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Home My WebLink AboutRBPR-11-2021-39391.tif .z.vBA •� THIS IS NOTA PERMIT Case# RBPR-11-2021-39391 �' f - CATAWBA COUNTY HEALTH DEPARTMENT t) PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES 2 5"" Residential BuildingPlan Review-BuildingNew IMPROVEMENT- AUTH_CONST- NEW WELL 1161) ) &op& 5trb lr Diftcka (A Applicant SCOTT IIART,4403 PAINT SHOP RD,LINCOLNTON NC 28092 HART1227 cr GMAIL.COM Contractor THOMAS L BLANTON (THOMAS BLANTON), 1062 20TI I AVE LN,HICKORY NC 28601 B:8283 1 0044 1 C:8283100441 TBWINI a YAHOO.COM Land Owner BOYCE&FRANCES HART,4403 PAINT SHOP RD,I,INCOLNTON NC 28092 NAME TO APPEAR ON PERMIT Scott Hart SITE ADDRESS: 2570 OLD SHELBY RD,HICKORY NC 28602 PIN# 278116856070 NAME of SUBDIVISION: f Lot# A Section/Block PROPERTY SIZE: Square Feet Acres j 5.01 DIRECTIONS: 140 W to Exit Old Shelby R urn L go Approx 1 mile past Hildebran Shelby Rd on R,then turn Left to Property PRIMARY CONTACT: Contractor SEWER TYPE: Septic Tank GALLONS PER DAY: 360 WATER SUPPLY: Private Well DESCRIBE WORK: New 60x30 SFD, 3 Bedrooms, 16x6 Back&14x6 Front porches, No Basement, Future 15x20 Pool House with bathroom only-Slab on Grade 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 Vancant Lot EXISTING STRUCTURES ON SITE(IF ANY) DIM EXISTING STRUCTURE: NUMBER OF EXISTING BEDROOMS: #OF OCCUPANTS: 4 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 60x30 SFD,16x6&14x6 Porches #OF NEW BEDROOMS:: 3 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 -.... aL.q+ph::nnn 07/06/2022 14:36 Page 1 of3 3y% • CATAWBA COUNTY Case# RBPR-11-2021-39391 .t. ,Z Department Public Health Subdivision tQ, Environmental Health Division PIN# 278116856070 PO Box 389,100-A Southwest Blvd,Newton,NC 28658 I vi NAME ON PERMIT: (SCOTT HART),4403 PAINT SI IOP RD,LINCOLNTON NC 28092 (Scott Hart) Site Address: 2570 OLD SHELBY RD,HICKORY NC 28602 Property Size: Square Feet Acres 5.01 Directions: 140 W to Exit Old Shelby Rd,Turn L go Approx 1 mile past Hildebran Shelby Rd on R,then turn Left to Property 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 the property or legal agent of the owner. Date: Signature of Applicant or Agent If you need further information or assistance please call 828-465-8270 AREA2 tttttt#tttttttttttttttttttttttttttttttttttttttttttttttttts*****tttttttttttttitttttttttttttttttttttt ttttttt#t FEENAME DATE FEE AMOUNT Authorization to Construct Fee(New/Expansion) 11/22/2021 $150.00 Fee Improvement Permit Fee 11/22/2021 $150.00 Well Permit&Inspection Fee 11/22/2021 $300.00 TOTAL FEES S600.00 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) elapplicatn,n 07/06/2022 14:36 Page 2 of3 ‘,1,A C CATAWBA COUNTY 100A SOUTHWEST BLVD (Eiji NEWTON,NORTH CAROLINA 28658 RECEIPT �I� PHONE:828.465.8399 0j�0 C) 14 Tuesday,March 21,2023 8 4 2 SM www.catawbacountync.gov PAYOR: Thomas L Blanton Thomas L Blanton(Blanton,Thomas) PAYMENTS TRANSACTION NUMBER: TRC-60137805-21-03-2023 PAYMENT DATE: 03/21/2023 PAYMENT TYPE: Credit Card 302654366 INVOICE NUMBER ACCOUNT FEE NAME FEE AMOUNT 03-23-420066 110-580200-663000 Authorization to Construct Fee(N S 150.00 ew/Expansion)Fee 03-23-420066 110-580200-663000 Improvement Permit Fee $150.00 TOTAL PAYMENTS: $300.00 RBPR-1 1-202 1-3939 1 CASE TYPE: Residential Building Plan Review WORK CLASS: Building New SITE ADDRESS: 2570 OLD SHELBY RD,HICKORY NC 28602 Applicant SCOTT HART,4403 PAINT SHOP RD,LINCOLNTON NC 28092 HART1227@GMAIL.COM Owner BOYCE&FRANCES HART,4403 PAINT SHOP RD,LINCOLNTON NC 28092 Contractor THOMAS L BLANTON, 1062 20TH AVE LN,HICKORY NC 28601 B:8283100441C:8283100441 TBWINI rr YAHOO.COM **NO PEOPLESOFT ACCOUNT ASSIGNED** receipt 03/21/2023 14:58 Page 1 of 1