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HomeMy WebLinkAboutEHPR-07-2016-24274.TIF s�Y'A - •• THIS IS NOT A PERMIT Case # EHPR-07-2016-24274 G CATAWBA COUNTY HEALTH DEPARTMENT 0 r 0',P . 0 Crir �. , PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES ti ti 1842 sM Environmental Health Plan Review - OSWP fio , • o+ ono• 74' IMPROVEMENT : ••• i •• • o Applicant GREG DRUM,4364 \V BANDYS CROSS RD, CLAREMONT NC 28610 C:8288965215 Land Owner KENNETH LEE& SHELBY DRUM, 4364 W BANDYS CROSSROAD, CLAREMONT NC 28610 C:8283105178 NAME TO APPEAR ON PERMIT Greg Drum SITE ADDRESS: 4348 W BANDYS CROSS RD, CLAREMONT NC 28610 PIN # 367901464342 NAME of SUBDIVISION: Lot 4 Section/Block PROPERTY SIZE: Square Feet 56,628.00 Acres 1.3 DIRECTIONS: 16s/left Balls Creek/right West Bandys X rds/with 1/4 mile on left PRIMARY CONTACT: Applicant SEWER TYPE: Septic Tank GALLONS PER DAY: 360 WATER SUPPLY: Public Water DESCRIBE WORK: IP Only for Subdividing* 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 Vacant Lot EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: NUMBER OF EXISTING BEDROOMS: #OF OCCUPANTS: 1 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 57'8"x 69'4" #OF NEW BEDROOMS:: 3 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: E9-ehappl icatinn 07/13/2016 10:14 Page I of 4 4o T CATAWBA COUNTY case EHPR-07-2 0 1 6-242 74 ,Tn:y Public Health Department Subdivision d ti)` Environmental Health Division PIN# """ ®' 367901464342 io a PO Box 389, 100-A Southwest Blvd, Newton. NC 28658 842 ,. NAME ON PERMIT: (GREG DRUM),4364 W BANDYS CROSS RD, CLAREMONT NC 28610 ( Greg Drum) Site Address: 4348 W BANDYS CROSS RD, CLAREMONT NC 28610 Property Size: Square Feet 56,628.00 Acres 1.3 Directions: 16s/left Balls Creek/right West Bandys X rds/with 1/4 mile on left 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 accessi le so that a complete site evaluation can be performed. Date: '1 — 1 3— I(ra Signature of Applicant or Agent ,taM,- An Environmental Health Specialist will contact you within 5 work) g days of application date. If you need further information or assistance please call 828-466-7291 AREA1 r loiINAIMEI�tI Milli prci j i�I r�1{p�'I�I1JIG i)gCl`i��11' .� -n-� yri111rhIIIIDATE I,`i IIIIIIi�III FE'Et�IAMOUNI o Improvement Permit Fee 07/13/2016 $150.00 ZaC? TI 1 { p i t lig r'I I I �� 1 '- vi n�I itt TOTAL FEES a'i un,191'i !IlI��l'lllli11�1�11�111�1��lti�lla n?Hi��l1r ��1'rl,I. X150 00 u 1.���.�111 '11 "!i' ;lieu li ;l i 4I .' ?kj;3',91WVI,,,,'mtli, " 1fltlftilillCIIINLu❑ . .dill ,NIIICr" _I ltriii_eili FEES ARE NON-REFUNDABLE ONCE A SITE VISIT 1S MADE OR WORK ON A PLAN REVIEW HAS COMMENCED SYSTEM REDESIGN AND/OR RETRIP WILL INCUR AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) E9-chapplication 07/13/2016 10:14 Page 2 of CATAWB A THIS IS NOT A PERMIT can_NT1' _ - CATAWBA COUNTY HEALTH DEPARTMENT �e.a, a„mom 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) ❑ Application is for New Construction ❑ Existing Facility ❑ Property Address_ 34 a is) $INJ s e enSS es) Subdivision C tC, ,,ri' AIL d 1(0(0 Lot# 9 Acres ( , a$(q Section/Block/Phase Driving Directions to Property NAME TO APPEAR ON PERMIT? ❑ Owner ❑ Applicant ❑ Contractor Applicant Contact Information Name (9 QC& Day nn Address `l.3 L45 t o 9A to ss ep , . L Rt rno t.l-r N C e g m 1 O Phone la$ . '9 to sd us- Cell Phone v Owner Contact Information Name kF-N NKr-r <} cuLla Address 4 Q,l C gp,vnys Lass to CLARcfwnrt Nc ditoto a Phone sza4 - gt . ,24to7 Cell Phone z 4 — �jlU - S11 '8 Contractor Contact Information Name ( p-C‘- D tia e,wt Address Phone •• Cell Phone WHO WILL BE THE PRIMARY CONTACT? ❑ Owner Applicant ❑ Contractor Description of Existing Structures on Site # of Bedrooms *t Structure Dimensions #of Occupants Basement ❑ Yes ❑ No Basement Fixtures C Yes a 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? El Yes IN No Does the site contain any existing wastewater systems? fl Yes 'in No Is any wastewater going to be generated on the site other than domestic sewage? El Yes ri No Is the site subject to approval by any other public agency? ® Yes NE 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 ❑ 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 _ CATAWBA COUNTY HEALTH DEPARTMENT -,o o Application for Environmental Services Page 2 Proposed Facility Type Primary Residence IT New Residence ❑ Addition to Residence #of New Bedrooms *t 3 _ Project Description C o n si c ..-r,o nJ o f 14 a ck Structure Dimensions 5'7'I(" 'W" #of Occupants Basement ❑ Yes k No Basement Fixtures 0 Yes ® No ❑ 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 ❑ 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. 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 dr 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 propertydines and comers and malting the site accessible so that a complete site evaluation can be performed. Signature of Owner or Agent %� _ ti+ �_ Date 1 - 1 — I (p Printed Name of Owner or Agent,fj (ey- r I Sc;s� ( D rte,.,. _ :. • Catawba County Environmental Health 7 • J .....„0„.....,,e--- - • 1/1"rit"--...--------.. .....e."--a--a'siec SW .. .... foc0:a '7 S'` 8 ' A • III M r rf 7,47, 8,. i te -4 111111-11.- I111 y.s,. 3 I mo' s _ _ - — w•BANDYS•CROSSiRD _• (635) • ' m ;71..__. \\\. Q n. N • V' • .. • Parcel: 367901464342 rW BANDYS 1 in=100ft CROSS RD CLAREMO -I , 28610 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 / 07/07/2015 11 Parcel Report Page 1 of 1 Parcel Report - Catawba County NC Parcel Information: Owner Information: Parcel ID: 367901464342 Owner: DRUM KENNETH LEE Parcel Address: 4306 W BANDYS CROSS RD Owner2: DRUM SHELBY City: CLAREMONT, 28610 Address: 4364 W BANDYS CROSS RD LRK(REID): 23221 Address2: Deed Book/Page: 2086/1385 City: CLAREMONT Subdivision: State/Zip: NC 28610-8305 Lots/Block: / Last Sale: School Information: School District: COUNTY Plat BooWPage: Legal: Elementary School: BALLS CREEK Middle School: MILL CREEK Calculated Acreage: 48.840 High School: BANDYS Tax Map: 023 Y 02055 Township: CATAWBA School Map State Road #: 2776 Tax/Value Information: Tax Rates(pdf) Zoning Information: City Tax District: All in County Zoning District: COUNTY County Fire District: BANDYS Zoning1: R-40 Building(s) Value: $2,000 Zoning2: Land Value: $237,100 Zoning3: Assessed Total Value: $18,500 Zoning Overlay: WP-O Use Land Value: $16,500 Small Area: BALLS CREEK Year Built/Remodeled: / Split Zoning Districts: / Current Tax Bill Zoning Agency Phone Numbers Miscellaneous: Firm Panel Date: 2007-09-05 Building Permits for this parcel. Firm Panel It: 37103679003 Building Details 2010 Census Block: 4012 WaterShed: WS-IV Protected Area 2010 Census Tract: 011402 Voter Precinct: P5 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. 11ttp://gis.catawbacountync.gov/nomap/parcel_report.php?key=367901464342&typ=P 7/13/2016 #gA `h CATAWBA COUNTY A• G IOOA SOUTHWEST BLVD a ��Y NEWTON, NORTH CAROLINA 28658 RECEIPT iti st► tf PHONE: 828.465.8399 �_ oi►�% Wednesday, July 13, 2016 1842 sM wtw.catawbacountync.gov PAYOR: Drum, Greg PAYMENTS TRANSACTION NUMBER: TRC-731239-13-07-2016 PAYMENT DATE : 07/13/2016 PAYMENT TYPE: Credit Card INVOICE NUMBER FEE NAME FEE AMOUNT 07-16-330376 Improvement Permit Fee S 150.00 TOTAL PAYMENTS : 5150.00 EHPR-07-2016-24274 CASE TYPE: Environmental Health Plan Review WORK CLASS: OSWP SITE ADDRESS: 4348 W BANDYS CROSS RD, CLAREMONT NC 28610 Applicant GREG DRUM,4364 W BANDYS CROSS RD, CLAREMONT NC 28610 C:82889652IS ** NO PEOPLESOFT ACCOUNT ASSIGNED ** Land Owner KENNETH LEE& SHELBY DRUM, 4364 W BANDYS CROSSROAD, CLAREMONT NC 2861 C:8283105178 receipt 07/1312016 10:13 Page 1 or 1