HomeMy WebLinkAboutRBPR-02-2022-40106.tif Y'A • THIS IS NOT A PERMIT Case# RBPR-02-2022-40106
„WI O CATAWBA COUNTY HEALTH DEPARTMENT
PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES
Ig 2 ski Residential Building Plan Review- Manufactured Home
IMPROVEMENT-AUTH CONST- NEW WELL
5IlofRothRostj -
Contractor *CMI I HOMES,INC./DBA OAKWOOD 110MES#712(NEWTON), 1265 HWY 70,NEWTON NC 28658
B:8284642662 C:8282171862 OTHER:8284464617F:828-464-430I R712 rr CLAYTONHOMES.COM
Owner WARREN&CAROLYN ELLWOOD,7523 WHITE PINE DR,HICKORY NC 28602
NAME TO APPEAR ON PERMIT
*CMH Homes, Inc. / dba OAKWOOD HOMES #712 (Newton)
SITE ADDRESS: 3777 AMBER DR,VALE NC 28168 PIN# 268701251378
NAME of SUBDIVISION: DOUGLAS CORNERS I of# 20 Section/Block
PROPERTY SIZE: Square Feet Acres 0.54
DIRECTIONS: Turn Right onto West C ST,Turn left Banoak RD,West Lee DR, Right onto Amber DR
P •NTACT: Contractor SEWER TYPE: Septic Tank
GALLONS PER D• : 360 WATER SUPPLY: Private Well
• • : 5/10/22 REVISED TO 28 X 68 3 BEDROOM HOME WITH 6X6 DECKS FRONTAND REAR, SAME LOCATION
PREVIOUS DESCRIPTION: New 4 bedroom Double wide Manufacture Home 28x68 w/6x6 front&read decks
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: Mobile Home OTHER DESCRIPTION:
DESCRIPTION OF vacant
EXISTING STRUCTURES
ON SITE(IF ANY)
DIM EXISTING STRUCTURE:
NUMBER OF EXISTING BEDROOMS: #OF OCCUPANTS: 3
PROPOSED CONSTRUCTION
NEW STRUCTURE DIM:: 28X68 3 BEDROOM HOME 6X6 DECKS FRONT/REAR
EW BEDROO .. 3
system types(Improvement Permit or Authorization to Construct):
ACCEPTED: ALTERNATIVE: CONVENTIONAL:
OTHER: INNOVATIVE: ANY: YES
Other described:
APPLICATION FOR WELL CONSTRUCTION
PROPOSED WELL TYPE: Individual Well REPLACE WELL?: NO
ch,poliL:ni.n 05/10/2022 14:48 Page I of3
.4413• • CATAWBA COUNTY Case# RBPR-02-2022-40 1 06
t Public Health Department Subdivision DOUGLAS CORNERS
Q Environmental Health Division PIN# 268701251378
PO Box 389,100 A Southwest Blvd,Newton,NC 28658
8 }4,,
NAME ON PERMIT: *CMH HOMES,INC./DBA OAKWOOD HOMES i 7I2(NEWTON) ( ), 1265 HWY 70,NEWTON NC 28658
'CMH Homes, Inc./dba OAKW
Site Address: 3777 AMBER DR,VALE NC 28168
Property Size: Square0.54
Feet Acres
Directions: Turn Right onto West C ST,Turn left Banoak RD,West Lee DR,Right onto Amber DR
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 theem owner of the property or legal agent of the owner.
Date: `� w- Z 2 Signature of Applicant or Agent /? 1�C, ,
If you need further information or assistance please call 828-465-8270
AREA1
************************************************************************************************************
FEENAME DATE FEE AMOUNT
Improvement Permit Fee 02/15/2022 $150.00
Authorization to Construct Fee(New/Expansion) 02/15/2022 $300.00
Fee
Well Permit&Inspection Fee 02/15/2022 $300.00
TOTAL FEES S750.00
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)
d,appli::anm 05/10/2022 14:4I Page 2 of3