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HomeMy WebLinkAboutEHPR-04-2018-28980.TIF • n ' THIS IS NOTA PERIMIT Case# EHPR-04-2018-28980 4•CF kiln '6, CATAWI3ACOUNI'Y 1-IEALTH DEPARTMENT °❑ ��k °❑k � it-fit r•r \� PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES �'3$ Ig42 Environmental Health Man Review- OSWP , 7tat IMPROVEMENT ^''r•,; . rrcX �vahF:Ww Owner KENNETH RHODES.9221 FAIR OAK DR,SHERRI LLS FORD NC 28673 11:8283126643 HOME:8283126643 NAME TO APPEAR ON PERMIT Kenneth Rhodes SITE ADDRESS: 12TH FAIRWAY LN,NEWTON NC 28658 PIN # 364609165928 NAME of SUISDIVI510�A: L ACARPENTER ESTATE Lot ft 3 Sectioidlllock PROPERTY SIZE: Square Feet 58,862.40 Acres 2.04 DIRECTIONS: Existing address is 121 Golf Course Rd,turn on gravel drive,go back approximately 1400 ft,lot will be marked on your right PRIMARY CONTACT: Owner SEWER TYPE: Septic Tank GALLONS PER DAY: 600 WATER SUPPLY: Public Water DESCRIBE WORK: IP Only for subdivision-95x48 3 BR house with 45x25 pool house with 1 BR and 18x36 pool with 5 ft cement around it SITE INFORMATION Do any of the following apply to the properly 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: #OF OCCUPANTS: 2 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 95x48 house #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: YES Other described: elupplication 0124/2018 14:27 Page 1 of4 SQA CATAW11ACOUNTY Case El-WIZ-N-2018-28980 .T 7. Public Health Department Subdivision LA CARPENTER ESTATE < �� ,t Environmental I lealth Division PIN# 364609165928 oi PO Box 389,100-A Southwest Blvd,Newton,NC 28658 1y, 2 se NAME ON PERMIT: (KENNETH RHODES),9221 FAIR OAK DR,SHERRILLS FORD NC 28673 ( Kenneth Rhodes) Site Address: 12TH FAIRWAY LN,NEWTON NC 28658 Property Size: Square Feet 88,862.40 Acres 2.04 Directions: Existing address is 121 Golf Course Rd,turn on gravel drive,go back approximately 1400 ft,lot will be marked on your right 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 if 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 theproperty 3property or legal agent of the owner. ' / Date: 52`7 — 1 Signature ofApplicant or Agent If you need further information or assistance please call 828-466-7291 AREAI 4k#4##t#!h###tk**t***#k#x#tt*it44#t4i444t44*4*4*44t44444444#4#4#4#4k4t4t4#i 41444444#414afi4444tfi4##kk 444#4444 • IIIcNAMli • - DATE FEE AVOW\T ' . Improvement Permit Fee 04/24/2018 $150.00 TOTAL Ills 5150.00. • 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) chapplication 04/24/2018 14:25 Page 2 of 4 (fl j� '`/ L3 TA THIS IS NOTA PERMIT Co N� , 111 it �y CAT'AW ILA COUNTY HEALTH DEPARTMENT 1 r ham,A�-. �, Applicat:ion Por Environmental Services �'� 5(It Application is fonaI�j New Construction I I Existing Facility I provement Permit Authorization to Construct IVew Septic Septic Repair/Malfunction Septic Relocation Septic Expansion Existing System Inspection or Reconnection New Well Replacement Well U Well Abandonment Well Repair Property Address /027' a,_rte,..1ALf 141/ Subdivision Lot# 3 Acres ?,Cif Driving Directions to Property X t 5 11_L cs� /a u �' g T_v_rn 001 6CB_VcL D/1 _o c- 1�a_eaG1�Y1p_Prz2xnza y/hi 4108-1- { 1...:,_; iii _k_e_ ar_ cLaiii y_cw;" 2L h.t Applicant Contact Information Name e n 4s dit ea, 5 Address 9 go_I _,_ i ---DRsetr - oz.. asl�3 Phone etel_Sf - _ 4,19.±1-r2-) l Cell P none Owner Contact Information Nance AGA.0el�h 'Lee - / Address 9�a 1 aLA^/.r DRDR Viet rt //s ;rC4 n Ca la_ .3 Phone g2-tY - 3/a- - 64.4 3 Cell P lone Contractor Contact Information Name License# Address Phone Cell Phone Name to Appear on Permit? Y6wner U Applicant LI Contractor Who will be the Primary Contact? YOwner ❑ Applicant 1 1 Contractor Existing Structures on Site? _ Yes 1/No If yes, describe #of Bedrooms ' # of Occupants Structure Dimensions_ Basement ❑ Yes I i No Basement Plumbing ❑ Ye, r No Existing Water Supply? n Individual Well n Community W .11 l �'County/City/Tonmsbip Water Line Is a public water supply available? ** Yes H No Well Construction/Abandonment/Repair • • Proposed Well Type I i Individual Well ❑ Semi-Public Well n Community Well Abandonment Type H Drilled H Bored ❑ Dug IT Unknown Well Repair Requested Yes ❑No Describe Will Certified Well Contractor Install Water Line or Electrical Line from Well Head to Pressure Tank? 0 Yes ❑No rct rifi _\ `f `A CHIS IS NOT A PERMIT ouN y • CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services Proposed New Construction - Residential Primary Residence 'New Residence Addition to Residence # of New Bedrooms *j 3 FerProject Description 35 o .5t f/—aloe li5tL4. 3AS 'GA_ray_< 4. LLDDS1ffHaase- Structure Dimensions 9c3—s1'ifQi _ Jccupants Basement n Yes Jo Basement Plumbing Lf Ye f'No rU` )[^3,30 Accessory Structure(a) Describe f�, Structure Dimensions x Plumbing ✓ Yes No Describe Plumbing Needed / ,BOJ Accessory Dwelling L Yes No # of New Bedrooms 't / # of Occupants — >✓1' 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 [ YesI No If Daycare,# of Children If Multi-Family Residence, # of Apartments #Bedrooms per Apartment*t Total#Bedrooms *t Other hrformation Calculated Design Flow, Commercial 'j (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 R'Ro Does the site contain any jurisdictional wetlands? ❑ Yes LYgio Does the site contain any existing wastewater systems? ❑ Yes cl-1Cto Is any wastewater going to be generated on the site other than domestic sewage? ❑ Yes ErNo Is the site subject to approval by any other public agency? ❑ Yes Rao Are there any easements or right of ways on this property? Describe If applying for an Improvement Permit/ or Authorization to Construct,Please Indica lc Desired System Type(s): (systems can be ranked in order of your preference) ����.�//// ❑ Accepted ❑ Alternative ❑ Conventional ❑ Innovative ❑ Other pfl 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. If structure is plumbed but has no bedrooms, calculated design flow will be determined by EH Staff. **IfNo,a well permit must be issued with the Authorization to Construct. RETRIP TO THE PROPERTY AND/OR SYS'T'EM REDESIGN WILL INCUR AN ADDITIONAL CHARGE(SEE FEE SCIIIEDUI,E1 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 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 conTect. 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 egal agent of the owner. �/ —/ Signature of Owner or Legal Agents Date '� /S Printed Name of Owner or Legal Agent /1<e,..41_27 I ; il 11.1.'691 41,00,91.10 N J` 11 I� . ig t w I Hr� I I ' � i Jr: -i- ,s-c, v I Cly )-i11, I H a a i; � s....1 l -nu „ 6 i 1 _ , u c., t � i '� '� 1 gl ti, , v - ZI , i 0 0l � j ilI,1. ' 1.'681 M�1L,91.10 N �, r8t5Lo) aoi39a ° Imoo1. IccI ' LN3113SY3 55300Y,9 31 VAI 1 Catawba County Environmental Health . ..._:&..4.----,s.. ----L ./ ,„,.--t--- OLD:TAV uzo iS4LIF1t /!/ / iti- sae ii 11111S ,. J 1 *v lir 1 sso 7) a _ _ i; T PUTTERSVIEW'LNi ill ,like y, rps — — — — — `'1111)14a — — — I U n • C} ct i • I ' 4111111111111M1 7 ITL 1111141 ill I ///if / / ill .: c i.,/ Parcel: 364609165928, 121 GOLF COURSE RD 1 in=300ft MAIDEN, 28650 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 04/24/2018 Parcel Report Page 1 of 1 • Parcel Report - Catawba County NC Parcel Information: Owner Information: Parcel ID: 364609165928 Owner: RHODES KENNETH EUGENE Parcel Address: 121 GOLF COURSE RD Owner2: RHODES CONNIE CANSLER City: MAIDEN, 28650 Address: PO BOX 687 LRK(REID): 35889 Address2: Deed Book/Page: 3430/0880 City: CONOVER Subdivision: L A CARPENTER ESTATE State/Zip: NC 28613-0687 Lots/Block: G/ Last Sale: School Information: School District: COUNTY Plat Book/Page: 1/109 Legal: LOT G PLAT 1-109 Elementary School: MAIDEN Middle School: MAIDEN Calculated Acreage: 12.370 Tax Map: 066N 02045 High School: MAIDEN Township: NEWTON School Map State Road #: 2003 Tax/Value Information: Tax Rates(pdf) Zoning Information: City Tax District: All in County Zoning District: MAIDEN County Fire District: MAIDEN RURAL Zoningl: R-20 Building(s) Value: $1,000 Zoning2: Land Value: $62,700 Zoning3: Assessed Total Value: $63,700 Zoning Overlay: Year Built/Remodeled: / Small Area: Current Tax Bill Split Zoning Districts: / Zoning Agency Phone Numbers Miscellaneous: Firm Panel Date: 2007-09-05 Building Permits for this parcel. Firm Panel #: 37103646003 Building Details 2010 Census Block: 5032 WaterShed: 2010 Census Tract: 011702 Voter Precinct: P20 Agricultural District: 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 arisos 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=364609165928&typ=P 4/24/2018 .1`14'A - O CATAWBA COUNTY 100A SOUTHWEST IDLV D �� NEWTON,NORTH CAROLINA 28658 RECEIPT pwsw�xq oV►o` �' PHONE: 828.465.8399 Tuesday,April 24,2018 1 842 sm www.eatawbacountvne.gov PAYOR: Rhodes,Kenneth PAYMENTS TRANSACTION NUMBER: TRC-3475440-24-04-2018 PAYMENT DATE: 04/24/2018 PAYMENT TYPE: Cheek 3240 NCDL-27984119 DOB- 11/7/52 EXP- 11/17/20 INVOICE NUMBER FEE NAME FEE AMOUNT 04-18-352159 Improvement Permit Fee S150.00 TOTAL PAYMENTS: SI50.00 EH PR-04-20I 8-28980 CASE TYPE: Environmental Health Plan Review WORK CLASS: OSWP SITE ADDRESS: 12TH FAIRWAY LN.NEWTON NC 28658 Owner KENNETH RHODES,9221 PAIR OAK DR,SHEItRILLS FORD NC 28673 H:8283126643 ** NO PEOPLESOFT ACCOUNT ASSIGNED** receipt 04/24/2018 14.24 Paye 1 al I