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HomeMy WebLinkAboutRBPR-07-2017-27023.TIFTHIS IS NOT A PERMIT Case # RBPR-07-2017-27023 CATAWBA COUNTY HEALTH DEPARTMENT PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES Residential Building Plan Review - Building New IMPROVEMENT - AUTH CONST - NEW WELL Applicant RICHARD (LOGAN) RIDDLE, , C:7046510193 Land Owner AMANDINE PROPERTIES LLC NONE, 26950 HAGGERTY RD, FARMINGTON MI 48331 Owner RICHARD (LOGAN) RIDDLE, , C:7046510193 NAME TO APPEAR ON PERMIT' Richard (Logan) Riddle SITE ADDRESS: 8577 AMANDINE WAY, TERRELL NC 28682 PIN # 461704538288 NAME of SUBDIVISION: AMANDINE Lot k 9 Section/Block PROPERTSSIZE: Square Feet Acres 0.69 DIRECTIONS: take Hwy 150W / left Kiser Island Rd right Amandine Way / lot on lefe before cul-de-sac PRIMARY CONTACT: Owner SEWER TYPE: Septic Tank GALLONS PER DAY: 480 WATER SUPPLY: Private Well DESCRIBE WORK: new single family dwelling 48 x 56 14 bedrooms/ 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? 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: New Structure STRUCTURE TYPE: PRIMARY RESIDENCE FACILITY TYPE: Single Family Residence OTHER DESCRIPTION: DESCRIPTION OF vacant lot EXISTING STRUCTURES ON SITE (IF ANY DIM EXISTING STRUCTURE: NUMBER OF EXISTING BEDROOMS: # OF OCCUPANTS: 4 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 48 x 56 # 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, Other described: APPLICATION FOR WELL CONSTRUCTION PROPOSED WELL TYPE: Individual Well REPLACE WELL?: NO E9 - ehappltcauon 07/24/2017 12 02 Page 1 of 4 �4gA CATH\\BA COUNTY Case k RBPR-07-2017-27023 ¢- Public Health Department AMANDINE Subdivision 4 Y Environmental Ilealth Division PIN4 461704538288 PO Bos 389, 100-A Southwest Blvd, Newton. NC 28658 NAME ON PERMIT: ( RICHARD (LOGAN) RIDDLE), , ( Richard (Logan) Riddle) Site Address: 8577 AMANDINE WAY, TERRELL NC 28682 Property Size: Square Feet Acres 0.69 P S Directions: take Hwy 15OW / left Kiser Island Rd right Amandine Way / lot on lefe before cul-de-sac 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 FEENAME Authorization to Construct Fee (New/Expansion) Fee Improvement Permit Fee Well Permit & Inspection Fee TOTAL FEES DATE FEE AMOUNT 07/24/2017 $300.00 07/24/2017 $150.00 07/24/2017 5300.00 $750.00 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) F,9 - ehapphcanon 07/24/2017 12:02 Page 2 of 4 AW Be I'H1S IS NOT A PERMIT `cLuu,•T1.I1V V 1J[ `, CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services Page 1 Ne,� Coy WN Improvement Permit M/ Authorization to Construct V Septic Repair ❑ Septic Malfunction ❑ Septic Expansion ❑ New Well Permit [X Replacement Well ❑ Well AbandongnentO Well Repair ❑ Existing System Inspection (Pre -Approval Required) Application isfor New Construction LJV Existing Facility ❑ ,p Property Address K51� /nMcvv jiq Q01 Subdivision p,t,+Atnd1G`lvle TP\I� N(,\i �, �� . Lot 1 Acres t�t Scction/Bloc WPhase Driving Directions to Property TCTQ 1rW`i_ 1�L1 ucsir ` rnn i��t �Clf,,vrh R-c-JMJ\ k7,,44 DSA AvLov)iAme �eFo j e �) NAME TO APPEAR ON PERMIT? C`!1 Owner ❑ Applicant ❑ Contractor Applicant Contact Information Name Address Phone Cell Phone Owner Contact Information Name �o`I<Av�, Address g11\ MCAI�t rA [LncsA UfiAuef Phone Cell Phone SOU — b cj ,CJ I q ? Contractor Contact Information _ Name Address ' r Phone / WHO WILL BE THE PRIMARY CONTACT? t°t Owner Description of Existing Structures on Site (IS/,6T-f-P0 # of Bedrooms *j' r 0 Structure Dimensions Basement El Yes Yes No Basement Fixtures ® Yes Cell Phone ❑ Applicant ❑ Contractor 0 \ # of Occupants U ®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 `'ye ', applicant must attach supporting documentation. fy ❑ Yes JNo Does the site contain any jurisdictional wetlands? • Yes h] No Does the site contain any existing wastewater systems? Yes R,No Is any wastewater going to he generated on the site other than domestic sewage? ,Yes /No is the site subject to approval by any other public agency? ® Yes d No Are there agy easements or right of ways on this property? Describe Existing water u iply in usship..WaterlLine nal Well ._ ., u - Community Well U Sem .. ... ................ .. . ...... _. ... . i -Public Well Is a public water supply available? ** ❑ Yes dNo 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) 0 Accepted 11 Alternative 0 Conventional 0 Innovative 0 Other ❑ Any CATAVV3A THIS IS NOT A PERMIT COUNTY CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services Page 2 Proposed Facility Type h ❑ Primary Residence © New Residence ❑ Addition to Residence # of New Bedrooms Project Description f(\l'`,.% (�(,r\CN�� (rU✓�ifVC w\A Structure Dimensions ��'�rJp #of Occupants L4 Basement ❑ Yes No Basement Fixtures ® Yes No H Accessory Structure(s) Describe # of New Bedrooms *j if applicable Structure Dimensions of Occupants Accessory Dwelling ❑ Yes ❑ No Plumbing ❑ Yes ❑ No Describe Plumbing Needed U Multi -Family Residence # Units #Bedrooms per Unit*t Total # Bedrooms *j' Structure Dimensions n Food Service Specify Type # Seats Floor Space -Entire Food Service Facility (Sq Ft) # Employees per Shift # of Shifts Dining Area (Sq. Ft.) U Business Specific Type of Business Retail Floor Space_ # of Employees per Shift # of Shifts U Other Facility Type Specify If Church # of Seats Kitchen ❑ Yes ❑ No If Daycare Specify Occupancy Application for Well Congtruction/Abandonment/Repair Proposed Well Type !J( Individual Well ❑ Semi -Public Well ❑ Community Well Abandonment Type ❑ 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 he 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. 'fire number of bedrooms will he 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. j 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 fiom 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. 1 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. Signature of Owner or Agent I(.L�pl'�(�x(2.7a-lm �lfr( /l Date Printed Name of Owner or Agent P "k (`A ck A L6 u v\ P A Me 85.05 Catawba County Environmental Health 51.43 78.32 AIhANOpNf IWIAY 60.33 26.49 1§ '190 44.50 a elz� 2k 13.40 Parcel: 461704538288, 8577 AMANDINE WAY TERRELL, 28682 rn 1 157•2q 1 in=50ft 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 07/20/2017 Printd_jtfa.jpg 827x522&PiXOS 7120117, 11:28 AM httn:)lois.catawbacountync.gPvLTileStitctaprintd_jifa.jpg Page 1 of 1 Parcel Report Parcel Report - Catawba County NC Parcel Information: Parcel ID: 461704538288 Parcel Address: 8577 AMANDINE WAY City: TERRELL, 28682 LRK(REID): 803262 Deed Book/Page: 3141/0762 Subdivision: AMANDINE Lots/Block: 9/ Last Sale: Plat Book/Page: 67/192 Legal: LOT 9 AMANDINE PL 67-192 Calculated Acreage: .690 Tax Map: Township: MOUNTAIN CREEK State Road #: Tax/Value Information: Tax Rates(pdf) City Tax District: All in County County Fire District: SHERRILLS FORD Building(s) Value: $0 Land Value: $48,700 Assessed Total Value: $48,700 Year Built/Remodeled: / Current Tax Bill Miscellaneous: Building Permits for this parcel. Building Details WaterShed: WS -IV Critical Area Voter Precinct: P41 Parcel Report Data Descriptions List all Owners Deed History Report Owner Information: Owner: AMANDINE PROPERTIES LLC Owner2: Address: 26950 HAGGERTY RD Address2: City: FARMINGTON State/Zip: MI 48331-3407 School Information: School District: COUNTY Elementary School: SHERRILLS FORD Middle School: MILL CREEK High School: BANDYS School Map Zoning Information: Zoning District: COUNTY Zoningl: R-30 Zoning2: Zoning3: Zoning Overlay: CRC-O,WP-O Small Area: SHERRILLS FORD Split Zoning Districts: / Zoning Agency Phone Numbers Firm Panel Date: Firm Panel #: 2010 Census Block: 2010 Census Tract: 011504 Agricultural District: Assessment Report Page 1 of I 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, us 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. © 2017, Catawba County Government, North Carolina. All rights reserved. �?�� NeiSPAf;, h tz ( 1qq) qy 4S0030c, http://gis.catawbacountync.gov/nonutp/parcel_report. php?key=461704538288&typ=P 7/20/2017 ^� CATAWBA COUNTY Case # WLS2008-00642 Pubhc Health Dep•uunem Envrcunmemel Health Dn•r,wn Subdivision AMANDINE '•., �, OR ' PO Box }S9 100-A Sowhwes1 Blvd Nc,won. NC '3658 Sect/ 13 L/Ph/Lot # 9 - _. .. (328)1(5-8270 FAX(828)465-82"/6 TDD(82SPINtf 911461704631335-9 Applicant/Owner DEBORAH P WRIGHT Site Address: 8577 AMANDINE WAY Property Size: SF 7 ACRES Directions: 16S/ LEFT 150E/ RT KISER ISLAND RD PROJECT IS 1 MILE ON RIGHT Improvement Permit o4 0 Permit Valid For: Five years ✓ No Expiration oA Facility (Residential): House House X Mobile IIonie Multi-Fanoly Bedrooms 4 New? _✓ Addition? Projected Daily Flow t(� g.p d Water Supply Pnvate Well? Public? Semi -Public? Basement, N Basement Plumbing N floi 1'ub/Spa: __N Special Fixtures (explain) Proposed Wastewater ystem://� _a _ _ _ OtK—�iOr.S —GJ"/� Type: _ ' Proposed Repair: _ Pl &S ;.o ._� �Br` —,8�,�—�i�l_fl� Permit Conditions: Owner or Legal Representative Siilly t.�y� _ r.% Date: Authorized State Agent: /lLl.–�,_/�S Date: 9 The Issuance of this permit by the Health Department docs not euai antee the Issuance of other permits. It is the responsibility of the apphcanUproperty owner to insure that all Catawba County Planning/Zomnl and Bmldu , Inspecuons rcqulrements are met This Improvement Permit is subject to revocation if the site plan, plat or the intended use changes, or it site conditions in c 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 'Laa,s #tart Rules Por Selemre Treatment and Uisvu3al Svsteals' (ISA NCAC 18A .191111). Neither Catawba County nor the Environmental health Specialist trarranls that the septic tank s2stem will continue to function satisfactorily for any given period of time. Authorization to Construct Wastewater Svstem (Reauired for Buildinq Permit) " See sae plan mrd additional atrnchments ( ) Proposed Wastewater System: Type: Wastewater Flow q.p.d New Repair Expansion Soil LTAR: g.p.d./ft2 Type of Facility: Basement N Basement Plumbing. N II01Tl1b/Spa: N Special Fuunes (explain) Wastewater Svstem Reauirements Tank Size: Septic Tank gal Pump Tank gal Grease Trap gal Drainfield: Total Area: sq It Total Length: It Maximum Trench Depth In Trench Width It Minimum Soil Cover in Minimum Trench Seperabon It Distribution: Distribution Box Serial Distribution _ Pressure Manifold LPP Other Additional Specifications: Authorized State Agent: Date: Permit Expiration Dat-' I have I ead and accept the 3pecificanonc nuc/ all conduiou3 of this permit chs indicated. Owner or Legal Representative Signature: Date: Fora 13 NTidun... cf....n•V"LSnnn rnI CATAWBA COUNTY Public Hrilth Dep,ntmrnt , . I Case 4 W LS2008-00642 Env>runmenial Health Division Subdivision AMANDINE d0 j \, Ft'; /r PO f3oa +89. 100-A Southwest 131, A. Nc„•Inn. NC 28658 Sec'USUPh/Lot rY 9 (828)465-8270 FAX (828) 465.8276 TDD (8251 »65-8200 PINit 9 1146 170463 1335-9 ApplicanUOwner DEBORAH P WRIGHT Site Address: 8577 AMANDINE WAY Properly Si SF .7 ACRES Directions: 16S/ LEFT 150E/ AT KISER ISLAND RD PROJECT IS 1 MILE ON RIGHT MImprovement Permit ElAuthorization To Construct SITE PLAN Well Permit /tihGn� / '�e Q Scale System components represent approximate contours only. The contractor must flag the system prior to beginning the installation to ensure that proper grade is maintained. Do not install system under wet conditions. This permit is subject of revocation if the site plan or site conditions are altered, A ulhoriz`ea State Agent' jute Form C 00•„..ot ,,m,VIVL4,o„n„