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HomeMy WebLinkAboutRBPR-05-2022-40961.TIF 7$A 0, THIS IS NOT A PERMIT Case# RBPR-05-2022-40961 i~ - CATAWBA COUNTY HEALTH DEPARTMENT PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES 8 2 sw Residential Building Plan Review-Building New IMPROVEMENT- AUTH CONST- NEW WELL Contractor *DEMENY ENTERPRISES LLC (KEVIN DEMENY),522 N LAUREL ST,LINCOLNTON NC 28092 C:7044009056 KEVINDEMENY@BELLSOUTH.NET Owner TYLE ARDREY,4700 MAIDEN HWY,MAIDEN NC 28650 C:828-461-4398 NAME TO APPEAR ON PERMIT Tyle Ardrey SITE ADDRESS: 4190 HERTER RD,LINCOLNTON NC 28092 PIN# 362703301944 NAME of SUBDIVISION: Lot# Section/Block PROPERTY SIZE: Square Feet Acres 29.36 DIRECTIONS: 1st driveway on the left past driveway on Right of 4169 Herter RD PRIMARY CONTACT: Owner SEWER TYPE: Septic Tank GALLONS PER DAY: 240 WATER SUPPLY: Private Well DESCRIBE WORK: New 1 story 2 bedrooms w/unfinished basement with porch connecting to garage;w/between garage carport 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 vacant lot EXISTING STRUCTURES ON SITE(IF ANY) DIM EXISTING STRUCTURE: NUMBER OF EXISTING BEDROOMS: #OF OCCUPANTS: 2 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 48x52,52x12 ,6x14;25'2"x24'8"; 13'8"x19'4" #OF NEW BEDROOMS:: 2 BASEMENT? Yes BASEMENT FIXTURES? Yes PLUMBING REQUIRED? Desired 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 ohapplication 05/06/2022 I6:16 Page 1 of 3 -.PA CATAWBA COUNTY Case# RBPR 05-2022-40961 �7' .. z Public Health Department Subdivision d - Environmental Health Division PIN# 362703301944 PO Box 389,100-A Southwest Blvd,Newton,NC 28658 8 9, NAME ON PERMIT: (TYLE ARDREY),4700 MAIDEN HWY,MAIDEN NC 28650 (Tyle Ardrey) Site Address: 4190 HERTER RD,LINCOLNTON NC 28092 Property Size: Square Feet Acres 29.36 Directions: 1st driveway on the left past driveway on Right of 4169 Herter RD 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: 5- (o -'ZL Signature of Applicant or Agent If you need further information or assistance please call 828-465-8270 AREA6 FEENAME DATE FEE AMOUNT Authorization to Construct Fee(New/Expansion) 05/06/2022 $150.00 Fee Improvement Permit Fee 05/06/2022 $150.00 Well Permit& Inspection Fee 05/06/2022 $300.00 TOTAL FEES $600.00 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) ehappi ication 05/06/2022 16:16 Page 2 of 3 a. TWQ y pGLo (; ) catawba county public health Application for Environmental Health Services THIS IS NOT A PERMIT Application is for: New Construction ❑ Existing Facility W. mprovement Permit Authorization to Construe •41New Septic Septic Repair/Malfunction ❑ Septic Relocation ❑ Septic Expansion /A Existing System Inspection or Reconnection . ' ['New Well ❑ Replacement Well ❑ Well Abandonment ❑ Well Repair Property Address t-t\°b'. /Ierlei Rd 1.,1nmO ` N c 2 6O82 . . - Acres Subdivision Lot#•. F Driving Directions to Property 1 (;,f�,iP ut c.+ - k '* ao.j,pccs{- dot, cr, ((t kt- _.•ere. Lt t b 4 kaki e . Describe work NCB septk, lf,A,1 .,(A C0hSIT*4c-f'i44 — Ta Applicant Name yk L . 4� ,< 0-td L .Ar8/4.1 Applicant Address 4-1CO-AV3.d (�„N • Makdw, trl C Za U Phone Cell Phone C8-104(\-4 1 Owner Name ,v,.e. as cit.4.1t Owner Address Phone _Cell Phone Contractor Name AJ,,,•n„r.ch e,,,;jas (n,,, y v l=n if,s6 License#Qs4141-11 Contractor Address Phone Cell Phone Name to Appear on Permit? "Owner Applicant ❑Contractor Who will be the Primary Contact? 0 Owner ❑Applicant ❑Contractor Proposed New Construction-Residential Primary Residence ErNew Residence 0 Addition to Residence #of New Bedrooms*t 2 #of Occupants 2 Project Description ' y,c'/<-Z'A.4 or?ce S2'x/2. rec.' (AQcA krill-tard, GA('{ yrrc t 2S'Z ",SLY✓e" Structure Dime sions,also specify dimensions o decks&porches 7 �l Basement 2 Yes ❑ No Basement Plumbing ["Yes ❑ No COercc n}p ral., s� eq� q• C Accessory Dwelling #of New Bedrooms*t #of Occupants Structure imen ns r 51-• �%3'S'",(/5'•B ar Y No (04th ;n Sry)ei i•ncs ont1 —vviYMI4+g3 4e0.0*t ,gyp i ,, Accessory Structure(s)Describe Structure(s)Dimensions `•�Ai' Plumbing ❑ Yes ❑No Describe Plumbing Needed \,,,o�'i Multi-Family Residence #of Apartments #Bedrooms per Apartment*t Total#Bedrooms in Structure'I- #of Occupants " Structure Dimensions Basement 0 Yes ❑ No Basement Plumbing ❑ Yes ❑ No Well Construction/Abandon ent/Repair Proposed Well Type 2 Individual Well ❑ Semi-Public Well ❑Community Well Abandonment Type ❑ Drilled El Bored 0 Dug ❑ Unknown Well Repair Requested ❑Yes El No Describe Will Certified Well Contractor Install Water Line or Electrical Line from Well Head to Pressure Tank? Yes ❑No catawbacountync.gov Environmental Health Catawba County Government Center 25 Government Drive I PO Box 389 I Newton NC 28658 1828.465.8270 MAKING. LIVING. BETTER. Existing Structures on Site Describe Structure Dimensions #of Bedrooms * #of Occupants Basement ❑ Yes ❑ No Basement Plumbing ❑ Yes ❑ No Existing Water Supply ❑ Individual Well ❑ Shared Well—Number of Connections ❑ Community Well ❑ County/City/Township Water Line Is a public water supply available? ** ❑ Yes i4No Commercial ❑ Proposed New Construction` ❑Existing/Change of Use ❑ Repair Food Service Specify Type #Seats Dining Area(Sq.Ft.) #Employees per Shift #of Shifts Church #of Seats Daycare❑ Yes ❑ No #of Children #of Employees per Shift #of Shifts Commercial Kitchen ❑ Yes ❑No Residential Kitchen ❑ Yes ❑ No Daycare#of Children #of Employees per Shift #of Shifts Business/Other Specify Type Structure Dimensions Retail Floor Space #of Employees per Shift #of Shifts Other Information Calculated Design Flow, Commercial t (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,to answer to any question is"yes", applicant must attach supporting documentation. ❑ Yes al No Does the site contain any jurisdictional wetlands? ❑ Yes L'SNo Does the site contain any existing wastewater systems? ❑ Yes l< o Is any wastewater going to be generated on the site other than domestic sewage? 'Yes IrNo Is the site subject to approval by any other public agency? ❑Yes 2 Jo 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 of your preference) / ❑Accepted 0 Alternative 0 Conventional 0 Innovative ❑Other Q 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. t If structure is plumbed but has no bedrooms,calculated design flow will be determined by EH Staff. ** If No,a well permit must be issued with the Authorization to Construct. RETRIP TO THE PROPERTY AND/OR 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 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. Signature of Owner or Legal AgetiT /4,,,, G-��i)7.-Date 5I'I2 Printed Name of Owner or Legal Agent y e41 Wiedl.{Logi 4/afei Catawba County Environmental Health Sy'•°z O �/ cif • 411 " +: s 4134 3o.r 8 489•41 8 hr " O .4190 � t-A 41/4 8 a 0411 750 h * • 4/////////////////d; I I " I I •4200 r Parcel: 362703301944, 4190 HERTER RD 1in=300ft LINCOLNTON, 28092 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 2021 Catawba County NC 02/07/2022 5/6/2,2,3:35 RM Parcel Report Parcel Report - Catawba County NC Parcel Information: Owner Information: Parcel ID: 362703301944 Owner: ARDREY TYLE L Parcel Address: 4190 HERTER RD Owner2: ARDREY KIMBERLY L City: LINCOLNTON, 28092 Address: 4700 MAIDEN HWY LRK(REID): 701041 Address2: Deed Book/Page: 3624/0992 City: MAIDEN Subdivision: State/Zip: NC 28650-9191 Lots/Block: / School Information: Last Sale: $238,500 on 2006-03-01 School District: COUNTY Plat Book/Page: Elementary School: MAIDEN Legal: Middle School: MAIDEN Calculated Acreage: 29.360 High School: MAIDEN Tax Map: Township: JACOBS FORK School Map State Road #: 2022 TaxNalue Information: Tax Rates(pdf) Zoning Information: City Tax District: All in County Zoning District: COUNTY County Fire District: MAIDEN RURAL Zoningl: R-40 Building(s)Value: $0 Zoning2: Land Value: $172,100 Zoning3: Assessed Total Value: $14,600 Zoning Overlay: ED-O,DWMH-O Use Land Value: $14,600 Small Area: STARTOWN Year Built/Remodeled: / Split Zoning Districts: / Current Tax Bill Zoning Agency Phone Numbers Miscellaneous: Firm Panel Date: 2007-09-05 Building Permit Address Search for this parcel. Firm Panel #: 3710362700J If available, Building Permits for this parcel. Septic 2010 Census Block: 1039 links are not permits. 2010 Census Tract: 011702 Septic Final Permits prior to 08/2018, contact Agricultural District: PROXIMITY Environmental Health. l�/ Building Details P"/ 4c WaterShed: 0_61-Z q0 Voter Precinct: P34/Voting Map Parcel Report Data Descriptions ! l l 3bO 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. ©2022, Catawba County Government, North Carolina. 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