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HomeMy WebLinkAboutRBPR-07-2017-26983.TIFTHIS IS NOT A PERMIT Case # RBPR-07-2017-26983 CATAWBA COUNTY HEALTH DEPARTMENT PLAN REVIEW APPLICNFION FOR ENVIRONMENTAL SERVICES Residential Building Plan RevieNN, - Modular RUTH CONST -NEW WELL �ji�ln Re���d daKc�wy - Contractor JERRY W POPE (.TERRY W POPE), 1325 NORMANDY ST, CONOVER NC 28613 B:828-464-6180 �. Owner KYLE MAJOR, 4183 ANDERSON MOUNTAIN RD, MAIDEN NC 28650 C 828-461-0784 NAME TO APPEAR ON PERMIT Kyle Major SITE ADDRESS: 4201 ANDERSON MOUNTAIN RD, MAIDEN NC 28650 PIN # 367704515293 NANI E of SUBDIVISION: Lot# 1 Section/Block PROPERTY SIZE: Square Feet Acres 1.23 DIRECTIONS: 4201 Anderson Mountain Rad, Maiden PRIMARY CONTACT: Contractor SEWERTYPE: SepticTank GALLONS P 360 WATER SUPPLY: Private Well E WORK: x 28 Modular Home with 16x22 Front & Rear Decks SI I t 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? Yes Are there any easements or right-of-ways on this property'? No APPLICATION FOR: STRUCTURE TYPE: FACILITY TYPE: Single Family Residence DESCRIPTION OF EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: NUMBER OF EXISTING BEDROOMS: New Structure PRIMARY RESIDENCE OTHER DESCRIPTION: # OF OCCUPANTS: 3 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 60x28 # OF NEW BEDROOMS:: 3 BASEMENT? No BASEMENT FIXTURES? No Desired system types (Improvement Permit or Authorization to Construct) ACCEPTED ALTERNATIVE. OTHER. INNOVATIVE Other described. PLUMBING REQUIRED? Yes CONVENTIONAL: ANY APPLICATION FOR WELL CONSTRUCTION PROPOSED WELL TYPE: Individual Well REPLACE WELL?: NO 1"- 0TI82017 12 01 Page 1 44 an CATAWBACOUNTY KBPR-07-2017-26983 case # Public I lealth Department r. Subdivision 2,I ,,, 0 Environmental Health Division I'IN# 367704515293 rg 2 M PO Box 389, 100-A Southwot Blvd, Newton, NC 28658 NAME ON PERMIT: ( KYLE MAJOR), 4183 ANDERSON MOUNTAIN RD, MAIDEN NC 28650 ( Kyle Major) Site Address: 4201 ANDERSON MOUNTAIN RD, MAIDEN NC 28650 Property Size: Square Peel Acres 1.23 Directions: 4201 Anderson Mountain Rad, Maiden 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 �'� ""'"�tl'I'II'!1ii'iliMll"r,- "*h!if,�I I :{E{• .....,!ili1: i 'Ips i rm.0J6r!I_I"-li11',.rlI. ."',m-EwiA- MiOtl UI NeTFEENAME DATEE Authorization to Construct Fee (New/Expansion) 07/14/2017 $150.00 Fee Well Permit & Inspection Fee 07/14/2017 $300.00 _ i di;'fi m;:... N,;!r: ';I:,IB Ir�!��I��i's.^�11i f i I TOTAL FEES I r '� � !•� -1 i�.l 1,! �. ' 1 illhl ff $45000i!:f i;11"e:d.lr'.._:tty2.1eM..=I 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) - ch:ygrha,p, ni (17/18/2017 12 01 Page 2 of 4 THIS IS NOT A PERMIT Case # RBPR-07-2017-26983 CATAWBA COUNTY HEALTH DEPARTMENT PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES Residential Building Plan Review - Modular AUTH CONST -NEW WELL Contractor JERRY W POPE (JERRY W POPE), 1329 NORMANDY ST, CONOVER NC 28613 B:828-464-6180 Owner KYLE MAJOR, 4183 ANDERSON MOUNTAIN RD, MAIDEN NC 28650 C 828-461-0784 NAME TO APPEAR ON PERMIT Kyle Major SITE ADDRESS: 4201 ANDERSON MOUNTAIN RD, MAIDEN NC 28650 PIN # 367704515293 NAME of SUBDIVISION: For # 1 Section/Block _ PROPERTISIZE: Squire peel Acres 123 DIRECTIONS: 4201 Anderson Mountain Rad, Maiden PRIMARY CONTACT: Contractor SEWER TYPE: Septic Tank GALLONS PER DAY: 360 WATER SUPPLY: Private Well DESCRIBE WORK: 16x22 Modular Home with Front & Rear Decks 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? Yes Are there any easements or right-of-ways on this property? No APPLICATION FOR: STRUCTURE TYPE: FACILITY TYPE: Single Family Residence DESCRIPTION OF EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: NUMBER OF EXISTING BEDROOMS: New Structure PRIMARY RESIDENCE OTHER DESCRIPTION: # OF OCCUPANTS PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 60x28 # OF NEW BEDROOMS:: 3 BASEMENT? No BASEMENT FIXTURES? No Desired system types (Improvement Permit or Authorization to Construct) ACCEPTED ALTERNATIVE: OTHER: INNOVATIVE Other described: 3 PLUMBING REQUIRED? Yes CONVENTIONAL ANY APPLICATION FOR WELL CONSTRUCTION PROPOSED WELL TYPE: Individual Well REPLACE WELL?: NO 1-1)-chapphcauan 07/14/2017 16 24 Page 1 ol'4 n �, cATAwsA couN rti RBPR-07-2017-2698 Case 4 C' Public Health Department Subdivision 6 , jYM/ Environmental health Division pIN# 367704515293 ` / / Pr1 Boa 389, 100-A Southwest Blvd, Newton, NC 28658 842 NAME ON PERMIT: ( KYLE MAJOR), 4183 ANDERSON MOUNTAIN RD, MAIDEN NC 28650 ( Kyle Major) Site Address: 4201 ANDERSON MOUNTAIN RD, MAIDEN NC 28650 Property Size: Square Feet Acres 1 23 Directions: 4201 Anderson Mountain Rad, Malden 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: % /°/ /7 Signature of Applicant or Agent2xn 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) 07/14/2017 $150.00 Fee Well Permit & Inspection Fee 07/14/2017 $300.00 TOTAL FEES $450.00 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) L9 - 07/14/2017 16 24 Page 2 of 4 CAArT/A THIS ISNOT APERMIT COUNTY iVV VV, 11JJ CATAWBA COUNTY HEALTII DEPARTMENT Application for Environmental Services Page 1 Improvement Permit ❑ Aulho izalion to Cons ruct Septic Repair F1 Septic Malfunction ❑ Septic Expansion ❑ New Well Permit Coils ment Well ❑ Well Abandonment ❑ Well Repair ❑ Existing System Inspection (Pre -Approval Required) ❑ Application is 1'or New Construction X Existing Facility ❑ Properh' Address LiW MIA Q- Subdivision M�rl�e( /�G Sufi a Lot # Acres 11,,�� Section/BlocI&I'In,y�se Driving Directions to Propftterty 11w 4 A rir 4K � 1�n�<�5Ji� /n}t1 FJ /I./ - NAME TO APPEAR ON PERMIT? X Owner ❑ Applicant ❑ Contractor Applicant Contact Information Name kyj�,_ unci Address 1/261 AA, J PM)1 mon Phone Owner Contact Information Name Addressc&I frAJec.5cA Mk Phone Contractor Contact Information Name Address Phone r2J lnudNr\ Nc .2%&S -o Cell Phone :ias L/l j - d7S/l R,a /hu;,a en 1110 a Qc'-�SU Coll Phone 1/0 �ONtt lbnn lee All 2 6/3 _ Cell Phone WHO WILL BE THE PRIMARY CONTACT? ❑ Owner ❑ Applicant ❑ Contractor Description of Existing Structures on Site 4 of Bedrornns 't Structure Dimensions It of Occupants Basement ❑ Yes ❑ No Basement Fixtures 0 Yes KDNo The Applicant shall noffy 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 0 Yes q No Does the site contain any jurisdictional wetlands? 0 Fes R No Does the site contain any existing wastewater systems? 0 Yes V No Is any wastewate going to be generated on the site other than domestic sewage? X1'es No Is the site subject to approval by any other public agency? Q3 Yes 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 Ovate supply available? ** ❑ Yes vvjl No 11applying for an Improvement Permit or Authorization to Construct, Please Indicate Desired System Type(s): (systems can be ranked in order of your preference) ❑ Accepted ❑ .•lliernative ❑ Conventional ❑ Innovative ❑ Other ❑ Anl' CATAi?C 7L11� I l IIS IS NOTA PERMIT Cvi7,'TY �'/YV. l -J- CATAWBA COt.NIN HEALTH DEPAR'rim LNT Application f,;r Ellviromnolttal Serv, ccs Proposed Facibly Type z Primary Revidence J New Itesideuce J Addition to R:'ddencc 1, of New Bedrocatu Project Description M0,1,1'r it x 22- 'D—k tt u ,,,pmurc Duucnsionl ;a� :t 1i� 1 r�o`Occupants 13as:tncnt J 1'cs i S No 3ttsc .cot "iytures U Yes &?oto [� Acc'essorN'Structures) Describe y of New Bedrooms, "I if applicable Stsucwrc Dimensions of lt.;Gt;p3t„—;' s . cesse'D�t'ei. ;ig �. , 'res ts, 1 Plumbing J Yes 1I&No Describe Plumbing Needed J Multi-Fumih Residence # I Inns _ _ _ kliedroonis per Unit” f Total # Budrooms is, Structure Dimensions [) Food Service Spucif.v Type #S,tis Floor Shoce-EJrei'Pod Sery".ecacitity'SA F`) # Employees fuer Shill _ _._ A of Shifts _ Dining Area (Sy. If.) LJ Business Specific Tyhc of Fiusiness Ketail Floor Since = of Emip:o,,1,. s; p;.r SLif', _ _ ? of I'lttts J Otherlracifity'rype Srev:Cy If Clnucl I # of Seats _ ^ - Kitchen J Yes J No IFDayc;ire Specify Occupancy _ Application for Well Construction/Abanrlonutent/Repair Proposed Well Typc t Individual Woll ❑ Semi Puhlic Nell ❑ C;ornmouily W01 Alan' amen,T1Ite IS Diille,i ❑ 301 ed a Dug J lini*rown Well Repair Rcquecled J Yes 1 No Desciif o Ciicu)ated Design i'1,:+', Corm erci ; i Additional information may be required to determine design flow from certain facilites. This value will lie determined during consultation With on-site staff. 'An. ,,ceir that vr'!!T rye into dei for sizcpino ,a the ;ince of eo'ig'r JJ''on ,r Cs f::ure :onsidaratic,n should Iw: ores s a b-d-o,,m „rd counted pan all applications. The number of bedrooms will be confirmed by rooms identified on house plans as a hedrooin at the time ei building permit issuance. I itis rrm� pre ent tic ;uec' for septic system size increase in the Itaure. ifstructure is plumbed but no bedrooms, calculated dosien flnw is roauiied. 's' If No, a well permit must be issued with the Authorizatinn to Construct. SYSTF,A1 REDESIGN AND/OR RETRIP WILL INCUR AN ADDI'I'ION'AI, CHARGE (SLE FEE SCIJEDUL.L Improvement Permits issued as a result of this informwion arc valid lui 5 years or may be non -expiring under certain specified condition:;. An Authotiz.ttien b, Cunstruct issued by this dcuarnuc'tt is vali fDr (5)5ve years fiona the date issued and is non transferable; ]mprovemeut Permits and Well Permits are transl''oimbie Permits may be revoked if the information on this application, _rte plans or intendod usr changes far the prepo�cd facility. T have read this apptication and certify that the uttortmriim pravided leznom is true, complete and cou"cet. Authorized county and state officiais are granted tight oifenay to conduct necessary inspections to detormhne compliance with applicable laws, and rules. I understand that I ant solely responsible for the proper identification and labclin�,, of all property lines and comers and malting the site accessible so that a complete silo evaluation can be performed. Si.onature ol`Owner or Agent f,4/ jri`i ` Date /'-1'/-17 ff ii Printed Name of`Owrter or Agent zi`N 1Q'" Catawba County Environmental Health Parcel: 367704515293, 4201 ANDERSON 1 in=50ft MOUNTAIN RD MAIDEN, 28650 This map/report product was prepared from the Catawba County, NC Geospahal 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 07/14/2017 Parcel Report Parcel Report - Catawba County NC Parcel Information: Parcel ID: 367704515293 Parcel Address: 4201 ANDERSON MOUNTAIN RD City: MAIDEN, 28650 LRK(REID): 201754 Deed Book/Page: 3362/1006 Subdivision: Lots/Block: 1/ Last Sale: Plat Book/Page: 76/74 Legal: LOT 1 PLAT 76-74 Calculated Acreage: 1.230 Tax Map: Township: CALDWELL State Road #: Tax/Value Information: Tax Rates(pdf) City Tax District: All in County County Fire District: BANDYS Building(s) Value: $0 Land Value: $6,300 Assessed Total Value: $6,300 Year Built/Remodeled: / Current Tax Bill Miscellaneous: Building Permits for this parcel. Building Details WaterShed: Voter Precinct: P1 Parcel Report Data Descriptions List all Owners Deed History Report Page 1 of 1 Owner Information: Owner: MAJOR KYLE ANDREW Owner2: Address: 4183 ANDERSON MOUNTAIN RD Address2: City: MAIDEN State/Zip: NC 28650-9019 School Information: School District: COUNTY Elementary School: TUTTLE Middle School: MAIDEN High School: MAIDEN School Map Zoning Information: Zoning District: COUNTY Zoningl: R-40 Zoning2: Zoning3: Zoning Overlay: Small Area: BALLS CREEK Split Zoning Districts: / Zoning Agency Phone Numbers Firm Panel Date: Firm Panel #: 2010 Census Block: 4001 2010 Census Tract: 011602 Agricultural District: Assessment Report This map/report product was p,epared from the Catawba County, NC Geospabal 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 o, consequential which arises or may arise from this map/report product or the use thereof by any person or entity. © 2017, Catawba County Government, North Carolina. All rights reserved. http://gis.catawbacounlync.goN,/nomap/parcel_report.php?key=367704515293&typ=P 7/14/2017 cnraa'ri.a COUN 1 v try �, � Puhlic lieal!h Department <, .. m. �", Envuonmenlal Ilc;dlh Di, cion PO Boy 339. IOII-A .Cntnh,vest Bled, Ne,elon. NC 2865> 0 C-tse'' IMPV-08-2016-07631_2 Subdivision Brian and Patricia Major PINg 367704515065 LU I'# 1 NAME ON PERMIT: BRIAN MAJOR, 4183 ANDERSON MOUNTAIN RD; MAIDEN NC 28650 Site Address: 4201 ANDERSON MOUNTAIN RD, MAIDEN NC 28650 Property Size: Square Feet. 54,450.00 Acres 1.250 Directions: Hwy 16 S, right on Anderson Mtn Rd, approx 1 miles property on right Improvement Permit Facility: Primary Residence Permit Category: New Septic bec:nm:ns 3 WATER SUPPLY: Private Well Basement? No Basement Plumbing? No INITIAL SYS'I'EM SPECIFIC/\TIONS Permit Valid: Expires In Five Years. _X_ No Expiration. Projected Daily Flow 360 g.p.d Proposed Wastewater System: 25% REDUCTION Type: IIIG - OTHER NON-CONV'I'RFNCH SYSTEMS Permit Conditions: Keep all parts of septic system and any future repair minimum. 5' from home,50' from any well, 10' from property Imes. Lines to be installed on contour Do not grade drive or fill over system or repair or permit will be revoked. An Authorization to Construct and well permit are required prior to obtaining budding permits. - REPAIR SYSTEM SPECIFICATIONS - -- --- — -- --- - -- --- — — — — — --- -- — --- --- - - — Repair System Required? Required Proposed Wastewater System: 25% REDUCTION Type: I I I G - OTI-IFR NON -CONY TRENCH SYS I'EN1S Landscaping or other site alterations that potentially divert Groundwater or surface water toward the septic system, or prevent proper drainage away from the septic system, including the direction of gutter flows or foundation drains, is not approved, and may result in failure to approve the initial system installation, or the suspersion/revocation of exislinq permits. fhe issuance of This pci mit by the health Depai uncut docs not guaumtee the issuance of other permit's. It is the responsibility of the applicantlpioperty owner to rosin that all Cat,m ba County I'Imuung/Zoning and Ruilchng Inspections requirements are rtes This Improvement Permit is subject to revocalinn it the site plan, plat or the intended use changes, or it site conditions are altered. The Improvement Permit is not affected by a change in ownership of the property. This permit was issued in compliance with the provisions of the North Carolina 'Lane and Rides for Senrnee Treatment and Dimoval Srstv,no' (15A NCAC I8A .1900). Neither Catawba Countv nor the Envirunarental Health Specialist warrants that the septic tank system will continue to function satisfactorily for any given period of time. Jason Boyd 08/3112016 AUTI IORIZED STATE AOLNT APPROVAL DATP Perms Expiration Date 08/31/2021 A-0 grading ar cans(rrrclinn ucf7t rn- r., uRotred nv nuns de.vpnated jar chvew curd repair ualheW approval offhe Heulth Dep<rument, chpennii 08/31/2016 049 A I Permit ri 4 G CATAWBA COUNTY Name Public Health Department Address Environmental Health Division � PO Box 389, 100A Southwest Blvd, Newton NC 28658 184 s (828)465-8270 Fax (828)465-8276 TDD (828)465-8200 1 PIN# jl_ku 1'L Scale I t 6 V Site Plan Improvement Permit O� \ � 2,e- 4 ZS �p K W ys' r-, v✓-� nJ�rsa-- Mt� EHPR 8-16-24463 Brian Major 4201 Anderson Mountain Rd Maiden NC 367704515065 r v�y l c-. Y 0 r , J J i I J a- U b � O� \ � 2,e- 4 ZS �p K W ys' r-, v✓-� nJ�rsa-- Mt� EHPR 8-16-24463 Brian Major 4201 Anderson Mountain Rd Maiden NC 367704515065 r v�y l c-. Y 0 r , J J i I J a-