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HomeMy WebLinkAboutEHPR-09-2016-24706 (2).TIF y�Y A G THIS IS NOTA PERMIT Case # EHPR-09-2016-24706 —"""Pani CATAWBA COUNTY HEALTH DEPARTMENT E' r- Y • ❑' +'L �°'� PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES -' � \842 sM Environmental Health Plan Review - OSWP o... o o ' IMPROVEMENT1:1147“ � o� 1 w Applicant *RMR CONSTRUCTION CO INC (RICHARD MATTHEWS), 119 CONOVER BLVD E, CONOVER 28613- B:828-464-8597 C:8283I20743F:828-466-1576 RMR@RMRREALESTATE.COM Owner CARL HEFNER, 1876 SIPE RD, CONOVER NC 28613 NAME TO APPEAR ON PERMIT *RMR CONSTRUCTION CO INC (Richard Matthews) SITE ADDRESS: 3222 SULPHUR SPRINGS RD NE, HICKORY NC 28601 PIN # 372416947061 NAME of SUBDIVISION: Lot# Section/Block (�(� PROPERTY SIZE: Square Feet 23,958.00 Acres e . `{"I DIRECTIONS: Corner of Sulphur Springs Rd NE, and 33rd Av NE PRIMARY CONTACT: Applicant SEWER TYPE: Septic Tank GALLONS PER DAY: 360 WATER SUPPLY: Public Water DESCRIBE WORK: IP for property combination 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? No Are there any easements or right-of-ways on this property? No APPLICATION FOR: New Structure STRUCTURE TYPE: PRIMARY RESIDENCE FACILITY TYPE: House OTHER DESCRIPTION: DESCRIPTION OF EXISTING STRUCTURES ON SITE(IF ANY) DIM EXISTING STRUCTURE: NUMBER OF EXISTING BEDROOMS: #OF OCCUPANTS: 2 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 55 x 52 #OF NEW BEDROOMS:: 3 BASEMENT? No BASEMENT FIXTURES? No PLUMBING REQUIRED?Yes Desired system types (Improvement Permit or Authorization to Construct): ACCEPTED: ALTERNATIVE: CONVENTIONAL: OTHER: INNOVATIVE: ANY: Other described: P9-chapplieation 09/12/2016 12:51 Page I of4 s° • CATAWBA COUNTY case# EHPR-09-2016-24706 ,Q y Public Health Department Subdivision 6 ,� '< P1614 Environmental Health Division PIN# 372416947061 -d} PO Box 389. 100-A Southwest Blvd,Newton,NC 28658 1842 ,. NAME ON PERMIT: *RMR CONSTRUCTION CO INC ( RICHARD MATTHEWS), 119 CONOVER BLVD E, CONOVER NC 2861: `RMR CONSTRUCTION CO INC ( Richard Matthews) Site Address: 3222 SULPHUR SPRINGS RD NE, HICKORY NC 28601 Property Size: Square Feet 23,958.00 Acres 0.55 Directions: Corner of Sulphur Springs Rd NE, and 33rd Av NE 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 solel resp sible for the proper identification and lab ing of all property lines and corners and making the site accessibl so ha a complete F n erformed. Date: 9 Ila ti b Signature of Applicant or Agent -'-v 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 TII FE EN. M E d��1��il1il C)�';'' cru`I9,Yn;'i(EPt«�°' . I 1�0 ]ilijji� !�i Ij,J L1 i t 7Ill tf ggi til i u Oki: ,,, . /DATE 4fFEEANIOUNTi Improvement Permit Fee 09/12/2016 $150.00 I'lIij(�( 'I;lj('t,ofx llEESuitk s'iN ta�iINIlei I��IIIIIliniJi'�!r ': I'I�Q1iIIIil ��1, IH!IgtI�M�: $15000, 1�lea( II 0����if ��i��thtt1.1 ''l'”1 1 ntriP 1111 11111e1M111 11E11munpl111111 q�l@i�nn�7m'nuuni1111111wt111111 N ra�etntll :J.�1!Ule -�yl111101Nltn. N dl ing,12 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-ehappiication 09/12/2016 12:51 Page 2 of 4 CATAWBA THIS 1S NOTA PERMIT COUNTY 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❑ Replacement Well ❑ Well Abandonment❑ Well Repair ❑ Existing System Inspection (Pre-Approval Required) ❑ 3.aD, Application is for New Construction ❑ Existing Facility ❑ �7D Property Address P' -3N 3124 I L9Y 7'°to / q,1 Subdivision - 7 / sie $ 37ati /L73 74›,)--3 c;- --1/41).‘,4_,1 3 Lot# — Acres /Acte St�IptwSpr 1,1f ilk 2cuol pet 61t n- 9/ILpp Section/Block/Phase Driving Directions to Property .1'?^4"jr /Z;.1 C14 a- '*.+,t-N L$ . 1).":3"3 „CInl..'er -CAN tr f /1_0 L - c.- ,o As 1, .I- h etsw-c 33re1 A.re (J.F. NAME TO APPEAR ON PERMIT? ❑ Owner XApplicant ❑ Contractor Applicant Contact Information Name C /' t \ al Co Address /v /ti=X S^4,I- cot—%"t^ PK, 4 a'LI.1 Phone (80/3)) Le L t(. e.r9 7 Cell Phone (a)a 3' ) 1i 2- e-ri jf Owner Contact Information Name Cot l I-V4"-et Address j3'7 L 1'.'(>f etri) Phone Cell Phone Contractor Contact Information Name Address Phone Cell Phone WHO WILL BE THE PRIMARY CONTACT? ❑ Owner Applicant ❑ Contractor Description of Existing Structures on Site v et Ca" #of Bedrooms *j' Structure Dimensions #of Occupants Basement ,❑ Yes ❑ No Basement Fixtures Q 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 'No Does the site contain any jurisdictional wetlands? O Yes %No Does the site contain any existing wastewater systems? Oyes { Alo Is any wastewater going to be generated on the site other than domestic sewage? ptYes ❑No Is the site subject to approval by any other public agency? ® Yes *Io Are there any easements or right of ways on this property? Describe Existing water supply in use I Individual Well • Community Well U 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) gAccepted ❑ Alternative ❑ Conventional 0 Innovative 0 Other 0 Any CATAWBA THIS IS NOT A PERMIT counry CATAWBA COUNTY HEALTH DEPARTMENT ,,„, Application for Environmental Services Page 2 Proposed Facility Type )Primary Residence ❑ New Residence ❑ Addition to Residence # of New Bedrooms *t 3 Project Description P' 't ' kJ)tit>, Structure Dimensions �-r 7� r T `tN#of Occupants 1c- t � Basement n Yes (QNo Basement Fixtures ® Yes if, No E Accessory Structure(s) Describe #of New Bedrooms *1' if applicable Structure Dimensions 0 #of Occupants Accessory Dwelling ❑ Yes ❑ No Plumbing ❑ Yes ❑ No Describe Plumbing Needed LJ Multi-Family Residence# Units #Bedrooms per Unit*t Total#Bedrooms *t 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.) ❑ 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 Design Flow, Commercial j' Additional information may be required to determine _ TILL; "' 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 arc 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 nue, 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 comers and making the site accessible so that a complete site evaluation can be performed. Signature of Owner or Agent Date ita-it C Printed Name of Owner or Agent Jejs:) +"1, -- received. rrisf•A Pkiki 11M411Cews CATAWBA, Oeospatial . , Real Estate Search '-'‘......410*---:- ........_ In: forrnation Services 6-02-1 131io Cl/ c) .. • . 330.„ _ _... --• AVE 0 1 35) . Ak. e . ?33 ....... x.... . al . ..r. tn.. CY) (1 "). , 04 $ ....., ' . , 41 ...... Pu cv Ili , ',ei • '' ,...- Ca ' 41.A.A. 0■,... -, - E .'•Z cly ...— a. .._, ...., ,..,–, 133, , a z- _ + ..... ......, u., ,- .._, . , 126.3 1 to . sti N. r) " in a (e. r. ...... ,... N 1irz:75ft WE 5 . • Parcel: 372416937853 HICKORY 28601 Owners: HEFNER CARL EVERETTE, HEFNER IMOGENE K Owner Address: 1876 SIPE RD Values- Building(s): $0 Land: $12,600, Total: $12 600 , ‘ , ,, , This map/report product was prepared frOrn the Catawba County NC GeospatiallnformationServic,es, Catawba County has made substaritial 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 Mali/report product by the User.The County of Catawba,its employees agent's,and personnel disclaim,and shall not be held liable for any and all Oamages,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 ,.. person - . .C.ibipYright 201 4 CatawbaCounty NC 09/13/2016 CATAWBA Geospatial Real Estate Search _...._ Information Services 0 130 33RD 0 AVE l ye 172 0 a) (7 � 133 4215) _ to v Z co tr cv ..— CID 0 Z 0 C2 N H ov X 2 r (115j RG_ 4 r —J 3d• fn �r e 133 w1 • 126.3Y ❑ co N N u) N N we 1 in=75ft s Parcel: 372416937853, HICKORY, 28601 Owners: HEFNER CARL EVERETTE, HEFNER IMOGENE K Owner Address: 1876 SIPE RD Values - Building(s): $0, Land: $12,600, Total: $12,600 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 - 09/12/2016 Catawba County Environmental Health 2 \: / ice/} I I I 1 1 -4. tc _ 1 •3si5I 7 Al" 1 I r /76.53 I 1 I I rn / f 1f I f f •3625 13p t I 1 331ipAVeNe _--- 71 I m (735 281,54 0 CID • 133 • (132) 4,15) 0 i cn — •3620 `3235 (13") a ty Co K a (115) Co 123. •3219 4,, 133 co ID st:j ilk. *3622 01 , 6.:7 Co ov ❑ r. N O co — co C) 1 2 Selected Parcels 1 in=80ft 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 09/12/2016 Parcel Report . Page 1 of 1 Parcel Report - Catawba County NC Parcel Information: Owner Information: Parcel ID: 372416947061 Owner: HEFNER CARL EVERETTE Parcel Address: Owner2: HEFNER IMOGENE K City: HICKORY, 28601 Address: 1876 SIPE RD LRK(REID): 50455 Address2: Deed Book/Page: 0570/0323 City: CONOVER Subdivision: State/Zip: NC 28613-8817 Lots/Block: / School Information: Last Sale: School District: COUNTY Plat Book/Page: Elementary School: SNOW CREEK Legal: ROAD 1529 Middle School: ARNDT Calculated Acreage: .550 Tax Map: 1416 03005 High School: ST STEPHENS Township: CLINES State Road #: 1529 Tax/Value Information: Tax Rates(pdf) Zoning Information: City Tax District: All in County Zoning District: COUNTY County Fire District: ST STEPHENS Zoningl: R-20 Building(s) Value: $0 Zoning2: Land Value: $14,300 Zoning3: Assessed Total Value: $14,300 Zoning Overlay: Year Built/Remodeled: / Small Area: ST STEPHENS/OXFORD Current Tax Bill Split Zoning Districts: / Zoning Agency Phone Numbers Miscellaneous: Firm Panel Date: 2007-09-05 Building Permits for this parcel. Firm Panel #: 3710372400J Building Details 2010 Census Block: 1064 WaterShed: 2010 Census Tract: 010301 Voter Precinct: P33 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. http://gis.catawbacountync.gov/nomap/parcel_report.php?key=372416947061&typ=P 9/12/2016 Parcel Report • Page 1 of 1 Parcel Report - Catawba County NC Parcel Information; Owner Information: Parcel ID: 372416937853 Owner: HEFNER CARL EVERETTE Parcel Address: Owner2: HEFNER IMOGENE K City: HICKORY, 28601 Address: 1876 SIPE RD LRK(REID): 50456 Address2: Deed Book/Page: 0904/0384 City: CONOVER Subdivision: State/Zip: NC 28613-8817 Lots/Block: / Last Sale: School Information: Plat Book/Page: School District: COUNTY Legal: RD 1529 KANUPP LAND Elementary School: SNOW CREEK Middle School: ARNDT Calculated Acreage: .440 Tax Map: 1416 03006 High School: ST STEPHENS Township: CLINES State Road #: 1529 Tax/Value Information: Tax Rates(pdf) Zoning Information: City Tax District: All in County Zoning District: COUNTY County Fire District: ST STEPHENS Zoningl: R-20 Building(s) Value: $0 Zoning2: Land Value: $12,600 Zoning3: Assessed Total Value: $12,600 Zoning Overlay: Year Built/Remodeled: / Small Area: ST STEPHENS/OXFORD Current Tax Bill Split Zoning Districts: / Zoning Agency Phone Numbers Miscellaneous: Firm Panel Date: 2007-09-05 Building Permits for this parcel. Firm Panel #: 3710372400J Building Details 2010 Census Block: 1064 WaterShed: 2010 Census Tract: 010301 Voter Precinct: P33 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. http://gis.catawbacountync.gov/nomap/parcel_report.php?key=372416937853&typ=P 9/12/2016