 WATER SUPPLY: Private Well DESCRIBE WORK: Zoning for Single family residence 2bedrooms 2 baths no basement 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 Mobile home to be removed with porch EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: 14x47 NUMBER OF EXISTING BEDROOMS: 2 #OF OCCUPANTS: 2 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 31'X56' Desired system types (Improvement Permit or Authorization to Construct): ACCEPTED: ALTERNATIVE: CONVENTIONAL: YES OTHER: INNOVATIVE: ANY: Other described: E9-ehapplication 08/09/2016 12:01 Page 1 of 4 745, " CATAWBA COUNTY Case# RBPR-08-2016-24478 lb-7 t 2 Public Health Department Subdivision MOBILE HOME ESTATE ¢' ,.p,t v "- Environmental Health Division PIN# 460604646536 � 'N ' �% PO Box 389. 100-A Southwest Blvd,Newton.NC 28658 NAME ON PERMIT: ( RANDOLPH SALTER), 4879 N HWY 16, ( Randolph Salter) Site Address: 7656 SKYLINE DR, SHERRILLS FORD NC 28673 Property Size: Square Feet Acres 0.46 Directions: 150to slanting bridge road turn right cross the slanting bridge second road wild life lane to the right. then turn onto skyline house is on the 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: 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 Improvement Permit Fee 08/09/2016 5150.00 TOTAL FEES ' .' $150.00 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-chapplication 08/09/2016 12:01 Page 2 of 4 CATAWBA THIS IS NOT A PERMIT counrr V V iJL , CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services Page I Improvement Perini Authorization to Construct❑ Septic Repair ❑ 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 4 ' P ropertyAddress • X76-S6. 'S ky ti✓t 911 Subdivision SNC2R 1/f F047 NC Lot# Acres , Y 6 Z$673 Section/BlocldPhase Driving Directions to Property l J FAJY 10 .5-CAP 7"11,/5 '3. oyer _ ; C'o ovE4 B41-(D5c=' , !oau K i 0,/ 2-No ?A0_0 P-0 skyc)rcf . g o ys C o%^' 121-1 NAME TO APPEAR ON PERMIT? KOwner ❑ Applicant ❑ Contractor Applicant Contact Information Name 24NOy SFi CTEtL Address dere Skyl,N6- DJ/ : MEI/M.llS Frog rr/L 2 %6.73 Phone 5/9 - t-/ 0 -005-7 Cell Phone Owner Contact Information Name ,f}-,,,9y d' AN, co ; SALT4n Address ( 5/�p Phone " / Cell Phone Contractor Contact Information Name D° 513 i n w, 71' Address ggf17 in Ovi+Tf)N' S Hon 0G? Phone 9) S-7 I rv— o6s .] Cell Phone WHO WILL BE THE PRIMARY CONTACT? ❑ Owner ❑ Applicant ArCntractor Description of Existing Structures on Site M ODi Lt NOME — 5gem ova~ # of Bedrooms *it Z Structure Dimensions q 7 )l f . #of Occupants 3 Basement ❑ Yes 1:1--No Basement Fixtures a Yes gi,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. CI Yes tNo Does the site contain any jurisdictional wetlands? 2111IYes ® No Does the site contain any existing wastewater systems? ID Yes No Is any wastewater going to be generated on the site other than domestic sewage? 'nes ❑ No Is the site subject to approval by any other public agency? (01..Yes tik1No Are there any easements or right of ways on this property? Describe Existing water supply in use IyILIndividual Well ❑ Community Well ❑ Semi-Public Well ❑ County/City/Township Water Line Is a public water supply available? ** ❑ Yes N No If applying for an Improvement Permit or Authorization to Construct, Please Indicate Desired System Type(s): 1 (systems can be ranked in order of your reference) \./..,12<ccepted 0 Alternative ja Conventional 0 Innovative 0 Other 0 Any CATAWIA THIS IS NOT A PERMIT COUNTY CATAWBA COUNTY HEALTH DEPARTMENT N•Iliat�®„,„ti �'� Application for Environmental Services Pale 2 Proposed Facility Type .Primary Residence % New Residence ❑ Addition to Residence # of New Bedrooms *t Z_- Project Project Description R cyLAc E ryl oqi t a H +E W 7•t he ilv r,/ SA In Structure Dimensions 37 jC S6 # of Occupants 3 Basement ❑ Yes . No Basement Fixtures ® Yes *No *( XYS P)CItIVIS viev dE ❑ Accessory Structure(s) Describe ��� #of New Bedrooms *t if applicable Structure Dimensions # of Occupants Accessory Dwelling ❑ Yes ❑ No Plumbing ❑ Yes ❑ No Describe Plumbing Needed ❑ Multi-Family Residence# Units #Bedrooms per Unit*t 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 7 Semi-Public Well ❑ Community Well Abandonment Type ❑ Drilled ❑ Bored ❑ Dug 7 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 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 cl Date K.— ” / C. $Printed Name of Owner or Agent -PouS LAI 4 0vKvc j1— 0 c-)/Gail- DR- F Aw Fs7ird� .....a:.., Y,.-I 't .tom, . .'� re { y0 • -Py .0,c9.. C00/0 4• 02. 16O A 9 ip • B0 • 14 Q G 3g v � �m JG�4O � / 9 -0 b O - / O� • s .P N. \o ° ?mo o o \\ e l� D�' /F \..cOR ' , A R. N N. G} r \ (4 Cfre \N N lezok. :Ar __aHVAI'ralbHAIPA°h1/ 4- Co 2yc:ny opo Q ! n c, 0 .) 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Ii �1'P�Mg'p'. •7658 t '?t" +' �� �,p itI� II Mi�� '<I�1�� 1T �'.,' ; I .LI 1 I I 1;ci C,, ra4. 1 41 -+ u1 i� 1 i1I �r 020 IntII�6, 1Iii,,lufl;4hlk.i ,1 42 g1 p '11 ."-'*;1110 �q 19 �; i .T r CI:,..% 1•76. . 40 1: '.4 ,.., (1 17 P ' 1 "'111 H 1II" II n I "Pt1r' til is 11 1) Y, lls\-- i'�, fr / 790 11a.00 I X11 u N ' 90.83 \Ohl 185g5 41 Parcel: 460604646536, 7656 SKYLINE DR lin=50ft SHERRILLS FORD, 28673 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 08/09/2016 Parcel Report Page 1 of 1 Parcel Report - Catawba County NC Parcel Information: Owner Information: Parcel ID: 460604646536 Owner: SALTER RANDOLPH L Parcel Address: 7656 SKYLINE DR Owner2: SALTER ANGELA W City: SHERRILLS FORD, 28673 Address: 4879 N HIGHWAY 16 LRK(REID): 18148 Address2: Deed Book/Page: 3314/0062 City: DENVER Subdivision: MOBILE HOME ESTATE State/Zip: NC 28037-7916 Lots/Block: 39/ Last Sale: School Information: Plat Book/Page: 12/39 School District: COUNTY Legal: LOT 39 PLAT 12-39 Elementary School: SHERRILLS FORD Middle School: MILL CREEK Calculated Acreage: .460 Tax Map: 017AX 02012 High School: BANDYS Township: MOUNTAIN CREEK School Map State Road #: 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: $4,700 Zoning2: Land Value: $107,000 Zoning3: Assessed Total Value: $111,700 Zoning Overlay: CRC-O,WP-O,FPM-O Year Built/Remodeled: / Small Areal SHERRILLS FORD Current Tax Bill Split Zoning Districts: / Zoning Agency Phone Numbers Miscellaneous: Firm Panel Date: 2007-09-05 Building Permits for this parcel. Firm Panel #: 3710460600J Building Details 2010 Census Block: 4022 WaterShed: WS-IV Critical Area 2010 Census Tract: 011504 Voter Precinct: P41 Agricultural District: 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. 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