HomeMy WebLinkAboutRBPR-07-2022-41761.TIF A •� THIS IS NOT A PERMIT Case# RBPR-07-2022-4 1 76 1
v , ll O CATAWBA COUNTY HEALTH DEPARTMENT
PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES
1842 sNi Residential Building Plan Review- Building New
IMPROVEMENT___)
•7 :8))J Reitcid
Applicant ASHLEY PENDERGRASS, 1305 MOREHEAD S'I',CONOVER NC 28613
C:95462I8844 JONES.ASIILEY1997.pYAHOO.COM
Owner SYLVIA SIGMON,4107 LEE CLINE RI),CONOVER NC 28613
NAME TO APPEAR ON PERMIT
Ashley Pendergrass
SITE ADDRESS: 1242 MORES LEAD ST,CONOVER NC 28613 PIN# 375016745471
NAME of SUBDIVISION: Lot# TR 2 Section/Block
PROPERTY SIZE: Square Feet Acres 5.59
DIRECTIONS: Turn right off of E NC 10 Hwy onto Morehead St.6th lot on left.
PRIMARY CONTACT: Applicant SEWER TYPE: Septic Tank
GALLONS •. : DAY: 360 WATER SUPPLY: Private Well
CRIBE WORK: 7/28/22 per Austin Pendergrass revise to IP only. Decided not to build home at this time, only need IP. Refund
AC/Well fees.
PREVIOUS DESCRIPTION: IP/AC/NEW SEPTIC/NEW WELL/360 GPD---New 70x51, 3 bedroom single
family dwelling on crawlspace w/attached garage-no basement/no bonus room
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
EXISTING STRUCTURES
ON SITE(IF ANY)
DIM EXISTING STRUCTURE:
NUMBER OF EXISTING BEDROOMS: #OF OCCUPANTS: 2
PROPOSED CONSTRUCTION
NEW STRUCTURE DIM:: 70x51 sfd
#OF NEW BEDROOMS:: 3
Desired system types(Improvement Permit or Authorization to Construct):
ACCEPTED: ALTERNATIVE: CONVENTIONAL:
OTHER: INNOVATIVE: ANY: YES
Other described:
07/28/2022 09:34 Page 1 of3
CATAW1IA COUNTY Case 0 RBPR-07-2022-4 1 76 1
r(t.... Public health Department Subdivision
I•nvironmentul 13ealth C)ivisinn
`1 y PC)Box 389,100-A Southwest Blvd,Newton,NC 28658 PINf1 375016745471
NAME ON PERMIT; (AShh1.,EY PI;NDI:RORASS), 1305 MOREHEAD ST,CONOVER NC 28613
(Ashley Pendergrass)
Site Address: 1242 MORRFif?AD ST,CONOVER NC 28613
Property Slze: Square Peet Acres 6.69_
Directions: Turn right off of E NC 10 Hwy onto Morehead St.6th lot on loll.
Competed applications are valid for a period of 2 years.Improvement Permits are valid:with complete site plan=80 months(8 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 lesuad for
septic repair is valid for 80 rronths(5 years),Pormits may be revoked if the Information on this application/site plan changes or If the Intended use for the
proposed!aWllty changes,Permits may be revoked it site conditions are altered such that they effect permit coedit one or Installation requirements
I have read this application and certify that the Information provided herein is tree,complete and correct. Authorized wunty end stale officials are
granted right of entry to conduct necessary Inspections 10 determine compliance with applicable laws and rules, i understand that I are solely
responsible for the proper identification end 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:V 7/N EVo2Qcqa_. Signature of Applicant or Agent /11
��-
If you need further information or assistance plea ell 828.465-8270
AREA2
FEENAMI DATE FEE.AMOUNT
Authorization to Construct Fee(New/Expansion) 07/25/2022 $150.00
Foe
Improvement Permit Fee 07/25/2022 $150.00
Well Permit&Inspection Fee 07/25/2022 $300.00
TOTAL,FEES $600,00
FEES AIil 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,11,h.,,1f,', 07/28/2022 09:30 Pogo 2 012
catawba county
public health
AUTHORIZATION OF REFUND
Date: 7/28/2022
Case #: RBPR-07-2022-41761
Applicant: Ashley Pendergrass
Refund Amount: S450.00
Refund Reason: Refund AC/Well fees. Not building house at this time.
111Q11
Authorizing Signature: ilrj/64A
7t) I 7 f
Received By Staff: L�1 �L
Date: ] J
catawbacountync.gov
Environmental Health
CctcwhG County Government Center
25 Government Drive PO Box 389 Newton NC 28658 1828.465.8270
MAKING. LIVING. BETTER.
Catawba County, North Carolina - Disbursement Voucher
Vendor No. Date: 7/28/2022
Make Payment To: ZV,Ps" C0 Voucher No(s)
Ashley Pendergrass - $1305 Morehead St Q0 "3Conover, NC 28613 ���
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ATTACHMENT
Prepared by: Julia English
Description Amount
Refund AC and well fees. Not building house at this time $450.00
Sub-Total
Food Tax
Sales Tax
Total $ 450.00
For Accounting Use
Fund Cost Center Object Project Amount Only
110 580200 663000
Total
The undersigned hereby certifies that the goods or services specified above have been received
or performed. Payment has not been previously authorized and this expenditure is a proper
charge to the appropriation indicated. The above charge is certified to you for payment.
(SIGNATURE-APPROPRIATE OFFICIAL)
Cp CATAWBA COUNTY
100A SOUTHWEST BLVD
NEWTON,NORTH CAROLINA 28658 RECEIPT
PHONE:828.465.8399
Thursday,July 28, 2022
18 4 Z am www.catawbacountync.gov
PAY OR:
Pendergrass,Ashley
PAYMENTS
TRANSACTION NUMBER: TRC-44243817-28-07-2022
PAYMENT DATE: 07/28/2022
PAYMENT TYPE: DV
INVOICE NUMBER ACCOUNT FEE NAME FEE AMOUNT
07-22-409593 110-580200-663000 Well Permit& Inspection Fee ($300.00)
07-22-409593 110-580200-663000 Authorization to Construct Fee(N ($150.00)
ew/Expansion) Fee
TOTAL PAYMENTS: (S450.00)
RBPR-07-2022-41761
CASE TYPE: Residential Building Plan Review WORK CLASS: Building New
SITE ADDRESS: 1242 MOREL LEAD ST,CONOVER NC 28613
Applicant ASHLEY PENDERGRASS, 1305 MOREHEAD ST,CONOVER NC 28613
C:9546218844 JONES.ASIILEY I997 a YAHOO.COM
**NO PEOPLESOFT ACCOUNT ASSIGNED**
Owner SYLVIA SIGMON,4107 LEE CLINE RD,CONOVER NC 28613
receipt 07/28/2022 11:I6 Page 1 of I