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Home My WebLink AboutRBPR-01-2022-39943.TIF A •� THIS IS NOT A PERMIT Case# RBPR-01-2022-39943 CATAWBA COUNTY HEALTH DEPARTMENT PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES 111 su Residential Building Plan Review- Building New IMPROVEMENT-AUTH CONST- NEW WELL ))ilit Reths% Owner ROBERT LAWHON,342 6TH ST NW,HICKORY NC 28601 C:8284431531 ALAWHON@HICKORYTOYOTA.COM HICKORYTOYOTA.COM Paid By LOIS LEONARD,785 HWY 70 SW 100,HICKORY NC 28602 C:8283206354 NAME TO APPEAR ON PERMIT ROBERT LAWHON SITE ADDRESS: 8765 JACOB FORK RIVER RD,VALE NC 28168 PIN# 266801485389 NAME of SUBDIVISION: Lot# Section/Block PROPERTY SIZE: Square Feet Acres 34.05 DIRECTIONS: Turn R on Old Shelby Rd to Jacobs Fork,Land has black gate half mile down road on left PRIM C T: Owner SEWER TYPE: Septic Tank ALLONS PER DAY: 360 WATER SUPPLY: Private Well ESCRIBE WORK: 7/11/2022 REVISED TO 3 BEDROOM 20X35 WITH 7X28 FRONT PORCH AND 10X14 SIDE PATIO PREVIOUS DESCRIPTION: New 40x60 Accessory Dwelling Garage with One Bedrooms, Kitchen and One Bath***See Farm Exemption 161744 for Zoning 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: ACCESSORY DWELLING FACILITY TYPE: Accessory Dwelling OTHER DESCRIPTION: DESCRIPTION OF Vacant Lot EXISTING STRUCTURES ON SITE(IF ANY) DIM EXISTING STRUCTURE: NUMBER OF EXISTING BEDROOMS: #OF OCCUPANTS: PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: ' 20X35 WITH 7X28 FRONT PORCH AND 10X14 SIDE PATIO OF NEW BEDROOMS:) 3 iteJ s em 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 ehappli:atnm 07/11/2022 14:11 Page 1 of3 ��_. CATAWBA COUNTY Case# RBPR-01-2022-39943 Public Health Department r.; `�" 2 Subdivision Q 1p,F J ,'"� Environmental Health Division PIN# 266801485389 PO E3ox 389,100-A Southwest Blvd,Newton,NC 28658 8, w NAME ON PERMIT: (ROBERT LAWHON),342 6TH ST NW,HICKORY NC 28601 ( ROBERT LAWHON) Site Address: 8765 JACOB FORK RIVER RD,VALE NC 28168 Property Size: Square Feet Acres 34.05 Directions: Turn R on Old Shelby Rd to Jacobs Fork,Land has black gate half mile down road on left 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 AREA1 **********************$**********************************$*****$*********************************►********** FEENAME DATE FEE AMOUNT Authorization to Construct Fee(New/Expansion) 01/31/2022 $150.00 Fee Improvement Permit Fee 01/31/2022 $150.00 Well Permit&Inspection Fee 01/31/2022 $300.00 Authorization to Construct Fee(New/Expansion) 07/11/2022 $150.00 Fee Improvement Permit Fee 07/11/2022 $150.00 TOTAL FEES S900.00 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) elr.ippli.:dwn 07/11/2022 13:41 Page 2 of 3 CATAWBA COUNTY h4" 100A SOUTHWEST BLVD NEWTON,NORTH CAROLINA 28658 RECEIPT PHONE:828.465.8399 O Monday,July 11,2022 1$42 5M www.catawbacountync.gov PAYOR: Leonard,Lois PAYMENTS TRANSACTION NUMBER: TRC-43220925-11-07-2022 PAYMENT DATE: 07/11/2022 PAYMENT TYPE: Cash INVOICE NUMBER ACCOUNT FEE NAME FEE AMOUNT 07-22-408940 110-580200-663000 Authorization to Construct Fee(N $150.00 ew/Expansion)Fee 07-22-408940 I10.580200.563000 Improvement Permit Fee $150.00 TOTAL PAYMENTS: $300.00 RBPR-01-2022-39943 CASE TYPE: Residential Building Plan Review WORK CLASS: Building New SITE ADDRESS: 8765 JACOB FORK RIVER RD,VALE NC 28168 Owner ROBERT LAWHON,342 6TH ST NW,HICKORY NC 28601 C:8284431531 ALAWHON r HICKORYTOYOTA.COM Paid By LOIS LEONARD,785 I IWY 70 SW 100,HICKORY NC 28602 C:8283206354 **NO PEOPLESOFT ACCOUNT ASSIGNED** receipt 07/11/2022 13:44 Page 1 of 1 catawba county public health Application for Environmental Health Services THIS I NOT A PERMIT Application is for: Z New Construction ❑Existing Facility ltnprovement Permit RiAuthorization to Construct iiil_Nett Septic ❑Septic Repair/Malfunction ❑ Septic Relocation ❑ Septic Expansion Eeisti.ng System Inspection or Reconnection V1revi,.Well ❑ Replacement Well ❑ Well Abandonment El Well Repair S Q do �[��k _ V C� , I' apert�,� � dress t'ti *v e IP Nic__- 21_111R 1, Tes__5(t.DD Subdivision &jO/L - Lot' I► •lying Directions to Property I L 2 kt e-PD rV D - k, Lj' iud t- rp, tolC)rii (401-C, +�, t� r t�i�>ti► N ��t e P-. II !scribe work p j , plicarit Name �/3 1ivae_ , --(7 .--.._. — 4 ippiicat t Address en73 L43 1 )),t)? '‘7/ 1 hone � � Zit)— 1 p �I Email i ,,,, Jea rl'�5 r,• I. ner 1 ame p_Qt 1____Ca,Ohc)NA, COni :)Wner Address .. 'hone Email :'cntractor Name ontmctor Address 'hone Email : wine to Appear on Permit? ❑ Owner [+�{lpplicant ❑ Contractor i'ho will be the Primary Contact? ❑ Owner Z Applicant ❑Contractor : roposed New Construction-Residential : lmary Residence ['New Residence 0 Addition to Residence: #of New Bedrooms*t 3 #of Occupants 5 1 reject Description rruelure Dimensions,also specifyl U� pb dimensions of decks&porches 'x 0 7X /FP � ag�/% 1° ID x �-y :Noose One) ❑Basement C wl Space 0 Slab If Basement,Will There Be Water Using Fixtures In Basement ❑Yes ❑ No .;taming Wall>2' El Yes MNo .ccessory Dwelling #of New Bedrooms*t #of Occupants Structure Dimensions ::aoo3e One) ❑Basement ❑Crawl Space 0 Slab If Basement,Will There Be Water Using Fixtures In Basement ❑Yes ❑ No teir.i_.g Wall>2' 0 Yes ❑ No .ecessery Structure(s)Describe Structure(s)Dimensions . lurnbiag 0 Yes El No Describe Plumbing Needed :: oose One) ❑ Basement ❑ Crawl Space 0 Slab If Basement,Will There Be Water Using Fixtures In Basement ❑Yes ❑ No . tainirg Wall>2' ❑ Yes ❑ No i t:lti-Family Residence #of Apartments #Bedrooms per Apartment*t Total#Bedrooms in Structure*t #of Occupants • iructare Dimensions :'Noose One) ❑Basement ❑ Crawl Space 0 Slab If Basement,Will There Be Water Using Fixtures In Basement ❑Yes ❑ No i .etair-irig Wall>2' ❑ Yes ❑ No Veil Construction/Abandon ent/Repair reposed Well Type individual Well ❑ Semi-Public Well ❑Community Well .bandonment Type ❑ Drilled 0 Bored El Dug El Unknown .'ell Repair Requested ❑ Yes 0 No Describe ill Certified Well Contractor Install Water Line or Electrical Line from Well Head to Pressure Tank?❑ Yes El No Environmental Health Catawba County Government Center, 25 Government Drive I PO. Box 389, Newton, NC 28658 Phone: (828)465-8270 I Fax: (828)465-8276 I EHAdmin@CatawbaCountyNC.gov , water sopriy av:Olatoe? U Yes ir! No • Ale E Proccead New Constructl.en Existing/Change of Use El Repair Ch Speoi Tyae Setee; Dining Area Scl. 'Ft.) 3.e.c.p:oyees?er ii.f. Shifts . of Seats Daycare E No e of Ceildren #of Employees per Shift #of Shif:s ::anoreercial Kitcher: E] Yes ,77 No aesidential Kitchen E Yes E No (MEC.%.3 cf Eeeployeos oer Shift #of Shifts i u Lee ; Stl "72 Structure Dimensions FL3.• r per Shift of Shifts :th - fbrrnation DesiET.,l i.y„Cottreercial t (This value will be determined by EH staff) .,,Opolicar.:si a]. efy eee local healt:-. ..opaeooe oeen submittal of this application if any of the following apply to the property.in . 1..f tie ero• ley question is se2 must attaoh supporting documentation. I :es := er the site cor..a.... e:ctional wet:anc.s? O'er; le_No t'e.i site coreae-: wastewater systems? - ZiND • '0rastewater ge...a e ec generated on the site other than domestic sewage? I Z-No ..•. s sukec;: ...II by any other public agency? .a- :bet •:'ei .on eeere any easen-:o...s • of ways on this properr.y? Describe //h./J:474— .E1 catel ..hprovetr..ent Fermi:c: to Construct,?lease Indicate Desired System Type;s): ray: eoi in erc...e.: of your pre:O.-or... ..alt erne:le Rr'Corn.eroieoa. Innovative Ei Other Any thaevi.. :ree...e2L for sleeping az teo tierie of construction or for future consideration should be noted as a bedroom and counted a-,:p.oations. afbedroerns wilt 'De confirmed by rooms identified on floor plans as a bedroom at:he time of building permit c.. This may aced for septic se ten.: expansion in the future. • oi ore is • .:as no bedrooms, oaleLiated design flow will be determined by EH Staff. ,a well perm . issued with he Aothorization to Construct. 1iJ 'TO'.1'.`.712. AND/OR SYSTE:`vi k2DESIGN WILL INCUR AN ADDITIONAL CHARGE(SEE FEE SCHEDULE) - eevintal HeaL.cs ei-osite evaluations require d:g2ing, augering,and'or probing into the ground. Property owner•applicant is responsible • ne..±Inc all undeoe.eeere toi....ties, including but no:limited to: underground power, cable,telephone, gas,water lines, and irrigation rirkler Sy8I-:,11:s. Catawba County Env:-onrncntal Health is not responsible for damage to unmarked utilities. 1;5 are ee.Oid for a period of 2 years. Improvement Permits are valid: with complete site plan=60 months(5 years); co: plat= expiration. An Authorization to Construct will remain valid as long as the :mprovernent Permit is valid. An iceie:Ei on to(.2•::1!:: ;et, SSL ad for septic repair is valid for 60 months (5 years). Permits may be revoked if the information on this 'site pee Lill or if the intended L for the proposed facility changes. Permits may be revoked if site conditions are altered such 1, eenni: oonciiti ens or installation aeld.this. Eppl:lca:ion and certify that the information provided herein is true,complete and correct. Authorized county and state erc granted right of entry to conduct necessary'inspections to determine compliance with applicable laws and rules. I that I am solely responsible for the proper identification and labeling of all property lines and corners and making the site : aF-ri: So la:a cempleoe site evaluation can be berforrned. is tire owner af the proneety or egal agent of the owner. venfiec: ED; 07/04/2022 of Owner or Legal A.gen.J =SML-ZEQE-,!7.1.M.K3kv'v Date ame of Ce.:rex or Legal Agent A Lawhon,III • Catawba County Environmental Health ,, , i It --7922 72 r Au 111- ets -lett 1711"V 5 0 8765 • ;to + • 1 b .4- . 7 1 1) 11-1-' . --• ' • , Po zot P 1. tiL.Se a c / • 30 i • v.. t if 5 ) .t- Plarl , - • , • • , pee' 03P 11-e a tk .4.• . . , 1t1 ?.5 i . , , r ,o r I ci N ?Do / ( ta 1 I 1.• Ace; Au& i -%, .. i , -,,f•,.- 1 / . . / / 1 i / 2 li / I Pareek 286801485389, 8755 JACOB FORK 1 in=80.!',...RIVEti RD.VALE, 28168 i Tie ntspireprt prodi..st was prepared:Torn the Cataw:la County.NC GaospaLlat Information Services. Catawba County has made aubstantlal efforts to ensue rts er.curaty of location and labeling Irdormatlon contained on this map or data on this report Catawba County promotes and recommends Oa tula->bndaal wirtri,. .Con of any data contained on this map/report product by the user.The County of Catawba.Its employes ,agents,and Panslirnal,disclaim,and shall not be held liable for any and ail damages.kiss or Cabitily,whether direct,Indirect or consequential which arises or may idle from Ns inepireNst product or the use thereof by any person or entity. Copyright 2021 Catawba County NC 06/27/2022 i A [la lit linisitousautimuulaiL......, ,,...— 4 c„....,...,/v.- \\., ...".4 c; \ . N \ J \\' Y 4 S \\\, 5` 1 y j ìç • / . t \\\ 4 g ‘\:\*)\\IN. iii ri a al ":":(7-'-'----- 1 I --------"---\\, \\t\\ n \ \ N 01 N • ......••71:I: 1 : ,i1,,,-_ ._ =11V11111111' ' PRI 1..011111111111 ' 11. • . ell..: el). %.-I Z.. itt:1 i...'..%•-• i \ 1 ''•:` i .. • , ... \ , . 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