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HomeMy WebLinkAboutRBPR-08-2016-24605.TIF C• THIS IS NOT A PERMIT Case # RBPR-08-2016-24605 CATAWBA COUNTY HEALTH DEPARTMENT ® ra•a: v t ,„, PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES rtir� - 1842 sM Residential Building Plan Review - Building New or.• ro�� o IMPROVEMENT- AUTH CONST- EXPANSION • -• „. Red'. sea dmetrievilq Owner KEVIN FULBRIGHT, 5161 HONEST BOB RD, MAIDEN NC 28650 C:8282174 88 NAME TO APPEAR ON PERMIT Kevin Fulbri• ht SITE ADDRESS: 5161 HONEST BOB RD,MAIDEN NC 28650 PIN # 366603441061 NAME of SUBDIVISION: Lot# Section/Block PROPERTY SIZE: Square Feet Acres 1.03 DIRECTIONS: Buffalo Shoals Rd & East Maiden Rd/left toward 150/go 1.2 miles Honest Bob Rd on right/go thru gate to end of road PRIMARY CONTACT: Owner SEWER TYPE: Septic Tank GALLONS PER DAY: 480 DESCRIBE WORK: 2 sto dwellin• (NO garage, NO basement ••OPERTY IS GATED CALL BEFORE OLD HOME TO BE REMOVED _- 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: New Structure STRUCTURE TYPE: PRIMARY RESIDENCE FACILITY TYPE: Single Family Residence OTHER DESCRIPTION: DESCRIPTION OF existing house to be removed EXISTING STRUCTURES ON SITE(IF ANY) DIM EXISTING STRUCTURE: 42 X 4 NUMBER OF EXISTING BEDROOMS: 3 #OF OCCUPANTS: 4 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 40 x 60 #OF NEW BEDROOMS:: 4 BASEMENT? No BASEMENT FIXTURES? No PLUMBING REQUIRED?Yes Desired system types(Improvement Permit or Authorization to Construct): ACCEPTED: ALTERNATIVE: CONVENTIONAL: OTHER: INNOVATIVE: ANY: YES Other described: F9-ehapplication 09/06/2016 10:18 Page 1 of4 SBA. r CATAWBA COUNTY Case# RBPR-08-2016-24605 UL Public Health Department Subdivision 4 c Environmental Health Division PIN# 366603441061 Ig4 2 5N 1 PO Box 389, 100-A Southwest Blvd,Newton,NC 28658 NAME ON PERMIT: (KEVIN FULBRIGHT), 5161 HONEST BOB RD, MAIDEN NC 28650 ( Kevin Fulbright) Site Address: 5161 HONEST BOB RD,MAIDEN NC 28650 Property Size: Square Feet Acres 1.03 Directions: Buffalo Shoals Rd & East Maiden Rd/left toward 150/go 1.2 miles Honest Bob Rd on right/go thru gate to end of road 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 ************************************************************************************************************ Authorization to Construct Fee (New/Expansion) 08/26/2016 $300.00 Fee Improvement Permit Fee 08/26/2016 $150.00 tl'� TOTAL FEES' 1 X450 00 s FEES ARE NON-REFUNDABLE ONCE A SITE VISIT IS MADE OR WORK ON A PLAN REVIEW HAS COMMENCED SYSTEM REDESIGN AND/OR RETRIP WILL INCUR AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) F9-ehapplication 09/06/2016 10:18 Page 2 of 4 �$A �G THIS IS NOTA PERMIT Case # RBPR-08-2016-24605 CATAWBA COUNTY HEALTH DEPARTMENT f� •o `,_I " kC PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES I 18 A 2 SM Residential Building Plan Review - Building New for •o' D . IMPROVEMENT- AUTH_CONST- EXPANSION K 1 o, Owner KEVIN FULBRIGHT, 5161 HONEST BOB RD, MAIDEN NC 28650 C:828-217-788 NAME TO APPEAR ON PERMIT Kevin Fulbri . ht SITE ADDRESS: 5161 HONEST BOB RD, MAIDEN NC 28650 PIN # 366603441061 NAME of SUBDIVISION: Lot# Section/Block PROPERTY SIZE: Square Feet Acres 1.03 DIRECTIONS: Buffalo Shoals Rd & East Maiden Rd/left toward 150/go 1.2 miles Honest Bob Rd on right/go thru gate to end of road PRIMARY CONTACT: Owner SEWER TYPE: Septic Tank GALLONS PER DAY: 480 WATER SUPPLY: Private Well DESCRIBE WORK: 2 story dwelling (NO garage, 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: New Structure STRUCTURE TYPE: PRIMARY RESIDENCE FACILITY TYPE: Single Family Residence OTHER DESCRIPTION: DESCRIPTION OF existing house to be removed EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: NUMBER OF EXISTING BEDROOMS: #OF OCCUPANTS: 4 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 40 x 60 #OF NEW BEDROOMS:: 4 BASEMENT? No BASEMENT FIXTURES? No PLUMBING REQUIRED?Yes Desired system types(Improvement Permit or Authorization to Construct): ACCEPTED: ALTERNATIVE: CONVENTIONAL: OTHER: INNOVATIVE: ANY: YES Other described: E9-ehapplication 08/26/2016 12:21 Page I of 4 4g. . CATAWBA COUNTY Case# RBPR-08-2016-24605 ;, ®2 Public Health Department Subdivision d „�r,,..y ,"i Environmental Health Division PIN# 366603441061 ''-'- PO Box 389, 100-A Southwest Blvd,Newton.NC 28658 Ig 2 w NAME ON PERMIT: (KEVIN FULBRIGHT), 5161 HONEST BOB RD, MAIDEN NC 28650 ( Kevin Fulbright) Site Address: 5161 HONEST BOB RD, MAIDEN NC 28650 Property Size: Square Feet Acres 1.03 Directions: Buffalo Shoals Rd & East Maiden Rd/left toward 150/go 1.2 miles Honest Bob Rd on right/go thru gate to end of road 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 accessibl tha m e site evaluation can be performed. Date: k-RG • IL 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) 08/26/2016 $300.00 Fee Improvement Permit Fee 08/26/2016 $150.00 i' TTOTAL FEES - - $450.00�l 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 08/26/2016 12:21 Page 2 of 4 • CATAWBA THIS IS NOT A PERMIT COUNTY���""' , CATAWBA COUNTY HEALTH DEPARTMENT . Nonth7, Application for Environmental Services Page I Improvement Permit' Authorization to Construct., Septic Repair I Septic Malfunction❑ Septic Expansion Ncw Well Permit E. Replacement Well n Well Abandonment ❑ Well Repair ❑ Existing System Inspection (Pre-Approval Required) ❑ Application is for New Construction H Existing Facility Property Address S({. ( /4n-a a k- at ), Cke Subdivision 4 m ....:1,..,. , wc. a%r6 Lot# Acres pp 1 Section/Block/Phase Driving Directions to Property 47 t.4 [-.b c q e,�\S a e ets - '(/'l,,'d cr\ Q 4 4„.„e (c- l' slow, 2 /.Yo 5 u 1. .2 ,h :/e 3 Run e ) ;" ea 5 At R k 5 0 \ 1.r.,— 0 c Irc e.r\e o-C- Q r,ti Z NAME TO APPEAR ON PERMIT?x Owner E. Applicant ❑ Contractor Applicant Contact Information Name Address Phone Cell Phone Owner Contact Information • Name K eu en v., (a rcn \ , 4 Address 5-141 ryoett„ &b (-2, Z (Y1 w.;Les. 2sG &—O Phone Cell Phone 9�Er - a I Z -t/7fll' Contractor Contact Information Name Address Phone Cell Phone WHO WILL BE THE PRIMARY CONTACT? Owner ❑ Applicant ❑ Contractor Description of Existing Structures on Site ) =. t • eil # of Bedrooms *t 3 Structure Dimensions • # of Occupants_ _ Basement ❑ Yes' No Basement Fixtures 0 Ye' 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. C Yes e No Does the site contain any jurisdictional wetlands? Yes o Does the site contain any existing wastewater systems? Ll Yes S Id"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? 0 Yes 0 No 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 Water Line Is a public water supply available? ** ❑ Yes Q No If applying for an Lnprovement Permit or Authorization to Construct, Please Indicate Desired System Type(s): (systems can be ranked in order of your preference) t.9 Accepted 0 Alternative 0 Conventional 0 Innovative 0 Other %Any C ATAwTH A THIS IS NOT A PERMIT COUNT, ^ `` CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services Page 2 Proposed Facility Type ❑ Primary Residence ell-New Residence ❑ Addition to Residence # of New Bedrooms *j L/ Project Description N e v 11 time Structure Dimensions -/0 Xe,U # of Occupants Le Basement _ Yes ,No Basement Fixtures ® Yes No _ Accessory Structure(s) Describe #of New Bedrooms *j 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 *j Structure Dimensions H Food Service Specify Type # Seats Floor Space-Entire Food Service Facility (Sq Ft) #Employees per Shift #of Shifts Dining Area(Sq. Ft.) LJ 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 H Drilled ❑ Bored ❑ Dug ❑ Unknown Well Repair Requested ❑ Yes ❑ No Describe Calculated Design Flow, Commercial f 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. 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 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, • x. 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 an. 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 lie Date £r 020— I G 4- Printed Name of Owner or Agent KL.r •rx 401cr,->1k • Catawba County Environmental Health N.. C.? Cc/ Yli • 41/ N- A_ . • 95 -74K . ho , `l o N Rte - wes aoti hILt J Q ao I/ • • rS • //// • aMC v3 /A5) IN eNN‘NN es. Parcel: 366603441061, 5161 HONEST BOB RD lin=50ft MAIDEN, 28650 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 08/26/2016 Parcel Report Page 1 of 1 • Parcel Report - Catawba County NC Parcel Information: Owner Information: Parcel ID: 366603441061 Owner: FULBRIGHT KEVIN R Parcel Address: 5161 HONEST BOB RD Owner2: City: MAIDEN, 28650 Address: 5161 HONEST BOB RD LRK(REID): 200538 Address2: Deed Book/Page: 3259/1945 City: MAIDEN Subdivision: State/Zip: NC 28650-9624 Lots/Block: / Last Sale: School Information: Plat Book/Page: 43/12 School District: COUNTY Legal: PLAT 43-12 Elementary School: TUTTLE Middle School: MAIDEN Calculated Acreage: 1.030 Tax Map: High School: MAIDEN Township: CALDWELL School Map State Road #: 3 TaxNalue Information: Tax Rates(pdf) Zoning Information: City Tax District: All in County Zoning District: COUNTY County Fire District: BANDYS Zoningl: R-40 Building(s) Value: $102,700 Zoning2: Land Value: $9,800 Zoning3: Assessed Total Value: $112,500 Zoning Overlay: Year Built/Remodeled: 2002/ 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 #: 3710366600J Building Details 2010 Census Block: 4010 WaterShed: 2010 Census Tract: 011602 Voter Precinct: P9 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 Count overnment, North Carolina. AM rights reserved. �,,,�O 0 u km Cm 20ai -? , Ex si or\ 4 http://gis.catawbacountync.gov/nomap/parcel_report.php?key=366603441061&typ=P 8/26/2016 • N° ' CATAWBA COUNTY HEALTH DEPARTMENT g Telephone: (704) 465-8270 TDD: (704) 465-8200 O Improve. Permits . uthorizzationn ,( to Construct pair Permit Oper. Permit System TypecZ \ 19- Q Owner/Agent KEU//(/ ie. 1'"(4f 3O )c44-r Phone - Address AO fL/P-5"r Ii D A /17jj9-D Subdivision t�J/tM, _ H h)/ .Q &N n/, G- ? .CO Section/Block/Phase ot# Lot Size _ Directions: - ,•.e a '��/ ' — L .W Sue,;_ ' <Tountea) no ED e At'of_Ac /'J n,,,=5 0 o -' i/,pn,Cc7- ill LI .GD Gen- c Facility: House Mobile Home Business . ether: Tax Map # /sr— '— a-, Multi-family Other . Zoning Approval # -701 . V9 # Bedrooms 3 # Seats # Employees . Application Rat GPD Flow ,34-0 Hot Tub or Spa yes r. pecial Fixtures . 100% Repair Are yes o Basement yes , Basement Plumbing ye no Water Supply: Private Well ca./ Public Type of System: Trench L-----bed Pump Pump/Panel Panel LPP Other Tank Size: Septic Tank Size /O o D Pump Tank Size Nitrification Field: Total Square Feet 5Pen1 Depth of Stone Bed Size Trench Width 3 Total Length of All Trenches 3 0-fr--- Number of TrenchJs 7. Individual Trench Length /Oo dD / q g // / Od'/ / Feet on Center / Maximum Trench Depth a Distance of Nearest Well Sp 't *DO NOT INSTALL WHEN WET' t .S, ,leo*.* Topo % Slope 1 Texture Gny, Q7 S.p� f91 , ?/GcI1Structure QcO� c, P\ 1— — __t L� Clay Min. ./..'/ J a t�2.N r `. Soil Wetness J Soil Depth y2 S8• 4F` , Restric. Hoz. at �� Teh,t t ..1 , - �` :,1, Available space o ■ -' �-7:1 Overall Class Slur •- -I ypCi Comments: T ' — _ �� N — - w .t n -c an e— T2s AJC-,i c-1 ,_lero • ic 3 ' n ' N **NO GUARANTEE OR WARRANTY IS IMPLIED OR • . , AS TO THE PERFORMANCE OR LENG • IME THIS SYSTEM WILL FUNCTION** i . 6 *Improvement Permit has no expiration date and is transferable, but may be revoked if site plane or intended use changes for the proposed facility. An Authorization to Construct is valid for (5) five ye re from dateissued and is not transferable. Permit Date .2y; /9�y /�f t Owner/Agent 3,4r Sanitarian _ a / .� Installed By Ca-Cr -,/ }GC.c:-U Date .Q/q-4 -5 9 Sanitar' -n e ___ ,_ White-Office Blue-Building Inspection Operation Permit Yellow-Owner/Agent Green-Building Inspection Authorization to Construct