Loading...
HomeMy WebLinkAboutEHPR-04-2018-28994.TIF THIS IS NOTA PERMIT Case# EHPR-04-2018-28994 1. vreB Al'AWBA COUNTY HEALTH DEPARTMENT ❑' r Ko -] C 'v��. PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES if' 1842 " Environmental Health Plan Review- OSWP •D • C r IMPROVEMENT ' a to 0 Applicant MICHAEL CLONINGER.P.O. 130X 358.DENVER NC '7 4 .577. ,L2 4t/li Owner BILLY SITES,601 SIPES ST, KINGS MOUNTAIN NC 28086-2910 1-1:704-739-2589 1-10131E:704-739-2589 NAME TO APPEAR ON PERMIT Billy Sipes SITE ADDRESS: 9615 RIVIERA DR,SHERRILLS FORD NC 28673 PIN# 462802663005 NAME of SUBDIVISION: LUTHER COWANS SHERRILL PROP I o1 N 70 Section/131ock PROPERTY SIZE: Square Feet 18,295.20 Acres 0.42 DIRECTIONS: Hwy 150 E,left Sherrills Ford Rd,right Island Point,left Riviera,lot on right PRIMARY CONTACT: Applicant SEWER TYPE: Septic Tank GALLONS PER DAY: 480 WATER SUPPLY: Private Well DESCRIBE WORK: IP only 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: #OF OCCUPANTS: PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 60 x40 #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: YES INNOVATIVE: ANY: Other described: 25%reduction chapplicati,m 04/252018 11:58 Page 1 of • e.\ , c,\'F,aaBA COUNTY Case Ii EHPR-04-2018-28994 ,T 9 Public Health Department Subdivision LUTHER COWANS SHERRILL P � bQf iitit,. Environmental Health Division I'IN# 462802663005 v.• PO Box 389.100-A Southwest Blvd,Newlon,NC 28658 !g 2 SU NAME ON PERMIT: ( BILLY SIPES),601 SIPES ST.KINGS MOUNTAIN NC 28086-2910 ( Billy Sipes) Site Address: 9615 RIVIERA DR,SI-IERRILLS FORD NC 28673 Property Size: Square Feet 18,295.20 Acres 0.42 Directions: Hwy 150 E,left Sherrills Ford Rd,right Island Point,left Riviera,lot on 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 l 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. • Date: ,9tStlSignature of Applicant or Aeent`/J/�//,J"4q�-/' ` _ If you need further information or assistantpC lease call 828-466-7291 AREAI 144*1****4*44**4*4414}iY44+14444444444*44*44*44***4*********14444***44***4444*4**4*4****4*4*4*4*44*4******** 1FI,LNANIE DATE FEL AMOUNT Improvement Permit Fee 04/25/2018 SI 50.00 TOTAL FEES 8150.00 FEES ARE NON-REFUNDABLE ONCE A SITE VISIT 15 MADE OR WORK ON A PLAN REVIEW HAS COMMENCED SYSTEM REDESIGN AND/OR RETRIP WILL INCUR AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) ehapplicauon 04/25/2018 11:58 Pace 2 of c � � TI-US IS NOT A P ERh9 iT coLINV ;' CATAWBA COUNTY HEALTH DEPARTMENT , , Application for Environmental Services Application is for: New Construction F Existing Facility Rprovement Permit Authorization to Construct New Septic I ( Septic Repair/Malfunction n Septic Relocation Septic Expansion I I Existing System Inspection or Reconnection New Well f Replacement Well Well Abandonment Well Repair Property Address 9vol.S A 01 ez.4/�l� � Subdivision iVa,/ e ht F_L_C�J /Le , Nd Lot# 67U Acres e 4� Driving Directions to Property_/y - o y��p rL /�L y/ID %G SZe, /(f' Applicant Contact /Information n Name I'IlljArt' lAddress p,D, &.c 3.s7 v&� Ne_ Phone Cell Phone 70 zf c 22 -62 V •6 Owner Contact Information Name ,31'/JV Address (QLD/ S.' - L*r5 /mit/, Phone (72 57 73 9 �5S_? ✓/ Cell Phone Contractor Contact Information Name License # Address Phone Cell Phone Name to Appear on Permit? rOT<ner Applicant ❑ Contractor Who will be the Primary Contact? ❑ Owner n pplicant ❑ Contractor Existing Structures on Site? H Yes o [ryes; describe #or Bedrooms * # of Occupants Structure Dimensions Basement Yes n No Basement Plumbing Yes Li No Existing Water Supply? ❑ Individual Well ❑ Community Well ❑ County/City/Township Water Line Is a public water supply available? ** ❑ Yes VSro Well Construction/Abandonment/Repair Proposed Well Type LI Individual Well n Semi-Public Well Community Well Abandonment Typo LJ Drilled l Bored Dug I I Unknown Well Repair Requested n Yes ❑No Describe Will Certified Well Contractor Install Water Line or Electrical Line from Well (lead to Pressure Tank? ❑ Yes ❑No �1 Atli {� THIS IS NOT A PERMIT o cup r CATAW II%A COUNTY HEALTH DEPARTMENT ENT ��- tion,e . Application for Environmental Services Proposed New Construction - Residential - Primary Residence ❑ New Residence ❑ Addition to Residence II of New Bedrooms *1- Project Description Structure Dimensions 4,') K 5/ # of Occupants Basement n Yes [oto Basement Plumbing Yes Accessory Structure(s) Describe Structure Dimensions Plumbing fl Yes No Describe Plumbing Needed Accessory Dwelling I- 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 ❑ Yes n No If Daycare, # of Children IfMulti-Family Residence,#of Apartments #Bedrooms per Apartment*j Total# Bedrooms 'It Other Information Calculated Design Flow, Commercial j (Tins 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 iy,question. 1 f the answer to any question is "yes", applicant must attach supporting documentation. ❑ Yeso Does the site contain any jurisdictional wetlands? O Yes dKo4 Does the site contain any existing wastewater systems? O Yes 11-210 Is any wastewater going to be generated on the site other than domestic sewage? ❑ Yes lao Is the site subject to approval by any other public agency? ❑ Yes IC 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 ofy..r preference) ❑ Accepted 0 Alternative 1 r onventional 0 Innovative lEri Cher 2-5:29,6,14e4.4,7 0 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 confined 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. I If structure is plumbed but has no bedrooms, calculated design flow will be determined by EH Staff. ** If No,a well permit must he issued with the Authorization to Construct. RETRIP TO THE PROPERTY AND/012 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 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 1 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 grope f y or legal agent .f the owner. Signature of Owner or Legal Agent . / Date "74-- Z,S-'/F Printed Name of Owner or Legal AgentVia,, Catawba County Environmental Health ______-------\ _ .. .------ \ _ RIVIERA DR 196115 / / 7v1' 2 ' ? gLL100.15 / t i ..o / 5c ::; )o I o \o 8500 a 730 10 4 7Q00 /rJt 16110 t .3cr sr ----, i .4. /-------,) / / / Parcel: 462802663005, 9615 RIVIERA DR lin=40ft SHERRILLS FORD, 28673 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 04/25/2018 Parcel Report Page 1 of 1 Parcel Report - Catawba County NC Parcel Information: Owner Information: Parcel ID: 462802663005 Owner: SIPES BILLY J Parcel Address: 9615 RIVIERA DR Owner2: SIPES BRENDA R City: SHERRILLS FORD, 28673 Address: 601 SIPES ST LRK(REID): 8274 Address2: Deed Book/Page: 1566/0584 City: KINGS MOUNTAIN Subdivision: LUTHER COWANS SHERRILL State/Zip: NC 28086-2910 PROP Lots/Block: 70/ School Information: Last Sale: $14,000 on 1988-06-01 School District: COUNTY Plat Book/Page: 12/102 Elementary School: SHERRILLS FORD Legal: LOT 70 70 PL12-102 IS POINT PL 12-102 Middle School: MILL CREEK Calculated Acreage: .420 High School: BANDYS Tax Map: 008AX 04006 School Map Township: MOUNTAIN CREEK State Road #: 2613 TaxNalue Information: Tax Rates(pdf) Zoning Information: City Tax District: All in County Zoning District: COUNTY County Fire District: SHERRILLS FORD Zoningl: R-30 Building(s) Value: $0 Zoning2: Land Value: $28,200 Zoning3: Assessed Total Value: $28,200 Zoning Overlay: CRC-O,WP-O Year Built/Remodeled: / Small Area: SHERRILLS FORD Current Tax Bill Split Zoning Districts: / Zoning Agency Phone Numbers Miscellaneous: Firm Panel Date: 2008-03-18 Building Permits for this parcel. Firm Panel #: 3710462800K Building Details 2010 Census Block: 2023 WaterShed: WS-IV Critical Area 2010 Census Tract: 011503 Voter Precinct: P31 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 arises or may arise from this map/report product or the use thereof by any person or entity. ©2018, Catawba County Government, North Carolina. All rights reserved. http://gis.catawbacountync.gov/nomap/parcel_report.php?key=462802663005&typ=P 4/25/2018 Krvii.„6-____L-44-- i CATAWBA COUNTY �( % IOOA SOUr1- WEST ULVD NEWTON,NORTH CAROLINA 28658 RECEIPT °'1°�i°I‘71,171 .vev a P1 lONE:828.465.8399 CV 'A ,, 'vd�, Wednesday,April 25,2018 \842 ve www.catawbacountync.gov PAYOR: Sipes,Billy PAYMENTS TRANSACTION NUMBER: TRC-3481515-25-04-20I8 PAYMENT DATE: 04/25/2018 PAYMENT TYPE: Check 8998 Michael Cloninger presented check NCDL 4267137 exp 7/10/18 dob 7/10/ 1965 INVOICE NUMBER FEE NAME FEE AMOUNT 04-18-352213 Improvement Permit Fee $150.00 TOTAL PAYMENTS: 5150.00 EHPR-04-2018-28994 CASE TYPE: Environmental Health Plan Review WORK CLASS: OSWP SITE ADDRESS: 9615 RIVIERA DR,SHERI(ILLS FORD NC 28673 Applicant MICHAEL CLONINGER,P.O. BOX 358,DENVER NC Owner BILLY SITES,601 Sll'ES ST, KINGS MOUNTAIN NC 28086-2910 H:704-739-2589 **NO PEOI'LESOFT ACCOUNT ASSIGNED** receipt 04/25/2018 11:57 Page 1 of