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HomeMy WebLinkAboutRBPR-09-2016-24694.TIF y54A G THIS IS NOT A PERMIT Case # RBPR-09-2016-24694 Q • ,fe,,,t -� CATAWBA COUNTY HEALTH DEPARTMENT l .v. f0 �`) r" PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES it 84T SM Residential Building Plan Review - Building New 'kap fir , ' • A IMPROVEMENT- AUTH_CONST- NEW WELL a y o vcci Owner, I CRAIG & PATRICIA CREWS, 1465 ROUNDSTONE RD, SHERRILLS FORD NC 28673 H:8284783139 C:7049054796 HOME:8284783139 NAME TO APPEAR ON PERMIT CRAIG & PATRICIA CREWS SITE ADDRESS: 1465 ROUNDSTONE RD, SHERRILLS FORD NC 28673 PIN # 461902587238 NAME of SUBDIVISION: CRESCENT LAND AND TIMBER CORP Lot# PT 1 Section/Block PROPERTY SIZE: Square Feet Acres 7.8 DIRECTIONS: MOLLYS BACKBONE FROM SHERRILLS FORD RD RIGHT ON AZALEA LEFT ON DOGLEG LEFT ROUNDSTONE LOT IS ON CORNER OF ROUNDSTONE AND LANGDON RD CONT 200'TO DRIVEWAY PRIMARY CONTACT: Owner SEWER TYPE: Septic Tank GALLONS PER DAY: 240 WATER SUPPLY: Private Well DESCRIBE WORK: New Barn w/ upstairs apartment. 40x36 : 1 BdRm, Full bath & Kitchen. Existing home on the property. Will need a sperate well & septic for new Accessory Dwelling. New Well may in the future serve 2 homes (accessory dwelling & future home to be located on neighboring property). 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: ACCESSORY DWELLING FACILITY TYPE: Single Family Residence OTHER DESCRIPTION: DESCRIPTION OF Main House EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: 45X27 NUMBER OF EXISTING BEDROOMS: #OF OCCUPANTS: 1 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: Barn w/Apartment 40X36 #OF NEW BEDROOMS:: 1 BASEMENT? No BASEMENT FIXTURES? No 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 IJ-chapptication 09/09/2016 08:23 Page I of 4 ,A3A • CATAWBA COUNTY Case# RBPR-09-2016-24694 .v y_ Public Health Department Subdivision CRESCENT LAND AND TIMBE < -"' „�, Environmental Health Division114W PIN# 461902587238 PO Box 389, 100-A Southwest Blvd,Newton,NC 28658 1• .2 „ NAME ON PERMIT: (CRAIG & PATRICIA CREWS), 1465 ROUNDSTONE RD, SHERRILLS FORD NC 28673 ( CRAIG & PATRICIA CREWS) Site Address: 1465 ROUNDSTONE RD, SHERRILLS FORD NC 28673 Property Size: Square Feet Acres 7'8 Directions: MOLLYS BACKBONE FROM SHERRILLS FORD RD RIGHT ON AZALEA LEFT ON DOGLEG LEFT ROUNDSTONE LOT IS ON CORNER OF ROUNDSTONE AND LANGDON RD CONT 200'TO DRIVEWAY 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 IIIFIEENAME I�I t .M lfrI r �•rlr'II I ��g. 1 1' !di IIIIIIl lilll (jifin llitDht A 1. ugairoFTEYAMOUNME Authorization to Construct Fee (New/Expansion) 09/08/2016 $150.00 Fee Improvement Permit Fee 09/08/2016 $150.00 Well Permit& Inspection Fee 09/08/2016 $300.00 1:at 1 �� '40,t8111,F;EES['i1III 11I1111111Ni I5, v tfi�111h111111111 ' !IIIIIIIIIII1IE l 1111115600boo;hl tis �'� ILFluiffir,NHi Jmfitti itutuurn tim .. , _ . .. :riWn Jrmir �noIIWIIIIO molnelll,�p,IIWlillll('„ 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-ehapplicatian 09/09/2016 08:23 Page 2 of 4 vJY'A •• THIS IS NOT A PERMIT Case # RBPR-09-2016-24694 � l' s�G a. CATAWBA COUNTY HEALTH DEPARTMENT _; �o. • ''D' PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES • `�1 ti-' -' IF I. /842 sM Residential Building Plan Review - Building New al •oro-` In r.fi`ty -: • .• ja IMPROVEMENT- AUTH CONST - NEW WELL 4 . o - o! :..;: Owner CRAIG CREWS, 1465 ROUNDSTONE RD, SHERRILLS FORD NC 28673 • NAME TO APPEAR ON PERMIT CRAIG CREWS SITE ADDRESS: 1465 ROUNDSTONE RD, SHERRILLS FORD NC 28673 PIN # 461902587238 NAME of SUBDIVISION: CRESCENT LAND AND TIMBER CORP Lot# PT 1 Section/Block PROPERTY SIZE: Square Feet Acres 7.8 DIRECTIONS: MOLLYS BACKBONE FROM SHERRILLS FORD RD RIGHT ON AZALEA LEFT ON DOGLEG LEFT ROUNDSTONE LOT IS ON CORNER OF ROUNDSTONE AND LANGDON RD CONT 200'TO DRIVEWAY PRIMARY CONTACT: Owner SEWER TYPE: Septic Tank GALLONS PER DAY: 240 WATER SUPPLY: Private Well DESCRIBE WORK: BUILDING 40X36 WITH 1 BEDROOM 1 BATH ACCESSORY 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? 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: ACCESSORY DWELLING FACILITY TYPE: Single Family Residence OTHER DESCRIPTION: - DESCRIPTION OF SINGLE FAMILY DWELLING EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: 45X27 NUMBER OF EXISTING BEDROOMS: #OF OCCUPANTS: 1 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 40X36 #OF NEW BEDROOMS:: 1 BASEMENT? No BASEMENT FIXTURES? No PLUMBING REQUIRED? Desired system types (Improvement Permit or Authorization to Construct): ACCEPTED: ALTERNATIVE: CONVENTIONAL: YES OTHER: INNOVATIVE: ANY: Other described: APPLICATION FOR WELL CONSTRUCTION PROPOSED WELL TYPE: Individual Well REPLACE WELL?: NO E9-ehapplication 09/08/2016 17:13 Page 1 of 4 k3A • CATAWBA COUNTYCaSe# RBPR-09-2016-24694 Public Health Dt >; :101G epartmenSubdivision CRESCENT LAND AND TIME 4. _e '� Environmental Health Division PIN# 461902587238 -' PO Bae 389.100-A Southwest Blvd. Newton.NC 28658 /832 sis• NAME ON PERMIT: (CRAIG CREWS), 1465 ROUNDSTONE RD, SHERRILLS FORD NC 28673 ( CRAIG CREWS) Site Address: 1465 ROUNDSTONE RD, SHERRILLS FORD NC 28673 Property Size: Square Feet Acres 7.8 Directions: MOLLYS BACKBONE FROM SHERRILLS FORD RD RIGHT ON AZALEA LEFT ON DOGLEG LEFT ROUNDSTONE LO IS ON CORNER OF ROUNDSTONE AND LANGDON RD CONT 200'TO DRIVEWAY 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 law d rules. I understand that I am solely responsible for the proper identification and I beling of all property lines and corners and making the site acces ib so complete site evaluation can be performed. Date: 9/f%3/%gyp Signature of Applicant or Agent( L...------ An Environmental Health Specialist will contact you wi in 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) 09/08/2016 5150.00 Fee Improvement Permit Fee 09/08/2016 5150.00 Well Permit & Inspection Fee 09/08/2016 5300.00 TOTAL FEES $600.00 ... 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-ehappliwation 09/08/2016 17:13 Page 2 of 4 CATAWBA THIS IS NOT A PERMIT � (P q COUNTY • CATAWBA COUNTY HEALTH DEPARTMENT . Application for Environmental Services Page 1 Improvement Permit❑ Authorization to Construct❑l Septic Repair❑ Septic Malfunction❑ Septic Expansion ❑ New Well Permi Replacement Well ❑ Well Abandonment❑ Well Repair ❑ Existing System nspection (Pre-Approval Required) ❑ Application is for New Construction ❑! Existing Facility ❑ Property Address 1465 Roundstone Road Subdivision Sherrills Ford,NC 28673 Lot# Acres 7.8 Section/Block/Phase Driving Directions to Property Turn onto Molly's Backbone Rd.from Sherrills Ford Rd. Right on Azalea Rd. Left on Dogleg Rd. Left on Roundstone Rd. Property is at corner of Roundstone and Langdon Rd intersection. Continue straight on Langdon 200 ft to driveway on right to bam site. Turn right on Roundstone Rd at intersection with Langdon Rd and property owner's home is 1000 ft at 1st concrete driveway on left. NAME TO APPEAR ON PERMIT? • Owner ❑ Applicant ❑ Contractor Applicant Contact Information Name Craig R Crews Address 1465 Roundstone Road,Sherrills Ford, NC 28673 Phone 828-478-3139 Cell Phone 704-905-4796 Owner Contact Information Name Craig R Crews Address 1465 Roundstone Road,Sherrills Ford, NC 28673 Phone 828-478-3139 Cell Phone 704-905-4796 Contractor Contact Information Name Address Phone Cell Phone WHO WILL BE THE PRIMARY CONTACT? ❑® Owner ❑ Applicant ❑ Contractor Description of Existing Structures on Site Single family 1 112 story home 2350 sq ft #of Bedrooms *I*3 Structure Dimensions 45'x 27' #of Occupants 2 Basement E Yes ❑ No Basement Fixtures 0 Yes ® 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 n No Does the site contain any jurisdictional wetlands? ^r 'es CI No Does the site contain any existing wastewater systems? HdJQ ' [.� 5,eplic. Yes 0 No Is any wastewater going to be generated on the site other than domestic sewage? ,Yes 0 No 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 Existing water supply in use j Individual Well ❑ 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) ❑ Accepted ❑ Alternative ® Conventional ❑ Innovative ❑ Other ❑ Any CATAWBA THIS IS NOT A PERMIT COUNTY. CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services Page 2 Proposed Facility Type ❑ Primary Residence ❑ New Residence ❑ Addition to Residence #of New Bedrooms *i Project Description Structure Dimensions #of Occupants Iu_I Basement ❑ Yes ❑ No Basement Fixtures ® Yes D No Accessory Structure(s) Describe Horse Barn with Accessory Dwelling(Apartment In 2nd story of barn) #of New Bedrooms *t if applicable One Structure Dimensions ^o.36 barn(16'•36'apt) #of Occupants 2 Accessory Dwelling • Yes ❑ No Plumbing ❑® Yes ❑ No Describe Plumbing Needed Kitchen sink, D/W, Bathroom,Washer,Wtr Htr ❑ 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 ❑ Semi-Public Well ❑ Community Well Abandonment Type ❑ Drilled ❑ Bored ❑ Dug ❑ Unknown Well Repair Requested ❑ Yes ❑ No Describe Calculated Desigm 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. 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, 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 evaluatiot be performed. Signature of Owner or Agent - Date ilf// • Printed Name of Owner or Agent c 't\ C,G: S C ce ws • Catawba County Environmental Health r 0 i O t\\I\r U 846 0�0 mt c a� 'Illibh o J C gp0 \ n w CO 0 006 Ot Ooy�a + .oda 11.11:77--Hri1111- r401 1, 1 -!JU ,, q '1kt 4: 4 _ l -:\\\\:\.:-s '\::::\N\\.. - .. ,a y Dom '\ / -,1111e Parcel: 461902587238, 1465 ROUNDSTONE RD lin=80ft 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 09/08/2016 Catawba County Environmental Health u ulil� \851 ,,,, i a� r+0 { I i ^gad .. 8 �r� r rt!Il1nl1 tib 1011 1 i f k:-.11. , / ,i Ill/„ ' . 40 .A4 / 0� I � i f . CI eti 4 44 1 h 1 i . . 4 A . ,, ,4 P Is?%\\ S� W' , (-as ,v$ ..,, <9yc , �R+OpR 00 0, OSA°E Sr..., ypa N i �P X 641 Parcel: 461902587238, 1465 ROUNDSTONE RD 1in=100ft 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 09/08/2016 Parcel Report Page 1 of 1 • Parcel Report - Catawba County NC Parcel Information: Owner Information: Parcel ID: 461902587238 Owner: CREWS CRAIG R Parcel Address: 1465 ROUNDSTONE RD Owner2: CREWS PATRICIA City: SHERRILLS FORD, 28673 Address: 1465 ROUNDSTONE RD LRK(REID): 16147 Address2: Deed Book/Page: 3309/1559 City: SHERRILLS FORD Subdivision: CRESCENT LAND AND TIMBER State/Zip: NC 28673-9760 CORP Lots/Block: PT 1/ School Information: Last Sale: School District: COUNTY Plat Book/Page: 51/145 Elementary School: CATAWBA Middle School: MILL CREEK Legal: PT 1 PLAT 51-145 Calculated Acreage: 7.800 High School: BANDYS Tax Map: 015 Y 02004 School Map Township: CATAWBA State Road #: 2683 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: $173,800 Zoning2: Land Value: $296,200 Zoning3: Assessed Total Value: $470,000 Zoning Overlay: CRC-O,WP-O,FPM-O Year Built/Remodeled: 1992/ Small Area: SHERRILLS FORD Current Tax Bill Split Zoning Districts: / Zoning Agency Phone Numbers Miscellaneous: Firm Panel Date: 2008-03-18 Building Permits for this parcel. Firm Panel #: 3710461900K Building Details 2010 Census Block: 2000 WaterShed: WS-IV Critical Area 2010 Census Tract: 011503 Voter Precinct: P21 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. Ail rights reserved. Z 34° gosIdab - http://gis.catawbacountync.gov/nomap/parcel_report.php?key=461902587238&typ=P 9/8/2016