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HomeMy WebLinkAboutEHPR-04-2018-28946.TIF Slv'A THIS IS NOTA PERMIT Case# EHPR-04-2018-28946 G G� �•', �3 CATAWBA COUNTY I-IEALTI-I DEPARTMENT 0° � •0 �' PLAN REVIEW APPLICATION FOR ENVIRONMEN'T'AL SERVICES 1842 sw Environmental Health Plan Review-OSWI' .1/2"4;";411,; LID. IMPROVEMENT t 0 Owner TIMOTHY M0012E.2615 MAUSER DR.NEWTON NC 28658 C:8283029199 NAME TO APPEAR ON PERMIT Timothy Moore SITE ADDRESS: 2210 OLD BEAMS FORD RD,CATAWBA NC 28609 PIN# 368904506513 NAME of SUBDIVISION: Lot# 1 Section/Block PROI'ER'I'1'SIZE: Square Feet 90,038.52 Acns 2.067 DIRECTIONS: Hwy 16 S till you get to Buffalo Shoals Store take left got to flashing light,take a right onto East Bandys Crossroads, go past Bandys football field take take the dirt road on right called Old Beattys Ford Rd,go 1.5 mile and property on left and has been flagged PRIMARY CONTACT: Owner SEWER TYPE: Septic Tank GALLONS PER DAY: 480 WATER SUPPLY: Private Well DESCRIBE WORK: IP Only-Subdivision-62X58 4 BR house with attached garage 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: U OF OCCUPANTS: 1 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 62x58 house with attached garage R OF NEW BEDROOMS:: 4 BASEMENT? Yes BASEMENT FIXTURES? Yes PLUMBING REQUIRED?Yes Desired system types(Improvement Permit or Authorization to Construct): ACCEPTED: ALTERNATIVE: CONVENTIONAL: OTHER: INNOVATIVE: ANY: YES Other described: aupplication 04/19/2018 15:11 Page 1 of CNEAWI3A COUNTYCaseq EI -04-20I 8-289'46 Public Health Department Subdivision Lilt Environmental Iicnith Division PINS 366904506513 r PO Box 389, 100-A Southwest Blvd,Newton,NC 28658 NAME ON PERMIT: ( 'TIMOTHY MOORE),2615 MA(1SER DR,NEWTON NC 28658 ( Timothy Moore) Site Address: 2210 OLID B&VFI'YS FORD RD,CAlAWBA NC 28609 Property Size: Square Feet 90,038.52 Acres 2.067 Directions: Hwy 16 S till you get to Buffalo Shoals Store take left got to flashing light,take a right onto East Bandys Crossroads, go past Bandys football field take take the dirt road on right called Old Beattys Ford Rd,go 1.5 mile and property on left and has been flagged Completed applications are valid for a period of 2 years.Improvement Permits are valid:with complete site plan=60 months(5 years);with complete plat =without expiration. An Authorization to Construct will remain valid as long as the Improvement Permit is valid.An Authorization to Construct issued for septic repair is valid for 60 months(5 years).Permits may be revoked it the information on this application/site plan changes or if the intended use for the proposed facility changes. Permits may be revoked if site conditions are altered such that they effect permit conditions or installation requirements 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. The undersigned is the owner of the property or legal agent of the owner. l yl Dale: 9// � �i J ���� Signature of or Agent � Ifyou need further information or assistance pli s call 828-466-7291 AREA1 ************************************************************************************************************ FEENANlE DATE FEE AMIOUN.h Improvement Permit Fee 04/19/2018 $150.00 '1'0'141,.FEES S 150.0(1 FEES ARE NON-REFUNDABLE ONCE A SITE VISIT IS MADE OR WORK ONA PLAN REVIEW HAS COMMENCED SYSTEM REDESIGN AND/OR RETRIP WILL INCUR AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) ehapphcauoa 04(1912018 15:11 Page 2 of 5 el Ar l[F`;Yj -% A THIS IS NOT APERMIT OUNTy:t _ \.�` l--.' CATAWBA COUNTY HEALTH DEPARTMENT courrr-,�� • ------"TioApplication for Environmental Services Application is for: k New Construction Existing Facility 7 Improvement Permit I J Authorization to Construct ?New Septic Septic Repair/Malfunction I I Septic Relocation Septic Expansion Existing System Inspection or Reconnection New Well I I Replacement Well Well Abandonment I I Well Repair Property Address a�oP. 0 S \ pg-H- S F. yd Ri_� Subdivision I a;u4a__h_A_ N _ , o j Lot# Acres 2.0(07 Driving Directions toPr-operty Tcrkp 1!oA Ito Sntr}h ,. . •k : . 0 ,1� i- 1 h4-14 ±-9�+a f la<k t g1� t �4ICe ry_ �I-_Dh f G itAS!�th P ois 17 1,- 4S s I-om'-teiK i17P -it, YP HIE U i y-F ICd , o In Pict (-c lie -c c rd Qd; 50 I, 5.M, E ro( co 1e-0- gild 14 as beIc et; Applicant Contact Information Name '1-1\.4,04_Ly .Moo V? Address 'No Iff ile Lcrkit 9y, ./UPvJ ch A/C 2. L' Phone , Cell Phone�l� � Owner Contact Information r f \anre ,� , \ _ !roYF Address Phone Cell Phone ix Contractor Contact Information Name iU &— � ��'�° .4..fQL cy PS License # Address " � JItJ� t UP IVr S ✓/ ;dress .A/.G 2kja2 Phone Cell Phone (e2&� 3a'7-g(, 27 Name to Appear.on Permit? 7 Owner H Applicant I 1 Contractor Who will be the Primary Contact? K Owner ❑ Applicant I l Contractor Existing Structures on Site? - n Yes [y] No If yes, describe #of Bedrooms * Al of Occupants Structure Dimensions Basement ❑ Yes ❑ No Basement Plumbing Yes n No Existing Water Supply? ❑ Individual Well H Community Well ❑ County/City/Township Water Line Is a public water supply available? ** LI Yes V No Well Construction/Abandonment/Repair Proposed Well Type H Individual Well H Semi-Public Well Lf Community Well Abandonment Type H Drilled Bored Li Dug Unknown Well Repair Requested HJ Yes ❑No Describe Will Certified Well Contractor Install Water Line or.Electrical Line from Well Bead to:Pressure Tank? ❑ Yes H No tk 11 'i /\ ,� i Iii A TATS IS NOT A PERMIT coup r CA'tt'AWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services Proposed New Construction - Residential Primary Residence T New Residence I I Addition to Residence # of New Bedrooms "j Project Description /lJOw SU S Structure Dimensions_Sgt,4145— (47.# of Occupants Basement K Yes n No Basement Plumbing Yes ❑ No Accessory Structures)Describe Structure Dimensions Plumbing PA Yes vi No Describe Plumbing Needed Accessory Dwelling n Yes No # of New Bedrooms "j # of Occupants Proposed New Construction - Commercial Food Service Specify Type #Seats Floor Space-Entire Food Service Facility(Sq.Ft.) #Employees per Shift #of Shifts Dining Area (Sq. Ft.) Business/Other Specify Type Structure Dimensions Retail Floor Space # of Employees per Shift #of Shifts If Church #of Seats Commercial Kitchen n Yes I No If Daycare, # of Children If Multi-Family Residence;# of Apartments #Bedrooms per Apartment*t Total#Bedrooms *t Other Information Calculated Design Flow, Commercial t (This value will be determined by EH staff) 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 XNo Does the site contain any jurisdictional wetlands? ❑ Yes ® No Does the site contain any existing wastewater systems? ❑ Yes [2 No Is any wastewater going to be generated on the site other than domestic sewage? ❑ Yes IY�f:No Is the site subject to approval by any other public agency? ❑ Yes a"No Are there any easements or right of ways on this property? Describe 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 0 Alternative 0 Conventional ❑ Innovative 0 Other Any *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 floor plans as a bedroom at the time of building permit issuance. This may prevent the need for septic system expansion in the future. t If structure is plumbed but has no bedrooms,calculated design flow will be determined by EH Staff ** If No,a well permit must be issued with the Authorization to Construct. RIITRLP TO THE PROPERTY AND/OR SYSTEM REDESIGN WILL INCUR AN ADDITIONAL CHARGE(SEE FEE SCHEDULE). Completed applications are valid for a period of 2 years. Improvement Permits are valid: with complete site plan=60 months(5 years);with complete plat=without expiration. An Authorization to Construct will remain valid as long as the Improvement Permit is valid.An Authorization to Construct, issued for septic repair is valid for 60 months(5 years). Permits may be revolted if the information on this application/site plan changes or if the intended use for the proposed facility changes. Permits may be revolted if site conditions are altered such that they effect permit conditions or installation requirements. 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. The undersigned is the owner of the property or legal as nt o the owner. Signature of Owner or Legal Agent-L-7201 ✓]� Date � / //g Printed Name of Owner or Legal Agent7'j{yi 0)-1,y_t/1I6oYP Catawba County Environmental Health , :11:::,, . 4 . el'C tr4 n f , l 'i, ...„ ,„, , i , 9.310t , Ni__......... pilot( r F � J. 1\e's:3 401""e" • y 451 i t, ��i 1 Pe ' .4 , )„,, , ,,, ,\,..„ , , i ,,,r--- „ ,/,.. e:f _o • , priiii925 f '9-- .,,...40. . ili..... ,,h, ii Ic iciA,.....9 tr • e I \ii ",• ti l ci1/4.0000doinik \l'IS t I.) ile? 1 11111101 imis Jr - IL::.g.trij? . Pz5i.. ..sH, . . rail co) . •fdieii '' '7f,'. trt -- ...__)%er 7 car—fi ....---1 )) t 'I'''. _ Parcel: 368904506513, 2210 OLD BEATTYS 1 in=400ft FORD RD CATAWBA, 28609 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 04/19/2018 Parcel Report Page 1 of 1 Parcel Report - Catawba County NC Parcel Information: Owner Information: Parcel ID: 368904506513 Owner: MOORE TIMOTHY ALLAN Parcel Address: 2210 OLD BEATTYS FORD RD Owner2: ROCKETT ALTON WOODY City: CATAWBA, 28609 Address: 2615 MAUSER DR LRK(REID): 661 Address2: Deed Book/Page: 2996/0789 City: NEWTON Subdivision: State/Zip: NC 28658-8423 Lots/Block: 2/ School Information: Last Sale: $65,500 on 1983-04-01 School District: COUNTY Plat Book/Page: 18/26 Legal: LOT 2 SETZER PL 18-26 Elementary School: BALLS CREEK Middle School: MILL CREEK Calculated Acreage: 81.490 Tax Map: 001 X 01025A High School: BANDYS Township: MOUNTAIN CREEK School Map State Road #: TaxNalue Information: Tax Rates(pdf) Zoning Information: City Tax District: All in County Zoning District: COUNTY County Fire District: BANDYS Zoningl: R-40 Building(s) Value: $0 Zoning2: Land Value: $311,700 Zoning3: Assessed Total Value: $311,700 Zoning Overlay: DWMH-O,WP-O Year Built/Remodeled: / Small Area: SHERRILLS FORD Current Tax Bill Split Zoning Districts: / Zoning Agency Phone Numbers Miscellaneous: Firm Panel Date: 2007-09-05 Building Permits for this parcel. Firm Panel It: 3710368800J Building Details 2010 Census Block: 2016 WaterShed: WS-IV Protected Area 2010 Census Tract: 011501 Voter Precinct: P1 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 Ceospatial 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. ©2017, Catawba County Government, North Carolina. All rights reserved. http://gis.catawbacountync.gov/nomap/parcel_report.php?key=368904506513&typ=P 4/19/2018 �Sy'�' C CATAWBA COUNTY f G� I00ASOUTHWEST BLVD /// NEWTON,NORTH CAROLINA 28658 RECEIPT �ii;� PHONE:828.465.8399 * yf Thursday, April 19, 2018 a 41' 94 wv' w .eatawbacountvnc.gov PAYO\\ t4 R: Moore,Timothy PAYMENTS TRANSACTION NUMBER: TRC-3438329-19-04-2018 PAYMENT DATE: 04/19/2018 PAYMENT TYPE: Cash INVOICE NUMBER FEE NAME FEE AMOUNT 04-18-351963 Improvement Permit Fee $150.00 TOTAL PAYMENTS: S150.00 E H P I2-04-20 18-28946 CASE TYPE: Environmental Health Plan Review WORK CLASS: OSWP SITE ADDRESS: 2210 01,1)BEATTYS FORD RD,C.VFAW BA NC 28609 Owner 'IIMOIlIY MOORE.2615 MAUSER DR_NEWTON NC 28658 C:8283029199 ** NC)PEOPLESOFT ACCOUNT ASSIGNED** receipt O1/19/20 IS 15106 Page I of l