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HomeMy WebLinkAboutRBPR-07-2017-27042.TIF1�A Q 7p `'PC 184?- sM Contractor THIS IS NOT A PERMIT Case # RBPR-07-2017-27042 CATAWBA COUNTY HEALTH DEPARTMENT PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES Residential Building Plan Review - Building New IMPROVEMENT - AUTH CONST - EXPANSION *BLACKBURN ENTERPRISES UNLIMITED, LLC (DAVID BLACKBURN), 2581 PENNGATE Df SHERRILLS FORD NC 28673- B:8284784727 C7044513398F:NONE 5KBLACKBURNaCHARTER.NET Owner JONATHAN HENRY. 13147 W BUCKHORN WAY, LITTLETON CO 80127 C:303-808-5862 NAME TO APPEAR ON PERMIT Jonathan Henry SITE ADDRESS: 3056 BASS DR, SHERRILLS FORD NC 28673 PIN # 369804807940 NAME of SUBDIVISION: MAT -FIE GABRIEL UNRECORDED Lot# 9 Section/Block PROPERTY SIZE: Square Feet Acres 057 DIRECTIONS: Hwy 16 S, Left on 150 E, Left on Mt Pleasant, Left on Little Mountain, Right on Ingleside, Left on Bass, Trailer on right about 1/2 mile PRIMARY CONTACT: Contractor SEWER TYPE: Septic Tank GALLONS PER DAY: 480 WATER SUPPLY : Private Well DESCRIBE WORK: One Story 66x60 New Home with 4 Bedrooms, with Basement, with Attached Garage - 14x70 Mobile will be removed from Lot 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: PRIMARY RESIDENCE FACILITY TYPE: Single Family Residence OTHER DESCRIPTION: DESCRIPTION OF 14x70 Moible Home will be removed EXISTING STRUCTURES ON SITE (IF ANY DIM EXISTING STRUCTURE: 14x70 NUMBER OF EXISTING BEDROOMS: 3 # OF OCCUPANTS: 2 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 66x60 New Home # OF NEW BEDROOMS:: 4 BASEMENT? Yes BASEMENT FIXTURES? Yes Desired system types (Improvement Permit or Authorization to Construct): ACCEPTED ALTERNATIVE: OTHER: INNOVATIVE: Other described PLUMBING REQUIRED? Yes CONVENTIONAL. YES ANY: E9 - chapphcauun 07/26/2017 12.24 Page I of 4 e CATAWBA COUNTY Case# RBPR-07-2017-27042 ,v y Public Health Department Subdivision MATTIE GABRIEL UNRECOF Environmental I lealth Division MATTI GABR PO Box 389. 100-A Southwest Blvd, Newton. NC 28658 I IN# 07940 !g w NAME ON PERMIT: ( JONATHAN HENRY). 13147 W BUCKHORN WAY, LITTLETON CO 80127 ( Jonathan Henry) Site Address: 3056 BASS DR, SHERRILLS FORD NC 28673 Property Size: Square Fcct Acres 057 Directions: Hwy 16 S, Left on 150 E, Left on Mt Pleasant, Left on Little Mountain, Right on Ingleside, Left on Bass, Trailer on right about 1/2 mile 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: -7 (zlo 11-, Signature of Applicant orAeent ITt-7-� 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 SETBACKS: AREA1 30 Foot Lake Buffer FEENAME Improvement Permit Fee Authorization to Construct Fee (New/Expansion) Fee TOTAL FEES DATE FEE AMOUNT 07/26/2017 $150.00 07/26/2017 5300.00 FEES ARE NON-REFUNDABLE ONCE A SITE VISIT IS MADE OR $450.00 WORK ON A PLAN REVIEW HAS COMMENCED SYSTEM REDESIGN AND/OR RETRIP WILL INCUR AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) F0 - chapplicauun 07/26/2017 1124 Pace 2 of 4 C nTLjWB e THIS IS NOT A PERIAIT COUNTT 1vpY _„ CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services Page I Improvement Permit K dhoriration to Construct V, Scplic Repair El septic Malfunction ❑ Septic Expansion Ncw Well Permit ❑ Replacement Well ❑ Well Abandonment ❑ Well Repair ❑ Existing System Inspection (Pre -Approval Required) r Application is for New Construction [K Existing Facility ❑ Property Address 3O5(o 6,pw ),,'V-It� Subdivision Cg4,,,q,4 .�-,O,Avrs <1,,,..,.-,(IIft-,h 4 Nr- 3 Lot:# q Acres Sectio 11/13toch/Phase Driving Directions to Property % So✓V% T L ow 1.f0 FR f TIL o.i MT. Pl,.u,-41—. I L o,J Lillir. Mr,j Rd. 7'/ 2 ct,/L icicriA� , -7-/L o.-,, i3ids, 7 -r,+ -mot o0112#47- ' x�w4 Ila md4 , NAME TO APPEAR ON PERMIT? [) Owner ❑ Applicant ❑ Contractor Applicant Contact Information Name �lAci4�� ✓ �vt .9: %S�l ll✓kr i4 --Cl. LLC, Address 6-d N 2 � 6.7 3 Phone ✓lo 4-- cis(. 3.39 g Cell Phone 0pµ, tf51 33%8 Owner Contact Information Name T)Jn r 14� ey Address �3D.SC, last LlrStu---,Jllj r -,d NL 2FL,173 Phone 30 9�3—µ�o� Cell Phone 302-90$-S86Z Contractor Contact Information Name (� A CV- b 0 F_ I Scl (/✓/! wr7/� CL G Address 05?l /ot;N✓G4-/-e, 6h -w S(a, Its j*ti-d hlG 2F603 Phone 2n-qu-(fo-2y) cc" Phone /) 0 U - lk V -,?3 9 F WHO WILL BE THIti PRIDIARY CONTACT? ❑ Owner ❑ Applicant Contractor Description of Existing Structures on Site 14 % X rlfl ' 1'rrrrlo� # of Bedrooms *t ,? Structure Dimensions 14 X 76 r # of Occupants -2- Easement Basement ❑ Yes �No Basement Fixtures a Yes KErNo 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 m"No Does the site contain any jurisdictional wetlands? 91Yes `- do Does the site contain any existing wastewater systems? ❑ Yes 17No Is any wastewater going to be generated on the site other than domestic sewage? VI -Yes LJ,No Is the site subject to approval by any other public agency? �Nryes 0,5Ano Are there anv easements or right of ways on this property'? Describe Z 01 R -vj em..—O, Existing water supply in use LY Individual '"'ell ❑ Community Well ❑ Scnni-Public Well ❑ County/City/Township Rater Line Is a public water supply available? ** ❑ Yes [B"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) 0 Accepted 0 Alternative VConventional 0 Innovative 0 Other 0 Any CATAWB� � THIS IS NOTA PER -MITT COUNTY CATAWBA COUNTY HEALTH DGPARTNMENT _... Application for L;nvironmentatl Services Page 2 Proposed Facility Type ! [} Primary Residence ❑ New Residence ❑ Addition to Residence 8 of New ltcdroonnl Project Description New matte. Structure Dimoonsions tateY, Ca 0# of Occupants �. Basement L+ Yes ❑ No Basement Fixtures VYes 0 No ❑ .Accessory Structure(s) Describe # of New Bedrooms *-I' if applicable Structure Dimensions # of Occupants Accessory Dwelling ❑ Yeti ❑ elo Plumbing ❑ Yes ❑ No DescribePlumbing Necded ❑ Multi -Fancily Residence # Unns _ #Bedrooms per iJnit*j' Total # Bedrooms *''j Structure Dimensions ❑ Food Service Specify Type # Seats Floor Space-Etaire Fond Service Facility (Sq Ft) # Employees per Shift ___ # of Shifts _ Dining Area (Sq. Ft.)_ ❑ Business Specific Type of Business Retail Floor Space of Elul) lm e ,z per Slnft # of Shifts 71 Other Facility Type Specify If Church # of Seats Kitchen ❑ Yes ❑ No If Daycare Specify Occupancy Application for Well Construction/Abandonment/Repair Proposed Well Type _j Individual Well ❑ Semi -Public Well ❑ Community Well Abandonment Type ❑ Drilled ❑ Bored ❑ Dug ❑ Unknotsn Well Repair Requested ❑ Yes ❑ No Describe Calculated Design Flow, Commercial j Additional information may be required to determine design flow from certain facilities. This value will be determined during consultation with on-site staff. -Amp root^ that will be imendad for sleeping.a the time of mistructim or for fa:ure consideration slwt:ld 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. j If structure is plumbed but no bedrooms. calculated design flow is required. '* IfNo, a well permit nnist be issued with the ,Authorization to Construct. SYS'T'EM REDESIGN AND/OR RETRIP WILL INCUR AN ADDITIONAL CHARGE (SLG FEE SCHEDULE) Improvement Permits issued as a result of this information are vat id for 5 years or may be note -expiring under certain specified conditions. An Authorization to Construct issued by this deperroci t is valid for (5) five years from the dace issued and is not tiausfuithIc; Iinpioveuceut Permits laid WclI Permits are transferrable. Permits may be revoked ifthe information on this application; site pians 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 light of cony to conduct necessary inspections to determine compliance with applicable Imvs and rules. I undci st;aid that I out solely responsible for the proper identification and labeling of al l property lines eud corners and making the site accessible, so that a complete site evaluation call be performed. Signature of Owncr or Agent �S /� t / ' Date r7/'zL1r7 Printed Name of Owner or Agent ��e; i h (3(n ac b ✓ Catawba County Environmental Health Parcel: 369804807940, 3056 BASS DR 1in=60ft SHERRILLS FORD, 28673 This map/repod 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 07/25/2017 Parcel Report Page I of I Parcel Report - Catawba County NC Parcel Information: Parcel I D: 369804807940 Parcel Address: 3056 BASS DR City: SHERRILLS FORD, 28673 LRK(REID): 6399 Deed Book/Page: 3299/0692 Subdivision: MATTIE GABRIEL UNRECORDED Lots/Block: 9/ Last Sale: $51,000 on 1989-09-01 Plat Book/Page: Legal: Calculated Acreage: .570 Tax Map: 006CX 02009 Township: MOUNTAIN CREEK State Road #: 1925 Tax[Value Information: Tax Rates(pdf) City Tax District: All in County County Fire District: SHERRILLS FORD Building(s) Value: $1,800 Land Value: $114,100 Assessed Total Value: $115,900 Year Built/Remodeled: / Current Tax Bill Miscellaneous: Building Permits for this parcel. Building Details Watershed: WS -IV Critical Area Voter Precinct: P31 Parcel Report Data Descriptions List all Owners Deed History Report Owner Information: Owner: HENRY JONATHAN LEIGH Owner2: HENRY SHARON RICHMOND Address: 13147 W BUCKHORN WAY Address2: City: LITTLETON State/Zip: CO 80127-5120 School Information: School District: COUNTY Elementary School: BALLS CREEK 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,FPM-O Small Area: SHERRILLS FORD Split Zoning Districts: / Zoning Agency Phone Numbers Firm Panel Date: 2007-09-05 Firm Panel #: 3710368800J 2010 Census Block: 3013 2010 Census Tract: 011501 Agricultural District: Proximity Assessment Report This mapfrepoh 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 mapheport 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 © 2017, Catawba County Government, North Carolina. All rights reserved. 4) RL -SV� http://gis.catawbacountync.gov/nomap/parcel_rcport.php?key=369804807940&typ=P 7/26/2017 ?•i;:c4'T, !£��,!3};S# "�'4"iik.�.e-=... -r -m-r."t"aY -,u'. .'�a '1tR F'•i`i"4a 1!Sy. z'�t"tie^''s�'r..'r'".'.'^'FBF"r,;-•.•..�:-i'.ro"'na^*T^'.._��`" Y Y '•„'•, ` fes- clan A COUNPy, t 1C u.7u {.TwClYl1,TJ�1 y •,, �S�t a+[rnntet.icut Permit ai;ot Evaluation jj _'Lrp{rnvem;nt F`elttut i, '„r-•Pe"p%ri-r Fe=at _ Manu AL {irC58 :C./'i;; �r`• ,,F-jj"-:,^Cy" ry"£ :;+ui tti'ivi:;,i ftn f, r~F.%i'/r! �F'ii°i)k` .- . <s-,r,.'= i:'. •'_ ''�'I', 7 r'l.-{"" r.':i'ir^ ^•,.iecti.onlE31v_•k G5t � ` j' - - , I , -Lot Size DS_t'ectiors: t5"h fr's r._ i' /�i✓i P CT h+ PV,- .'_ .^J. �{ �,'-Y:'"�'T„r=r; ,” K':r.: f4..^ It elri.-1 .'i/U'1 ~�'!.^�`X ?.:1�• i?t✓ Ci!rr�-t"- , ?`.-,5 ;.lJ'•_�..`�� i7� ?'a{' ?Fr✓1. %'it' i'Si3s�Y"• .�✓: `w. !^I. J' lir .f/.,t{./�_".. I i I Facility: Hour c._-Mobile Hone IiusinesS Other: "'oning ApprovaL(,sslno i Nuiti-Eam lv s: -- 240's Repair Area Yes/110 i gecirCOMS 3 Baths��..., Seats D-.pl.oyees -,PD F].a,•, Application Gats t � C-cr*9 age D-iSo_os31=.Snecial Fixtures :_.._�� REPAIR �WRICt:,.f7,�1tIR5 MJSC �_NT14iLN-�O - Erie,-,e'nt (+esf_no FFsel;e:l3-e' ?ltird;:Sty�'yr^S; ro _,C>ItYS";OR�" +-r DAYS F'R[T7'PATE OP PF'33•tI`P. i*ttac S13pialy:. 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